PURPOSE: Coronavirus-2019 (COVID-19) mortality is higher in patients with cancer than in the general population, yet the cancer-associated risk factors for COVID-19 adverse outcomes are not fully characterized. PATIENTS AND METHODS: We reviewed clinical characteristics and outcomes from patients with cancer and concurrent COVID-19 at Memorial Sloan Kettering Cancer Center until March 31, 2020 (n = 309), and observed clinical end points until April 13, 2020. We hypothesized that cytotoxic chemotherapy administered within 35 days of a COVID-19 diagnosis is associated with an increased hazard ratio (HR) of severe or critical COVID-19. In secondary analyses, we estimated associations between specific clinical and laboratory variables and the incidence of a severe or critical COVID-19 event. RESULTS: Cytotoxic chemotherapy administration was not significantly associated with a severe or critical COVID-19 event (HR, 1.10; 95% CI, 0.73 to 1.60). Hematologic malignancy was associated with increased COVID-19 severity (HR, 1.90; 95% CI, 1.30 to 2.80). Patients with lung cancer also demonstrated higher rates of severe or critical COVID-19 events (HR, 2.0; 95% CI, 1.20 to 3.30). Lymphopenia at COVID-19 diagnosis was associated with higher rates of severe or critical illness (HR, 2.10; 95% CI, 1.50 to 3.10). Patients with baseline neutropenia 14-90 days before COVID-19 diagnosis had worse outcomes (HR, 4.20; 95% CI, 1.70 to 11.00). Findings from these analyses remained consistent in a multivariable model and in multiple sensitivity analyses. The rate of adverse events was lower in a time-matched population of patients with cancer without COVID-19. CONCLUSION: Recent cytotoxic chemotherapy treatment was not associated with adverse COVID-19 outcomes. Patients with active hematologic or lung malignancies, peri-COVID-19 lymphopenia, or baseline neutropenia had worse COVID-19 outcomes. Interactions among antineoplastic therapy, cancer type, and COVID-19 are complex and warrant further investigation.
PURPOSE:Coronavirus-2019 (COVID-19) mortality is higher in patients with cancer than in the general population, yet the cancer-associated risk factors for COVID-19 adverse outcomes are not fully characterized. PATIENTS AND METHODS: We reviewed clinical characteristics and outcomes from patients with cancer and concurrent COVID-19 at Memorial Sloan Kettering Cancer Center until March 31, 2020 (n = 309), and observed clinical end points until April 13, 2020. We hypothesized that cytotoxic chemotherapy administered within 35 days of a COVID-19 diagnosis is associated with an increased hazard ratio (HR) of severe or critical COVID-19. In secondary analyses, we estimated associations between specific clinical and laboratory variables and the incidence of a severe or critical COVID-19 event. RESULTS: Cytotoxic chemotherapy administration was not significantly associated with a severe or critical COVID-19 event (HR, 1.10; 95% CI, 0.73 to 1.60). Hematologic malignancy was associated with increased COVID-19 severity (HR, 1.90; 95% CI, 1.30 to 2.80). Patients with lung cancer also demonstrated higher rates of severe or critical COVID-19 events (HR, 2.0; 95% CI, 1.20 to 3.30). Lymphopenia at COVID-19 diagnosis was associated with higher rates of severe or critical illness (HR, 2.10; 95% CI, 1.50 to 3.10). Patients with baseline neutropenia 14-90 days before COVID-19 diagnosis had worse outcomes (HR, 4.20; 95% CI, 1.70 to 11.00). Findings from these analyses remained consistent in a multivariable model and in multiple sensitivity analyses. The rate of adverse events was lower in a time-matched population of patients with cancer without COVID-19. CONCLUSION: Recent cytotoxic chemotherapy treatment was not associated with adverse COVID-19 outcomes. Patients with active hematologic or lung malignancies, peri-COVID-19 lymphopenia, or baseline neutropenia had worse COVID-19 outcomes. Interactions among antineoplastic therapy, cancer type, and COVID-19 are complex and warrant further investigation.
