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09-11-2021 | COVID-19 | News

Recent cancer treatment linked to poor COVID-19 outcomes

Author: Laura Cowen


medwireNews: People with COVID-19 who have recently undergone cancer treatment have a significantly higher risk for death, intensive care unit (ICU) admission, and hospitalization than those without cancer, suggest data from a large US study.

Conversely, individuals with cancer but no recent treatment fared no worse and sometimes better when they had COVID-19 than people without cancer.

Sharon Giordano and colleagues from The University of Texas MD Anderson Cancer Center in Houston, USA, say their findings suggest “that patients with cancer represent a heterogenous group, and risk stratification according to recent treatment and the treatment administered has important implications for patients, clinicians, and health care systems.”

Using the Optum COVID-19 electronic health record dataset, Giordano and team identified 507,307 patients (mean age 48.4 years, 55.4% women) with COVID-19 in 2020, of whom 97.2% did not have cancer.

Among the 14,287 patients with cancer, 30.1% had received radiation or systemic therapy in the 3 months prior to their COVID-19 diagnosis, while the remaining 69.9% had received no recent cancer therapy.

The researchers report in JAMA Oncology that individuals with recent cancer treatment had a significant 1.74-fold higher odds of death within 30 days of COVID-19 diagnosis than people without cancer after adjustment for potential confounders including age, sex, race and ethnicity, and severe obesity among others.

They also had a significant 1.69-fold increased risk for an ICU stay within the same time period and a 1.19-fold increased likelihood of hospitalization.

Conversely, people with cancer but no recent treatment had a similar risk for death to those without cancer and were significantly less likely to need mechanical ventilation for or be hospitalized with COVID-19, at odds ratios (ORs) of 0.61 and 0.79, respectively.

Subgroup analyses among the people with cancer revealed that those with metastatic solid tumors had significantly increased risks for 30-day mortality (OR=2.36) and hospitalization (OR=1.37) than those with nonmetastatic tumors.

Individuals with hematologic cancers also had significantly worse outcomes than those with nonmetastatic solid tumors, at ORs of 1.72, 1.44, 1.42, and 1.29 for mortality, hospitalization, mechanical ventilation, and ICU stays, respectively.

Other factors associated with poor outcomes among the people with cancer included receipt of radiotherapy, chemotherapy, or chemoimmunotherapy, but not immunotherapy or endocrine or targeted therapy, in the previous 3 months, relative to no systemic therapy.

Giordano and team note that although this “is one of the largest reports to date to evaluate the diverse outcomes among patients with cancer and COVID-19” their findings are specific to the USA and “may differ in settings with fewer resources or in areas of the world with health care capacity constraints.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group

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JAMA Oncol 2021; doi:10.1001/jamaoncol.2021.5148