ABCL-013: Factors Associated with SARS-CoV-2 Infection and Outcome in Patients with Solid Tumors or Hematological Malignancies: A Single-Center Study

CONTEXT: Immunocompromised cancer patients are presumed to be at high risk of developing COVID-19 infection. OBJECTIVE: Predisposing factors to contracting COVID-19 and to severe outcomes have been described in registries but were not compared between solid tumors and hematological malignancies. DESIGN: This retrospective study included patients from March 10 to May 18, 2020. SETTING: The study took place in a single oncologic tertiary center in Belgium. PATIENTS OR OTHER PARTICIPANTS: 212 adult patients with solid tumors or hematological malignancies referred to testing by naso-pharyngeal swab for a SARS-CoV-2 RT-PCR were included in the study. INTERVENTIONS: We collected data on demographics, symptoms, comorbidities, performance status, type and stage of cancer, anti-cancer treatment, blood work, imaging and outcome. MAIN OUTCOMES MEAUSRES: The primary endpoint was the incidence of COVID-19 among patients with concordant symptoms, close contact with a confirmed case or concordant imaging among patients with solid tumors or hematological malignancies. RESULTS: Among the 212 patients included in the study, 45 (21%) tested positive with SARS-CoV-2. The univariate analysis with positive SARS-CoV-2 PCR as a dependent variable reveals significant Odds Ratios (ORs) for age with a mean of 62.5 years - (OR: 1.05, 95% CI: 1.02-1.08), performance status ≥2 (OR: 2.38, 95% CI: 1.22-4.70), inpatient status (OR: 2.36, 95% CI: 1.11-4.91) and hematological malignancies (OR: 2.48, 95% CI: 1.23-4.96). In contrast, OR for solid tumors reveals a negative association (OR: 0.40, 95% CI: 0.20-0.81). When integrating severe outcome (ICU admission or COVID-19 related death) as a dependent variable, the univariate logistic regression model shows significant ORs for pre-existing lymphopenia (OR: 4.0, 95% CI: 1.17-15.04), hematological malignancies (OR: 3.73, 95% CI: 1.09-13.80), and a negative association for solid tumors (OR: 0.27; 95% CI: 0.07-0.92). CONCLUSIONS: In patients referred for SARS-CoV-2 testing, hematological malignancies were associated with a higher risk of COVID-19 infection and severe outcomes. Other factors were age, active chemotherapy treatment and inpatient status.