Covid-19 and lung cancer: A greater fatality rate?
Jacobo Rogado, Cristina Pangua, Gloria Serrano-Montero, Berta Obispo, Almudena Martín Marino, Mar Pérez-Pérez, Ana López-Alfonso, Pedro Gullón, Miguel Ángel Lara
Lung Cancer, doi:10.1016/j.lungcan.2020.05.034
Background: Currently there are no reported series determining the Covid-19 infected lung cancer patient´s characteristics and outcome that allow us to clarify strategies to protect our patients. In our study we determine whether exists differences in cumulative incidence and severity of Covid-19 infection between lung cancer patients visiting our Medical Oncology department and the reference population of our center (320,000 people), in the current epicenter of the pandemic in Europe (Madrid, Spain). We also describe clinical and demographic factors associated with poor prognosis and Covid-19 treatment outcomes. Patients and methods: We retrospectively reviewed 1878 medical records of all Covid-19 patients who were admitted at Hospital Universitario Infanta Leonor of Madrid between March 5, 2020 and April 7, 2020, in order to detect cumulative incidence of Covid-19 in lung cancer patients. We also described Covid-19 treatment outcome, mortality and associated risk factors using univariate and multivariate logistic regression analysis. Results: 17/1878 total diagnosis in our center had lung cancer (0.9 %) versus 1878/320,000 of the total reference population (p = 0.09). 9/17 lung cancer patients with Covid-19 diagnosis died (52.3 %) versus 192/ 1878 Covid-19 patients in our center (p < 0.0001). Dead lung cancer patients were elderly compared to survivors: 72 versus 64.5 years old (p = 0.12). Combined treatment with hydroxychloroquine and azithromycin improves the outcome of Covid-19 in lung cancer patients, detecting only 1/6 deaths between patients under this treatment versus others treatment, with statistical significance in the univariate and multivariate logistic regression (OR 0.04, p = 0.018). Conclusions: Lung cancer patients have a higher mortality rate than general population. Combined hydroxychloroquine and azithromycin treatment seems like a good treatment option. It is important to try to minimize visits to hospitals (without removing their active treatments) in order to decrease nosocomial transmission.
Authors contributions J.R. contributed to the conception and design of the study, data acquisition, statistical analysis, interpretation of the data and writing of the manuscript. C.P and G.S.M contributed to the conception and design of the study, interpretation of the data and writing of the manuscript. B.O., A.M.M., M.P.P., A.L.A. contributed to the acquisition of the data. P.G. contributed to the statistical analysis and interpretation of the data. M.A.L. contributed to the conception and design of the study, interpretation of the data and writing of the manuscript. All authors reviewed and approved the final version of the manuscript.
Declaration of Competing Interest The authors declare no conflict of interest for the present work.
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