COVID-19 outbreak in Italy. Report of 20 cancer patients with COVID-19 treated at home during the first wave

Abstract

The published studies of patients with COVID-19 and cancer are done on hospitalized patients, and data on early outpatient treatment of symptomatic COVID-19 cancer patients are unavailable in English literature. This study included a retrospective, single-center case series of 20 consecutive symptomatic non-hospitalized adults with laboratory confirmed or probable COVID-19 infection. The diagnosis of pneumonia was done with portable ultrasound (US). The treatment was based on hydroxychloroquine (HCQ) plus azithromycin (AZ), drugs allowed during the first wave. Oxygen was delivered when necessary, and enoxaparine was done in bedridden patients. The primary endpoint was clinical improvement or hospitalization considered as worsening of clinical conditions. The secondary endpoints were mortality at day 30 and at day 60. A finger oximeter was delivered to each patient and all patients were monitored by tele-medicine, the side effects of treatment were registered and reported. From March 13rd to May 26th, 2020, 180 patients with laboratory confirmed COVID-19 infection or with epidemiologically linked exposure to a person with laboratory confirmed infection were managed at home for COVID-19 in the district of Piacenza, Emilia Romagna Region. Among these 180 patients, 20 (11.11%) had cancer and form the basis of this report. There were 13 females (65%) and 7 males (35%), the majority of cancers were breast (40%) and gastrointestinal (30%). Seven patients (35%) were on active anticancer treatment when infected and all with metastatic disease, 13 patients (65%)