COVID-19 in breast cancer patients: a cohort at the Institut Curie hospitals in the Paris area

  1. Perrine Vuagnat
  2. Maxime Frelaut
  3. Toulsie Ramtohul
  4. Clémence Basse
  5. Sarah Diakite
  6. Aurélien Noret
  7. Audrey Bellesoeur
  8. Vincent Servois
  9. Delphine Hequet
  10. Enora Laas
  11. Youlia Kirova
  12. Luc Cabel
  13. Jean-Yves Pierga
  14. Institut Curie Breast Cancer and COVID Group
  15. Laurence Bozec
  16. Xavier Paoletti
  17. Paul Cottu
  18. François-Clément Bidard
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Abstract

Background

Cancer patients have been reported to be at higher risk of COVID-19 complications and deaths. We report the characteristics and outcome of patients diagnosed with COVID-19 during breast cancer treatment at Institut Curie hospitals (ICH, Paris area, France).

Methods

An IRB-approved prospective registry was set up at ICH for all breast cancer patients with COVID-19 symptoms or radiologic signs.

Results

Among 15,600 patients actively treated for early or metastatic breast cancer during the last 4 months at ICH, 76 patients with suspected COVID-19 infection were included in the registry and followed. Fifty-nine of these patients were diagnosed with COVID-19 based on viral RNA testing or typical radiologic signs: 37/59 (63%) COVID-19 patients were treated for metastatic breast cancer, and 13/59 (22%) of them were taking corticosteroids daily. Common clinical features mostly consisted of fever and/or cough, while ground-glass opacities were the most common radiologic sign at diagnosis. We found no association between prior radiation therapy fields or extent of radiation therapy sequelae and extent of COVID-19 lung lesions. Twenty-eight of these 59 patients (47%) were hospitalized and 6 (10%) were transferred to an intensive care unit. At the time of analysis, 45/59 (76%) patients were recovering or had been cured, 10/59 (17%) were still followed and 4/59 (7%) had died from COVID-19. All 4 patients who died had significant non-cancer comorbidities. In univariate analysis, hypertension and age (>70) were the two factors associated with a higher risk of intensive care unit admission and/or death.

Conclusions

This prospective registry analysis suggests that the COVID-19 mortality rate in breast cancer patients depends more on comorbidities than prior radiation therapy or current anti-cancer treatment. Special attention must be paid to comorbidities when estimating the risk of severe SARS-CoV-2 infection in breast cancer patients.

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