key: cord-0947024-4w1l82wm authors: Cui, W.; Yousaf, N.; Bhosle, J.; Minchom, A. R.; Ahmed, M.; McDonald, F.; Locke, I.; Lee, R.; O'Brien, M.; Popat, S. title: Real-world outcomes in thoracic cancer patients (pts) with severe acute respiratory syndrome coronavirus 2 (COVID-19): Single UK institution experience date: 2020-09-30 journal: Annals of Oncology DOI: 10.1016/j.annonc.2020.08.1812 sha: 7f67a2164af04933bbd0b7101a59bf7f37b27b55 doc_id: 947024 cord_uid: 4w1l82wm nan Results: A total of 337 pts with solid tumors treated with anti-PD1/PDL-1 antibody regardless the line of treatment was identified. Cancer diagnosis included 156 (46,3%) lung, 74 (22%) melanoma, 36 (10,7%) kidney, 23 (7%) colorectal, 12 (3,4%) head and neck, 36 (10,6%) miscellaneous. Only 3 pts (0.9%), with advanced disease and in first line therapy were hospitalized for COVID-19 (Table) . The onset symptom was fever in 2 pts, and subjective dyspnea in 1 pt. Subsequently, they develop respiratory distress and underwent to non-invasive assisted ventilation, receiving hydroxychloroquine, steroids, low molecular weight heparin. Tocilizumab was administered in 1 pt due to progressive increase of serum IL-6 values. Nobody was admitted in Intensive Care Unit. Since the last update, May 15 th 2020, 1 pt died; the others have recovered with negative nasopharyngeal swab. Conclusions: Although not conclusive, in our series, cancer pts infected by COVID-19 receiving immunotherapy do not appear to be exposed to greater risk of recovery. Legal entity responsible for the study: Angela Damato. Funding: Has not received any funding. Methods: Medical records from 299 breast cancer patients who started neo/adjuvant chemotherapy from January/2018 at the Hospital das Clínicas de Ribeirão Preto e USP (HCRP-USP) were retrospectively analyzed, with a total of 2,003 cycles. Clinical data, treatment information and outcomes were collected; COVID-19 pandemic period (CPP) (Mar/2020-Apr/2020) was compared to pre-pandemic period (PPP) (Jan/ 2018-Feb/2020). Results: The mean number of neo/adjuvant chemotherapy cycles prescribed monthly and the mean number of treatments initiated monthly during CPP, respectively, 76 (AE 9) and 10.5 (AE 2.1) were similar to PPP, respectively, 77 (AE12; p¼ 1) and 10.7 (AE3.5; p¼0.94). An average of 6.0% (AE 1.6%) of the patients who received chemotherapy sought emergency care monthly during CPP compared to 10.9% (AE 3.8%, p¼0.07) before the pandemic. Conclusions: According to ESMO recommendation, neo/adjuvant breast cancer treatments have been prioritized considering its curative benefit. During COVID-19 pandemic there seems to be no compromising in patient acceptance or medical recommendations at our institution. On the other hand, there was a trend to decrease the attendance in the emergency units, what could compromise treatment safety. Telemedicine and continuous monitoring could minimize unfavorable outcomes. Further analyzes to correlate the impact of the pandemic on the safety and efficacy of the treatment in this population will be completed soon. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Methods: Thoracic cancer pts diagnosed with COVID-19 (PCR, radiological or clinical) at a UK academic centre between March-May 2020 were included. Data were extracted from pts records. Demographics, treatment and outcomes are described. Results: 27 pts were included, 12 (44%) diagnosed by PCR, 4 (15%) radiologically and 11 (41%) clinically. 89% had advanced thoracic malignancies. Symptoms included dyspnoea (52%), cough (67%), fever (59%), fatigue (37%), confusion (22%), diarrhoea (11%), anosmia (7%). 14 (52%) patients were hospitalised (median 6d); 4 (15%) required intensive care (ICU), of which 3 died. 10 (37%) pts required oxygen, 4 (14%) required non invasive ventilation. No pts were intubated. Complications included pneumonia (26%), sepsis (11%) and ARDS (7%). 2 pts required home oxygen at discharge. 5 (19%) pts died; all were smokers. Median time from symptom onset to death was 10d (range 3-13). Cancer therapy was delayed or ceased in 11 (41%) patients. Conclusions: Despite UK patient shielding and risk-minimizing therapy modifications, the immediate morbidity from COVID-19 remains high in thoracic cancer pts. Rates of hospitalisation and treatment interruption were high. Although numbers were small, no deaths occurred in never smokers or pts on single modality therapy. Continued follow up is needed to better understand the direct and indirect impacts of COVID-19 on morbidity and subsequent mortality. Legal entity responsible for the study: The authors. Background: SARS-CoV-2 is a novel coronavirus that has been responsible for the