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COVID-19 among lung cancer patients: Data from a real-life prospective French multicentric study - 07/06/24

Doi : 10.1016/j.resmer.2024.101093 
O. Molinier a, , J. Pinsolle b, A. Bizieux Thaminy c, S. Schneider d, B. Godbert e, L. Portel f, F. Hugues g, C. Dayen h, J. Obert i, C. Dujon j, P. Dumont k, S. Julien l, N. Meyer m, A. Letierce n, H. Morel o, D. Debieuvre p

On behalf of the Study Group KBP-2020-CPHG

a Respiratory Medicine Department, Centre Hospitalier Le Mans, Le Mans, France 
b Respiratory Medicine Department, Centre Hospitalier Métropole Savoie, Aix-les-Bains, France 
c Respiratory Medicine Department, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France 
d Respiratory Medicine Department, Centre Hospitalier de la Côte Basque, Bayonne, France 
e Respiratory Medicine Department, Hôpital Robert Schuman - UNEOS, Metz, France 
f Respiratory Medicine Department, Centre Hospitalier Robert Boulin, Libourne, France 
g Respiratory Medicine Department, Centre Hospitalier de Polynésie française, Papeete, France 
h Respiratory Medicine Department, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France 
i Respiratory Medicine Department, Groupe Hospitalier Intercommunal Le Raincy Montfermeil, France 
j Respiratory Medicine Department, Centre Hospitalier de Versailles, Versailles, France 
k Respiratory Medicine Department, Centre Hospitalier de Chauny, Chauny, France 
l Respiratory Medicine Department, Centre Hospitalier Rodez, Rodez, France 
m Biostatistician, Public Health Department, CHU de Strasbourg, GMRC, Strasbourg, France 
n Biostatistician, QualityStat, Morangis, France 
o Respiratory Medicine Department, Centre Hospitalier Régional D'Orléans Hôpital de La Source, Orléans, France 
p Respiratory Medicine Department, Hospital Group of the Mulhouse Sud-Alsace Region, Emile Muller Hospital, Mulhouse, France 

Corresponding author at: Respiratory Medicine Department, Centre Hospitalier Le Mans, 194 Av. Rubillard 72037 Le Mans, France.Respiratory Medicine DepartmentCentre Hospitalier Le Mans194 Av. RubillardLe Mans72037France

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Highlights

The incidence of COVID-19 was higher in former smokers, specific histological subgroups, PS score ≥2 vs 0- and in stages III-IV vs I-II patients.
In our cohort, the incidence COVID-19 was lower in active smokers, compared to former smokers and the chemotherapy had no impact.
In 2020, COVID-19 had a major impact on mortality of LC patients with the risk of death being more than four times that of the population non-COVID-19.

El texto completo de este artículo está disponible en PDF.

Summary

Background

COVID-19 started to spread early in 2020, the precise year that lung cancer (LC) patients were recruited into the prospective epidemiological cohort KBP-2020-CPHG in French hospitals. This provides a unique opportunity to study COVID-19 incidence, survival risk factors, and overall prognosis.

Methods

COVID data was collected before vaccination was made available. Clinical characteristics were compared (COVID vs non-COVID), incidence rate ratios were calculated based on clinical characteristics, survival (1 and 3 months) was estimated and the impact of COVID-19 on the overall prognosis of the cohort was studied.

Results

In 2020, 285 out of 8,999 lung cancer patients were diagnosed with COVID-19. Diagnosis was mainly based on PCR tests (86.3 %). The annual incidence was 8.3 % (95 % CI [7.4, 9.3]); it was higher in former smokers and patients with squamous cell carcinoma or small cell carcinoma than in those with adenocarcinoma, in those with a PS score ≥2 versus 0–1, and with stages III-IV versus stages I-II. The incidence was reduced in patients who received chemotherapy or immunotherapy. 64.9 % of patients were hospitalized due to COVID-19. Risk factors for death at 1 and 3 months in COVID-19 patients were age, LC stage, and PS score. Multivariate analysis showed a major prognostic impact of COVID-19 on mortality of LC patients (hazard ratio: 4.12, 95 % CI [3.42, 4.97], p < 0.001).

Conclusions

This prospective study demonstrated the high incidence of COVID-19 in LC patients and identified as risk factors for COVID-19: smoking status, histology, PS, and stage. The impact of COVID-19 on lung cancer mortality appears major.

El texto completo de este artículo está disponible en PDF.

Keywords : Lung cancer, Covid, Mortality, Stages


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