Background: Cancer patients may carry a worse prognosis with SARS-CoV-2 infection. Most of the previous studies described the outcomes of hospitalized cancer patients. We aimed to study the clinical factors differentiating patients requiring hospital care vs. home recovery, and the trajectory of their anti-cancer treatment. Methods: This study was conducted in a community cancer center in New York City. Eligible patients were those who had cancer history and were diagnosed of SARS-CoV-2 infection between March 1 and May 30, 2020, with confirmatory SARs-CoV-2 virus test or antibody test. Four groups were constructed: (A) hospitalized and survived, (B) hospitalized requiring intubation and/or deceased, (C) non-hospitalized, asymptomatic, with suspicious CT image findings, close exposure, or positive antibody test, and (D) non-hospitalized and symptomatic. Results: One hundred and six patients were included in the analysis. Thirty-five patients (33.0%) required hospitalization and 13 (12.3%) died. Thirty (28.3%) patients were asymptomatic and 41 (38.7%) were symptomatic and recovered at home. Comparing to patients who recovered at home, hospitalized patients were composed of older patients (median age 71 vs. 63 years old, p = 0.000299), more who received negative impact treatment (62.9 vs. 32.4%, p = 0.0036) that mostly represented myelosuppressive chemotherapy (45.7 vs. 23.9%, p = 0.0275), and more patients with poorer baseline performance status (PS ≥ 2 25.7 vs. 2.8%, p = 0.0007). Hypoxemia (35% in group A vs. 73.3% in group B, p = 0.0271) at presentation was significant to predict mortality in hospitalized patients. The median cumulative hospital stay for discharged patients was 16 days (range 5-60). The median duration of persistent positivity of SARS-CoV-2 RNA was 28 days (range 10-86). About 52.9% of patients who survived hospitalization and required anti-cancer treatment reinitiated therapy. Ninety-two percent of the asymptomatic patients and 51.7% of the symptomatic patients who recovered at home continued treatment on schedule and almost all reinitiated treatment after recovery. Conclusions: Cancer patients may have a more severe status of SARS-CoV-2 infection after receiving myelosuppressive chemotherapy. Avoidance should be considered in older patients with poor performance status. More than two thirds of patients exhibit minimal to moderate symptoms, and many of them can continue or restart their anti-cancer treatment upon recovery.
Background: Cancerpatients may carry a worse prognosis with SARS-CoV-2 infection. Most of the previous studies described the outcomes of hospitalized cancerpatients. We aimed to study the clinical factors differentiating patients requiring hospital care vs. home recovery, and the trajectory of their anti-cancer treatment. Methods: This study was conducted in a community cancer center in New York City. Eligible patients were those who had cancer history and were diagnosed of SARS-CoV-2 infection between March 1 and May 30, 2020, with confirmatory SARs-CoV-2 virus test or antibody test. Four groups were constructed: (A) hospitalized and survived, (B) hospitalized requiring intubation and/or deceased, (C) non-hospitalized, asymptomatic, with suspicious CT image findings, close exposure, or positive antibody test, and (D) non-hospitalized and symptomatic. Results: One hundred and six patients were included in the analysis. Thirty-five patients (33.0%) required hospitalization and 13 (12.3%) died. Thirty (28.3%) patients were asymptomatic and 41 (38.7%) were symptomatic and recovered at home. Comparing to patients who recovered at home, hospitalized patients were composed of older patients (median age 71 vs. 63 years old, p = 0.000299), more who received negative impact treatment (62.9 vs. 32.4%, p = 0.0036) that mostly represented myelosuppressive chemotherapy (45.7 vs. 23.9%, p = 0.0275), and more patients with poorer baseline performance status (PS ≥ 2 25.7 vs. 2.8%, p = 0.0007). Hypoxemia (35% in group A vs. 73.3% in group B, p = 0.0271) at presentation was significant to predict mortality in hospitalized patients. The median cumulative hospital stay for discharged patients was 16 days (range 5-60). The median duration of persistent positivity of SARS-CoV-2 RNA was 28 days (range 10-86). About 52.9% of patients who survived hospitalization and required anti-cancer treatment reinitiated therapy. Ninety-two percent of the asymptomatic patients and 51.7% of the symptomatic patients who recovered at home continued treatment on schedule and almost all reinitiated treatment after recovery. Conclusions: Cancerpatients may have a more severe status of SARS-CoV-2 infection after receiving myelosuppressive chemotherapy. Avoidance should be considered in older patients with poor performance status. More than two thirds of patients exhibit minimal to moderate symptoms, and many of them can continue or restart their anti-cancer treatment upon recovery.
