Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients
Restrospective 890 cancer patients with COVID-19, adjusted mortality HR for HCQ/CQ 0.41,
p<0.0001.
Confirmed SARS-CoV-2 infection was required, which may help focus on more severe cases. Analysis with Cox proportional hazard model. Potential unmeasured confounders.
risk of death, 59.0% lower, HR 0.41, p < 0.001, treatment 30 of 182 (16.5%), control 181 of 446 (40.6%), NNT 4.1.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Pinato et al., 18 Aug 2020, retrospective, multiple countries, peer-reviewed, 64 authors.
Abstract: Published OnlineFirst July 31, 2020; DOI: 10.1158/2159-8290.CD-20-0773
reseArch BrIeF
Clinical Portrait of the SARS-CoV-2 Epidemic
in European Patients with Cancer
David J. Pinato1, Alberto Zambelli2, Juan Aguilar-Company3,4, Mark Bower5, Christopher C.T. Sng6,
Ramon Salazar7, Alexia Bertuzzi8, Joan Brunet9, Ricard Mesia10, Elia Seguí11, Federica Biello12,
Daniele Generali13,14, Salvatore Grisanti15, Gianpiero Rizzo16, Michela Libertini17, Antonio Maconi18,
Nadia Harbeck19, Bruno Vincenzi20, Rossella Bertulli21, Diego Ottaviani6, Anna Carbó9, Riccardo Bruna22,
Sarah Benafif6, Andrea Marrari8, Rachel Wuerstlein19, M. Carmen Carmona-Garcia9, Neha Chopra6,
Carlo Tondini2, Oriol Mirallas3, Valeria Tovazzi15, Marta Betti18, Salvatore Provenzano21, Vittoria Fotia2,
Claudia Andrea Cruz11, Alessia Dalla Pria5, Francesca D’Avanzo12, Joanne S. Evans1, Nadia Saoudi-Gonzalez3,
Eudald Felip10, Myria Galazi6, Isabel Garcia-Fructuoso9, Alvin J.X. Lee6, Thomas Newsom-Davis5,
Andrea Patriarca22, David García-Illescas3, Roxana Reyes11, Palma Dileo6, Rachel Sharkey5,
Yien Ning Sophia Wong6, Daniela Ferrante23, Javier Marco-Hernández24, Anna Sureda25, Clara Maluquer25,
Isabel Ruiz-Camps4, Gianluca Gaidano22, Lorenza Rimassa8,26, Lorenzo Chiudinelli2, Macarena Izuzquiza27,
Alba Cabirta27, Michela Franchi2, Armando Santoro8,26, Aleix Prat11,28, Josep Tabernero3, and
Alessandra Gennari12
The SARS-CoV-2 pandemic significantly affected oncology practice across the
globe. There is uncertainty as to the contribution of patients’ demographics and
oncologic features to severity and mortality from COVID-19 and little guidance as to the role of anticancer and anti–COVID-19 therapy in this population. In a multicenter study of 890 patients with cancer
with confirmed COVID-19, we demonstrated a worsening gradient of mortality from breast cancer to
hematologic malignancies and showed that male gender, older age, and number of comorbidities identify a subset of patients with significantly worse mortality rates from COVID-19. Provision of chemotherapy, targeted therapy, or immunotherapy did not worsen mortality. Exposure to antimalarials
was associated with improved mortality rates independent of baseline prognostic factors. This study
highlights the clinical utility of demographic factors for individualized risk stratification of patients
and supports further research into emerging anti–COVID-19 therapeutics in SARS-CoV-2–infected
patients with cancer.
ABstrAct
SIGNIFICANCE: In this observational study of 890 patients with cancer diagnosed with SARS-CoV-2,
mortality was 33.6% and predicted by male gender, age ≥65, and comorbidity burden. Delivery of cancer
therapy was not detrimental to severity or mortality from COVID-19. These patients should be the
focus of shielding efforts during the SARS-CoV-2 pandemic.
1
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom. 2Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy. 3Medical Oncology, Vall d’Hebron University
Hospital and Institute of Oncology (VHIO), Barcelona, Spain. 4Infectious
Diseases, Vall d’Hebron University Hospital, Barcelona, Spain. 5Department
of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom. 6Cancer Division, University
College London Hospitals, London, United Kingdom. 7Departament of Medical Oncology, ICO L’Hospitalet, Oncobell Program (IDIBELL), CIBERONC,
Hospitalet de Llobregat,..
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