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Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.
Hwang, Clara; Izano, Monika A; Thompson, Michael A; Gadgeel, Shirish M; Weese, James L; Mikkelsen, Tom; Schrag, Andrew; Teka, Mahder; Walters, Sheetal; Wolf, Frank M; Hirsch, Jonathan; Rivera, Donna R; Kluetz, Paul G; Singh, Harpreet; Brown, Thomas D.
  • Hwang C; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.
  • Izano MA; Syapse, San Francisco, California, USA.
  • Thompson MA; Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.
  • Gadgeel SM; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.
  • Weese JL; Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.
  • Mikkelsen T; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.
  • Schrag A; Syapse, San Francisco, California, USA.
  • Teka M; Syapse, San Francisco, California, USA.
  • Walters S; Syapse, San Francisco, California, USA.
  • Wolf FM; Syapse, San Francisco, California, USA.
  • Hirsch J; Syapse, San Francisco, California, USA.
  • Rivera DR; Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.
  • Kluetz PG; Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.
  • Singh H; Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.
  • Brown TD; Syapse, San Francisco, California, USA.
Cancer Rep (Hoboken) ; 4(5): e1388, 2021 10.
Article in English | MEDLINE | ID: covidwho-1235659
Semantic information from SemMedBD (by NLM)
1. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Malignant Neoplasms AFFECTS COVID-19
Subject
Malignant Neoplasms
Predicate
AFFECTS
Object
COVID-19
4. Malignant Neoplasms PROCESS_OF Adult
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Adult
5. Comorbidity PROCESS_OF Patients
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Patients
6. Malignant Neoplasms PROCESS_OF African race
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
African race
7. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
8. Household composition PROCESS_OF Patients
Subject
Household composition
Predicate
PROCESS_OF
Object
Patients
9. Pharmacotherapy TREATS Disorder of pulmonary circulation
Subject
Pharmacotherapy
Predicate
TREATS
Object
Disorder of pulmonary circulation
10. Immune Checkpoint Inhibitors TREATS Disorder of pulmonary circulation
Subject
Immune Checkpoint Inhibitors
Predicate
TREATS
Object
Disorder of pulmonary circulation
11. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
13. Malignant Neoplasms AFFECTS COVID-19
Subject
Malignant Neoplasms
Predicate
AFFECTS
Object
COVID-19
14. Malignant Neoplasms PROCESS_OF Adult
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Adult
15. Comorbidity PROCESS_OF Patients
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Patients
16. Malignant Neoplasms PROCESS_OF African race
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
African race
17. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
18. Household composition PROCESS_OF Patients
Subject
Household composition
Predicate
PROCESS_OF
Object
Patients
19. Pharmacotherapy TREATS Disorder of pulmonary circulation
Subject
Pharmacotherapy
Predicate
TREATS
Object
Disorder of pulmonary circulation
20. Immune Checkpoint Inhibitors TREATS Disorder of pulmonary circulation
Subject
Immune Checkpoint Inhibitors
Predicate
TREATS
Object
Disorder of pulmonary circulation
ABSTRACT

BACKGROUND:

The understanding of the impact of COVID-19 in patients with cancer is evolving, with need for rapid analysis.

AIMS:

This study aims to compare the clinical and demographic characteristics of patients with cancer (with and without COVID-19) and characterize the clinical outcomes of patients with COVID-19 and cancer. METHODS AND

RESULTS:

Real-world data (RWD) from two health systems were used to identify 146 702 adults diagnosed with cancer between 2015 and 2020; 1267 COVID-19 cases were identified between February 1 and July 30, 2020. Demographic, clinical, and socioeconomic characteristics were extracted. Incidence of all-cause mortality, hospitalizations, and invasive respiratory support was assessed between February 1 and August 14, 2020. Among patients with cancer, patients with COVID-19 were more likely to be Non-Hispanic black (NHB), have active cancer, have comorbidities, and/or live in zip codes with median household income <$30 000. Patients with COVID-19 living in lower-income areas and NHB patients were at greatest risk for hospitalization from pneumonia, fluid and electrolyte disorders, cough, respiratory failure, and acute renal failure and were more likely to receive hydroxychloroquine. All-cause mortality, hospital admission, and invasive respiratory support were more frequent among patients with cancer and COVID-19. Male sex, increasing age, living in zip codes with median household income <$30 000, history of pulmonary circulation disorders, and recent treatment with immune checkpoint inhibitors or chemotherapy were associated with greater odds of all-cause mortality in multivariable logistic regression models.

CONCLUSION:

RWD can be rapidly leveraged to understand urgent healthcare challenges. Patients with cancer are more vulnerable to COVID-19 effects, especially in the setting of active cancer and comorbidities, with additional risk observed in NHB patients and those living in zip codes with median household income <$30 000.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Socioeconomic Factors / Social Determinants of Health / COVID-19 / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Cancer Rep (Hoboken) Year: 2021 Document Type: Article Affiliation country: Cnr2.1388

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Socioeconomic Factors / Social Determinants of Health / COVID-19 / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Cancer Rep (Hoboken) Year: 2021 Document Type: Article Affiliation country: Cnr2.1388