COVID-19 Increases Death, Hospitalization Rates in Patients With Mesothelioma

The average survival for patients with malignant pleural mesothelioma was less than a month after being diagnosed with COVID-19, according to a small study.

About one-fifth of patients with malignant pleural mesothelioma were also diagnosed with COVID-19 during the first year of the pandemic at one hospital in Barcelona, which contributed to both high hospitalization and mortality rates, according to recent findings presented at the 2021 World Conference on Lung Cancer.

The results showed that seven patients (18%) were diagnosed with COVID-19; the average overall survival (OS) of these patients was 17.8 months from cancer diagnosis.

Five of these patients died; reasons for death included COVID-19 (four patients) and progressive disease (one patient). The median OS of these patients was 0.4 months since COVID-19 diagnosis.

Patients with thoracic malignancies may be particularly vulnerable to COVID-19, lead study author Dr. Susana Cedres, a medical oncologist in the Thoracic Tumors Unit at the Vall d’Hebron University Hospital and Institute of Oncology in Barcelona, Spain, said in explaining the basis for the study in a virtual presentation of the data.

Although the effect of SARS-CoV-2 infection has previously been evaluated in 200 patients with thoracic malignancies in the TERAVOLT registry, only eight patients with malignant pleural mesothelioma were included in the assessment.

In the United States, tuberculosis, drug use disorder, hepatitis, HIV/AIDS, cardiomyopathy, diabetes and malignant pleural mesothelioma have been associated with worse COVID-19 related mortality outcomes.

Therefore, investigators sought to tease out the effect of COVID-19 infection on patients with malignant pleural mesothelioma at Vall d’Hebron University Hospital.

In the study, investigators compiled the medical records of 38 patients with malignant pleural mesothelioma who had visited Vall d’Hebron University Hospital between March 2020 and March 2021.

The data that was collected included information on demographics, comorbidities, oncological background and course of COVID-19 illness.

Regarding the patient characteristics of those diagnosed with COVID-19, the median age was 62 years (range, 62-87). The study population comprised four men (57%) and four women (43%). Four patients were non-smokers (57%), and three patients were current or former smokers (43%).

All seven patients (100%) had epithelioid histology. Five patients (71%) were not receiving cancer treatment at COVID-19 diagnosis vs two (29%) patients who were.

Additionally, investigators stratified patients by six characteristics at COVID-19 diagnosis: comorbidity, concomitant treatment, clinical onset, laboratory, hospitalization and respiratory symptoms.

Regarding comorbidities, four patients (57%) had a cardiovascular comorbidity, one patient (14%) had a respiratory comorbidity and one patient (14%) had a renal comorbidity.

Regarding concomitant treatments, four patients (57%) were receiving antiplatelet or anticoagulant therapy, 2 patients (29%) were receiving antidiabetic therapy, and one patient (14%) was receiving corticosteroids.

Regarding clinical onset, four patients (57%) had symptomatic onset, and three patients (43%) had asymptomatic onset.

Regarding laboratory results, six patients (85%) had lymphopenia, four patients (57%) had high d-dimer, and four patients (57%) had high IL-6.

Regarding hospitalization, six patients (85%) were hospitalized, and one patient (14%) was not.

Regarding respiratory symptoms, four patients (57%) had bilateral pneumonia, and six patients (85%) had oxygen support.

A version of this article was originally published on OncLive as, “COVID-19 Leads to High Hospitalization and Mortality in Malignant Pleural Mesothelioma.”

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