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Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium.
Grivas, P; Khaki, A R; Wise-Draper, T M; French, B; Hennessy, C; Hsu, C-Y; Shyr, Y; Li, X; Choueiri, T K; Painter, C A; Peters, S; Rini, B I; Thompson, M A; Mishra, S; Rivera, D R; Acoba, J D; Abidi, M Z; Bakouny, Z; Bashir, B; Bekaii-Saab, T; Berg, S; Bernicker, E H; Bilen, M A; Bindal, P; Bishnoi, R; Bouganim, N; Bowles, D W; Cabal, A; Caimi, P F; Chism, D D; Crowell, J; Curran, C; Desai, A; Dixon, B; Doroshow, D B; Durbin, E B; Elkrief, A; Farmakiotis, D; Fazio, A; Fecher, L A; Flora, D B; Friese, C R; Fu, J; Gadgeel, S M; Galsky, M D; Gill, D M; Glover, M J; Goyal, S; Grover, P; Gulati, S.
  • Grivas P; University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA. Electronic address: pgrivas@uw.edu.
  • Khaki AR; University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA; Stanford University, Stanford, USA.
  • Wise-Draper TM; University of Cincinnati Cancer Center, Cincinnati, USA.
  • French B; Vanderbilt University Medical Center, Nashville, USA.
  • Hennessy C; Vanderbilt University Medical Center, Nashville, USA.
  • Hsu CY; Vanderbilt University Medical Center, Nashville, USA.
  • Shyr Y; Vanderbilt University Medical Center, Nashville, USA.
  • Li X; Vanderbilt University School of Medicine, Nashville, USA.
  • Choueiri TK; Dana-Farber Cancer Institute, Boston, USA.
  • Painter CA; Broad Institute, Cancer Program, Cambridge, USA.
  • Peters S; Lausanne University, Lausanne, Switzerland.
  • Rini BI; Vanderbilt University Medical Center, Nashville, USA.
  • Thompson MA; Advocate Aurora Health, Milwaukee, USA.
  • Mishra S; Vanderbilt University Medical Center, Nashville, USA.
  • Rivera DR; Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, USA.
  • Acoba JD; University of Hawaii Cancer Center, Honolulu, USA.
  • Abidi MZ; University of Colorado School of Medicine, Aurora, USA.
  • Bakouny Z; Dana-Farber Cancer Institute, Boston, USA.
  • Bashir B; Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA.
  • Bekaii-Saab T; Mayo Clinic Cancer Center, Phoenix, USA.
  • Berg S; Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, USA.
  • Bernicker EH; Houston Methodist Cancer Center, Houston, USA.
  • Bilen MA; Winship Cancer Institute of Emory University, Atlanta, USA.
  • Bindal P; Beth Israel Deaconess Medical Center, Boston, USA.
  • Bishnoi R; University of Florida, Gainesville, USA.
  • Bouganim N; McGill University Health Centre, Montréal, Canada.
  • Bowles DW; University of Colorado School of Medicine, Aurora, USA.
  • Cabal A; University of California San Diego, Moores Cancer Center, La Jolla, USA.
  • Caimi PF; University Hospitals Seidman Cancer Center, Cleveland, USA; Case Western Reserve University, Cleveland, USA.
  • Chism DD; Thompson Cancer Survival Center, Knoxville, USA.
  • Crowell J; St. Elizabeth Healthcare, Edgewood, USA.
  • Curran C; Dana-Farber Cancer Institute, Boston, USA.
  • Desai A; Mayo Clinic Cancer Center, Rochester, USA.
  • Dixon B; St. Elizabeth Healthcare, Edgewood, USA.
  • Doroshow DB; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
  • Durbin EB; Markey Cancer Center, University of Kentucky, Lexington, USA.
  • Elkrief A; McGill University Health Centre, Montréal, Canada.
  • Farmakiotis D; The Warren Alpert Medical School of Brown University, Providence, USA.
  • Fazio A; Tufts Medical Center Cancer Center, Boston and Stoneham, USA.
  • Fecher LA; University of Michigan Rogel Cancer Center, Ann Arbor, USA.
  • Flora DB; St. Elizabeth Healthcare, Edgewood, USA.
  • Friese CR; University of Michigan Rogel Cancer Center, Ann Arbor, USA.
  • Fu J; Tufts Medical Center Cancer Center, Boston and Stoneham, USA.
  • Gadgeel SM; Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA.
  • Galsky MD; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
  • Gill DM; Intermountain Healthcare, Salt Lake City, USA.
  • Glover MJ; Stanford University, Stanford, USA.
  • Goyal S; George Washington University, Washington DC, USA.
  • Grover P; University of Cincinnati Cancer Center, Cincinnati, USA.
  • Gulati S; University of Cincinnati Cancer Center, Cincinnati, USA.
Ann Oncol ; 32(6): 787-800, 2021 06.
Article in English | MEDLINE | ID: covidwho-1191173
ABSTRACT

BACKGROUND:

Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. PATIENTS AND

METHODS:

Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients).

RESULTS:

A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality.

CONCLUSIONS:

Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies. CLINICAL TRIAL IDENTIFIER NCT04354701.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male Language: English Journal: Ann Oncol Journal subject: Neoplasms Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male Language: English Journal: Ann Oncol Journal subject: Neoplasms Year: 2021 Document Type: Article