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.
References
Banna, Curioni-Fontecedro, Friedlaender, How we treat patients with lung cancer during the SARS-CoV-2 pandemic: primum non nocere, ESMO Open
Conti, Ronconi, Caraffa, Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies, J. Biol. Regul. Homeost. Agents
Cortiula, Pettke, Bastoletti, Managing COVID-19 in the oncology clinic and avoiding the distraction effect, Ann. Oncol
Garassino, TERAVOLT (thoracic cancER interational coVid 19 cOLlaboraTion): first results of a global collaboration to address the impact of COVID-19 in patients with thoracic malignancies, Abstract
Li, Guan, Wu, Early Transmission Dynamics In Wuhan, China, of Novel Coronavirus-Infected PneumoniaEarly transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia, N. Engl. J. Med
Liang, Guan, Chen, Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China, Lancet Oncol
Sidaway, COVID-19 and cancer: what we know so far, Nat. Rev. Clin. Oncol
Wang, Horby, Hayden, A novel coronavirus outbreak of global health concern, Lancet
Yin, Wunderink, MERS, SARS and other coronaviruses as causes of pneumonia, Respirology
Yu, Ouyang, Chua, SARS-CoV-2 transmission in patients with Cancer at a tertiary care hospital in Wuhan, China, JAMA Oncol
Zhang, Zhu, Xie, Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China, Ann. Oncol
{ 'indexed': {'date-parts': [[2024, 3, 15]], 'date-time': '2024-03-15T19:08:50Z', 'timestamp': 1710529730634},
'reference-count': 11,
'publisher': 'Elsevier BV',
'license': [ { 'start': { 'date-parts': [[2020, 8, 1]],
'date-time': '2020-08-01T00:00:00Z',
'timestamp': 1596240000000},
'content-version': 'tdm',
'delay-in-days': 0,
'URL': 'https://www.elsevier.com/tdm/userlicense/1.0/'}],
'content-domain': { 'domain': [ 'clinicalkey.jp', 'clinicalkey.com', 'lungcancerjournal.info',
'clinicalkey.es', 'clinicalkey.fr', 'clinicalkey.com.au', 'elsevier.com',
'sciencedirect.com'],
'crossmark-restriction': True},
'published-print': {'date-parts': [[2020, 8]]},
'DOI': '10.1016/j.lungcan.2020.05.034',
'type': 'journal-article',
'created': {'date-parts': [[2020, 5, 30]], 'date-time': '2020-05-30T11:49:46Z', 'timestamp': 1590839386000},
'page': '19-22',
'update-policy': 'http://dx.doi.org/10.1016/elsevier_cm_policy',
'source': 'Crossref',
'is-referenced-by-count': 87,
'title': 'Covid-19 and lung cancer: A greater fatality rate?',
'prefix': '10.1016',
'volume': '146',
'author': [ {'given': 'Jacobo', 'family': 'Rogado', 'sequence': 'first', 'affiliation': []},
{'given': 'Cristina', 'family': 'Pangua', 'sequence': 'additional', 'affiliation': []},
{'given': 'Gloria', 'family': 'Serrano-Montero', 'sequence': 'additional', 'affiliation': []},
{'given': 'Berta', 'family': 'Obispo', 'sequence': 'additional', 'affiliation': []},
{'given': 'Almudena Martín', 'family': 'Marino', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mar', 'family': 'Pérez-Pérez', 'sequence': 'additional', 'affiliation': []},
{'given': 'Ana', 'family': 'López-Alfonso', 'sequence': 'additional', 'affiliation': []},
{'given': 'Pedro', 'family': 'Gullón', 'sequence': 'additional', 'affiliation': []},
{'given': 'Miguel Ángel', 'family': 'Lara', 'sequence': 'additional', 'affiliation': []}],
'member': '78',
'reference': [ { 'issue': '20',
'key': '10.1016/j.lungcan.2020.05.034_bib0005',
'first-page': '30185',
'article-title': 'A novel coronavirus outbreak of global health concern',
'volume': 'S0140-6736',
'author': 'Wang',
'year': '2020',
'journal-title': 'Lancet'},
{ 'key': '10.1016/j.lungcan.2020.05.034_bib0010',
'doi-asserted-by': 'crossref',
'first-page': '1199',
'DOI': '10.1056/NEJMoa2001316',
'article-title': 'Early Transmission Dynamics In Wuhan, China, of Novel '
'Coronavirus-Infected PneumoniaEarly transmission dynamics in Wuhan, '
'China, of novel coronavirus-infected pneumonia',
'volume': '382',
'author': 'Li',
'year': '2020',
'journal-title': 'N. Engl. J. Med.'},
{ 'issue': '2',
'key': '10.1016/j.lungcan.2020.05.034_bib0015',
'doi-asserted-by': 'crossref',
'first-page': '130',
'DOI': '10.1111/resp.13196',
