Sars-CoV-2 infection in cancer patients undergoing active treatment. Analysis of clinical features and predictive factors for severe respiratory failure and death

Yarza, Ramón; Bover, Mateo; Paredes, Diana; López-López, Flora; Jara-Casas, Diego; Castelo-Loureiro, Alicia; Baena, Javier; Mazarico, José María; Folgueira, María Dolores; Meléndez-Carmona, María Ángeles; Reyes, Alhena; Lumbreras, Carlos; Paz-Ares, Luis; Díaz-Pedroche, Carmen; Gómez-Martín, Carlos

AIM: Previous studies have suggested a more frequent and severe course of novel coronavirus Sars-coV-2 infection in cancer patients undergoing active oncologic treatment. Our aim was to describe the characteristics of the disease in this population and to determine predictive factors for poor outcome in terms of severe respiratory distress (ARDS) or death. PATIENTS AND METHODS: Patients consecutively admitted for SARS-CoV-2 infection were prospectively collected and retrospective statistical analysis was performed. Univariate and multivariate analyses were performed to assess potential factors for poor outcomes defined as ARDS or death. RESULTS: 63 patients were analyzed, 34 of them developed respiratory failure (70% as ARDS). Lymphocytes/mm3 (412 vs. 686; p=0.001), serum albumin (2.84 vs. 3.1); LDH (670vs. 359; p<0.001) and C-Reactive Protein (CRP) levels (25.8 vs. 9.9; p<0.001) discriminate those that developed respiratory failure. Mortality Rate was 25%, significantly higher among ARDS, neutropenic patients (p=0.01) and in those with bilateral infiltrates (44% vs. 0%; p<0.001). Multivariate logistic analyses model confirmed the predictive value of severe neutropenia (OR 16.54 CI 95% 1.43-190.9, p 0.025), bilateral infiltrates (OR 32.83, CI95% 3.51-307, p 0.002) and tumor lung involvement (OR 4.34, CI95% 1.2-14.95, p 0.02). CONCLUSION: Cancer patients under active treatment admitted for Sars-coV2 infection have worse outcomes in terms of mortality and respiratory failure rates compared with COVID-19 global population. Lymphopenia, LDH, CRP and albumin discriminate illness severity while neutropenia; bilateral infiltrates and tumor pulmonary involvement are predictive of higher mortality.