Nearly one in five patients with malignant pleural mesothelioma have contracted COVID-19

Nearly one in five patients with malignant pleural mesothelioma (MPM) in a Barcelona hospital contracted COVID-19 during the pandemic. In addition, these patients experienced a 75% death rate, according to a study presented today at MA04: Current Status and Future Prospects of Pleural Mesothelioma and Thymoma at the 2021 IASLC Global Lung Cancer Conference. .

Malignant pleural mesothelioma is an aggressive pleural tumor associated with asbestos exposure and limited survival despite systemic treatment.

Patients with cancer or chest malignancies may be particularly affected by COVID-19. The TERAVOLT registry evaluated the effect of SARS-CoV-2 infection on patients with thoracic malignancies, but included only eight patients with malignant pleural mesothelioma. In a recent study on COVID-19 and mortality in the United States, malignant pleural mesothelioma was significantly associated with an increased likelihood of worse outcomes.

To study the effect of COVID-19 infection on patients with malignant pleural mesothelioma, Dr Susana Cedres of Vall d’Hebron University Hospital and the Institute of Oncology in Barcelona, ​​Spain, has analyzed the medical records of 38 patients with malignant pleural mesothelioma. Dr Cedres collected clinical data, including demographics, co-morbidities, oncology history, and COVID-19 disease status.

“Of the 38 patients with malignant pleural mesothelioma in our facility in this era of a pandemic, seven were diagnosed with COVID-19 infection (18%) by a positive RT-PCR,” she reported.

The clinical characteristics of patients with COVID-19 were: median age of 62 years, four (57%) males, four (57%) patients who choose not to smoke, and three (43%) patients who have smoked in the past . All patients had a history of epithelioid histology of malignant pleural mesothelioma. The most common comorbidities were hypertension, ischemic heart disease and chronic obstructive disease. Four patients (57%) were taking anticoagulants or aspirin.

At the time of COVID-19 infection, two patients were receiving cancer treatment: one patient was receiving chemotherapy and one patient was receiving chest radiation therapy. Regarding the clinical onset of COVID-19 infection, three patients were asymptomatic (tested due to known exposure to a patient with confirmed infection), and four patients were symptomatic with a median of four days between onset. symptoms and diagnosis of COVID-19.

All symptomatic patients had fever and dyspnea. A total of six patients (85%) were hospitalized for a median stay of 12 days (3-28) of hospitalization. All patients required oxygen (three patients used a simple face mask and three patients with a non-rebreathing mask), and four patients developed bilateral pneumonia. Four patients had a complete blood test and all presented with lymphopenia, elevated D-dimers and elevated serum IL-6 levels.

A total of five patients died, four of whom died from COVID-19 infection (54%). The median overall survival was 17.8 months since diagnosis of cancer (9.3-NA) and 0.4 months (0.06-5 months) since diagnosis of COVID-19.

“In our experience, 18% of patients with malignant pleural mesothelioma were diagnosed with COVID-19 infection during the pandemic, and these patients suffered a very high death rate of 54%,” said the Dr Cedres. “I urge health services to pay special attention to patients with malignant pleural mesothelioma while managing COVID-19 infections. “