High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR
Cancer 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. PRE-COVID-19 is a retrospective study of all 302 cancer patients presenting to this institute with a suspicion o...
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Veröffentlicht in: | European journal of cancer (1990) 2020-08, Vol.135, p.251-259 |
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creator | Assaad, Souad Avrillon, Virginie Fournier, Marie-Line Mastroianni, Benedicte Russias, Bruno Swalduz, Aurélie Cassier, Philippe Eberst, Lauriane Steineur, Marie-Pierre Kazes, Marianne Perol, Maurice Michallet, Anne-Sophie Rey, Philippe Erena-Penet, Anne-Sophie Morel, Astrid Brahmi, Mehdi Dufresne, Armelle Tredan, Olivier Chvetzoff, Gisèle Fayette, Jérome de la Fouchardiere, Christelle Ray-Coquard, Isabelle Bachelot, Thomas Saintigny, Pierre Tabutin, Mayeul Dupré, Aurélien Nicolas-Virelizier, Emmanuelle Belhabri, Amine Roux, Pierre-Eric Fuhrmann, Christine Pilleul, Franck Basle, Alexandre Bouhamama, Amine Galvez, Christelle Herr, Andrée-Laure Gautier, Julien Chabaud, Sylvie Zrounba, Philippe Perol, David Blay, Jean-Yves |
description | Cancer 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.
PRE-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.
Fifty-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 |
doi_str_mv | 10.1016/j.ejca.2020.05.028 |
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PRE-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.
Fifty-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.
The 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.
•Cancer patients with SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR have a death rate of 20% at 30 days.•Cancer patients with clinical symptoms of COVID-19 but SARS-COV-2 RT-PCR have high death rate.•70% cancer patients suspected COVID-19 dying before day 30 have no SARS-COV-2 on RT-PCR or computed tomography.•For both groups, the risk factors of death include "relapsing cancer", Karnofsky performance status <60, male gender, lymphopenia, and high CRP levels.•PD1 Ab, anti-CD20 and antiangiogenic treatments do not correlate with risk of death.</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2020.05.028</identifier><identifier>PMID: 32540204</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Age Factors ; Betacoronavirus - genetics ; Betacoronavirus - isolation & purification ; Cancer patients ; Clinical Laboratory Techniques - statistics & numerical data ; Coronavirus Infections - complications ; Coronavirus Infections - diagnosis ; Coronavirus Infections - mortality ; Coronavirus Infections - virology ; COVID-19 ; COVID-19 Testing ; COVID-19 Vaccines ; Female ; Follow-Up Studies ; Humans ; Karnofsky Performance Status - statistics & numerical data ; Life Sciences ; Male ; Middle Aged ; Mortality ; Neoplasm Recurrence, Local - complications ; Neoplasm Recurrence, Local - mortality ; Neoplasms - complications ; Neoplasms - mortality ; Original Research ; Pandemics ; Pneumonia, Viral - complications ; Pneumonia, Viral - diagnosis ; Pneumonia, Viral - mortality ; Pneumonia, Viral - virology ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data ; Risk Factors ; RNA, Viral - isolation & purification ; RT-PCR ; SARS-COV-2 ; Sex Factors ; Survival ; Survival Analysis ; Time Factors</subject><ispartof>European journal of cancer (1990), 2020-08, Vol.135, p.251-259</ispartof><rights>2020 The Author(s)</rights><rights>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</rights><rights>Attribution - NonCommercial</rights><rights>2020 The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-1bec3fbb588b4cfac8d5293168946a72543077dcd7d81d624d6b096e6562620a3</citedby><cites>FETCH-LOGICAL-c489t-1bec3fbb588b4cfac8d5293168946a72543077dcd7d81d624d6b096e6562620a3</cites><orcidid>0000-0002-0866-9484 ; 0000-0002-3296-423X ; 0000-0002-6637-3526 ; 0000-0002-8090-9323 ; 0000-0001-7190-120X ; 0000-0003-0655-6678 ; 0000-0002-6429-7419 ; 0000-0002-2957-1531 ; 0000-0002-4256-8126 ; 0000-0003-2472-8306</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0959804920303142$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32540204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03491257$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Assaad, Souad</creatorcontrib><creatorcontrib>Avrillon, Virginie</creatorcontrib><creatorcontrib>Fournier, Marie-Line</creatorcontrib><creatorcontrib>Mastroianni, Benedicte</creatorcontrib><creatorcontrib>Russias, Bruno</creatorcontrib><creatorcontrib>Swalduz, Aurélie</creatorcontrib><creatorcontrib>Cassier, Philippe</creatorcontrib><creatorcontrib>Eberst, Lauriane</creatorcontrib><creatorcontrib>Steineur, Marie-Pierre</creatorcontrib><creatorcontrib>Kazes, Marianne</creatorcontrib><creatorcontrib>Perol, Maurice</creatorcontrib><creatorcontrib>Michallet, Anne-Sophie</creatorcontrib><creatorcontrib>Rey, Philippe</creatorcontrib><creatorcontrib>Erena-Penet, Anne-Sophie</creatorcontrib><creatorcontrib>Morel, Astrid</creatorcontrib><creatorcontrib>Brahmi, Mehdi</creatorcontrib><creatorcontrib>Dufresne, Armelle</creatorcontrib><creatorcontrib>Tredan, Olivier</creatorcontrib><creatorcontrib>Chvetzoff, Gisèle</creatorcontrib><creatorcontrib>Fayette, Jérome</creatorcontrib><creatorcontrib>de la Fouchardiere, Christelle</creatorcontrib><creatorcontrib>Ray-Coquard, Isabelle</creatorcontrib><creatorcontrib>Bachelot, Thomas</creatorcontrib><creatorcontrib>Saintigny, Pierre</creatorcontrib><creatorcontrib>Tabutin, Mayeul</creatorcontrib><creatorcontrib>Dupré, Aurélien</creatorcontrib><creatorcontrib>Nicolas-Virelizier, Emmanuelle</creatorcontrib><creatorcontrib>Belhabri, Amine</creatorcontrib><creatorcontrib>Roux, Pierre-Eric</creatorcontrib><creatorcontrib>Fuhrmann, Christine</creatorcontrib><creatorcontrib>Pilleul, Franck</creatorcontrib><creatorcontrib>Basle, Alexandre</creatorcontrib><creatorcontrib>Bouhamama, Amine</creatorcontrib><creatorcontrib>Galvez, Christelle</creatorcontrib><creatorcontrib>Herr, Andrée-Laure</creatorcontrib><creatorcontrib>Gautier, Julien</creatorcontrib><creatorcontrib>Chabaud, Sylvie</creatorcontrib><creatorcontrib>Zrounba, Philippe</creatorcontrib><creatorcontrib>Perol, David</creatorcontrib><creatorcontrib>Blay, Jean-Yves</creatorcontrib><title>High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Cancer 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.
PRE-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.
Fifty-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.
The 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.
•Cancer patients with SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR have a death rate of 20% at 30 days.•Cancer patients with clinical symptoms of COVID-19 but SARS-COV-2 RT-PCR have high death rate.•70% cancer patients suspected COVID-19 dying before day 30 have no SARS-COV-2 on RT-PCR or computed tomography.•For both groups, the risk factors of death include "relapsing cancer", Karnofsky performance status <60, male gender, lymphopenia, and high CRP levels.•PD1 Ab, anti-CD20 and antiangiogenic treatments do not correlate with risk of death.</description><subject>Age Factors</subject><subject>Betacoronavirus - genetics</subject><subject>Betacoronavirus - isolation & purification</subject><subject>Cancer patients</subject><subject>Clinical Laboratory Techniques - statistics & numerical data</subject><subject>Coronavirus Infections - complications</subject><subject>Coronavirus Infections - diagnosis</subject><subject>Coronavirus Infections - mortality</subject><subject>Coronavirus Infections - virology</subject><subject>COVID-19</subject><subject>COVID-19 Testing</subject><subject>COVID-19 Vaccines</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Karnofsky Performance Status - statistics & numerical data</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Recurrence, Local - complications</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - mortality</subject><subject>Original Research</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - complications</subject><subject>Pneumonia, Viral - diagnosis</subject><subject>Pneumonia, Viral - mortality</subject><subject>Pneumonia, Viral - virology</subject><subject>Retrospective Studies</subject><subject>Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data</subject><subject>Risk Factors</subject><subject>RNA, Viral - isolation & purification</subject><subject>RT-PCR</subject><subject>SARS-COV-2</subject><subject>Sex Factors</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-P0zAQxSMEYsvCF-CAfIRDytixHVtCSFX505UqLeouXC3HcbaukjjYblG_PS5dVsCB00gz773x-FcULzHMMWD-dje3O6PnBAjMgc2BiEfFDItaliAYeVzMQDJZCqDyongW4w4AakHhaXFREUazi86KaeXutmjwIenepSMKOlnkRmT0aGxAk07OjimiHy5tUTwOU_JDRL5Dy-tvVx9KLM8TH35Vv0-otcmapJveopvF5qbMwpIgP6LNbflluXlePOl0H-2L-3pZfP308Xa5KtfXn6-Wi3VpqJCpxI01Vdc0TIiGmk4b0TIiK8yFpFzX-f0V1HVr2roVuOWEtrwByS1nnHACuros3p9zp30z2NbkK4Lu1RTcoMNRee3U35PRbdWdP6ia1ExKmgPenAO2_9hWi7U69aCiEhNWH3DWvr5fFvz3vY1JDS4a2_d6tH4fFaGYAnDOqiwlZ6kJPsZgu4dsDOqEVe3UCas6YVXAVMaaTa_-PObB8ptjFrw7C2z-0oOzQUWTwRnbupBpqNa7_-X_BDF3sgs</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Assaad, Souad</creator><creator>Avrillon, Virginie</creator><creator>Fournier, Marie-Line</creator><creator>Mastroianni, Benedicte</creator><creator>Russias, Bruno</creator><creator>Swalduz, Aurélie</creator><creator>Cassier, Philippe</creator><creator>Eberst, Lauriane</creator><creator>Steineur, Marie-Pierre</creator><creator>Kazes, Marianne</creator><creator>Perol, Maurice</creator><creator>Michallet, Anne-Sophie</creator><creator>Rey, Philippe</creator><creator>Erena-Penet, Anne-Sophie</creator><creator>Morel, Astrid</creator><creator>Brahmi, Mehdi</creator><creator>Dufresne, Armelle</creator><creator>Tredan, Olivier</creator><creator>Chvetzoff, Gisèle</creator><creator>Fayette, Jérome</creator><creator>de la Fouchardiere, Christelle</creator><creator>Ray-Coquard, Isabelle</creator><creator>Bachelot, Thomas</creator><creator>Saintigny, Pierre</creator><creator>Tabutin, Mayeul</creator><creator>Dupré, Aurélien</creator><creator>Nicolas-Virelizier, Emmanuelle</creator><creator>Belhabri, Amine</creator><creator>Roux, Pierre-Eric</creator><creator>Fuhrmann, Christine</creator><creator>Pilleul, Franck</creator><creator>Basle, Alexandre</creator><creator>Bouhamama, Amine</creator><creator>Galvez, Christelle</creator><creator>Herr, Andrée-Laure</creator><creator>Gautier, Julien</creator><creator>Chabaud, Sylvie</creator><creator>Zrounba, Philippe</creator><creator>Perol, David</creator><creator>Blay, Jean-Yves</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>The Author(s). Published by Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0866-9484</orcidid><orcidid>https://orcid.org/0000-0002-3296-423X</orcidid><orcidid>https://orcid.org/0000-0002-6637-3526</orcidid><orcidid>https://orcid.org/0000-0002-8090-9323</orcidid><orcidid>https://orcid.org/0000-0001-7190-120X</orcidid><orcidid>https://orcid.org/0000-0003-0655-6678</orcidid><orcidid>https://orcid.org/0000-0002-6429-7419</orcidid><orcidid>https://orcid.org/0000-0002-2957-1531</orcidid><orcidid>https://orcid.org/0000-0002-4256-8126</orcidid><orcidid>https://orcid.org/0000-0003-2472-8306</orcidid></search><sort><creationdate>20200801</creationdate><title>High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR</title><author>Assaad, Souad ; Avrillon, Virginie ; Fournier, Marie-Line ; Mastroianni, Benedicte ; Russias, Bruno ; Swalduz, Aurélie ; Cassier, Philippe ; Eberst, Lauriane ; Steineur, Marie-Pierre ; Kazes, Marianne ; Perol, Maurice ; Michallet, Anne-Sophie ; Rey, Philippe ; Erena-Penet, Anne-Sophie ; Morel, Astrid ; Brahmi, Mehdi ; Dufresne, Armelle ; Tredan, Olivier ; Chvetzoff, Gisèle ; Fayette, Jérome ; de la Fouchardiere, Christelle ; Ray-Coquard, Isabelle ; Bachelot, Thomas ; Saintigny, Pierre ; Tabutin, Mayeul ; Dupré, Aurélien ; Nicolas-Virelizier, Emmanuelle ; Belhabri, Amine ; Roux, Pierre-Eric ; Fuhrmann, Christine ; Pilleul, Franck ; Basle, Alexandre ; Bouhamama, Amine ; Galvez, Christelle ; Herr, Andrée-Laure ; Gautier, Julien ; Chabaud, Sylvie ; Zrounba, Philippe ; Perol, David ; Blay, Jean-Yves</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-1bec3fbb588b4cfac8d5293168946a72543077dcd7d81d624d6b096e6562620a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age Factors</topic><topic>Betacoronavirus - genetics</topic><topic>Betacoronavirus - isolation & purification</topic><topic>Cancer patients</topic><topic>Clinical Laboratory Techniques - statistics & numerical data</topic><topic>Coronavirus Infections - complications</topic><topic>Coronavirus Infections - diagnosis</topic><topic>Coronavirus Infections - mortality</topic><topic>Coronavirus Infections - virology</topic><topic>COVID-19</topic><topic>COVID-19 Testing</topic><topic>COVID-19 Vaccines</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Karnofsky Performance Status - statistics & numerical data</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasm Recurrence, Local - complications</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - mortality</topic><topic>Original Research</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - complications</topic><topic>Pneumonia, Viral - diagnosis</topic><topic>Pneumonia, Viral - mortality</topic><topic>Pneumonia, Viral - virology</topic><topic>Retrospective Studies</topic><topic>Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data</topic><topic>Risk Factors</topic><topic>RNA, Viral - isolation & purification</topic><topic>RT-PCR</topic><topic>SARS-COV-2</topic><topic>Sex Factors</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Assaad, Souad</creatorcontrib><creatorcontrib>Avrillon, Virginie</creatorcontrib><creatorcontrib>Fournier, Marie-Line</creatorcontrib><creatorcontrib>Mastroianni, Benedicte</creatorcontrib><creatorcontrib>Russias, Bruno</creatorcontrib><creatorcontrib>Swalduz, Aurélie</creatorcontrib><creatorcontrib>Cassier, Philippe</creatorcontrib><creatorcontrib>Eberst, Lauriane</creatorcontrib><creatorcontrib>Steineur, Marie-Pierre</creatorcontrib><creatorcontrib>Kazes, Marianne</creatorcontrib><creatorcontrib>Perol, Maurice</creatorcontrib><creatorcontrib>Michallet, Anne-Sophie</creatorcontrib><creatorcontrib>Rey, Philippe</creatorcontrib><creatorcontrib>Erena-Penet, Anne-Sophie</creatorcontrib><creatorcontrib>Morel, Astrid</creatorcontrib><creatorcontrib>Brahmi, Mehdi</creatorcontrib><creatorcontrib>Dufresne, Armelle</creatorcontrib><creatorcontrib>Tredan, Olivier</creatorcontrib><creatorcontrib>Chvetzoff, Gisèle</creatorcontrib><creatorcontrib>Fayette, Jérome</creatorcontrib><creatorcontrib>de la Fouchardiere, Christelle</creatorcontrib><creatorcontrib>Ray-Coquard, Isabelle</creatorcontrib><creatorcontrib>Bachelot, Thomas</creatorcontrib><creatorcontrib>Saintigny, Pierre</creatorcontrib><creatorcontrib>Tabutin, Mayeul</creatorcontrib><creatorcontrib>Dupré, Aurélien</creatorcontrib><creatorcontrib>Nicolas-Virelizier, Emmanuelle</creatorcontrib><creatorcontrib>Belhabri, Amine</creatorcontrib><creatorcontrib>Roux, Pierre-Eric</creatorcontrib><creatorcontrib>Fuhrmann, Christine</creatorcontrib><creatorcontrib>Pilleul, Franck</creatorcontrib><creatorcontrib>Basle, Alexandre</creatorcontrib><creatorcontrib>Bouhamama, Amine</creatorcontrib><creatorcontrib>Galvez, Christelle</creatorcontrib><creatorcontrib>Herr, Andrée-Laure</creatorcontrib><creatorcontrib>Gautier, Julien</creatorcontrib><creatorcontrib>Chabaud, Sylvie</creatorcontrib><creatorcontrib>Zrounba, Philippe</creatorcontrib><creatorcontrib>Perol, David</creatorcontrib><creatorcontrib>Blay, Jean-Yves</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Assaad, Souad</au><au>Avrillon, Virginie</au><au>Fournier, Marie-Line</au><au>Mastroianni, Benedicte</au><au>Russias, Bruno</au><au>Swalduz, Aurélie</au><au>Cassier, Philippe</au><au>Eberst, Lauriane</au><au>Steineur, Marie-Pierre</au><au>Kazes, Marianne</au><au>Perol, Maurice</au><au>Michallet, Anne-Sophie</au><au>Rey, Philippe</au><au>Erena-Penet, Anne-Sophie</au><au>Morel, Astrid</au><au>Brahmi, Mehdi</au><au>Dufresne, Armelle</au><au>Tredan, Olivier</au><au>Chvetzoff, Gisèle</au><au>Fayette, Jérome</au><au>de