Reply to the Letter to the Editor: “COVID-19 in patients with cancer: can baseline radiologic severity and early evolution predict clinical outcomes?”

by Rocio Perez‑Johnston ( perezjor@MSKCC.ORG)

COVID-19 in patients with cancer: can baseline radiologic severity and early evolution predict clinical outcomes?

Dear Editor,
Dear Drs. Mungmunpuntipantip and Wiwanitkit,

Thank you very much for your comments. We completely agree that there are many factors determining the clinical outcome of patients with cancer and COVID-19. It has been reported in the literature that many clinical variables have been shown to be predictors of outcome in patients with COVID-19. For example, Rechtman et al demonstrated how vital signs- heart rate, respiratory rate, oxygen saturation were associated with mortality [1]. Basheer M et al showed that age, BMI, hemodialysis, history of supplemental oxygen and certain laboratory results were associated with increased mortality [2].

One of the variables evaluated in the general population is the radiological presentation as a predictor of outcome [3]. In our study we attempted to determine if the initial and early follow-up radiologic presentation would determine outcome in a population of patients with cancer. One of the main reasons why we decided not to include clinical variables in our analysis is that cancer patients have many baseline confounding variables related to their cancer and their treatments. We agree with you that there are many other clinical variables that determine outcome as demonstrated by Nath et al [4]. Part of the results that Nath et out found is that a negative baseline Xray was a main predictor for not having a severe event within 30 days of diagnosis.

We are aware that further studies need to be performed in the oncologic population and hope that further multi institutional studies reveal how any new confounding clinical factor can affect patients with cancer and COVID-19.