PURPOSE: Variation in risk of adverse clinical outcomes in patients with cancer and COVID-19 has been reported from relatively small cohorts. The NCATS' National COVID Cohort Collaborative (N3C) is a centralized data resource representing the largest multicenter cohort of COVID-19 cases and controls nationwide. We aimed to construct and characterize the cancer cohort within N3C and identify risk factors for all-cause mortality from COVID-19. METHODS: We used 4,382,085 patients from 50 US medical centers to construct a cohort of patients with cancer. We restricted analyses to adults ≥ 18 years old with a COVID-19-positive or COVID-19-negative diagnosis between January 1, 2020, and March 25, 2021. We followed N3C selection of an index encounter per patient for analyses. All analyses were performed in the N3C Data Enclave Palantir platform. RESULTS: A total of 398,579 adult patients with cancer were identified from the N3C cohort; 63,413 (15.9%) were COVID-19-positive. Most common represented cancers were skin (13.8%), breast (13.7%), prostate (10.6%), hematologic (10.5%), and GI cancers (10%). COVID-19 positivity was significantly associated with increased risk of all-cause mortality (hazard ratio, 1.20; 95% CI, 1.15 to 1.24). Among COVID-19-positive patients, age ≥ 65 years, male gender, Southern or Western US residence, an adjusted Charlson Comorbidity Index score ≥ 4, hematologic malignancy, multitumor sites, and recent cytotoxic therapy were associated with increased risk of all-cause mortality. Patients who received recent immunotherapies or targeted therapies did not have higher risk of overall mortality. CONCLUSION: Using N3C, we assembled the largest nationally representative cohort of patients with cancer and COVID-19 to date. We identified demographic and clinical factors associated with increased all-cause mortality in patients with cancer. Full characterization of the cohort will provide further insights into the effects of COVID-19 on cancer outcomes and the ability to continue specific cancer treatments.
PURPOSE: Variation in risk of adverse clinical outcomes in patients with cancer and COVID-19 has been reported from relatively small cohorts. The NCATS' National COVID Cohort Collaborative (N3C) is a centralized data resource representing the largest multicenter cohort of COVID-19 cases and controls nationwide. We aimed to construct and characterize the cancer cohort within N3C and identify risk factors for all-cause mortality from COVID-19. METHODS: We used 4,382,085 patients from 50 US medical centers to construct a cohort of patients with cancer. We restricted analyses to adults ≥ 18 years old with a COVID-19-positive or COVID-19-negative diagnosis between January 1, 2020, and March 25, 2021. We followed N3C selection of an index encounter per patient for analyses. All analyses were performed in the N3C Data Enclave Palantir platform. RESULTS: A total of 398,579 adult patients with cancer were identified from the N3C cohort; 63,413 (15.9%) were COVID-19-positive. Most common represented cancers were skin (13.8%), breast (13.7%), prostate (10.6%), hematologic (10.5%), and GI cancers (10%). COVID-19 positivity was significantly associated with increased risk of all-cause mortality (hazard ratio, 1.20; 95% CI, 1.15 to 1.24). Among COVID-19-positive patients, age ≥ 65 years, male gender, Southern or Western US residence, an adjusted Charlson Comorbidity Index score ≥ 4, hematologic malignancy, multitumor sites, and recent cytotoxic therapy were associated with increased risk of all-cause mortality. Patients who received recent immunotherapies or targeted therapies did not have higher risk of overall mortality. CONCLUSION: Using N3C, we assembled the largest nationally representative cohort of patients with cancer and COVID-19 to date. We identified demographic and clinical factors associated with increased all-cause mortality in patients with cancer. Full characterization of the cohort will provide further insights into the effects of COVID-19 on cancer outcomes and the ability to continue specific cancer treatments.
Authors: Gagandeep Brar; Laura C Pinheiro; Michael Shusterman; Brandon Swed; Evgeniya Reshetnyak; Orysya Soroka; Frank Chen; Samuel Yamshon; John Vaughn; Peter Martin; Doru Paul; Manuel Hidalgo; Manish A Shah Journal: J Clin Oncol Date: 2020-09-28 Impact factor: 44.544
Authors: Gregorio A Millett; Austin T Jones; David Benkeser; Stefan Baral; Laina Mercer; Chris Beyrer; Brian Honermann; Elise Lankiewicz; Leandro Mena; Jeffrey S Crowley; Jennifer Sherwood; Patrick S Sullivan Journal: Ann Epidemiol Date: 2020-05-14 Impact factor: 3.797
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
Authors: Christopher T Rentsch; Farah Kidwai-Khan; Janet P Tate; Lesley S Park; Joseph T King; Melissa Skanderson; Ronald G Hauser; Anna Schultze; Christopher I Jarvis; Mark Holodniy; Vincent Lo Re; Kathleen M Akgün; Kristina Crothers; Tamar H Taddei; Matthew S Freiberg; Amy C Justice Journal: PLoS Med Date: 2020-09-22 Impact factor: 11.069
Authors: Melissa A Haendel; Christopher G Chute; Tellen D Bennett; David A Eichmann; Justin Guinney; Warren A Kibbe; Philip R O Payne; Emily R Pfaff; Peter N Robinson; Joel H Saltz; Heidi Spratt; Christine Suver; John Wilbanks; Adam B Wilcox; Andrew E Williams; Chunlei Wu; Clair Blacketer; Robert L Bradford; James J Cimino; Marshall Clark; Evan W Colmenares; Patricia A Francis; Davera Gabriel; Alexis Graves; Raju Hemadri; Stephanie S Hong; George Hripscak; Dazhi Jiao; Jeffrey G Klann; Kristin Kostka; Adam M Lee; Harold P Lehmann; Lora Lingrey; Robert T Miller; Michele Morris; Shawn N Murphy; Karthik Natarajan; Matvey B Palchuk; Usman Sheikh; Harold Solbrig; Shyam Visweswaran; Anita Walden; Kellie M Walters; Griffin M Weber; Xiaohan Tanner Zhang; Richard L Zhu; Benjamin Amor; Andrew T Girvin; Amin Manna; Nabeel Qureshi; Michael G Kurilla; Sam G Michael; Lili M Portilla; Joni L Rutter; Christopher P Austin; Ken R Gersing Journal: J Am Med Inform Assoc Date: 2021-03-01 Impact factor: 7.942
Authors: Santosha A Vardhana; David A Knorr; David J Chung; Gunjan L Shah; Sean M Devlin; Lakshmi V Ramanathan; Sital Doddi; Melissa S Pessin; Elizabeth Hoover; LeeAnn T Marcello; Jennifer C Young; Sawsan R Boutemine; Edith Serrano; Saumya Sharan; Saddia Momotaj; Lauren Margetich; Christina D Bravo; Genovefa A Papanicolaou; Mini Kamboj; Anthony R Mato; Lindsey E Roeker; Malin Hultcrantz; Sham Mailankody; Alexander M Lesokhin Journal: Blood Cancer Discov Date: 2021-09-13
Authors: Shawn N Murphy; Shyam Visweswaran; Michael J Becich; Thomas R Campion; Boyd M Knosp; Genevieve B Melton-Meaux; Leslie A Lenert Journal: J Am Med Inform Assoc Date: 2022-03-15 Impact factor: 7.942