90‐day mortality and clinical outcomes of patients with solid tumours and COVID‐19 infection during the first pandemic outbreak in Catalonia, Spain: a multicentre retrospective study

To describe the clinical outcomes and risk factors for 90-day mortality in patients with solid tumours (ST) and COVID-19 during the first outbreak in Catalonia. This is a multicentre retrospective study including adults with ST and COVID-19 confirmed by RT-PCR between March 13 and April 30, 2020. Clinical and survival data were collected. Follow-up ended on July 30, 2020. Multivariate and survival analysis were performed. A hundred and fifteen patients were included. 42.6% had advanced disease and were receiving anticancer treatment. 7% were admitted to the ICU and 22.6% died during hospitalization. 30-day mortality was 27.8%, which increased to 33.9% at 90 days. 90-day mortality was associated with current smoker status (HR: 2.91, 95% CI: 1.03-8.33, p=0.044), baseline ECOG-PS 2-3 (HR: 3.88, 95% CI: 1.77-8.46, p<0.001]), dyspnoea (HR: 3.02, 95%CI: 1.31-6.96, p= 0.009), a respiratory rate ≥24 (HR: 2.24, 95% CI: 1.02-4.92, p=0.046), and sepsis (HR: 3.97, 95% CI: 1.78-8.88, p<0.001). Of the 76 survivors, 73.6% had a follow-up visit. Of those, 33.9% had their cancer controlled and 23.2% had progressed. 35 survivors were receiving anticancer treatment before COVID-19 diagnosis though 14 had to discontinue treatment. 8 survivors without previous anticancer therapy started therapy. The median time to start anticancer therapy after COVID-19 was 45 days (IQR: 28-61). In conclusion, 90-day mortality in patients with ST and COVID-19 was 33.9%; current smoker status, poor ECOG-PS, dyspnoea, respiratory rate ≥24 and sepsis were independent risk factors for mortality; and survivors did not restart their anticancer treatment until 1.5 months after COVID-19 diagnosis.

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