Clinical impact of COVID-19 in a single-center cohort of a prospective study in cancer patients receiving immunotherapy

Abstract

Aim: Evaluating the incidence and course of COVID-19 in cancer patients treated with immunotherapy. Patients & methods: We reported the influenza-like illness events with diagnosis of COVID-19 within the patient cohort enrolled in the prospective observational multicenter INVIDIa-2 study in the single center of Parma. Results: Among 53 patients, eight experienced influenza-like illness during the influenza season 2019/2020, and three of them had diagnosis of COVID-19. They were males, elderly, with cardiovascular disease. Radiological features of COVID-19 pneumonitis were found in all of three cases, although the pharyngeal swab resulted positive in only two. Two of these three patients died due to respiratory failure. Conclusion: Cancer patients are at high risk of severe events from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Keywords: COVID-19; SARS-CoV2; anti-PD-1; cancer patients; immune checkpoint inhibitors; immunotherapy; influenza vaccine; interstitial pneumonia.

Figure 1.. Flow diagram of the cases included in the present analysis according to the end points of interest.

ILI: Influenza-like illness.

Figure 2.. CT scan imaging of patients 1, 2 and 3.

Ground glass opacities, with peripheral and subpleural distribution, and the involvement of multiple lobes, mainly the lower lobes, are suggestive for COVID-19-related pneumonia. SARS-CoV-2 nasal-pharyngeal swab was positive in patients 1 and 2 and negative in patient 3.

Figure 3.. Clinical characteristics of COVID-related and not-COVID related influenza-like illness.

ILI: Influenza-like illness.