Cumulative COVID-19 incidence, mortality, and prognosis in cancer survivors: a population-based study in Reggio Emilia, Northern Italy
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
The aim of this population‐based study was to evaluate the impact of being a cancer survivor (CS) on COVID‐19 risk and prognosis during the first wave of the pandemic (27 February – 13 May 2020) in Reggio Emilia Province. Prevalent cancer cases diagnosed between 1996 and 2019 were linked with the provincial COVID‐19 surveillance system. We compared CS’ cumulative incidence of being tested, testing positive for SARS‐CoV‐2, being hospitalized, and dying of COVID‐19 with that of the general population; we compared COVID‐19 prognosis in CS and in patients without cancer.
During the study period, 15,391 people (1527 CS) underwent RT‐PCR for SARS‐CoV‐2, of whom 4541 (447 CS) tested positive; 541 (113 CS) died of COVID‐19. CS had higher age‐ and sex‐adjusted incidence rate ratios (IRR) of testing (1.28 [95%CI = 1.21, 1.35]), of positive test (IRR 1.06 [95%CI = 0.96, 1.18]), and of hospitalization and death (IRR 1.27 [95%CI = 1.09, 1.48] and 1.39 [95%CI = 1.12, 1.71], respectively). CS had worse prognosis when diagnosed with COVID‐19, particularly those below age 70 (adjusted odds ratio (OR) of death 5.03; [95%CI = 2.59, 9.75]), while the OR decreased after age 70. The OR of death was higher for CS with a recent diagnosis, i.e. <2 years (OR=2.92; 95%CI = 1.64, 5.21), or metastases (OR=2.09; 95%CI = 0. 88, 4.93).
CS showed the same probability of being infected, despite a slightly higher probability of being tested than the general population. Nevertheless, CS were at higher risk of death once infected.
International Journal of Cancer , résumé, 2020