演題番号 : O8-3
Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an international outbreak of Coronavirus Disease 2019 (COVID-19), there is still insufficient data on the clinical characteristics and the mortality risk in cancer patients. In particular, details of the viral shedding period and its association with chemotherapy have not been well described. The aim of this study was to evaluate the clinical characteristics and outcomes including mortality and viral shedding period in COVID-19 patients with cancer in Japan.
We retrospectively analyzed 32 patients with a history of cancer out of 235 COVID-19 patients who were referred to our hospital between January 31, 2020 and May 25, 2020. We evaluated the association between the clinical outcomes and potential prognostic factors using univariate analyses.
The median age was 74.5 (range, 24-90) years and 22 patients (69%) were male. A total of 11 patients (34%) died. Our analyses demonstrated that the mortality was significantly associated with lymphocyte count, albumin, lactate dehydrogenase and C-reactive protein on admission. The median period between the illness onset and the first effective negative SARS-CoV-2 PCR result was 22 days (IQR, 18-25) in survivors. Of four patients with hematological malignancy who developed COVID-19 within the rest periods of chemotherapy, three died and the other one, who received bendamustine plus rituximab therapy, recoded the longest duration of viral shedding (56 days).
Our study suggested that risk factors for mortality previously reported in general COVID-19 patients, including lymphocytopenia, were also effective in cancer patients. Patients who received cytotoxic chemotherapy recently or were treated with chemotherapy that can lead to lymphocyte reduction were found to have poor prognosis and prolonged viral shedding periods.