학술논문
COVID-19 in breast cancer patients: a cohort at the Institut Curie hospitals in the Paris area
Document Type
Academic Journal
Author
Vuagnat, Perrine; Frelaut, Maxime; Ramtohul, Toulsie; Basse, Clémence; Diakite, Sarah; Noret, Aurélien; Bellesoeur, Audrey; Servois, Vincent; Hequet, Delphine; Laas, Enora; Kirova, Youlia; Cabel, Luc; Pierga, Jean-Yves; Alimi, Aurélia; Belotti, Muriel; Bensaoula, Okba; Bertrand, Ophélie; Bilger, Geoffroy; Brain, Etienne; Brisse, Hervé; Buecher, Bruno; Chanas, Laetitia; Chapus, Caroline; Charles-Massar, Isabelle; Chérel, Pascal; Créhange, Gilles; Colas, Christelle; Delhomelle, Hélène; Frederic-Moreau, Thomas; Fourme, Emmanuelle; Fumoleau, Pierre; Gauthier-Villars, Marion; Lantz, Olivier; Lassalle, Sophie; Le Mentec, Marine; Lerebours, Florence; Loirat, Delphine; Minsat, Matthieu; Moreau, Pauline; de Pauw, Antoine; Priour, Maël; Reyal, Fabien; Rouzier, Roman; Saad, Mary; Saule, Claire; Sebbag, Clara; Stoppa-Lyonnet, Dominique; Tardivon, Anne; Takanen, Silvia; Vanjak, Dominique; Villy, Marie-Charlotte; Vincent-Salomon, Anne; Warcoin, Mathilde
Source
Breast Cancer Research. May 28, 2020, Vol. 22 Issue 1
Subject
Language
English
ISSN
1465-5411
Abstract
Author(s): Perrine Vuagnat[sup.1,2,3], Maxime Frelaut[sup.4], Toulsie Ramtohul[sup.5], Clémence Basse[sup.2,3], Sarah Diakite[sup.2,3], Aurélien Noret[sup.2,3], Audrey Bellesoeur[sup.2,3], Vincent Servois[sup.5], Delphine Hequet[sup.6], Enora Laas[sup.6], Youlia Kirova[sup.7], Luc Cabel[sup.2,3], Jean-Yves Pierga[sup.2,3,8], Aurélia Alimi, Muriel [...]
Background Cancer patients have been reported to be at higher risk of COVID-19 complications and deaths. We report the characteristics and outcome of patients diagnosed with COVID-19 during breast cancer treatment at Institut Curie hospitals (ICH, Paris area, France). Methods An IRB-approved prospective registry was set up at ICH on March 13, 2020, for all breast cancer patients with COVID-19 symptoms or radiologic signs. Registered data included patient history, tumor characteristics and treatments, COVID-19 symptoms, radiological features, and outcome. Data extraction was done on April 25, 2020. COVID-19 patients were defined as those with either a positive RNA test or typical, newly appeared lung CT scan abnormalities. Results Among 15,600 patients actively treated for early or metastatic breast cancer during the last 4 months at ICH, 76 patients with suspected COVID-19 infection were included in the registry and followed. Fifty-nine of these patients were diagnosed with COVID-19 based on viral RNA testing (N = 41) or typical radiologic signs: 37/59 (63%) COVID-19 patients were treated for metastatic breast cancer, and 13/59 (22%) of them were taking corticosteroids daily. Common clinical features mostly consisted of fever and/or cough, while ground-glass opacities were the most common radiologic sign at diagnosis. We found no association between prior radiation therapy fields or extent of radiation therapy sequelae and extent of COVID-19 lung lesions. Twenty-eight of these 59 patients (47%) were hospitalized, and 6 (10%) were transferred to an intensive care unit. At the time of analysis, 45/59 (76%) patients were recovering or had been cured, 10/59 (17%) were still followed, and 4/59 (7%) had died from COVID-19. All 4 patients who died had significant non-cancer comorbidities. In univariate analysis, hypertension and age (> 70) were the two factors associated with a higher risk of intensive care unit admission and/or death. Conclusions This prospective registry analysis suggests that the COVID-19 mortality rate in breast cancer patients depends more on comorbidities than prior radiation therapy or current anti-cancer treatment. Special attention must be paid to comorbidities when estimating the risk of severe COVID-19 in breast cancer patients. Keywords: SARS-CoV-2, COVID-19, Breast cancer, Outcome, Survival
Background Cancer patients have been reported to be at higher risk of COVID-19 complications and deaths. We report the characteristics and outcome of patients diagnosed with COVID-19 during breast cancer treatment at Institut Curie hospitals (ICH, Paris area, France). Methods An IRB-approved prospective registry was set up at ICH on March 13, 2020, for all breast cancer patients with COVID-19 symptoms or radiologic signs. Registered data included patient history, tumor characteristics and treatments, COVID-19 symptoms, radiological features, and outcome. Data extraction was done on April 25, 2020. COVID-19 patients were defined as those with either a positive RNA test or typical, newly appeared lung CT scan abnormalities. Results Among 15,600 patients actively treated for early or metastatic breast cancer during the last 4 months at ICH, 76 patients with suspected COVID-19 infection were included in the registry and followed. Fifty-nine of these patients were diagnosed with COVID-19 based on viral RNA testing (N = 41) or typical radiologic signs: 37/59 (63%) COVID-19 patients were treated for metastatic breast cancer, and 13/59 (22%) of them were taking corticosteroids daily. Common clinical features mostly consisted of fever and/or cough, while ground-glass opacities were the most common radiologic sign at diagnosis. We found no association between prior radiation therapy fields or extent of radiation therapy sequelae and extent of COVID-19 lung lesions. Twenty-eight of these 59 patients (47%) were hospitalized, and 6 (10%) were transferred to an intensive care unit. At the time of analysis, 45/59 (76%) patients were recovering or had been cured, 10/59 (17%) were still followed, and 4/59 (7%) had died from COVID-19. All 4 patients who died had significant non-cancer comorbidities. In univariate analysis, hypertension and age (> 70) were the two factors associated with a higher risk of intensive care unit admission and/or death. Conclusions This prospective registry analysis suggests that the COVID-19 mortality rate in breast cancer patients depends more on comorbidities than prior radiation therapy or current anti-cancer treatment. Special attention must be paid to comorbidities when estimating the risk of severe COVID-19 in breast cancer patients. Keywords: SARS-CoV-2, COVID-19, Breast cancer, Outcome, Survival