Characteristics and outcomes of COVID-19 infection in 45 patients with breast cancer: A multi-center retrospective study in Hubei, China

Breast. 2021 Oct:59:102-109. doi: 10.1016/j.breast.2021.06.006. Epub 2021 Jun 26.

Abstract

Background: The COVID-19 pandemic is a significant worldwide health crisis. Breast cancer patients with COVID-19 are fragile and require particular clinical care. This study aimed to identify the clinical characteristics of breast cancer patients with COVID-19 and the risks associated with anti-cancer treatment.

Methods: The medical records of breast cancer patients with laboratory-confirmed COVID-19 were collected among 9559 COVID-19 patients from seven designated hospitals from 13th January to 18th March 2020 in Hubei, China. Univariate and multivariate analyses were performed to assess risk factors for COVID-19 severity.

Results: Of the 45 breast cancer patients with COVID-19, 33 (73.3%) developed non-severe COVID-19, while 12 (26.7%) developed severe COVID-19, of which 3 (6.7%) patients died. The median age was 62 years, and 3 (6.7%) patients had stage IV breast cancer. Univariate analysis showed that age over 75 and the Eastern Cooperative Oncology Group (ECOG) score were associated with COVID-19 disease severity (P < 0.05). Multivariate analysis showed that patients who received chemotherapy within 7 days had a significantly higher risk for severe COVID-19 (logistic regression model: RR = 13.886, 95% CI 1.014-190.243, P = 0.049; Cox proportional hazards model: HR = 13.909, 95% CI 1.086-178.150, P = 0.043), with more pronounced neutropenia and higher LDH, CRP and procalcitonin levels than other patients (P < 0.05).

Conclusions: In our breast cancer cohort, the severity of COVID-19 could be associated with baseline factors such as age over 75 and ECOG scores. Chemotherapy within 7 days before symptom onset could be a risk factor for severe COVID-19, reflected by neutropenia and elevated LDH, CRP and procalcitonin levels.

Keywords: Anti-cancer treatment; Breast cancer; COVID-19; Chemotherapy; Retrospective study.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality
  • C-Reactive Protein
  • COVID-19 / diagnosis*
  • China / epidemiology
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Middle Aged
  • Neutropenia / epidemiology
  • Neutropenia / etiology*
  • Pandemics
  • Procalcitonin / blood
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Procalcitonin
  • C-Reactive Protein
  • L-Lactate Dehydrogenase