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COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study
- Source :
- Lancet oncology, 21(7), 914-922. Elsevier Science, Lancet Oncology, 21(7), 914-922. Lancet Publishing Group, The Lancet. Oncology, vol. 21, no. 7, pp. 914-922, Lancet Oncology, 21, 7, pp. 914-922, The lancet oncology, The Lancet. Oncology, Lancet Oncology, 21, 914-922, The Lancet Oncology
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Contains fulltext : 229846.pdf (Publisher’s version ) (Closed access) BACKGROUND: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. METHODS: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. FINDINGS: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68.0 years (61.8-75.0) and the majority had an Eastern Cooperative Oncology Group performance status of 0-1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1.88, 95% 1.00-3.62), being a current or former smoker (4.24, 1.70-12.95), receiving treatment with chemotherapy alone (2.54, 1.09-6.11), and the presence of any comorbidities (2.65, 1.09-7.46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3.18, 95% CI 1.11-9.06) was associated with increased risk of death. INTERPRETATION: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference. FUNDING: None.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
Aged
Betacoronavirus
Cause of Death
Coronavirus Infections
Cross-Sectional Studies
Female
Hospitalization
Humans
Longitudinal Studies
Middle Aged
Pandemics
Pneumonia
Viral
Registries
Risk Factors
Thoracic Neoplasms
COVID-19
Pneumonia, Viral
SARS-CoV-2
Article
03 medical and health sciences
0302 clinical medicine
Disease registry
Intensive care
Internal medicine
medicine
Medical history
Risk factor
Lung cancer
business.industry
Mortality rate
Cancer
Coronavirus Infections/epidemiology
Coronavirus Infections/mortality
Coronavirus Infections/pathology
Hospitalization/statistics & numerical data
Pneumonia, Viral/epidemiology
Pneumonia, Viral/mortality
Pneumonia, Viral/pathology
Registries/statistics & numerical data
Thoracic Neoplasms/epidemiology
Thoracic Neoplasms/mortality
Thoracic Neoplasms/pathology
Thoracic Neoplasms/therapy
medicine.disease
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Human medicine
business
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Cohort study
Subjects
Details
- ISSN :
- 14702045
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- The Lancet Oncology
- Accession number :
- edsair.doi.dedup.....84a9f8f38fad67aa7bfcdffffed283f4