Lung cancer patients have high mortality rate with COVID-19

Lung cancer

By Michael Woodhead

16 Sep 2020

Prof Jan van Meerbeeck

People with thoracic cancers are at higher risk of death from COVID-19 with one in three dying, according to the latest data from the international TERAVOLT registry.

Presenting an update of COVID-19 outcomes for 1053 patients with a range of lung cancers  at ERS 2020, Professor Jan van Meerbeeck, Head of Department of Pulmonology, Antwerp University, said the latest results confirmed preliminary findings about prognostic risk factors but also provided some  surprising results.

The all-cause mortality rate was 35.5% for all thoracic cancers and mortality rates appeared to be highest for patients with mesothelioma (45%) and SCLC (41%), he told the meeting.

Overall hospitalisation rates were 78% for COVID-19 patients with thoracic cancers, and 8.3% required ICU admission.

The cohort consisted of a mainly European population, mean age 68 years, of whom 82% had NSCLC and 58% had stage 4 disease. The most common COVID-19-related complications were pneumonitis and pneumonia (39%).

Most of the patients (74%) were on active therapy at the time of COVID-19 diagnosis, but in multivariate analysis, chemotherapy was not associated with any increased risk of worse outcome. Similarly steroids and anticoagulants were also not associated with poor outcomes, said Professor van Meerbeeck.

Interestingly, immunotherapy appeared to be protective against poor outcomes, with an odds ratio of 0.6, he noted. In addition to age, the main prognostic factors for poor outcome were performance status (odds ratio 3.7), smoking (OR 2.0) and disease stage (OR 1.9).

Professor van Meerbeeck said the results confirmed that patients with lung cancers had much poor outcomes from COVID-19 compared to patients with other cancers (mortality rates 13% – 28% and the general community (1.8% – 7.2%).

The findings represented the most up-to-date figures from the TERAVOLT registry, with a cutoff of submissions of 20 August 2020.

Ongoing analysis of the TERAVOLT registry data, which is still accepting submissions, would provide thoracic physicians “with real time data on therapeutic strategies that may impact survival,” he concluded.

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