Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multi-Center Study During the COVID-19 Outbreak

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

“…Second, many oncologists are being redeployed to general or acute medicine roles to support the many COVID-19 admissions requiring intensive medical support and input. Third, two small studies 2,3 reporting COVID-19 outcomes in patients with cancer have resulted in the community being fearful of giving effective anticancer treatments. These studies concluded that cancer patients are not only more susceptible to contracting the virus compared with the general population, but also at risk of developing more severe sequelae.…”

“…3,4 In the largest cohort of 105 cancer patients, consisting of only 17 on chemotherapy, six patients on immunotherapy, and four on targeted therapies, strong recommendations were made about the COVID-19 risk from anticancer treatments. 2 All of these studies are small cohorts and limited to a few cancer centres. We felt that the studies raised important hypotheses but were in no way unequivocal and indeed a single-centre study 14 from the USA yielded contradictory results.…”

“…The evidence to support this claim is scarce and limited to retrospective series arising from China, the epicentre of the COVID-19 pandemic, and involving small numbers of patients. [2][3][4] However, despite these severe limitations, the promulgation of this hypothesis has led to widespread global changes to patterns of prescribing chemotherapy and anticancer treatment. 5 In a global health emergency, oncologists must secure evidence from a large dataset, which can then inform their risk-benefit analyses for individual patients in terms of the use of anticancer treatments.…”

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

“…The second, COVID-specific rapid review identified 418 distinct articles from 3 search engines and an additional 1 through a web search; we identified 1 case-control study that reported odds ratios for the risk of death in cancer patients infected with COVID (Appendix E). This study reported elevated risk of death and ITU admission in 105 cancer patients compared with 536 matched controls, with an OR for death in cancer patients of 2.34 (95% CI 1.15 - 4.77), OR of death in cancer without active treatment of 2.23 (0.98 - 5.11) and OR of death in cancer with chemotherapy of 4.54 (1.21 - 16.99) [5]. We used these latter two ORs to convert baseline age-sex stratified IFRs to age-sex stratified IFRs in cancer +/- chemotherapy in Table 2.…”

“…There is one small series of 18 patients with cancer, which suggests higher risks of intubation or death, but it is too small to draw robust conclusions. One very recent case control study also suggests higher risks of death or ITU admission in patients with COVID who have a history of cancer, compared to COVID-infected non-cancer controls [5]. There are several studies indicating an increased risk of death in patients with cancer or those who are immunosuppressed who are infected during influenza pandemics [19].…”