504P SARS-CoV-2 Omicron (B.1.1.529) variant infection leads to high morbidity and mortality in unvaccinated patients with cancer

Pinato, D.J.; Aguilar-Company, J.; Bertuzzi, A.; Hanbury, G.H.; Bower, M.D.; Salazar, R.; Lambertini, M.; Pedrazzoli, P.; Lee, A.J.X.; Sinclair, A.; Townsend, S.; Salarich, A. Plaja; Sita-Lumsden, A.R.; Mukherjee, U.; Diamantis, N.; Sharkey, R.; Gaidano, G.; Gennari, A.; Tabernero, J.; Cortellini, A.

doi:10.1016/j.annonc.2022.07.632

Cited by 9 publications

(21 citation statements)

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“…The TERAVOLT study presented a significant lower mortality of 3.2% in 346 patients compared with 24.2%-33% in prior variants [8][9][10]. Pinato et al [11] showed a 28-day case-fatality rate of less than 13% in cancer patients with Omicron, but patient number was low with only 365 patients enrolled in this analysis.…”

Section: Introductionmentioning

confidence: 70%

“…Therefore, the large CORONA Germany study confirms findings of other investigations, showing a lower mortality during Omicron compared to previous variants or wild-type. Pinato et al [11] showed a 28-day case-fatality rate of less than 13% in 365 cancer patients with Omicron, the TERAVOLT study showed a mortality of 3.2% in 346 patients with thoracic malignancies during the Omicron phase compared to 24.2%-33% in prior variants [8][9][10]. Nevertheless, there were some differences compared to our study: Both studies included outpatients as well as patients in hospital [10,11], which is important when comparing the abovementioned mortalities to our results showing solely in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Pinato et al [11] showed a 28-day case-fatality rate of less than 13% in 365 cancer patients with Omicron, the TERAVOLT study showed a mortality of 3.2% in 346 patients with thoracic malignancies during the Omicron phase compared to 24.2%-33% in prior variants [8][9][10]. Nevertheless, there were some differences compared to our study: Both studies included outpatients as well as patients in hospital [10,11], which is important when comparing the abovementioned mortalities to our results showing solely in-hospital mortality. Additionally, there was no differentiation between cancer patients with history of cancer and active cancer disease [10,11].…”

Section: Discussionmentioning

confidence: 99%

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High In-Hospital Mortality in SARS-CoV-2-Infected Patients with Active Cancer Disease during Omicron Phase of the Pandemic: Insights from the CORONA Germany Study

Konermann¹,

Geßler²,

Wohlmuth³

et al. 2023

Oncol Res Treat

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Introduction: SARS-CoV-2 infected patients with cancer have a worse outcome including a significant higher mortality, compared to non-cancer patients. However, limited data are available regarding in-hospital mortality during the Omicron phase of the pandemic. Therefore, the aim of the study was the comparison of mortality in patients with history of cancer and patients with active cancer disease during the different phases of the COVID-19 pandemic, focusing on the current Omicron variant of concern. Methods: We conducted a multicenter, observational, epidemiological cohort study at 45 hospitals in Germany. Until July 20, 2022, all adult hospitalized SARS-CoV-2 positive patients were included. The primary endpoint was in-hospital mortality regarding cancer status (history of cancer and active cancer disease) and SARS-CoV-2 virus type. Results: From March 11 2020 to July 20 2022, a total of 27,490 adult SARS-CoV-2 positive patients were included into the study. 2,578 patients (9.4%) had diagnosis of cancer, of whom 1,065 (41.3%) had history of cancer, whereas 1,513 (58.7%) had active cancer disease. Overall 3,749 out of the total of 27,490 patients (13.6%) died during the hospital stay. Patients with active cancer disease had a significantly higher mortality compared to patients without cancer diagnosis, in both phases of the pandemic (wild-type to Delta: OR 1.940 [1.646-2.285]); Omicron: 2.864 [2.354-3.486]). After adjustment to co-variables, SARS-CoV-2 infected patients with active cancer disease had the highest risk for in-hospital mortality compared to the other groups, in both phases of the pandemic. Conclusion: The CORONA Germany study indicates that hospitalized patients with active cancer disease are at high risk of death during a SARS-CoV-2 infection. Mortality of patients with history of cancer improved to nearly the level of non-cancer patients during Omicron phase.