la Fouchardiere, Christelle</au><au>Ray-Coquard, Isabelle</au><au>Bachelot, Thomas</au><au>Saintigny, Pierre</au><au>Tabutin, Mayeul</au><au>Dupré, Aurélien</au><au>Nicolas-Virelizier, Emmanuelle</au><au>Belhabri, Amine</au><au>Roux, Pierre-Eric</au><au>Fuhrmann, Christine</au><au>Pilleul, Franck</au><au>Basle, Alexandre</au><au>Bouhamama, Amine</au><au>Galvez, Christelle</au><au>Herr, Andrée-Laure</au><au>Gautier, Julien</au><au>Chabaud, Sylvie</au><au>Zrounba, Philippe</au><au>Perol, David</au><au>Blay, Jean-Yves</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>135</volume><spage>251</spage><epage>259</epage><pages>251-259</pages><issn>0959-8049</issn><eissn>1879-0852</eissn><abstract>Cancer 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.
PRE-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.
Fifty-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.
The 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.
•Cancer patients with SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR have a death rate of 20% at 30 days.•Cancer patients with clinical symptoms of COVID-19 but SARS-COV-2 RT-PCR have high death rate.•70% cancer patients suspected COVID-19 dying before day 30 have no SARS-COV-2 on RT-PCR or computed tomography.•For both groups, the risk factors of death include "relapsing cancer", Karnofsky performance status <60, male gender, lymphopenia, and high CRP levels.•PD1 Ab, anti-CD20 and antiangiogenic treatments do not correlate with risk of death.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32540204</pmid><doi>10.1016/j.ejca.2020.05.028</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0866-9484</orcidid><orcidid>https://orcid.org/0000-0002-3296-423X</orcidid><orcidid>https://orcid.org/0000-0002-6637-3526</orcidid><orcidid>https://orcid.org/0000-0002-8090-9323</orcidid><orcidid>https://orcid.org/0000-0001-7190-120X</orcidid><orcidid>https://orcid.org/0000-0003-0655-6678</orcidid><orcidid>https://orcid.org/0000-0002-6429-7419</orcidid><orcidid>https://orcid.org/0000-0002-2957-1531</orcidid><orcidid>https://orcid.org/0000-0002-4256-8126</orcidid><orcidid>https://orcid.org/0000-0003-2472-8306</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0959-8049 |
ispartof | European journal of cancer (1990), 2020-08, Vol.135, p.251-259 |
issn | 0959-8049 1879-0852 |
language | eng |
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source | MEDLINE; Elsevier ScienceDirect Journals |
subjects | Age Factors Betacoronavirus - genetics Betacoronavirus - isolation & purification Cancer patients Clinical Laboratory Techniques - statistics & numerical data Coronavirus Infections - complications Coronavirus Infections - diagnosis Coronavirus Infections - mortality Coronavirus Infections - virology COVID-19 COVID-19 Testing COVID-19 Vaccines Female Follow-Up Studies Humans Karnofsky Performance Status - statistics & numerical data Life Sciences Male Middle Aged Mortality Neoplasm Recurrence, Local - complications Neoplasm Recurrence, Local - mortality Neoplasms - complications Neoplasms - mortality Original Research Pandemics Pneumonia, Viral - complications Pneumonia, Viral - diagnosis Pneumonia, Viral - mortality Pneumonia, Viral - virology Retrospective Studies Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data Risk Factors RNA, Viral - isolation & purification RT-PCR SARS-COV-2 Sex Factors Survival Survival Analysis Time Factors |
title | High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR |
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