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      Outcomes of novel coronavirus disease 2019 (COVID‐19) infection in 107 patients with cancer from Wuhan, China

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          Abstract

          Background

          Patients 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.

          Methods

          The 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.

          Results

          A 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]).

          Conclusions

          The 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.

          Abstract

          Patients with cancer who are receiving anticancer treatment have a 3‐fold higher risk of death from coronavirus disease 2019 (COVID‐19) than those on follow‐up. The authors report that this detrimental effect on survival appears to be independent of anticancer treatment modalities.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Chaolin Huang, Yeming Wang, Xingwang Li … (2020)
          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

              Dawei Wang, Bo Hu, Fangfang Zhu … (2020)
              In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
              Article 0 comments Cited 10773 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yahua Zhong: chxie_65@whu.edu.cn , melvin.chua.l.k@singhealth.com.sg , wangxinghuan@whu.edu.cn , doctorzyh73@163.com
                Xinghuan Wang: wangxinghuan@whu.edu.cn
                Melvin L. K. Chua:
                ORCID: https://orcid.org/0000-0002-1648-1473
                melvin.chua.l.k@singhealth.com.sg
                Conghua Xie:
                ORCID: https://orcid.org/0000-0001-6623-9864
                chxie_65@whu.edu.cn
                Journal
                Journal ID (nlm-ta): Cancer
                Journal ID (iso-abbrev): Cancer
                Journal ID (doi): 10.1002/(ISSN)1097-0142
                Journal ID (publisher-id): CNCR
                Title: Cancer
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0008-543X
                ISSN (Electronic): 1097-0142
                Publication date (Electronic): 23 June 2020
                Electronic Location Identifier: 10.1002/cncr.33042
                Affiliations
                [ 1 ] Department of Radiation and Medical Oncology Zhongnan Hospital of Wuhan University Wuhan China
                [ 2 ] Hubei Key Laboratory of Tumor Biological Behaviors Hubei Cancer Clinical Study Center Wuhan China
                [ 3 ] Convalife (Shanghai) Company Ltd Shanghai China
                [ 4 ] Department of Oncology Fifth Hospital of Wuhan Wuhan China
                [ 5 ] Department of Infection Seventh Hospital of Wuhan Wuhan China
                [ 6 ] Department of Oncology Han Kou Hospital of Wuhan Wuhan China
                [ 7 ] Center for Evidence‐based and Translational Medicine Zhongnan Hospital of Wuhan University Wuhan China
                [ 8 ] Department of Urology Zhongnan Hospital of Wuhan University Wuhan China
                [ 9 ] Division of Radiation Oncology National Cancer Center Singapore Singapore Singapore
                [ 10 ] Division of Medical Sciences National Cancer Center Singapore Singapore Singapore
                [ 11 ] Oncology Academic Programme Duke‐NUS Medical School Singapore Singapore
                Author notes
                [*] [* ] Corresponding Authors: Conghua Xie, MD, PhD, Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Rd, Wuchang District, Wuhan, Hubei Province, 430071 China ( chxie_65@ 123456whu.edu.cn ); Melvin L. K. Chua, MBBS, FRCR, PhD, Division of Radiation Oncology, National Cancer Center Singapore, 11 Hospital Crescent, Singapore 169610 ( melvin.chua.l.k@ 123456singhealth.com.sg ); Xinghuan Wang, MD, PhD, Department of Urology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Rd, Wuchang District, Wuhan, Hubei Province, 430071 China ( wangxinghuan@ 123456whu.edu.cn ); and Yahua Zhong, MD, PhD, Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Rd, Wuchang District, Wuhan, Hubei Province, 430071 China ( doctorzyh73@ 123456163.com ).

                Author information
                https://orcid.org/0000-0002-1648-1473
                https://orcid.org/0000-0001-6623-9864
                Article
                Publisher ID: CNCR33042
                DOI: 10.1002/cncr.33042
                PMC ID: 7361610
                PubMed ID: 32573776
                SO-VID: 5af0c45b-dac9-4f7b-81d8-4ffc2b6c3344
                Copyright © © 2020 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 24 March 2020
                Date revision received : 02 May 2020
                Date accepted : 14 May 2020
                Page count
                Figures: 2, Tables: 4, Pages: 9, Words: 12319
                Funding
                Funded by: Health Commission of Hubei Province Medical Leading Talent Project
                Award ID: 2042018kf1037
                Award ID: 2042019kf0329
                Funded by: Health Commission of Hubei Province Scientific Research Project
                Award ID: WJ2019H002
                Categories
                Subject: Original Article
                Subject: Original Articles
                Subject: Discipline
                Subject: Medical Oncology
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:15.07.2020

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: anticancer treatment,cancer,case fatality rate,coronavirus disease 2019 (covid‐19),systemic therapy
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: anticancer treatment, cancer, case fatality rate, coronavirus disease 2019 (covid‐19), systemic therapy

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