1587P SARS-CoV-2 infection risk and COVID-19 prevalence in cancer patients during the first wave of COVID-19 pandemic in a Northern Italy’s virus epicenter area

Background: Patients (pts) with cancer are purported to be more vulnerable to coronavirus disease 2019 (COVID-19). However, cancer encompasses a spectrum of heterogenous tumor subtypes. The aim of this study was to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection risk and COVID-19 prevalence according to tumor subtype in the resident cancer population of the Province of Parma (Emilia Romagna Region, Nothern Italy) during the first wave of COVID-19 pandemic in Italy. Methods: We analyzed data from the Parma Province Cancer Registry, COVID-19 hospital medical records, and local surveillance system of all laboratory-confirmed cases tested positive for SARS-CoV-2 from the beginning of the outbreak (February, 20) to July 19, 2020. All the Parma resident cancer population was classified as either “active” or “inactive” according to the evidence of any referral to health services, for any reason, during the observation period. Study analyses were adjusted for patient demographics, tumor subtype and period of cancer diagnosis. Results: 40,148 cancer pts (mean age 68;57.8% females;45.1% active) were analyzed. The cumulative risk of SARS-CoV-2 infection was 11.2% for cancer pts vs. 7% for non-cancer subjects (P < 0.0001). The overall COVID-19 attack rate was 2.2% (95% CI, 2.0-2.4) and 2.6% (95% CI, 2.4-2.9) for inactive and active cancer pts, respectively. The cumulative incidence of COVID-19 was higher in active vs. inactive cancer subjects (HR 1.18, P = 0.01). In the active cancer group, the cumulative incidence of COVID-19 was higher in lung cancer pts vs. other tumors (HR 4.3). In the same group, HR for breast cancer pts was 0.86. Interestingly, the subgroup analysis of COVID-19 cumulative incidence showed a significant interaction between active patient status and hematological malignancies. Conclusions: In our study, cancer pts were more susceptible to SARS-CoV-2 infection. The cumulative incidence of COVID-19 was higher in active vs. inactive cancer subjects. However, cancer is a heterogeneous group of diseases and pts with different tumor types had differing susceptibility to COVID-19 phenotypes. COVID-19 fatality rates for subgroups will be reported at the meeting. Legal entity responsible for the study: University Hospital of Parma. Funding: Has not received any funding. Disclosure: A. Musolino: Financial Interests, Institutional, Research Grant: Lilly;Financial Interests, Personal, Advisory Board: Roche;Financial Interests, Personal, Advisory Board: Macrogenics;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Personal, Advisory Board: Seagen. B. Pellegrino: Financial Interests, Personal, Research Grant: Roche. All other authors have declared no conflicts of interest.