Authors: Ying Taur; Mini Kamboj; Elizabeth V Robilotti; N Esther Babady; Peter A Mead; Thierry Rolling; Rocio Perez-Johnston; Marilia Bernardes; Yael Bogler; Mario Caldararo; Cesar J Figueroa; Michael S Glickman; Alexa Joanow; Anna Kaltsas; Yeon Joo Lee; Anabella Lucca; Amanda Mariano; Sejal Morjaria; Tamara Nawar; Genovefa A Papanicolaou; Jacqueline Predmore; Gil Redelman-Sidi; Elizabeth Schmidt; Susan K Seo; Kent Sepkowitz; Monika K Shah; Jedd D Wolchok; Tobias M Hohl Journal: Nat Med Date: 2020-06-24 Impact factor: 53.440
Authors: Nicole M Kuderer; Toni K Choueiri; Dimpy P Shah; Yu Shyr; Samuel M Rubinstein; Donna R Rivera; Sanjay Shete; Chih-Yuan Hsu; Aakash Desai; Gilberto de Lima Lopes; Petros Grivas; Corrie A Painter; Solange Peters; Michael A Thompson; Ziad Bakouny; Gerald Batist; Tanios Bekaii-Saab; Mehmet A Bilen; Nathaniel Bouganim; Mateo Bover Larroya; Daniel Castellano; Salvatore A Del Prete; Deborah B Doroshow; Pamela C Egan; Arielle Elkrief; Dimitrios Farmakiotis; Daniel Flora; Matthew D Galsky; Michael J Glover; Elizabeth A Griffiths; Anthony P Gulati; Shilpa Gupta; Navid Hafez; Thorvardur R Halfdanarson; Jessica E Hawley; Emily Hsu; Anup Kasi; Ali R Khaki; Christopher A Lemmon; Colleen Lewis; Barbara Logan; Tyler Masters; Rana R McKay; Ruben A Mesa; Alicia K Morgans; Mary F Mulcahy; Orestis A Panagiotou; Prakash Peddi; Nathan A Pennell; Kerry Reynolds; Lane R Rosen; Rachel Rosovsky; Mary Salazar; Andrew Schmidt; Sumit A Shah; Justin A Shaya; John Steinharter; Keith E Stockerl-Goldstein; Suki Subbiah; Donald C Vinh; Firas H Wehbe; Lisa B Weissmann; Julie Tsu-Yu Wu; Elizabeth Wulff-Burchfield; Zhuoer Xie; Albert Yeh; Peter P Yu; Alice Y Zhou; Leyre Zubiri; Sanjay Mishra; Gary H Lyman; Brian I Rini; Jeremy L Warner Journal: Lancet Date: 2020-05-28 Impact factor: 79.321
Authors: Vikas Mehta; Sanjay Goel; Rafi Kabarriti; Balazs Halmos; Amit Verma; Daniel Cole; Mendel Goldfinger; Ana Acuna-Villaorduna; Kith Pradhan; Raja Thota; Stan Reissman; Joseph A Sparano; Benjamin A Gartrell; Richard V Smith; Nitin Ohri; Madhur Garg; Andrew D Racine; Shalom Kalnicki; Roman Perez-Soler Journal: Cancer Discov Date: 2020-05-01 Impact factor: 38.272