Clinical impact of COVID-19 on patients with cancer: Data from the COVID-19 and Cancer Consortium (CCC19).

Abstract

LBA110 Background: There are limited data on COVID-19 in patients with cancer. We characterize the outcomes of patients with cancer and COVID-19 and identify potential prognostic factors. Methods: The COVID-19 and Cancer Consortium (CCC19) cohort study includes patients with active or prior hematologic or invasive solid malignancies reported across academic and community sites. Results: We included 1,018 cases accrued March-April 2020. Median age was 66 years (range, 18-90). Breast (20%) and prostate (16%) cancers were most prevalent; 43% of patients were on active anti-cancer treatment. At time of data analysis, 106 patients (10.4%) have died and 26% met the composite outcome of death, severe illness requiring hospitalization, and/or mechanical ventilation. In multivariable logistic regression analysis, independent factors associated with increased 30-day mortality were age, male sex, former smoking, ECOG performance status (2 versus 0/1: partially adjusted odds ratio (pAOR) 2.74, 95% CI 1.31-5.7; 3/4 versus 0/1: pAOR 5.34, 95% CI 2.44-11.69), active malignancy (stable/responding, pAOR 1.93, 95% CI 1.06-3.5; progressing, pAOR 3.79, 95% CI 1.78-8.08), and receipt of azithromycin and hydroxychloroquine. Tumor type, race/ethnicity, obesity, number of comorbidities, recent surgery, and type of active cancer therapy were not significant factors for mortality. Conclusions: All-cause 30-day mortality and severe illness in this cohort were significantly higher than previously reported for the general population and were associated with general risk factors as well as those unique to patients with cancer. Cancer type and treatment were not independently associated with increased 30-day mortality. Longer follow-up is needed to better understand the impact of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments.

COVID-19 and cancer care: what do international guidelines say?

“…The last ASCO annual meeting hosted a special session on cancer and COVID-19 pandemic. In this session data from the thoracic cancers international COVID-19 collaboration (TERAVOLT) registry and from the COVID-19 and cancer consortium registry (CCC-19) were presented [19][20][21]. The TERAVOLT study focused on thoracic Patient's condition is stable enough that services can be delayed for the duration of the COVID-19 pandemic and/or the intervention is no priority based on the magnitude of benefit malignancies and recruited 400 patients, mainly from Italy, with either confirmed COVID-19 infection or clinically/radiologically suspected infection [19].…”

“…The authors reported a mortality rate of 35% with a median follow-up of 33 days. The CCC-19 study reported data on 928 confirmed COVID-19 positive patients, mostly from USA, with various types of cancers [ 20 , 21 ]. The most prevalent malignancies were breast (21%) and prostate cancer (16%), while the mortality rate was 13% with a median follow-up of 21 days.…”

Cancer Treatment and Research During the COVID-19 Pandemic: Experience of the First 6 Months

“…A retrospective chart review of 1878 patients with COVID-19 at a Spanish hospital found that 17 had lung cancer, of whom 9 died [24]. Among 1018 patients with both COVID-19 and cancer, independent factors associated with increased 30-day mortality were age, male sex, former smoking, and worse Eastern Cooperative Oncology Group (ECOG) performance status [25].…”

“…Among 1018 patients with both COVID-19 and cancer, independent factors associated with increased 30-day mortality were age, male sex, former smoking, and worse Eastern Cooperative Oncology Group (ECOG) performance status [ 25 ].…”

Triage process for the assessment of coronavirus disease 2019‐positive patients with cancer: The ONCOVID prospective study

“…However, the limited data have not led to evidence‐based recommendations. Evidence suggests that COVID‐19 diffusion in patients with cancer is not as prominent as expected; however, mortality seems to be higher than that reported for the general population and correlates with general risk factors as well as those unique to patients with cancer 8‐12 . Indeed, other comorbidities (eg, cardiovascular disease, diabetes, chronic obstructive pulmonary disease) correlate with a higher risk of infection and severe events 13 …”