Differences in Outcomes and Factors Associated With Mortality Among Patients With SARS-CoV-2 Infection and Cancer Compared With Those Without Cancer

Khoury, Emma; Nevitt, Sarah J; Madsen, William; Turtle, Lance; Davies, Gerry; Palmieri, Carlo

doi:10.1001/jamanetworkopen.2022.10880

Cited by 67 publications

(68 citation statements)

References 116 publications

(1,775 reference statements)

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“…As a result, since the beginning of 2022 there has been a renewed interest toward CCP use, particularly for immunocompromised patients, who are not able to mount a sufficiently protective antibody response against the virus and have contraindications or side effects from small molecule antivirals (11, 12). These patients are at higher risk for morbidity and mortality from COVID-19 (13). A few controlled studies and a number of case reports and case series have shown a clinical benefit from CCP use for COVID-19 patients with hematological or solid cancer or other underlying causes of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

Senefeld

Franchini

Mengoli

et al. 2022

Preprint

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Immunosuppressed patients have increased risk for morbidity and mortality from COVID-19 because they less frequently mount antibody responses to vaccines and often cannot tolerate small-molecule antivirals. The Omicron variant of concern of SARS-CoV-2 has progressively defeated anti-Spike mAbs authorized so far, paving the way to a return to COVID-19 convalescent plasma (CCP) therapy. In this systematic review we performed a metanalysis of 6 controlled studies (including 2 randomized controlled trials; totaling 368 treated patients and 1119 control), an individual patient data analysis of 125 case reports/series (totaling 265 patients), and a descriptive analysis of 13 uncontrolled large case series without individual patient data available (totaling 358 patients). The metanalysis showed a risk ratio for mortality of 0.61 in treatment with CCP versus standard of care for immunosuppressed COVID-19 patients. On the basis of this evidence, we encourage initiation of high-titer CCP from vaccinees (hybrid plasma) in immunocompromised patients.

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Section: Introductionmentioning

confidence: 99%

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

Senefeld

Franchini

Mengoli

et al. 2022

Preprint

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“…Clinical outcomes were much worse, particularly in patients with cancer affected by COVID-19. In a meta-analysis, which included a total of 81 studies (19 for mortality) and 61532 participants, conducted by Khoury et al [17], a signi cant increase in mortality was reported in patients with cancer affected by COVID-19 (RR = 2.12, 95% CI: 1.71-2.62, p < 0.001, I 2 = 84.4%). They also reported an increased mortality in patients with hematological (RR = 1.42, 95% CI:…”

Section: Discussionmentioning

confidence: 99%

The impact of cancer on the severity of disease in patients affected with COVID-19: an umbrella review and meta-meta-analysis of systematic reviews and meta-analyses involving 1,064,476 participants

Arayıcı

Başbınar

Ellıdokuz

2022

Preprint

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During the COVID-19 pandemic, cancer patients were among the most vulnerable patient groups to the SARS-CoV-2 infection effects. This paper aimed to conduct an umbrella review and meta-meta-analysis to determine the severity of disease in cancer patients affected with COVID-19. The umbrella review and meta-meta-analysis were undertaken according to the PRISMA and MOOSE guidelines. The Pubmed/Medline, Web of Science, and Scopus databases were searched for published papers from the start of the pandemic through July 18, 2022. The pooled effect sizes (ES) and odds ratios (ORs) were calculated using a random effect model in the 95% confidence interval (CI) for ICU (Intensive Care Unit) admissions and mortality in cancer patients infected with SARS-CoV-2. Egger's linear regression test, schematic illustrations of funnel plots, and Begg and Mazlumdar's rank correlation tests were used to quantify the possibility of publication bias. The pooled ES was calculated based on 1031783 participants and mortality was significantly increased in cancer patients affected with COVID-19 (OR = 2.02, %95 CI: 1.74–2.35, p < 0.001). The pooled ES for ICU admission was also significantly increased in cancer patients infected with SARS-CoV-2 (OR = 1.84, %95 CI: 1.44–2.34, p < 0.001). As a result, this synthesis of systematic reviews and meta-analyses by the meta-meta-analysis method revealed that disease severity is higher in cancer patients affected by COVID-19. Since cancer patients are a more sensitive and specific patient group, they should be evaluated more carefully, especially during the COVID-19 pandemic.

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“…It is now well-established that coronavirus disease 2019 (COVID-19) in patients with cancer carries a higher morbidity and mortality, especially in patients with hematologic malignancies [1][2][3][4][5]. While overall case fatality has decreased over time, mostly related to the impact of broad vaccinations and improved supportive/antimicrobial management, a higher case fatality rate was noted amongst cancer patients even during the Omicron (B.1.1.529) wave [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and longevity of immune response to 3^rd COVID-19 vaccine and effectiveness of a 4^th dose in severely immunocompromised patients with cancer

Thakkar

Pradhan

Duva

et al. 2022

Preprint

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Cancer patients show increased morbidity with COVID-19 and need effective immunization strategies. We demonstrate that a 3rd dose of COVID-19 vaccine leads to seroconversion in 57% of patients that were seronegative after primary vaccination. The immune response is durable as assessed by anti-S antibody titers, T-cell activity and neutralization activity against wild-type SARS-CoV2 and BA1.1.529 at 6 months of follow up. A subset of severely immunocompromised hematologic malignancy patients were unable to mount adequate immune response after the 3rd dose and were treated with a 4th dose in a prospective clinical trial which led to adequate immune-boost in 67% of patients. Low baseline IgM levels and CD19 counts were associated with inadequate seroconversion. Booster doses induced limited neutralization activity against the Omicron variant. These results indicate that vaccine booster-induced immunity is durable in cancer patients and additional doses can further stimulate immunity in a subset of hematologic malignancy patients.Statement of significanceWe demonstrate that a 3rd dose of vaccine leads to seroconversion in 57% of negative patients with durable immune responses at 6 months. A 4th dose of vaccine can seroconvert hematologic malignancy patients with higher baseline IgM and CD19 levels.

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Differences in Outcomes and Factors Associated With Mortality Among Patients With SARS-CoV-2 Infection and Cancer Compared With Those Without Cancer

Abstract: This systematic review and meta-analysis analyzed the association of age, sex, and cancer types and therapies with survival rates among patients with both cancer and COVID-19 diagnosis.

Cited by 67 publications

References 116 publications

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

The impact of cancer on the severity of disease in patients affected with COVID-19: an umbrella review and meta-meta-analysis of systematic reviews and meta-analyses involving 1,064,476 participants

Efficacy and longevity of immune response to 3^rd COVID-19 vaccine and effectiveness of a 4^th dose in severely immunocompromised patients with cancer

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Differences in Outcomes and Factors Associated With Mortality Among Patients With SARS-CoV-2 Infection and Cancer Compared With Those Without Cancer

Abstract: This systematic review and meta-analysis analyzed the association of age, sex, and cancer types and therapies with survival rates among patients with both cancer and COVID-19 diagnosis.

Cited by 67 publications

References 116 publications

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

The impact of cancer on the severity of disease in patients affected with COVID-19: an umbrella review and meta-meta-analysis of systematic reviews and meta-analyses involving 1,064,476 participants

Efficacy and longevity of immune response to 3rd COVID-19 vaccine and effectiveness of a 4th dose in severely immunocompromised patients with cancer

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Efficacy and longevity of immune response to 3^rd COVID-19 vaccine and effectiveness of a 4^th dose in severely immunocompromised patients with cancer