How does COVID-19 affect patients with cancer undergoing chemotherapy?

This study examined how COVID-19 infection affects patients with cancer undergoing chemotherapy and the role of other factors in COVID-19 complications. The results showed that patients with advanced age and other medical conditions had a higher risk of COVID-19 complications but chemotherapy treatment did not need to be stopped.

The spread of COVID-19 puts certain members of the population at a high risk of health complications and death. Patients with cancer receiving treatments are considered high-risk as many treatments, such as chemotherapy, weaken patients’ immune systems. It is unclear, however, if the benefit of chemotherapy outweighs the risk if a patient develops COVID-19 infection.

Data from 800 patients with cancer receiving chemotherapy and symptoms for COVID-19 infection were analyzed. 

52% of patients were diagnosed with mild COVID-19 infection and 12% of patients did not need to be admitted to hospital. 39% of the patients required oxygen due to breathing difficulties. 7% of patients were treated in intensive care. 

28% of the patients passed away. Of these, COVID-19 was the cause of death in 93% of patients. The patients who passed away were significantly older than those who were discharged from the hospital. The average age of patients who were discharged was 66. Patients who passed away were 73 years on average.

Other factors that were associated with increased mortality risk from COVID-19 infection were male sex and additional medical conditions. 21% of patients who passed away had heart disease compared to 11% of patients who were discharged. 41% of patients who passed away had high blood pressure compared to 27% of patients who were discharged. 

The major COVID-19 symptom that developed in patients who passed away was shortness of breath (57%), which was less common in those discharged (32%). 

Overall, 22% of patients had their treatments stopped during the pandemic. The mortality rate was similar between patients who received chemotherapy while having COVID-19 (27%) and those that did not receive chemotherapy (29%). Patients who were also receiving immunotherapy, hormonal therapy, radiotherapy, or targeted therapy did not have a higher risk of death compared to those only receiving chemotherapy.

The authors concluded that factors such as older age and additional heart disease increased the risk of complications from the COVID-19 infection but that chemotherapy treatment did not need to be stopped in patients with cancer.

COVID-19 is a relatively new disease and recommendations may change as we learn more about it. In cases where chemotherapy was stopped, this may have been for reasons other than COVID-19 and this may have affected results.