1. Real-world outcomes in thoracic cancer patients with severe Acute respiratory syndrome Coronavirus 2 (COVID-19): Single UK institution experience
- Author
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Richard W J Lee, Jaishree Bhosle, Anna Minchom, I. Locke, Nadia Yousaf, Sanjay Popat, Mary O'Brien, Andrew G. Nicholson, Fiona McDonald, Wanyuan Cui, and Merina Ahmed
- Subjects
Male ,Cancer Research ,CFR, Case fatality rate ,HDU, High dependency unit ,PET, Positron Emission Tomography ,RMH, Royal Marsden Hospital ,US, United States ,TERAVOLT, Thoracic Cancers International COVID-19 Collaboration ,0302 clinical medicine ,Epidemiology ,030212 general & internal medicine ,RC254-282 ,UKCCMP, UK Coronavirus Cancer Monitoring Project ,Mortality rate ,SARS-CoV, Severe acute respiratory syndrome ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,MERS-CoV, Middle East respiratory syndrome coronavirus ,COVID-19, Severe acute respiratory syndrome coronavirus 2 ,Middle Aged ,Hospitalization ,ICU, Intensive care unit ,Oncology ,030220 oncology & carcinogenesis ,UK, United Kingdom ,Female ,WHO, World Health Organisation ,Adult ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Critical Care ,NIV, Non-invasive ventilation ,NHS, National Health Service ,Article ,Thoracic cancer ,Sepsis ,03 medical and health sciences ,Intensive care ,Internal medicine ,Covid-19 ,LUng cancer ,ARDS, Acute respiratory distress syndrome ,medicine ,Humans ,Lung cancer ,CT, Computerised tomography ,TKI, Tyrosine kinase inhibitor ,business.industry ,ARB, Angiotensin-II receptor blockers ,SARS-CoV-2 ,GGO, Ground-glass opacities ,Cancer ,COVID-19 ,RT-PCR, Reverse transcriptase polymerase chain reaction ,Thoracic Neoplasms ,medicine.disease ,United Kingdom ,Pneumonia ,business - Abstract
Highlights • The immediate morbidity from COVID-19 is high in UK thoracic cancer patients. • Mortality, hospitalisation and treatment interruption rates were high. • All patients who died were current or ex-smokers., Background UK COVID-19 mortality rates are amongst the highest globally. Controversy exists on the vulnerability of thoracic cancer patients. We describe the characteristics and sequelae of patients with thoracic cancer treated at a UK cancer centre infected with COVID-19. Methods Patients undergoing care for thoracic cancer diagnosed with COVID-19 (RT-PCR/radiology/clinically) between March-June 2020 were included. Data were extracted from patient records. Results Thirty-two patients were included: 14 (43%) diagnosed by RT-PCR, 18 (57%) by radiology and/or convincing symptoms. 88% had advanced thoracic malignancies. Eleven of 14 (79%) patients diagnosed by RT-PCR and 12 of 18 (56%) patients diagnosed by radiology/clinically were hospitalised, of which four (29%) and 2 (11%) patients required high-dependency/intensive care respectively. Three (21%) patients diagnosed by RT-PCR and 2 (11%) patients diagnosed by radiology/clinically required non-invasive ventilation; none were intubated. Complications included pneumonia and sepsis (43% and 14% respectively in patients diagnosed by RT-PCR; 17% and 11% respectively in patients diagnosed by radiology/clinically). In patients receiving active cancer treatment, therapy was delayed/ceased in 10/12 (83%) and 7/11 (64%) patients diagnosed by RT-PCR and radiology/clinically respectively. Nine (28%) patients died; all were smokers. Median time from symptom onset to death was 7 days (range 3–37). Conclusions The immediate morbidity from COVID-19 is high in thoracic cancer patients. Hospitalisation and treatment interruption rates were high. Improved risk-stratification models for UK cancer patients are urgently needed to guide safe cancer-care delivery without compromising efficacy.
- Published
- 2020