• Souad Assaad, Virginie Avrillon, Marie-Line Fournier, Benedicte Mastroianni, Bruno Russias, Aurélie Swalduz, Philippe Cassier, Lauriane Eberst, Marie-Pierre Steineur, Marianne Kazes, Maurice Perol, Anne-Sophie Michallet, Philippe Rey, Anne-Sophie Erena-Penet, Astrid Morel, Mehdi Brahmi, Armelle Dufresne, Olivier Tredan, Gisèle Chvetzoff, Jérome Fayette, Christelle de la Fouchardiere, Isabelle Ray-Coquard, Thomas Bachelot, Pierre Saintigny, Mayeul Tabutin, Aurélien Dupré, Emmanuelle Nicolas-Virelizier, Amine Belhabri, Pierre-Eric Roux, Christine Fuhrmann, Franck Pilleul, Alexandre Basle, Amine Bouhamama, Christelle Galvez, Andrée-Laure Herr, Julien Gautier, Sylvie Chabaud, Philippe Zrounba, David Perol, and Jean-Yves Blay.
• Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France.
• Eur. J. Cancer. 2020 Aug 1; 135: 251-259.

BackgroundCancer patients presenting with COVID-19 have a high risk of death. In this work, predictive factors for survival in cancer patients with suspected SARS-COV-2 infection were investigated.MethodsPRE-COVID-19 is a retrospective study of all 302 cancer patients presenting to this institute with a suspicion of COVID-19 from March 1st to April 25th 2020. Data were collected using a web-based tool within electronic patient record approved by the Institutional Review Board. Patient characteristics symptoms and survival were collected and compared in SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR)-positive and RT-PCR-negative patients.ResultsFifty-five of the 302 (18.2%) patients with suspected COVID-19 had detectable SARS-COV-2 with RT-PCR in nasopharyngeal samples. RT-PCR-positive patients were older, had more frequently haematological malignancies, respiratory symptoms and suspected COVID-19 pneumonia of computed tomography (CT) scan. However, respectively, 38% and 20% of SARS-COV-2 RT-PCR-negative patients presented similar respiratory symptoms and CT scan images. Thirty of the 302 (9.9%) patients died during the observation period, including 24 (80%) with advanced disease. At the median follow-up of 25 days after the first symptoms, the death rate in RT-PCR-positive and RT-PCR-negative patients were 21% and 10%, respectively. In both groups, independent risk factors for death were male gender, Karnofsky performance status <60, cancer in relapse and respiratory symptoms. Detection of SARS-COV-2 on RT-PCR was not associated with an increased death rate (p = 0.10). None of the treatment given in the previous month (including cytotoxics, PD1 Ab, anti-CD20, VEGFR2…) correlated with survival. The survival of RT-PCR-positive and -negative patients with respiratory symptoms and/or COVID-19 type pneumonia on CT scan was similar with a 18.4% and 19.7% death rate at day 25. Most (22/30, 73%) cancer patients dying during this period were RT-PCR negative.ConclusionThe 30-day death rate of cancer patients with or without documented SARS-COV-2 infection is poor, but the majority of deaths occur in RT-PCR-negative patients.Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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