Clinical Portrait of the SARS-CoV-2 Epidemic in European Patients with Cancer
David J. Pinato, Alberto Zambelli, Mark Bower, Christopher C.T. Sng, Ramón Salazar, Alexia Bertuzzi, Joan Brunet, Ricard Mesı́a, Elia Seguí, Federica Biello, Daniele Generali, Salvatore Grisanti, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Diego Ottaviani, Anna Carbó, Riccardo Bruna, Sarah Benafif, Andrea Marrari, Rachel Wuerstlein, M. Carmen Carmona-García, Neha Chopra, Carlo Tondini, Oriol Mirallas, Valeria Tovazzi, Marta Betti, Salvatore Provenzano, Vittoria Fotia, Claudia Andrea Cruz, Alessia Dalla Pria, Francesca D’Avanzo, Joanne Evans, N. Saoudi Gonzalez, Eudald Felip, Myria Galazi, Isabel García-Fructuoso, Alvin Lee, Thomas Newsom-Davis, Andrea Patriarca, David García-Illescas, Roxana Reyes, Palma Dileo, Rachel Sharkey, Yien Ning Sophia Wong, Daniela Ferrante, Javier Marco‐Hernández, Anna Sureda, Clara Maluquer, Isabel Ruíz-Camps, Gianluca Gaïdano, Lorenza Rimassa, Lorenzo Chiudinelli, Macarena Izuzquiza, Alba Cabirta, Michela Franchi, Armando Santoro, Aleix Prat, Josep Tabernero, Alessandra Gennari, Gian Carlo Avanzi, Mattia Bellan, Luigi Mario Castello, María Martínez-Martínez, Meritxell Mollà, Mario Pirisi, Lorenza Scotti, Judith Swallow
Abstract
Abstract The SARS-CoV-2 pandemic significantly affected oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncologic features to severity and mortality from COVID-19 and little guidance as to the role of anticancer and anti–COVID-19 therapy in this population. In a multicenter study of 890 patients with cancer with confirmed COVID-19, we demonstrated a worsening gradient of mortality from breast cancer to hematologic malignancies and showed that male gender, older age, and number of comorbidities identify a subset of patients with significantly worse mortality rates from COVID-19. Provision of chemotherapy, targeted therapy, or immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk stratification of patients and supports further research into emerging anti–COVID-19 therapeutics in SARS-CoV-2–infected patients with cancer. Significance: In this observational study of 890 patients with cancer diagnosed with SARS-CoV-2, mortality was 33.6% and predicted by male gender, age ≥65, and comorbidity burden. Delivery of cancer therapy was not detrimental to severity or mortality from COVID-19. These patients should be the focus of shielding efforts during the SARS-CoV-2 pandemic. This article is highlighted in the In This Issue feature, p. 1426