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Section: Introductionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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High In-Hospital Mortality in SARS-CoV-2-Infected Patients with Active Cancer Disease during Omicron Phase of the Pandemic: Insights from the CORONA Germany Study

Konermann¹,

Geßler²,

Wohlmuth³

et al. 2023

Oncol Res Treat

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“…Although improved outcomes have been found in patients with haematological malignancy with the Omicron strain, it has been postulated that unvaccinated patients have an equal or higher mortality rate with Omicron infection. 13 In our unvaccinated cohort of 10 patients, eight were admitted to the hospital and three to the ICU. Of the six unvaccinated patients with likely Delta strain, half were admitted to the ICU and there was one death.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, studies in vaccinated patients with haematological conditions who contracted the Omicron strain have reported lower mortality rates, to less than 10%. 13 Australia provides a unique cohort of patients, with a population that had low exposure to COVID-19 prior to widespread vaccination, due to national border controls and strict isolation measures. Improved public health messaging and widespread protective measures within the community may have also impacted on outcomes compared with the beginning of the pandemic.…”

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confidence: 99%

Low mortality in vaccinated immunocompromised haematology patients infected with SARS‐CoV‐2

Shaw

Shortt

Löw

et al. 2022

Internal Medicine Journal

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Coronavirus disease 2019 (COVID-19) infection in patients with haematological neoplasms has been associated with increased mortality; however, many studies in this patient group were reported early in the pandemic. The authors evaluated outcomes of COVID-19 infection in patients with haematological conditions following widespread vaccination, newer viral variants and increasingly effective antiviral therapies. A 4% mortality rate was found and contemporary risk factors for hospitalisation including older age, nonvaccination or partial COVID-19 vaccination status and infection with non-Omicron strain were identified.

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Risk of COVID‐19 death for people with a pre‐existing cancer diagnosis prior to COVID‐19‐vaccination: A systematic review and meta‐analysis

Steinberg,

Hughes,

Hui

et al. 2023

Intl Journal of Cancer

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While previous reviews found a positive association between pre‐existing cancer diagnosis and COVID‐19‐related death, most early studies did not distinguish long‐term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher‐quality evidence on risk of COVID‐19‐related death for people with recent/active cancer (compared to people without) in the pre‐COVID‐19‐vaccination period. We searched the WHO COVID‐19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk‐of‐bias assessment was based on the Newcastle‐Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse‐variance random‐effects models. Random‐effects meta‐regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID‐19‐related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36‐1.61, I2 = 0; people with COVID‐19: aOR = 1.58, 95% CI: 1.41‐1.77, I2 = 0.58; inpatients with COVID‐19: aOR = 1.66, 95% CI: 1.34‐2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4‐4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68‐2.68, I2 = 0.43), and for metastatic cancers. Meta‐regression suggested risk of COVID‐19‐related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37‐1.75) at 1 year and aOR = 0.98 (95% CI: 0.80‐1.20) at 5 years post‐cancer diagnosis/treatment. In conclusion, before COVID‐19‐vaccination, risk of COVID‐19‐related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.

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504P SARS-CoV-2 Omicron (B.1.1.529) variant infection leads to high morbidity and mortality in unvaccinated patients with cancer

Cited by 9 publications

References 0 publications

High In-Hospital Mortality in SARS-CoV-2-Infected Patients with Active Cancer Disease during Omicron Phase of the Pandemic: Insights from the CORONA Germany Study

High In-Hospital Mortality in SARS-CoV-2-Infected Patients with Active Cancer Disease during Omicron Phase of the Pandemic: Insights from the CORONA Germany Study

Low mortality in vaccinated immunocompromised haematology patients infected with SARS‐CoV‐2

Risk of COVID‐19 death for people with a pre‐existing cancer diagnosis prior to COVID‐19‐vaccination: A systematic review and meta‐analysis

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