COVID-19 in patients with lung cancer #MMPMID32561401
Luo J; Rizvi H; Preeshagul I; Egger J; Hoyos D; Bandlamudi C; McCarthy C; Falcon C; Schoenfeld A; Arbour K; Chaft J; Daly R; Drilon A; Eng J; Iqbal A; Lai W; Li B; Lito P; Namakydoust A; Ng K; Offin M; Paik P; Riely G; Rudin C; Yu H; Zauderer M; Donoghue M; ?uksza M; Greenbaum B; Kris M; Hellmann M
Ann Oncol 2020[Oct]; 31 (10): 1386-96 PMID32561401show ga
Background: Patients with lung cancers may have disproportionately severe coronavirus disease 2019 (COVID-19) outcomes. Understanding the patient-specific and cancer-specific features that impact the severity of COVID-19 may inform optimal cancer care during this pandemic. Patients and methods: We examined consecutive patients with lung cancer and confirmed diagnosis of COVID-19 (n = 102) at a single center from 12 March 2020 to 6 May 2020. Thresholds of severity were defined a priori as hospitalization, intensive care unit/intubation/do not intubate ([ICU/intubation/DNI] a composite metric of severe disease), or death. Recovery was defined as >14 days from COVID-19 test and >3 days since symptom resolution. Human leukocyte antigen (HLA) alleles were inferred from MSK-IMPACT (n = 46) and compared with controls with lung cancer and no known non-COVID-19 (n = 5166). Results: COVID-19 was severe in patients with lung cancer (62% hospitalized, 25% died). Although severe, COVID-19 accounted for a minority of overall lung cancer deaths during the pandemic (11% overall). Determinants of COVID-19 severity were largely patient-specific features, including smoking status and chronic obstructive pulmonary disease [odds ratio for severe COVID-19 2.9, 95% confidence interval 1.07?9.44 comparing the median (23.5 pack-years) to never-smoker and 3.87, 95% confidence interval 1.35?9.68, respectively]. Cancer-specific features, including prior thoracic surgery/radiation and recent systemic therapies did not impact severity. Human leukocyte antigen supertypes were generally similar in mild or severe cases of COVID-19 compared with non-COVID-19 controls. Most patients recovered from COVID-19, including 25% patients initially requiring intubation. Among hospitalized patients, hydroxychloroquine did not improve COVID-19 outcomes. Conclusion: COVID-19 is associated with high burden of severity in patients with lung cancer. Patient-specific features, rather than cancer-specific features or treatments, are the greatest determinants of severity.
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Ann+Oncol 2020 ; 31 (10): 1386-96
