medwireNews: Patients with cancer and comorbid SARS-CoV-2 infection have elevated age-adjusted case fatality rates relative to COVID-19 patients without cancer, shows an analysis from a US hospital system.
Highlighting that the results held true when the data for cancer patients were compared with those for non-cancer patients from the wider New York City region, the researchers write in Cancer Discovery that “proactive strategies to reduce likelihood of infection and improve early identification of COVID-19 positivity in the cancer patient population are clearly warranted.”
They continue: “Overall, we hope and expect that our data from the current epicenter of the COVID-19 epidemic will help inform other healthcare systems, cancer patients, and the public about the particular vulnerability of oncologic patients to this disease.”
The analysis included 218 cancer patients who received a laboratory-confirmed diagnosis of COVID-19 at the Montefiore Health System in New York between 18 March and 8 April 2020. Seventy-five percent of the patients had a solid tumor, while the remaining 25% had a hematologic malignancy. The median age of the participants was 69 years and 58% were men.
In all, 28% of the patients had died from COVID-19 at the time of analysis, with respective mortality rates of 25% and 37% for those with solid and hematologic malignancies. In the solid tumor group, the highest mortality rates were observed among patients with pancreatic and lung cancers, at 67% and 55%, respectively, while the rates were lower for those with genitourinary and breast cancers, at 15% and 14%, respectively.
Compared with a propensity score-matched cohort of 1090 cancer-free individuals with COVID-19 from the same health system, the participants with cancer and COVID-19 had higher case fatality rates across all age cohorts, with the between-group differences reaching statistical significance among patients aged 45–64 years and those older than 75 years (odds ratio [OR]=4.35 and 2.83, respectively).
Similarly, COVID-19 case fatality rates remained significantly higher for cancer patients than those without cancer when data for all patients diagnosed with COVID-19 during the same time period in New York City were used for comparison. And this was true for all age groups except the 18–44-year-old group, with ORs ranging from 2.17 for the 65–74-year-olds to 304.66 for the 0–17-year-olds.
Vikas Mehta and fellow investigators, from the Montefiore Medical Center, highlight that their “cancer patients were predominantly from the Bronx and potentially had increased mortality in part due to socioeconomic [factors] and comorbidities.”
They add, however: “Even after accounting for the increased mortality seen in COVID-19 in the Bronx, the many-fold magnitude increase in death rates within […] our cancer cohort can potentially be attributed to the vulnerability of oncology patients.”
Discussing the drawbacks of the study, such as the limited follow-up, the researchers “acknowledge that the mortality rate is highly dependent on the breadth of testing, and therefore understand that more widespread detection of viral infection would likely alter the results.”
And they add that “[f]uture comparative studies to non-cancer patients will be needed to fully ascertain the risk posed to oncology patients.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group
19 May 2020: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.
Cancer Discov 2020; doi:10.1158/2159-8290.CD-20-0516