• Maria Madeleine Rüthrich, C Giessen-Jung, S Borgmann, A Y Classen, S Dolff, B Grüner, F Hanses, N Isberner, P Köhler, J Lanznaster, U Merle, S Nadalin, C Piepel, J Schneider, M Schons, R Strauss, L Tometten, J J Vehreschild, M von Lilienfeld-Toal, G Beutel, K Wille, and LEOSS Study Group.
• Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany. maria.ruethrich@med.uni-jena.de.
• Ann. Hematol. 2021 Feb 1; 100 (2): 383-393.

IntroductionSince the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk.Patients And MethodsWe retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality.ResultsIn total, 435 cancer patients were included in our analysis. Commonest age category was 76-85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable.ConclusionComparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.

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