Determinants of the outcomes of patients with cancer infected with SARS-CoV-2: results from the Gustave Roussy cohort

Laurence Albiges, Stéphanie Foulon, Arnaud Bayle, Bertrand Gachot, Fanny Pommeret, Christophe Willekens, Annabelle Stoclin, Mansouria Merad, Frank Griscelli, Ludovic Lacroix, Florence Netzer, Thomas Hueso, Corinne Balleyguier, Samy Ammari, Emeline Colomba, Giulia Baciarello, Audrey Perret, Antoine Hollebecque, Julien Hadoux, Jean Marie MichotNathalie Chaput, Veronique Saada, Mathilde Hauchecorne, Jean Baptiste Micol, Roger Sun, Dominique Valteau-Couanet, Fabrice André, Florian Scotte, Benjamin Besse, Jean Charles Soria, Fabrice Barlesi

Research output: Contribution to journalArticlepeer-review

91 Scopus citations

Abstract

Patients with cancer are presumed to be at increased risk of severe COVID-19 outcomes due to underlying malignancy and treatment-induced immunosuppression. Of the first 178 patients managed for COVID-19 at the Gustave Roussy Cancer Centre, 125 (70.2%) were hospitalized, 47 (26.4%) developed clinical worsening and 31 (17.4%) died. An age of over 70 years, smoking status, metastatic disease, cytotoxic chemotherapy and an Eastern Cooperative Oncology Group score of ≥2 at the last visit were the strongest determinants of increased risk of death. In multivariable analysis, the Eastern Cooperative Oncology Group score remained the only predictor of death. In contrast, immunotherapy, hormone therapy and targeted therapy did not increase clinical worsening or death risk. Biomarker studies found that C-reactive protein and lactate dehydrogenase levels were significantly associated with an increased risk of clinical worsening, while C-reactive protein and D-dimer levels were associated with an increased risk of death. COVID-19 management impacted the oncological treatment strategy, inducing a median 20 d delay in 41% of patients and adaptation of the therapeutic strategy in 30% of patients.

Original languageEnglish
Pages (from-to)965-975
Number of pages11
JournalNature Cancer
Volume1
Issue number10
DOIs
StatePublished - 1 Oct 2020
Externally publishedYes

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