largest pandemic in the last century: COVID-19. This disease has widely affected Spain with a high lethality in ancient patients (pts) and with comorbidities. Oncological pts were not an exception. We evaluated the association between COVID-19 mortality and clinical/ laboratory/radiological parameters in cancer pts from March to April 2020 at our institution. Past medical history and COVID-19-related parameters (symptoms, laboratory/x-ray findings and treatments) were retrospectively collected. Univariate analysis (UA) has been done using Fisher exact and U-Mann-Withney test for qualitative and quantitative variables, respectively. Multivariant analysis (MA) has been done using logistic regression. Results: Forty three hospitalized pts were diagnosed with COVID-19; 30 pts (69.8%) were symptomatic on admission and 13 pts (30.2%) were hospital-acquired cases. Median age was 68.8 AE 7.8 years. Most part of the pts had gastrointestinal (GI) (13; 30.2%), thoracic (Tx) (12; 27.9%) and breast (6; 14%) cancer. A higher prevalence of Tx tumours compared to our new pts prevalence is observed (9%). Fever was the most common symptom ( Conclusions: COVID-19 showed a relative higher incidence in pts with Tx and GI tumours. Some clinical and laboratory parameters were found to be predictive factors for mortality as previously reported in non-cancer pts. Further investigations with larger number of pts are needed. Legal entity responsible for the study: HM Hospitales. Funding: Has not received any funding. Background: Cancer patients are considered at higher risk of SARS-CoV-2 infection and more serious COVID-19 illness compared to the general population. We present the early results of the "onCOVID-19" study exploring the clinical course and outcomes of SARS-CoV-2 infection in patients affected by cancer. Methods: In this observational study, we collected clinical data from patients referred to our institution with histologically confirmed diagnosis of solid cancer and COVID-19 from Feb 1 to May 20,2020. COVID-19 diagnosis was laboratory or radiologically confirmed or clinically suspected for suggestive symptoms, including fever (>37,5 C) and/or respiratory tract symptoms. Univariate and multivariate analyses were performed to explore the risk factors associated with severe events defined as hospitalisation, admission to an intensive care unit, mechanical ventilation or death. Results: A total of 162 medical oncology patients had unscheduled admissions during this period. Over half (57%) were receiving anticancer systemic treatment. The most common presenting complaints were pain (21%), pyrexia (17%) and dyspnoea (14%). The underlying diagnosis was cancer-related in 51%, treatment-related toxicity in 10% and non-cancer related in 39%. One patient was CoV positive. Unscheduled hospital admissions, source of admission and aLOS are outlined in the Table. . Conclusions: A reduction in aLOS and ED admissions was paralleled by increasing use of alternative pathways. Processes which facilitate urgent assessment of oncology patients in specialized units avoid ED attendance and accelerate discharge planning in the care of cancer patients in the face of a pandemic and beyond. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest. https://doi.org/10.1016/j.annonc.2020.08.1815 Out 26 (74%) patients on active anti-tumor treatment, 6 (23%) received immune checkpoint inhibitors (ICI) The diagnosis of COVID-19 was only clinically suspected in 2 (6%) cases and confirmed by RT-PCR or imaging (ground glass opacity and/or patchy consolidation) in 11 (31%) and 31 (88%) patients, respectively. An antimicrobial treatment was administered in 19 patients. Eleven (31%) patients had severe events, death occurred in 7 (20%) cases. Higher risk for developing severe events was associated with active treatment with ICI Although the sample size was small, treatment with ICI and lymphopenia seem to be risk factors for death and severe events. Screening cancer patients for infection is advisable, in particular before starting immunotherapy or in case of lymphopenia. Legal entity responsible for the study: The authors. Funding: Has not received any funding 1751P Lessons from a pandemic: An audit of acute medical oncology admissions during SARS-CoV-2 outbreak The first community acquired case in Ireland was reported March 5th. The World Health Organisation declared CoV a pandemic March 11th. Lockdown measures were implemented in Ireland Data was organised into 3 phases: four week period prior to a confirmed case of CoV in Ireland (phase I), four week period from confirmed case to lockdown implementation (phase 2) and four week period during lockdown (phase 3)