A study by researchers from the Memorial Sloan Kettering Cancer Center estimated that 40% of the 423 patients with cancer who were symptomatic for SARS-CoV-2 were hospitalized for COVID-19.1 Looking at these patients, the researchers identified several characteristics that conferred risk.

A multivariable analysis showed that patients 65 years or older and those who had been treated with immune checkpoint inhibitors (ICIs) within 90 days of admittance had a higher likelihood for hospitalization and severe disease. In contrast, receipt of chemotherapy within 30 days and prior major surgery did not increase the risk of developing the virus.

These data were published online on medRxiv.org, so it is important to note that the data were not peer-reviewed, and the results of the study should be considered preliminary.

Among patients included in the study, the most frequent cancer types seen were breast (20%), colorectal (9%), and lung cancer (8%). More than half of patients (55.3%) had a comorbid condition — most commonly diabetes, hypertension or cardiovascular disease.

Twenty percent of patients developed severe respiratory illness, with 9% requiring mechanical ventilation — and 9% of patients ultimately died.

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The researchers cautioned that their data involving ICIs should be interpreted with caution.

“It is possible that patients with lung cancer have confounding from other risk factors beyond ICI treatment (eg, surgery, preexisting lung disease, radiotherapy, prior smoking) that contributed to the finding of increased disease severity and were not fully evaluable in our population,” they wrote. “Until more extensive studies are available, it is prudent not to alter treatment decisions, but consider SARS-CoV-2 testing for patients initiating or continuing treatment with ICIs irrespective of symptoms.”

Disclosure: Some of the authors reported financial relationships with the pharmaceutical and/or medical device industry. For a full list of disclosures, please refer to the original study.

Reference

Robilotti EV, Babady NE, Mead PA, et al. Determinants of severity in cancer patients with COVID-19 illness [preprint published online May 8, 2020]. medRxiv. doi: 10.1101/2020.05.04.20086322