Clinical profile and mortality of Sars-Cov-2 infection in cancer patients across two pandemic time periods (Feb 2020-Sep 2020; Sep2020- May 2021) in the Veneto Oncology Network: the ROVID study
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Introduction : We analyzed a cohort of consecutive patients with cancer and Sars-Cov-2 infection from the Veneto Oncology Network registry across two pandemic time periods.
Materials and methods : 761 patients with cancer and SARS-CoV-2 infection were included.
Results : 198 patients were diagnosed during the first pandemic time period (TP1; February 2020-mid September 2020), 494 during TP2 before the vaccination campaign (TP2/pre-vaccination; mid September 2020-21 February 2021) and 69 in TP2/post-vaccination (22 February 2021-15 May 2021).
TP2 vs TP1 patients were younger (p=0.004), showed more frequently a good performance status (p<0.001) and <2 comorbidities (p=0.002), were more likely to be on active anticancer therapy (p=0.006). Significantly fewer patients in TP2 (3-4%) vs TP1 (22%) had an in-hospital potential source of infection (p<0.001). TP2 patients were more frequently asymptomatic (p=0.003). Significantly fewer patients from TP2 were hospitalized (76% TP1, 38% TP2/pre-vaccination, 42% TP2/post-vaccination, p<0.001) or admitted to intensive care unit (5% TP1, 1% TP2/pre-vaccination, 0% TP2/post-vaccination, p=0.006).
All-cause mortality significantly decreased from 30.3% in TP1, to 8.9% and 8.7% in the two TP2 periods (p<0.001), reflected by a significant reduction in Sars-Cov-2-related mortality (15.2%, 7.5% and 5.8% in the three consecutive time periods, p=0.004).
Conclusions : Differences in clinical characteristics and features of Sars-Cov-2 infection between TP1 and TP2 reflect the effects of protective measures and increased testing capacity. The lower mortality in TP2 is in line with a less frail population. However, the vast majority of death events in TP2 were related to COVID-19, reinforcing the priority to protect cancer patients.
European Journal of Cancer , résumé, 2021