Anurag Mehta1, Smreti Vasudevan2, Anuj Parkash3, Anurag Sharma2, Tanu Vashist2, Vidya Krishna2. 1. Department of Laboratory, Transfusion and Molecular Diagnostics Services, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India. 2. Department of Research, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India. 3. Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, Delhi, India.
Abstract
BACKGROUND: Cancer patients, especially those receiving cytotoxic therapy, are assumed to have a higher probability of death from COVID-19. We have conducted this study to identify the Case Fatality Rate (CFR) in cancer patients with COVID-19 and have explored the relationship of various clinical factors to mortality in our patient cohort. METHODS: All confirmed cancer cases presented to the hospital from June 8 to August 20, 2020, and developed symptoms/radiological features suspicious of COVID-19 were tested by Real-time polymerase chain reaction assay and/or cartridge-based nucleic acid amplification test from a combination of naso-oropharyngeal swab for SARS-CoV-2. Clinical data, treatment details, and outcomes were assessed from the medical records. RESULTS: Of the total 3,101 cancer patients admitted to the hospital, 1,088 patients were tested and 186 patients were positive for SARS-CoV-2. The CFR in the cohort was 27/186 (14.52%). Univariate analysis showed that the risk of death was significantly associated with the presence of any comorbidity (OR: 2.68; (95% CI [1.13-6.32]); P = 0.025), multiple comorbidities (OR: 3.01; (95% CI [1.02-9.07]); P = 0.047 for multiple vs. single), and the severity of COVID-19 presentation (OR: 27.48; (95% CI [5.34-141.49]); P < 0.001 for severe vs. not severe symptoms). Among all comorbidities, diabetes (OR: 3.31; (95% CI [1.35-8.09]); P = 0.009) and cardiovascular diseases (OR: 3.77; (95% CI [1.02-13.91]); P = 0.046) were significant risk factors for death. Anticancer treatments including chemotherapy, surgery, radiotherapy, targeted therapy, and immunotherapy administered within a month before the onset of COVID-19 symptoms had no significant effect on mortality. CONCLUSION: To the best of our knowledge, this is the first study from India reporting the CFR, clinical associations, and risk factors for mortality in SARS-CoV-2 infected cancer patients. Our study shows that the frequency of COVID-19 in cancer patients is high. Recent anticancer therapies are not associated with mortality. Pre-existing comorbidities, especially diabetes, multiple comorbidities, and severe symptoms at presentation are significantly linked with COVID-19 related death in the cohort.
BACKGROUND: Cancer patients, especially those receiving cytotoxic therapy, are assumed to have a higher probability of death from COVID-19. We have conducted this study to identify the Case Fatality Rate (CFR) in cancer patients with COVID-19 and have explored the relationship of various clinical factors to mortality in our patient cohort. METHODS: All confirmed cancer cases presented to the hospital from June 8 to August 20, 2020, and developed symptoms/radiological features suspicious of COVID-19 were tested by Real-time polymerase chain reaction assay and/or cartridge-based nucleic acid amplification test from a combination of naso-oropharyngeal swab for SARS-CoV-2. Clinical data, treatment details, and outcomes were assessed from the medical records. RESULTS: Of the total 3,101 cancer patients admitted to the hospital, 1,088 patients were tested and 186 patients were positive for SARS-CoV-2. The CFR in the cohort was 27/186 (14.52%). Univariate analysis showed that the risk of death was significantly associated with the presence of any comorbidity (OR: 2.68; (95% CI [1.13-6.32]); P = 0.025), multiple comorbidities (OR: 3.01; (95% CI [1.02-9.07]); P = 0.047 for multiple vs. single), and the severity of COVID-19 presentation (OR: 27.48; (95% CI [5.34-141.49]); P < 0.001 for severe vs. not severe symptoms). Among all comorbidities, diabetes (OR: 3.31; (95% CI [1.35-8.09]); P = 0.009) and cardiovascular diseases (OR: 3.77; (95% CI [1.02-13.91]); P = 0.046) were significant risk factors for death. Anticancer treatments including chemotherapy, surgery, radiotherapy, targeted therapy, and immunotherapy administered within a month before the onset of COVID-19 symptoms had no significant effect on mortality. CONCLUSION: To the best of our knowledge, this is the first study from India reporting the CFR, clinical associations, and risk factors for mortality in SARS-CoV-2 infected cancer patients. Our study shows that the frequency of COVID-19 in cancer patients is high. Recent anticancer therapies are not associated with mortality. Pre-existing comorbidities, especially diabetes, multiple comorbidities, and severe symptoms at presentation are significantly linked with COVID-19 related death in the cohort.
