• Hongyan Zhang, Linwei Wang, Yuanyuan Chen, Qiuji Wu, Gaili Chen, Xiaokun Shen, Qun Wang, Youqin Yan, Yi Yu, Yahua Zhong, Xinghuan Wang, Chua Melvin L K MLK 0000-0002-1648-1473 Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China. , and Conghua Xie.
• Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.
• Cancer. 2020 Sep 1; 126 (17): 4023-4031.

BackgroundPatients with cancer have a higher risk of coronavirus disease 2019 (COVID-19) than noncancer patients. The authors conducted a multicenter retrospective study to investigate the clinical manifestations and outcomes of patients with cancer who are diagnosed with COVID-19.MethodsThe authors reviewed the medical records of hospitalized patients who were treated at 5 hospitals in Wuhan City, China, between January 5 and March 18, 2020. Clinical parameters relating to cancer history (type and treatment) and COVID-19 were collected. The primary outcome was overall survival (OS). Secondary analyses were the association between clinical factors and severe COVID-19 and OS.ResultsA total of 107 patients with cancer were diagnosed with COVID-19, with a median age of 66 years (range, 37-98 years). Lung (21 patients; 19.6%), gastrointestinal (20 patients; 18.7%), and genitourinary (20 patients; 18.7%) cancers were the most common cancer diagnoses. A total of 37 patients (34.6%) were receiving active anticancer treatment when diagnosed with COVID-19, whereas 70 patients (65.4%) were on follow-up. Overall, 52.3% of patients (56 patients) developed severe COVID-19; this rate was found to be higher among patients receiving anticancer treatment than those on follow-up (64.9% vs 45.7%), which corresponded to an inferior OS in the former subgroup of patients (hazard ratio, 3.365; 95% CI, 1.455-7.782 [P = .005]). The detrimental effect of anticancer treatment on OS was found to be independent of exposure to systemic therapy (case fatality rate of 33.3% [systemic therapy] vs 43.8% [nonsystemic therapy]).ConclusionsThe results of the current study demonstrated that >50.0% of infected patients with cancer are susceptible to severe COVID-19. This risk is aggravated by simultaneous anticancer treatment and portends for a worse survival, despite treatment for COVID-19.© 2020 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

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