COVID-19 in patients with lung cancer Journal Article
| Authors: | Luo, J.; Rizvi, H.; Preeshagul, I. R.; Egger, J. V.; Hoyos, D.; Bandlamudi, C.; McCarthy, C. G.; Falcon, C. J.; Schoenfeld, A. J.; Arbour, K. C.; Chaft, J. E.; Daly, R. M.; Drilon, A.; Eng, J.; Iqbal, A.; Lai, W. V.; Li, B. T.; Lito, P.; Namakydoust, A.; Ng, K.; Offin, M.; Paik, P. K.; Riely, G. J.; Rudin, C. M.; Yu, H. A.; Zauderer, M. G.; Donoghue, M. T. A.; Łuksza, M.; Greenbaum, B. D.; Kris, M. G.; Hellmann, M. D. |
| Article Title: | COVID-19 in patients with lung cancer |
| Abstract: | 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. © 2020 European Society for Medical Oncology |
| Keywords: | chemotherapy; lung cancer; covid-19; immunotherapy/checkpoint blockade; small molecule agents |
| Journal Title: | Annals of Oncology |
| Volume: | 31 |
| Issue: | 10 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2020-10-01 |
| Start Page: | 1386 |
| End Page: | 1396 |
| Language: | English |
| DOI: | 10.1016/j.annonc.2020.06.007 |
| PUBMED: | 32561401 |
| PROVIDER: | scopus |
| PMCID: | PMC7297689 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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