Authors: Kevin Kalinsky; Melissa K Accordino; Kristina Hosi; Jessica E Hawley; Meghna S Trivedi; Katherine D Crew; Dawn L Hershman Journal: Breast Cancer Res Treat Date: 2020-05-14 Impact factor: 4.872
Authors: Nicole M Kuderer; Toni K Choueiri; Dimpy P Shah; Yu Shyr; Samuel M Rubinstein; Donna R Rivera; Sanjay Shete; Chih-Yuan Hsu; Aakash Desai; Gilberto de Lima Lopes; Petros Grivas; Corrie A Painter; Solange Peters; Michael A Thompson; Ziad Bakouny; Gerald Batist; Tanios Bekaii-Saab; Mehmet A Bilen; Nathaniel Bouganim; Mateo Bover Larroya; Daniel Castellano; Salvatore A Del Prete; Deborah B Doroshow; Pamela C Egan; Arielle Elkrief; Dimitrios Farmakiotis; Daniel Flora; Matthew D Galsky; Michael J Glover; Elizabeth A Griffiths; Anthony P Gulati; Shilpa Gupta; Navid Hafez; Thorvardur R Halfdanarson; Jessica E Hawley; Emily Hsu; Anup Kasi; Ali R Khaki; Christopher A Lemmon; Colleen Lewis; Barbara Logan; Tyler Masters; Rana R McKay; Ruben A Mesa; Alicia K Morgans; Mary F Mulcahy; Orestis A Panagiotou; Prakash Peddi; Nathan A Pennell; Kerry Reynolds; Lane R Rosen; Rachel Rosovsky; Mary Salazar; Andrew Schmidt; Sumit A Shah; Justin A Shaya; John Steinharter; Keith E Stockerl-Goldstein; Suki Subbiah; Donald C Vinh; Firas H Wehbe; Lisa B Weissmann; Julie Tsu-Yu Wu; Elizabeth Wulff-Burchfield; Zhuoer Xie; Albert Yeh; Peter P Yu; Alice Y Zhou; Leyre Zubiri; Sanjay Mishra; Gary H Lyman; Brian I Rini; Jeremy L Warner Journal: Lancet Date: 2020-05-28 Impact factor: 79.321
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: A Sud; M E Jones; J Broggio; C Loveday; B Torr; A Garrett; D L Nicol; S Jhanji; S A Boyce; F Gronthoud; P Ward; J M Handy; N Yousaf; J Larkin; Y-E Suh; S Scott; P D P Pharoah; C Swanton; C Abbosh; M Williams; G Lyratzopoulos; R Houlston; C Turnbull Journal: Ann Oncol Date: 2020-05-19 Impact factor: 32.976
Authors: Vikas Mehta; Sanjay Goel; Rafi Kabarriti; Balazs Halmos; Amit Verma; Daniel Cole; Mendel Goldfinger; Ana Acuna-Villaorduna; Kith Pradhan; Raja Thota; Stan Reissman; Joseph A Sparano; Benjamin A Gartrell; Richard V Smith; Nitin Ohri; Madhur Garg; Andrew D Racine; Shalom Kalnicki; Roman Perez-Soler Journal: Cancer Discov Date: 2020-05-01 Impact factor: 38.272
Authors: David J Pinato; Alberto Zambelli; Juan Aguilar-Company; Mark Bower; Christopher Sng; Ramon Salazar; Alexia Bertuzzi; Joan Brunet; Ricard Mesia; Elia Segui; Federica Biello; Daniele Generali; Salvatore Grisanti; Gianpiero Rizzo; Michela Libertini; Antonio Maconi; Nadia Harbeck; Bruno Vincenzi; Rossella Bertulli; Diego Ottaviani; Anna Carbo; Riccardo Bruna; Sarah Benafif; Andrea Marrari; Rachel Wuerstlein; M Carmen Carmona-Garcia; Neha Chopra; Carlo Tondini; Oriol Mirallas; Valeria Tovazzi; Marta Betti; Salvatore Provenzano; Vittoria Fotia; Claudia Andrea Cruz; Alessia Dalla Pria; Francesca D'Avanzo; Joanne S Evans; Nadia Saoudi-Gonzalez; Eudald Felip; Myria Galazi; Isabel Garcia-Fructuoso; Alvin J X Lee; Thomas Newsom-Davis; Andrea Patriarca; David Garcia-Illescas; Roxana Reyes; Palma Dileo; Rachel Sharkey; Yien Ning Sophia Wong; Daniela Ferrante; Javier Marco-Hernandez; Anna Sureda; Clara Maluquer; Isabel Ruiz-Camps; Gianluca Gaidano; Lorenza Rimassa; Lorenzo Chiudinelli; Macarena Izuzquiza; Alba Cabirta; Michela Franchi; Armando Santoro; Aleix Prat; Josep Tabernero; Alessandra Gennari Journal: Cancer Discov Date: 2020-07-31 Impact factor: 39.397
Authors: Kamal S Saini; Marco Tagliamento; Matteo Lambertini; Richard McNally; Marco Romano; Manuela Leone; Giuseppe Curigliano; Evandro de Azambuja Journal: Eur J Cancer Date: 2020-09-02 Impact factor: 9.162