Covid-19 and lung cancer: A greater fatality rate?

Lung Cancer. 2020 Aug;146:19-22. doi: 10.1016/j.lungcan.2020.05.034. Epub 2020 May 30.

Abstract

Background: Currently there are no reported series determining the Covid-19 infected lung cancer patient´s characteristics and outcome that allow us to clarify strategies to protect our patients. In our study we determine whether exists differences in cumulative incidence and severity of Covid-19 infection between lung cancer patients visiting our Medical Oncology department and the reference population of our center (320,000 people), in the current epicenter of the pandemic in Europe (Madrid, Spain). We also describe clinical and demographic factors associated with poor prognosis and Covid-19 treatment outcomes.

Patients and methods: We retrospectively reviewed 1878 medical records of all Covid-19 patients who were admitted at Hospital Universitario Infanta Leonor of Madrid between March 5, 2020 and April 7, 2020, in order to detect cumulative incidence of Covid-19 in lung cancer patients. We also described Covid-19 treatment outcome, mortality and associated risk factors using univariate and multivariate logistic regression analysis.

Results: 17/1878 total diagnosis in our center had lung cancer (0.9 %) versus 1878/320,000 of the total reference population (p = 0.09). 9/17 lung cancer patients with Covid-19 diagnosis died (52.3 %) versus 192/1878 Covid-19 patients in our center (p < 0.0001). Dead lung cancer patients were elderly compared to survivors: 72 versus 64.5 years old (p = 0.12). Combined treatment with hydroxychloroquine and azithromycin improves the outcome of Covid-19 in lung cancer patients, detecting only 1/6 deaths between patients under this treatment versus others treatment, with statistical significance in the univariate and multivariate logistic regression (OR 0.04, p = 0.018).

Conclusions: Lung cancer patients have a higher mortality rate than general population. Combined hydroxychloroquine and azithromycin treatment seems like a good treatment option. It is important to try to minimize visits to hospitals (without removing their active treatments) in order to decrease nosocomial transmission.

Keywords: Covid-19; Lung cancer; Mortality; Non-small cell lung cancer; Small cell lung cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Azithromycin / therapeutic use
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Cross Infection / complications
  • Cross Infection / drug therapy
  • Cross Infection / prevention & control*
  • Cross Infection / virology
  • Drug Combinations
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Logistic Models
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / virology
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Prognosis
  • SARS-CoV-2
  • Spain / epidemiology

Substances

  • Drug Combinations
  • Hydroxychloroquine
  • Azithromycin