Authors: Safiya Richardson; Jamie S Hirsch; Mangala Narasimhan; James M Crawford; Thomas McGinn; Karina W Davidson; Douglas P Barnaby; Lance B Becker; John D Chelico; Stuart L Cohen; Jennifer Cookingham; Kevin Coppa; Michael A Diefenbach; Andrew J Dominello; Joan Duer-Hefele; Louise Falzon; Jordan Gitlin; Negin Hajizadeh; Tiffany G Harvin; David A Hirschwerk; Eun Ji Kim; Zachary M Kozel; Lyndonna M Marrast; Jazmin N Mogavero; Gabrielle A Osorio; Michael Qiu; Theodoros P Zanos Journal: JAMA Date: 2020-05-26 Impact factor: 56.272
Authors: Brandon Michael Henry; Maria Helena Santos de Oliveira; Stefanie Benoit; Mario Plebani; Giuseppe Lippi Journal: Clin Chem Lab Med Date: 2020-06-25 Impact factor: 3.694
Authors: Lennard Yw Lee; Jean-Baptiste Cazier; Vasileios Angelis; Roland Arnold; Vartika Bisht; Naomi A Campton; Julia Chackathayil; Vinton Wt Cheng; Helen M Curley; Matthew W Fittall; Luke Freeman-Mills; Spyridon Gennatas; Anshita Goel; Simon Hartley; Daniel J Hughes; David Kerr; Alvin Jx Lee; Rebecca J Lee; Sophie E McGrath; Christopher P Middleton; Nirupa Murugaesu; Thomas Newsom-Davis; Alicia Fc Okines; Anna C Olsson-Brown; Claire Palles; Yi Pan; Ruth Pettengell; Thomas Powles; Emily A Protheroe; Karin Purshouse; Archana Sharma-Oates; Shivan Sivakumar; Ashley J Smith; Thomas Starkey; Chris D Turnbull; Csilla Várnai; Nadia Yousaf; Rachel Kerr; Gary Middleton Journal: Lancet Date: 2020-05-28 Impact factor: 79.321
Authors: David J Chung; Gunjan L Shah; Roni Tamari; Ioannis Politikos; David A Knorr; Santosha A Vardhana; Jennifer C Young; LeeAnn T Marcello; Sital Doddi; Sean M Devlin; Lakshmi V Ramanathan; Melissa S Pessin; Erica Dunn; Meighan Palazzo; Christina D Bravo; Genovefa A Papanicolaou; Mini Kamboj; Miguel Angel Perales Journal: Blood Cancer Discov Date: 2021-09-13
Authors: Mariano Provencio; José María Mazarico Gallego; Antonio Calles; Mónica Antoñanzas; Cristina Pangua; Xabier Mielgo Rubio; Ernest Nadal; Rafael López Castro; Ana López-Martín; Edel Del Barco; Manuel Dómine; Fernando Franco; Pilar Diz; Carmen Sandoval; Elia Sais Girona; Ivana Sullivan; Mª Ángeles Sala; Gema García Ledo; Marc Cucurull; Joaquín Mosquera; Mireia Martínez; Luis Enrique Chara; Edurne Arriola; Beatriz Esteban Herrera; José Ramón Jarabo; Rosa Álvarez Álvarez; Javier Baena; María González Cao Journal: Lung Cancer Date: 2021-05-14 Impact factor: 5.705
Authors: Aakash Desai; Turab J Mohammed; Narjust Duma; Marina C Garassino; Lisa K Hicks; Nicole M Kuderer; Gary H Lyman; Sanjay Mishra; David J Pinato; Brian I Rini; Solange Peters; Jeremy L Warner; Jennifer G Whisenant; William A Wood; Michael A Thompson Journal: JAMA Oncol Date: 2021-12-01 Impact factor: 31.777