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Research article
Yanxia Zhao
Wuhan Union Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4609-4298
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The COVID-19 pandemic is a significant worldwide health crisis. Patients with malignancy are considered at substantially increased risk of infection and poor outcomes. Breast cancer patients with COVID-19 represent an urgent clinical need. This study aimed to identify clinical characteristics of breast cancer patients with COVID-19 and risks associated with anti-cancer treatment.
Methods: This multicenter retrospective cohort study included 45 breast cancer patients with laboratory-confirmed COVID-19 at seven designated hospitals in Hubei, China. The medical records of breast cancer patients were collected from the records of 9559 COVID-19 patients from 13th January, 2020 to 18th March, 2020. Univariate and multivariate analyses were performed to assess risk factors for COVID-19 severity.
Results: Of 45 breast cancer patients with COVID-19, 33 (73.3%) developed non-severe COVID-19, while 12 (26.7%) developed severe COVID-19, of which 3 (6.7%) patients died. The median age was 62 years, and 3 (6.7%) patients had stage IV breast cancer. Most patients developed fever (37, 82.2%), and most had bilateral lung involvement on chest CT (36, 80.0%). Univariate analysis showed the age over 75 and Eastern Cooperative Oncology Group (ECOG) score were associated with COVID-19 disease severity (P<0.05). Multivariate analysis showed patients received chemotherapy within 7 days had a significantly higher risk for severe COVID-19 (logistic regression model: RR=13.886, 95% CI 1.014-190.243, P=0.049; Cox proportional hazards model: HR=13.909, 95% CI 1.086-178.150, P=0.043), with more pronounced neutropenia and higher LDH, CRP and procalcitonin levels than patients else (P<0.05).
Conclusions: The severity of COVID-19 in breast cancer patients was associated with baseline factors of the age over 75 and ECOG score, but not with tumor characteristics. Chemotherapy within 7 days before symptom onset was a risk factor for severe COVID-19, reflected by neutropenia and elevated LDH, CRP and procalcitonin levels.
Keywords
COVID-19, breast cancer, retrospective study, anti-cancer treatment, chemotherapy
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This is a preprint. It has not completed peer review.
Research article
Yanxia Zhao
Wuhan Union Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4609-4298
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 18 Aug, 2020
No community comments so far
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The COVID-19 pandemic is a significant worldwide health crisis. Patients with malignancy are considered at substantially increased risk of infection and poor outcomes. Breast cancer patients with COVID-19 represent an urgent clinical need. This study aimed to identify clinical characteristics of breast cancer patients with COVID-19 and risks associated with anti-cancer treatment.
Methods: This multicenter retrospective cohort study included 45 breast cancer patients with laboratory-confirmed COVID-19 at seven designated hospitals in Hubei, China. The medical records of breast cancer patients were collected from the records of 9559 COVID-19 patients from 13th January, 2020 to 18th March, 2020. Univariate and multivariate analyses were performed to assess risk factors for COVID-19 severity.
Results: Of 45 breast cancer patients with COVID-19, 33 (73.3%) developed non-severe COVID-19, while 12 (26.7%) developed severe COVID-19, of which 3 (6.7%) patients died. The median age was 62 years, and 3 (6.7%) patients had stage IV breast cancer. Most patients developed fever (37, 82.2%), and most had bilateral lung involvement on chest CT (36, 80.0%). Univariate analysis showed the age over 75 and Eastern Cooperative Oncology Group (ECOG) score were associated with COVID-19 disease severity (P<0.05). Multivariate analysis showed patients received chemotherapy within 7 days had a significantly higher risk for severe COVID-19 (logistic regression model: RR=13.886, 95% CI 1.014-190.243, P=0.049; Cox proportional hazards model: HR=13.909, 95% CI 1.086-178.150, P=0.043), with more pronounced neutropenia and higher LDH, CRP and procalcitonin levels than patients else (P<0.05).
Conclusions: The severity of COVID-19 in breast cancer patients was associated with baseline factors of the age over 75 and ECOG score, but not with tumor characteristics. Chemotherapy within 7 days before symptom onset was a risk factor for severe COVID-19, reflected by neutropenia and elevated LDH, CRP and procalcitonin levels.
Figure 1
Figure 2
Figure 3
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