Characteristics and outcome of SARS-CoV-2 infection in cancer patients

Basse, Clémence; Diakite, Sarah; Servois, Vincent; Frelaut, Maxime; Noret, Aurélien; Bellesoeur, Audrey; Moreau, Pauline; Massiani, Marie-Ange; Bouyer, Anne-Sophie; Vuagnat, Perrine; Malak, Sandra; Bidard, François-Clément; Vanjak, Dominique; Kriegel, Irène; Burnod, Alexis; Bilger, Geoffroy; Ramtohul, Toulsie; Dhonneur, Gilles; Bouleuc, Carole; Cassoux, Nathalie; Paoletti, Xavier; Bozec, Laurence; Cottu, Paul

BACKGROUND: Concerns have emerged about the higher risk of fatal COVID-19 in cancer patients. In this paper, we review the experience of a comprehensive cancer center. METHODS: A prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days. RESULTS: Among 9,842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on RT-PCR testing and/or CT-scan. In line with our case-mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19 related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O(2) saturation. CONCLUSIONS: COVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.