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

Perrine Vuagnat (1, 2, 3) , Maxime Frelaut (2) , Toulsie Ramtohul (2) , Clémence Basse (2, 3) , Sarah Diakite (2, 3) , Aurélien Noret (2, 3) , Audrey Bellesoeur (2, 3) , Vincent Servois (2) , Delphine Hequet (2) , Enora Laas (2) , Youlia M. Kirova (2) , Luc Cabel (2, 3) , Jean Yves Pierga (2, 3) , Aurélia Alimi (2) , Muriel Belotti (2) , Okba Bensaoula (2) , Ophélie Bertrand (2) , Geoffroy Bilger (2) , Étienne G.C. Brain (2) , Hervé Brisse (2) , Bruno Buecher (2) , Laetitia Chanas (2) , Caroline Chapus (2) , Isabelle Charles-Massar (2) , Pascal J.P. Chérel (2) , Gilles Créhange (2) , Christelle Colas (2) , Hélène Delhomelle (2) , Thomas Frederic-Moreau (2) , Emmanuelle Fourme (2) , Pierre Fumoleau (2) , Marion Gauthier-Villars (2) , Olivier Lantz (2) , Sophie Lassalle (2) , Marine Le Mentec (2) , Florence Lerebours (2) , Delphine Loirat (2) , Mathieu Minsat (2) , Pauline Moreau (2) , Antoine de Pauw (2) , Maël Priour (2) , Fabien Reyal (2) , Roman Rouzier (2) , Mary Saad (2) , Claire Saule (2) , Clara Sebbag (2) , Dominique Stoppa-Lyonnet (2) , Anne A. Tardivon (2) , Silvia Takanen (2) , Dominíque Vanjak (2) , Marie Charlotte Villy (2) , Anne Vincent-Salomon (2) , Mathilde Warcoin (2) , Laurence Bozec (2, 3) , Xavier Paoletti (1, 2, 3, 4) , Paul Henri Cottu (2, 3) , François Clément Bidard (1, 2, 3)

1 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
2 Institut Curie [Paris]
3 Institut Curie [Saint-Cloud]
4 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe

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 on March 13, 2020, for all breast cancer patients with COVID-19 symptoms or radiologic signs. Registered data included patient history, tumor characteristics and treatments, COVID-19 symptoms, radiological features, and outcome. Data extraction was done on April 25, 2020. COVID-19 patients were defined as those with either a positive RNA test or typical, newly appeared lung CT scan abnormalities. 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 (N = 41) 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 COVID-19 in breast cancer patients.

Mots clés: Breast cancer; COVID-19; Outcome; SARS-CoV-2; Survival

Domaines: Cancer

Perrine Vuagnat, Maxime Frelaut, Toulsie Ramtohul, Clémence Basse, Sarah Diakite, et al.. COVID-19 in breast cancer patients: A cohort at the Institut Curie hospitals in the Paris area. Breast Cancer Research, 2020, 22 (1), ⟨10.1186/s13058-020-01293-8⟩. ⟨hal-02844089⟩