P09.35 COVID-19 in Patients with Lung Cancer – Experience from a Thoracic Oncology Center

Abstract

Introduction: Cancer patients appear to be at higher risk of complications from sars-cov-2 infection Specific data regarding lung cancer patients, on active treatment and/or recent diagnosis is limited Recent data suggests that a bad prognosis is associated with older age (>65 years-old), comorbidities, ECOG2, steroids (>10mg prednisolone), anticoagulants, chemotherapy and chemotherapy-immunotherapy With this study we aim to investigate the clinical presentation, baseline characteristics and outcomes of patients with lung cancer and Covid-19 Methods: A retrospective case study was carried out at Centro Hospitalar Universitário de São Joao (CHUSJ), a tertiary hospital in the Oporto region of Portugal Data from all patients from our center was evaluated, and lung cancer patients with covid19 diagnosis during the first 2 months of the Covid-19 pandemic in Portugal (March-April) were included Results: A total of 5 patients with active lung cancer had a diagnosis of Covid-19 at our center Adenocarcinoma was the histological type in all patients (n=5, 100%) Most had metastatic stage IV lung cancer (n=3;60,0%) Two patients (40,0%) had relevant comorbidities including HBP, Diabetes and Heart Failure due to heart valvular disease Of the patients on anti-neoplasic treatment, median time from the last chemotherapy administration to Covid-19 diagnosis was 4 days (min 4;max 39 days) Four patients (80,0%) were receiving corticosteroid therapy The most common symptoms were cough (n=4, 80,0%) and dyspnea (n=3, 60,0%) Lab results revealed neutrophilia in all patients (n=5, 100%), lymphopenia in 4 patients (80,0%), anemia in 4 patients (80,0%), leukocytosis in 2 patients (40,0%) An example of chest CT scan features is represented in the image attached All patients (n=5, 100,0%) were admitted to hospital and received oxygen therapy Two (40,0%) received HFNC with good tolerability and one (20,0%) NIV Two patients were admitted to Intensive Care Unit, with recovery No patient received mechanical ventilation or extracorporeal membrane oxygenation Empirical sars-cov-2 treatment with hydroxychloroquine was administered in most patients (n=4, 80,0%) and antibiotics in three (60,0%) Two of the patients had recent chemotherapy treatment (4 days before diagnosis), and later developed pancytopenia during the next days associated with clinical deterioration Three patients (60,0%) died after a median time of 5 days since Covid-19 diagnosis (min 2;max 16 days) [Formula presented] Conclusion: This study is one of the first to report outcomes that can be associated with Covid-19 in Lung Cancer patients and highlights the necessity to create protocols to reduce their susceptibility and bad outcomes in future waves of Covid-19 Keywords: lung cancer, Covid19, infection