Simple Summary The study investigated diagnostic, clinical and post-SARS-CoV-2 scenarios in cancer patients with SARS-CoV-2 aiming to improve management of SARS-CoV-2 infections and cancer afterwards. Around half of patients were initially asymptomatic and were diagnosed with SARS-CoV-2 during routine or contact tracing screening. Of them, 33% developed COVID-19 lately. Eventually, predominant part of patients had asymptomatic SARS-CoV-2 or mild COVID-19 course. Lymphocytopenia preceding SARS-CoV-2 was associated with a significantly increased risk for severe or critical COVID-19 course. Commonly patients experienced a treatment delay post-SARS-CoV-2; one fifth developed progressive disease (PD) within that time and/or had to undergo therapy modifications following deterioration of the performance status or PD post-COVID-19. This study provides knowledge of real-life clinical courses of SARS-CoV-2 in oncology and contributes to improving therapeutic strategies for cancer patients in the COVID-19 pandemic. Abstract Oncologists face challenges in the management of SARS-CoV-2 infections and post-SARS-CoV-2 cancer treatment. We analyzed diagnostic, clinical and post-SARS-CoV-2 scenarios in patients from three German cancer centers with RT-PCR confirmed SARS-CoV-2 infection. Sixty-three patients with SARS-CoV-2 and hematologic or solid neoplasms were included. Thirty patients were initially asymptomatic, 10 of whom developed COVID-19 symptoms subsequently. Altogether 20 (32%) patients were asymptomatic, 18 (29%) had mild, 12 (19%) severe and 13 (20%) critical courses. Lymphocytopenia increased risk of severe/critical COVID-19 three-fold ( p = 0.015). Asymptomatic course was not associated with age, remission status, therapies or co-morbidities. Secondary bacterial infection accompanied more than one third of critical COVID-19 cases. Treatment was delayed post-SARS-CoV-2 in 46 patients, 9 of whom developed progressive disease (PD). Cancer therapy was modified in 8 SARS-CoV-2 survivors because of deteriorating performance or PD. At the last follow-up, 17 patients had died from COVID-19 ( n = 8) or PD ( n = 9) giving an estimated 73% four-month overall survival rate. SARS-CoV-2 infection has a heterogenous course in cancer patients. Lymphocytopenia carries a significant risk of severe/critical COVID-19. SARS-CoV-2 disruption of therapy is as serious as SARS-CoV-2 infection itself. Careful surveillance will allow early restart of the anti-cancer treatment.
【저자키워드】 COVID-19, SARS-CoV-2, Cancer patients, SARS-CoV-2 scenarios, 【초록키워드】 Treatment, therapy, knowledge, SARS-COV-2 infection, COVID-19 pandemic, Cancer, diagnostic, risk, Contact tracing, RT-PCR, Clinical course, Deterioration, Asymptomatic, Surveillance, management, Patient, Bacterial infection, Mild, age, Follow-up, survival rate, anti-cancer treatment, Critical, cancer treatment, patients, therapeutic strategy, co-morbidities, neoplasm, COVID-19 cases, performance status, COVID-19 symptom, cancer patient, Cancer center, oncology, increased risk, progressive disease, hematologic, Modification, heterogenous, survivor, courses, simple, secondary, oncologist, significantly increased, IMPROVE, Course, analyzed, died, investigated, diagnosed, undergo, provide, contribute, predominant, accompanied, patients with SARS-CoV-2, 【제목키워드】 clinical, scenario, center,