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Longitudinal analysis of biochemical and haematological features of cancer patients with COVID-19
Tivey, Ann Shotton, R. Lee, Rebecca J Zhou, Cong Banfill, Kathryn Hague, Christina Gomes, Fabio Weaver, Jamie M Armstrong, Anne C Cooksley, Timothy J
Tivey, Ann
Shotton, R.
Lee, Rebecca J
Zhou, Cong
Banfill, Kathryn
Hague, Christina
Gomes, Fabio
Weaver, Jamie M
Armstrong, Anne C
Cooksley, Timothy J
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Abstract
Background: Cancer patients (pts) are at increased risk of severe COVID-19 infection
and death. Older pts, men and those with haematological malignancies and receiving
anti-tumour therapy within 14 days appear to be at highest risk for poor outcomes. In
general populations, severe COVID-19 infection has been associated with neutrophilia,
raised lactate dehydrogenase (LDH) and C-reactive protein (CRP). Cancer and
its treatment affect many haematological and biochemical parameters.We examined
whether COVID-19 infection affected these compared to pts’ baseline parameters by
longitudinal tracking. We also investigated whether changes were associated with
poor outcome.
Methods: Consecutive pts with solid or haematological malignancies presenting with
index symptoms and testing positive for SARS-CoV-2 at a tertiary oncology centre
were identified following institutional board approval. Clinical and laboratory data
were extracted from the pt record. Paired T-tests were used for longitudinal sampling
and ANOVA/Chi squared for outcomes.
Results: 52 pts tested positive (27 male, 25 female; median age 63). 80.5% had solid
cancers, and 19.5% haematological. 31/52 pts were lymphopenic prior to infection.
Comparing mean pre-infection counts (6 months-14 days¼PRE) with mean counts
from the 5 days following positive test (DURING) lymphocyte counts significantly
decreased during infection (p<0.0001). Platelets were significantly reduced DURING
vs. PRE COVID-19 (p¼0.0028). 17/52 pts developed transient (median 2 days) neutropenia
(<2x109/L) DURING infection (6 pts <1x109/L, 2 pts <0.5x109/L), 8/17
attributed to cancer/cancer therapy, the rest had no underlying cause. 8/17 pts
received growth factor support. Reduced lymphocytes/neutrophils/platelets at diagnosis
were not associated with oxygen requirement (O2) or death. Different CRP
trajectories were observed when comparing pts grouped by discharge/ O2/death.
Higher CRP and LDH at diagnosis were associated with admission (p¼0.02 CRP/0.2
LDH), O2 (p¼0.0002 CRP/p<0.01 LDH) and death (p¼0.069 CRP/p¼0.04 LDH).
Updated analysis will be presented.
Conclusions: Infection with SARS-CoV-2 commonly affects haematological parameters
in cancer pts. High CRP and LDH are associated with poor outcomes.
Description
Date
2020
Publisher
Collections
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Keywords
Type
Meetings and Proceedings
Citation
Tivey A, Shotton R, Lee R, Zhou C, Banfill K, Hague C, et al. 1722P Longitudinal analysis of biochemical and haematological features of cancer patients with COVID-19. Annals of Oncology. 2020;31:S1011-S.