'article-title': 'Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia',
'volume': '23',
'author': 'Yin',
'year': '2018',
'journal-title': 'Respirology'},
{ 'issue': '2',
'key': '10.1016/j.lungcan.2020.05.034_bib0020',
'article-title': 'Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung '
'inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): '
'anti-inflammatory strategies',
'volume': '34',
'author': 'Conti',
'year': '2020',
'journal-title': 'J. Biol. Regul. Homeost. Agents'},
{ 'issue': 'March 19',
'key': '10.1016/j.lungcan.2020.05.034_bib0025',
'article-title': 'Managing COVID-19 in the oncology clinic and avoiding the distraction '
'effect',
'author': 'Cortiula',
'year': '2020',
'journal-title': 'Ann. Oncol.'},
{ 'key': '10.1016/j.lungcan.2020.05.034_bib0030',
'doi-asserted-by': 'crossref',
'DOI': '10.1038/s41571-020-0366-2',
'article-title': 'COVID-19 and cancer: what we know so far',
'author': 'Sidaway',
'year': '2020',
'journal-title': 'Nat. Rev. Clin. Oncol.'},
{ 'key': '10.1016/j.lungcan.2020.05.034_bib0035',
'article-title': 'How we treat patients with lung cancer during the SARS-CoV-2 pandemic: '
'primum non nocere',
'volume': '5',
'author': 'Banna',
'year': '2020',
'journal-title': 'ESMO Open'},
{ 'issue': 'March 25',
'key': '10.1016/j.lungcan.2020.05.034_bib0040',
'article-title': 'SARS-CoV-2 transmission in patients with Cancer at a tertiary care '
'hospital in Wuhan, China',
'author': 'Yu',
'year': '2020',
'journal-title': 'JAMA Oncol.'},
{ 'issue': '20',
'key': '10.1016/j.lungcan.2020.05.034_bib0045',
'article-title': 'Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China',
'volume': 'S1470-2040',
'author': 'Liang',
'year': '2020',
'journal-title': 'Lancet Oncol.'},
{ 'issue': '20',
'key': '10.1016/j.lungcan.2020.05.034_bib0050',
'first-page': '36383',
'article-title': 'Clinical characteristics of COVID-19-infected cancer patients: a '
'retrospective case study in three hospitals within Wuhan, China',
'volume': 'S0923-7534',
'author': 'Zhang',
'year': '2020',
'journal-title': 'Ann. Oncol.'},
{ 'key': '10.1016/j.lungcan.2020.05.034_bib0055',
'series-title': 'Abstract. American Association for Cancer Research Virtual Annual '
'Meeting I',
'article-title': 'TERAVOLT (thoracic cancER interational coVid 19 cOLlaboraTion): first '
'results of a global collaboration to address the impact of COVID-19 in '
'patients with thoracic malignancies',
'author': 'Garassino',
'year': '2020'}],
'container-title': 'Lung Cancer',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://api.elsevier.com/content/article/PII:S0169500220304682?httpAccept=text/xml',
'content-type': 'text/xml',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://api.elsevier.com/content/article/PII:S0169500220304682?httpAccept=text/plain',
'content-type': 'text/plain',
'content-version': 'vor',
'intended-application': 'text-mining'}],
'deposited': { 'date-parts': [[2020, 7, 16]],
'date-time': '2020-07-16T20:18:53Z',
'timestamp': 1594930733000},
'score': 1,
'resource': {'primary': {'URL': 'https://linkinghub.elsevier.com/retrieve/pii/S0169500220304682'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2020, 8]]},
'references-count': 11,
'alternative-id': ['S0169500220304682'],
'URL': 'http://dx.doi.org/10.1016/j.lungcan.2020.05.034',
'relation': {},
'ISSN': ['0169-5002'],
'subject': ['Cancer Research', 'Pulmonary and Respiratory Medicine', 'Oncology'],
'container-title-short': 'Lung Cancer',
'published': {'date-parts': [[2020, 8]]},
'assertion': [ {'value': 'Elsevier', 'name': 'publisher', 'label': 'This article is maintained by'},
{ 'value': 'Covid-19 and lung cancer: A greater fatality rate?',
'name': 'articletitle',
'label': 'Article Title'},
{'value': 'Lung Cancer', 'name': 'journaltitle', 'label': 'Journal Title'},
{ 'value': 'https://doi.org/10.1016/j.lungcan.2020.05.034',
'name': 'articlelink',
'label': 'CrossRef DOI link to publisher maintained version'},
{'value': 'article', 'name': 'content_type', 'label': 'Content Type'},
{ 'value': '© 2020 Elsevier B.V. All rights reserved.',
'name': 'copyright',
'label': 'Copyright'}]}
