COVID-19 and Thoracic Cancer: First Results From TERAVOLT
Posted: Friday, August 28, 2020
According to a preliminary analysis of data from the ongoing TERAVOLT registry, patients with thoracic cancer and COVID-19 infection have high rates of mortality and low rates of admission to intensive care units. However, it remains to be seen whether outcomes could be improved with treatment in intensive care for these patients. Leora Horn, MD, of Vanderbilt-Ingram Cancer Center in Nashville, and colleagues, reported these findings in The Lancet Oncology.
A total of 200 patients with thoracic cancer and COVID-19 were included in this multicenter, international analysis. The majority of patients were current or former smokers, with non–small cell lung cancer, and on therapy at the time of diagnosis. The median age of patients was 68 years.
Of the patients included in the analysis, 152 were hospitalized, and 66 died. Of the hospitalized patients, 134 (88%) met criteria for intensive care unit admission, although just 13 (10% of eligible patients) were actually admitted. Of the patients who died and for whom data were available, 52 died in the hospital, 8 died in the intensive care unit, and 3 died at home. Multivariable analysis showed that smoking history was associated with an increased risk of death.
The principal reason cited for patients not being admitted to the intensive care unit was a lack of indication. The authors suggested the reason for that may have been one of the following situations: mild or moderate COVID-19 symptoms, underlying cancer diagnosis, physician recommendation against escalation due to COVID-19 severity, or institutional policy concerning patients with lung cancer.
“At this time, it is not clear if intubation and more aggressive care in patients with cancer could improve COVID-19–specific survival,” the authors concluded. “In the absence of clear data, the integration of patients’ preferences could provide a benefit, especially in decisions in which uncertainty is high.”
Disclosure: For full disclosure of the study authors, visit thelancet.com.