Covid-19 transmission, outcome and associated risk factors in cancer patients at the first month of the pandemic in a Spanish hospital in Madrid

This study investigates whether there exists differences in cumulative incidence and mortality of Covid-19 between cancer patients visiting the Medical Oncology department and general population, in the current epicenter of the pandemic in Europe (Madrid, Spain). This study describe clinical and demographic factors associated with poor prognosis and Covid-19 treatment outcomes in a cohort of cancer patients where an advanced stage predominates. We retrospectively review 1069 medical records admitted to Medical Oncology department at Hospital Universitario Infanta Leonor of Madrid, from February 1, 2020, to April 7, 2020. We study cumulative incidence of Covid-19 infection and its mortality in cancer patients. Covid-19 diagnosis was made based on WHO criteria and/or confirmed by RT-PCR of nasopharyngeal specimens. Severe Covid-19 infection was defined as presence of bilateral pneumonia with CURB-65 scale score ≥ 2/FiO2 ≥ 35% or admission to an Intensive Care Unit (ICU). Forty-five patients were diagnosed with Covid-19 from February 1, 2020, to April 7, 2020, within 1069 cancer patients (4.2%) visited at Medical Oncology department in Hospital Universitario Infanta Leonor in Madrid (Spain). The median follow-up until data cut off was 14 days (range 1–28). The median age was 71 years old (range 34–90). Regarding sex, a higher prevalence of males were detected (n = 30, 66.7%). Most patients had metastatic disease (n = 26, 57.8%). Most frequent histology were lung cancer (n = 17, 37.8%). The overall survivals were similar between patients with active treatment or not active treatment (8 months vs 7 months). All patients who were able to receive treatment for Covid-19 infection received hydroxychloroquine (n = 37, 82.2%), most combined with lopinavir/ritonavir (n = 14, 31.1%) or azithromycin (n  = 18, 40.0%). All patients required admission except for 7 patients (84.5%), 29 of them were diagnosed with severe Covid-19 infection (64.4%). Covid-19 triggers serious complications in cancer patients, so our efforts should be made to reduce visits to hospital during the pandemic. The severity of the infection at admission and the elderly patients are independents indicators of mortality, and combined treatment with hydroxychloroquine and azithromycin seems a good option in cancer patients To read more-https://link.springer.com/article/10.1007%2Fs12094-020-02381-z

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