Age-Sex based estimates of risk of death from COVID Infection in Adult Cancer Patients

Abstract

The SARS-CoV-2 (COVID-19) novel corona virus represents a significant health risk, particularly in older patients. Cancer is one of the leading causes of death in most rich countries, and delivering chemotherapy may be associated with increased risk in the presence of a pandemic infection. Estimating this risk is crucial in making decisions about balancing risks and benefits from administering chemotherapy. However, there are no specific data about chemotherapy risks per se. Here we develop a simple model to estimate the potential harms in patients undergoing chemotherapy during a COVID outbreak. We use age-related case fatality rates as a basis for estimating risk, and use previous data from risk of death during influenza outbreaks to estimate the additional risk associated with chemotherapy. We use data from randomised trials to estimate benefit across a range of curative and palliative settings, and address the balance of benefit against the risk of harm. We then use those data to estimate the impact on national chemotherapy delivery patterns.

Management of urologic cancers during the pandemic and potential impact of treatment deferrals on outcomes

“…Further there are concerns regarding chemotherapy administration in the elderly with cancer. In a modeling study, it was estimated that the case fatality rate from COVID-19 infection in a 70-year-old patient may be 2- to 3-folds higher than the 5% survival benefit from chemotherapy [24] . Thus, in the context of pandemic-related limitations on access, the initial treatment should be that which provides the highest cure fraction, e.g., radical cystectomy.…”

COVID-19 Testing in Patients with Cancer: Does One Size Fit All?

“…As the coronavirus disease (COVID-19) pandemic unfolds, there is emerging evidence that patients with cancer are particularly vulnerable to infection and adverse events, with poorer outcomes than the general population (1,2). In response, cancer centers and physicians around the world are rapidly trying to determine the best strategies to protect patients with cancer from COVID-19.…”

Rationalizing Treatment for Gynecological Cancers During the COVID-19 Pandemic: An Indian Experience

“…In carcinoma ovary, a retrospective study by Starbuck et al [14] has shown that timely chemotherapy completion was associated with better survival and high complete response rates. It was seen by Williams et al that mortality from chemotherapy was doubled in the presence of COVID-19 infection, in the age group of over 50 years [15]. In patients who were initiated on neoadjuvant chemotherapy, plans were modified to complete chemotherapy to six cycles instead of the usual three before assessment for interval debulking surgery.…”