Open AccessMortality of COVID-19 pneumonia during anticancer treatment in lung cancer patients
Author(s) -
Daliborka Bursać,
Bojan Zarić,
Darijo Bokan,
Tomi Kovačević,
Vladimir Stojšić,
Svetlana Petkov,
Kosana Mitrović,
Goran Stojanović
Publication year - 2022
Publication title -
vojnosanitetski pregled
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 19
eISSN - 2406-0720
pISSN - 0042-8450
DOI - 10.2298/vsp211120018b
Subject(s) - medicine , comorbidity , pneumonia , diabetes mellitus , lung cancer , cancer , copd , univariate analysis , retrospective cohort study , hydroxychloroquine , disease , multivariate analysis , covid-19 , infectious disease (medical specialty) , endocrinology
Background/Aim: The COVID-19 pandemic has multiple impacts on the management of cancer patients. Treatment of malignancies, including chemotherapy, targeted therapy, immunotherapy and radiotherapy, can suppress the immune system and lead to the development of severe complications of COVID-19 infection. The aim of this study was to determine the mortality of lung cancer (LC) patients, in whom the COVID-19 infection was confirmed during active antitumor treatment. Methods: This retrospective study was conducted at the Institute for Pulmonary Diseases of Vojvodina. All patients included in the study underwent active anticancer treatment at the time of diagnosis of COVID-19. SARS-CoV-2 infection was determined with polymerase chain reaction test (PCR). Patient data were collected using the institutional database and observed period was from November 20, 2020 to June 5, 2021. Statistical analysis of the derived patient?s data using the multivariate and univariate testing. Results: Out of total 828 observed COVID-19 hospitalized patients 81 were LC patient on active antitumor treatment. Patients were predominantly male (67.9%), smokers (55.6%), 66.47 years old (range 43-83). Majority of patients (50.6%) were Eastern Cooperative Oncology Group performance status (ECOG PS) 1 and 83.9% had at least one comorbidity. The most common comorbidities were arterial hypertension (66.7%), chronic obstructive pulmonary disease (COPD) (28.4%) and diabetes (21%). Obesity, congestive heart failure and other cardiovascular diseases were present in 11%, 6.2% and 7.4% of patients. The most common was adenocarcinoma (33.3%), followed by squamous (30.9%) and small-cell lung cancer (24.7%). Predominantly 63% of the patients were in stage III of disease and 33.3% were in stage IV. Metastases were most commonly present in the contralateral lung/pleura (14.8%), brain (6.2%), bone (3.7%) and liver (3.7%). Systemic anticancer therapy was applied in 37/81 patients (45.6%), chest radiotherapy in 35/81 (43.2%), concurrent chemoradiotherapy in 1/81 (1.2%) and other types of radiotherapy in 8/81 patients (9.87%). The most common forms of systemic therapy were chemotherapy (35.8%), immunotherapy (7.4%) and targeted therapy (2.4%) patients. Most common chemotherapy was cisplatin-based regiment applied in 34.6% of patients. The mortality from COVID-19 was 19.8%. The statistically significance in relation to the type of treatment was not observed (p = 0.973). Statistical significance was observed between mortality and ECOG PS (p = 0.011). Conclusions: LC patients are dependent on antitumor treatment and at the same time highly susceptible to potential infection. In this study we did not find statistically significant differences in mortality related to the type of antitumor treatment in COVID-19 positive LC patients. Further detailed research on larger scale is needed to be performed in order to explore the effects of SARS-CoV-2 on cancer patients. All possible methods of protection against SARS-CoV-2 virus should be performed in order to minimize the risk of infection in all but especially in immunocompromised cancer patients.