Aim: Assessing impacts of Covid-19 infection in Medical Oncology patients in a highly vaccinated population at a Western Australian hospital post opening of state borders
Methods: Patients with Covid-19 RAT positivity were prospectively identified between March and May 2022 by treating clinicians. Electronic case notes and pathology records were reviewed for data collection. Outcomes assessed included treatment delays and mortality.
Results: 36 patients were identified with solid organ malignancy and RAT positive Covid-19 infection of whom 64% (23) were female. The median age was 57.5 years. 81% (29) had metastatic disease and the most predominant subtype was breast cancer (42%). 81% (29) were on active therapy with 55% on chemotherapy (31% chemotherapy alone). 78% of the patients had received at least 2 doses of Covid-19 vaccination, with 53% having had at least 1 booster. 8% were unvaccinated. 78% were community acquired infections vs 22% acquired during a hospital admission. 67% (24) patients were symptomatic at detection, with symptom severity ranging from mild to moderate, with 8% patients needing oxygen for desaturation. 64% were managed as outpatients. A total of 58% received antiviral therapy (14% IV Remdesevir and 86% oral with Molnupiravir (44%) and Paxlovid (50%)) of which 90% completed their course. 90% of those receiving antivirals were on active therapy.
Treatment delays were observed in 83% (24/29) of patients with a median delay of 2 weeks. 2 deaths were partially attributed to Covid-19 infection in inpatients with disease progression and concurrent bacterial sepsis. Both these patients were double vaccinated and on chemotherapy. No deaths were solely attributed to Covid-19.
Conclusion: The overall outcomes in this population of WA Oncology patients from Covid-19 infection remained favourable with low mortality despite symptomatic infection requiring antiviral therapy and treatment delays.