New data show patients with thoracic cancers who were infected by SARS-CoV-2 (COVID-19) suffered a high death rate of 33%. The findings were published in The Lancet Oncology. The data came from TERAVOLT, a consortium that specifically tracks outcomes of people with thoracic cancer who developed the novel respiratory virus.
While the majority of those who died were hospitalized, only 9% were admitted to intensive care units, according to a study published in The Lancet Oncology. Most died from complications of COVID-19, not the progression of cancer.
“Just having a lung cancer diagnosis in and of itself shouldn’t exclude patients from care,” said Leora Horn, MD, MSc, Ingram Associate Professor of Cancer Research at Vanderbilt-Ingram Cancer Center, who is a senior author of the study and a TERAVOLT consortium steering committee member in a press release.
The study is based on the first 200 patients for which TERAVOLT received outcomes data. Of the 152 hospitalized patients, 134 or 88% met the criteria for ICU admission, but only 13 of those patients were admitted to an ICU. Only 5 were mechanically ventilated. “We tried to capture the reasons for the lack of ICU admission,” the authors noted in the study. “Difficult decisions were made limiting ICU admissions to cancer patients and others with terminal illness due to equipment and personnel shortages. However, we are aware that behind these choices there may also be patients’ decisions, cultural and institutional choices that our work is unable to properly capture.” “Not all lung cancer patients are at risk for hospitalization,” Horn said.
That data revealed that patients treated with chemotherapy within three months of a COVID-19 diagnosis had a significantly increased risk of 64% of dying from the coronavirus. Patients treated with anticoagulants to prevent blood clots and corticosteroids to reduce inflammation also had a greater mortality risk. Patients treated with immunotherapies had no increased risk of mortality.
The authors noted, according to the release, that at this point it remains unclear if intubation and more aggressive care could improve survival for people with thoracic cancers sickened by COVID-19, but the integration of patients’ preferences could provide guidance for clinicians while uncertainty is high.