Cancer and SARS-CoV-2 Infection: A Third-Level Hospital Experience

Madrid has been the epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Spain. We analyzed our experience with SARS-CoV-2 infected and cancer patients.

We included patients from March 1 to April 30 2020 at Hospital Universitario Puerta de Hierro, Majadahonda, Madrid (Spain). The inclusion criteria were diagnosis of SARS-CoV-2 infection made by reverse transcription polymerase chain reaction (RT-PCR) of nasopharyngeal specimens in cancer patients who were admitted to the hospital due to the need for respiratory support. The exclusion criteria were suspected cases not confirmed. The primary objective was to analyze the mortality rates of patients with cancer, especially those with lung cancer and COVID-19.

Overall in-hospital mortality of cancer patients with coronavirus disease 2019 (COVID-19) was 15.2% similar to 12.7% of the global COVID-19 hospitalized population (p=0.615) and greater than that of patients admitted without SARS-CoV-2 infection during the same period 4.3% (p<0.001). Among 653 patients receiving active cancer therapy during the study period, 24 (3.7%) developed COVID-19 and required admission, 4.2% of those receiving chemotherapy, 9.5% immunotherapy and 2.1% targeted therapies. Lung and breast cancer were the most frequent cancer types (26.1%), followed by colorectal cancer (19.6%). Mortality in patients with lung cancer was 25%. The univariate analysis comparing patients who developed a serious event to those who did not showed that the higher Brescia index, CURB-65 scale, lactate dehydrogenase (LDH) or C-reactive protein (CRP) were the risk factors of developing severe complications.

Patients with cancer, especially lung cancer, and SARS-CoV-2 infection have a worse overall prognosis than the general population.