Descriptive Comparative Analysis of Patients With Cancer Referring to the Emergency Department of an Italian University Hospital Across the Severe Acute Respiratory Syndrome Coronavirus 2 Waves.

Abstract

COVID-19 cancer patients (C19-CP) represent a population at high risk for mortality, whose clinical characteristics are still unknown in the second SARS-CoV-2 wave. The aim of this retrospective study was to compare epidemiology and clinical presentation of C19-CP referring to the emergency department (ED) of our institution (San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy), in a 3-week observation period of the first and second COVID-19 waves, starting from the introduction of the corresponding national lockdowns. We retrieved ED admissions from March 9 to 29, 2020, for the first wave, and from October 24 to November 13, 2020, for the second wave. We collected clinical characteristics of consecutive patients with molecularly confirmed SARS-CoV-2 infection. We also considered untested or SARS-CoV-2-negative cancer patients referring to the ED in the reference time frames. C19-CP in the second wave exceeded those in the first wave despite the nonsignificant difference (39 of 576 <i>v</i> 8 of 163; <i>P</i> = .5). Compared with nononcological patients, C19-CP were older (median age 70 years [interquartile range 61-77] <i>v</i> 60 years [interquartile range 45-73]; <i>P</i> = .02) and presented more often with ≥ 2 comorbidities (40.4% <i>v</i> 24.3%; <i>P</i> = .02). Compared with nononcological patients, in C19-CP, respiratory failure (29 of 47 <i>v</i> 321 of 692; <i>P</i> = .049) and hospitalization (37 of 47 <i>v</i> 363 of 692; <i>P</i> = .0004) were higher, with comparable frequencies across the waves. Five of 24 and 10 of 27 hospitalized cancer patients in the first and second waves developed SARS-CoV-2 infection during hospitalization. C19-CP were a vulnerable population, irrespective of the COVID-19 waves. This highlights the need to prioritize vaccinations in oncological patients to safeguard and guarantee optimal anticancer care.