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Characteristics and Outcome of SARS-CoV-2 Infection in Cancer Patients

5 janv. 2021JNCI Cancer Spectrum

DOI : 10.1093/jncics/pkaa090

Auteurs

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

Résumé

Abstract

Background

Concerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, 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 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography 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 O2 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.