Lung Cancer and Severity of COVID-19: Experience From MSK
Posted: Tuesday, November 3, 2020
According to research published in the Annals of Oncology, patients with lung cancer who contract COVID-19 may experience increased severity of the effects of the virus. However, Matthew D. Hellmann, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York, and colleagues, noted that levels of severity seem to be more closely associated with patient-specific characteristics than cancer-specific or treatment-specific features.
The study included 102 patients with lung cancer who had confirmed COVID-19 and received treatment at MSK between March 12, 2020, and May 6, 2020. Most patients experienced severe COVID-19, including 62% who required hospitalization, and 25% who died. Among those who required admission to an intensive care unit (21%), 14% recovered, and 72% died. The most common symptoms included cough (70%) and fever (59%), although a wide variety of symptoms was reported across all patients. Overall, most patients did recover from COVID-19, including 25% of those who had been intubated. Hydroxychloroquine was not found to improve outcomes for hospitalized patients.
Patient-specific characteristics, such as smoking status and chronic obstructive pulmonary disease, were found to be determinants of COVID-19 severity [odds ratio for severe COVID-19 = 2.9, 95% confidence interval = 1.07–9.44 comparing the median (23.5 pack-years) to never-smoker and 3.87, 95% confidence interval = 1.35–9.68, respectively]. Other determining factors were age, hypertension, and congestive heart failure.
Features specific to cancer type and treatment type, including prior thoracic surgery, radiation therapy, recent therapies, histology, and PD-L1 immunohistochemistry expression, were not found to affect COVID-19 severity. There was no significant difference in human leukocyte antigen supertypes in patients with mild versus severe COVID-19. COVID-19–related deaths in patients included in this study accounted for 11% of total deaths in patients with lung cancer at MSK during this pandemic.
Disclosure: For full disclosures of the study authors, visit annalsofoncology.org.