COVID-19 outbreak in Italy: Clinical-radiological presentation and outcome in three oncologic patients

J Infect Chemother. 2021 Jan;27(1):99-102. doi: 10.1016/j.jiac.2020.09.008. Epub 2020 Sep 10.

Abstract

We present three patients affected by pulmonary squamous cell carcinoma, metastatic esophageal cancer and advanced non-Hodgkin lymphoma, who incurred in coronavirus 2019 (COVID-19) infection during the early phase of epidemic wave in Italy. All patients presented with fever. Social contact with subject positive for COVID-19 was declared in only one of the three cases. In all cases, laboratory findings showed lymphopenia and elevated C-reactive protein (CRP). Chest x-ray and computed tomography showed bilateral ground-glass opacities, shadowing, interstitial abnormalities, and "crazy paving" pattern which evolved with superimposition of consolidations in one patient. All patients received antiviral therapy based on ritonavir and lopinavir, associated with hydroxychloroquine. Despite treatment, two patients with advanced cancers died after 39 and 17 days of hospitalization, while the patient with lung cancer was dismissed at home, in good conditions.

Keywords: 2019 novel coronavirus disease; Antineoplastic chemotherapy protocols; Computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus
  • COVID-19
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / drug therapy
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Disease Outbreaks
  • Drug Therapy, Combination
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / drug therapy
  • Fatal Outcome
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Italy
  • Lopinavir / therapeutic use*
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / drug therapy
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy*
  • Ritonavir / therapeutic use*
  • SARS-CoV-2
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Lopinavir
  • Hydroxychloroquine
  • Ritonavir