1. Coronavirus Disease 2019 Infection in a Patient Population with Lung Cancer: Incidence, Presentation, and Alternative Diagnostic Considerations
- Author
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Andrew J. Piper-Vallillo, MD, Meghan J. Mooradian, MD, Catherine B. Meador, MD, PhD, Beow Y. Yeap, ScD, Jennifer Peterson, BS, Mustafa Sakhi, BS, MS, Andrew Do, BS, Leyre Zubiri, MD, Sara Stevens, NP, Jeanne Vaughn, NP, Kelly Goodwin, NP, Alexander Gavralidis, MD, Henning Willers, MD, Adam Miller, MD, Anna Farago, MD, PhD, Zofia Piotrowska, MD, MHS, Jessica J. Lin, MD, Ibiayi Dagogo-Jack, MD, Inga T. Lennes, MD, MPH, MBA, Lecia V. Sequist, MD, MPH, Jennifer S. Temel, MD, Rebecca S. Heist, MD, Subba Digumarthy, MD, Kerry L. Reynolds, MD, and Justin F. Gainor, MD
- Subjects
COVID-19 ,SARS-CoV-2 ,NSCLC ,SCLC ,Lung cancer ,Thoracic oncology ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: Lung cancer is associated with severe coronavirus disease 2019 (COVID-19) infections. Symptom overlap between COVID-19 and lung cancer may complicate diagnostic evaluation. We aimed to investigate the incidence, symptoms, differential diagnosis, and outcomes of COVID-19 in patients with lung cancer. Methods: To determine an at-risk population for COVID-19, we retrospectively identified patients with lung cancer receiving longitudinal care within a single institution in the 12 months (April 1, 2019 to March 31, 2020) immediately preceding the COVID-19 pandemic, including an “active therapy population” treated within the last 60 days of this period. Among patients subsequently referred for COVID-19 testing, we compared symptoms, laboratory values, radiographic findings, and outcomes of positive versus negative patients. Results: Between April 1, 2019 and March 31, 2020, a total of 696 patients received longitudinal care, including 406 (58%) in the active therapy population. Among 55 patients referred for COVID-19 testing, 24 (44%) were positive for COVID-19, representing a cumulative incidence of 3.4% (longitudinal population) and 1.5% (active therapy population). Compared with patients who were COVID-19 negative, those who were COVID-19 positive were more likely to have a supplemental oxygen requirement (11% versus 54%, p = 0.005) and to have typical COVID-19 pneumonia imaging findings (5 versus 56%, p = 0.001). Otherwise, there were no marked differences in presenting symptoms. Among patients who were COVID-19 negative, alternative etiologies included treatment-related toxicity (26%), atypical pneumonia (22%), and disease progression (22%). A total of 16 patients positive for COVID-19 (67%) required hospitalization, and seven (29%) died from COVID-related complications. Conclusions: COVID-19 was infrequent in this lung cancer population, but these patients experienced high rates of morbidity and mortality. Oncologists should maintain a low threshold for COVID-19 testing in patients with lung cancer presenting with acute symptoms.
- Published
- 2021
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