David J Pinato1,2, Meera Patel1, Lorenza Scotti3, Emeline Colomba4, Saoirse Dolly5, Angela Loizidou6, John Chester7,8, Uma Mukherjee9, Alberto Zambelli10, Alessia Dalla Pria11, Juan Aguilar-Company12,13, Mark Bower11, Ramon Salazar14, Alexia Bertuzzi15, Joan Brunet16, Matteo Lambertini17,18, Marco Tagliamento17,18, Anna Pous19, Ailsa Sita-Lumsden5, Krishnie Srikandarajah5, Johann Colomba4, Fanny Pommeret4, Elia Seguí20, Daniele Generali21,22, Salvatore Grisanti23, Paolo Pedrazzoli24,25, Gianpiero Rizzo24, Michela Libertini26, Charlotte Moss27, Joanne S Evans1, Beth Russell27, Nadia Harbeck28, Bruno Vincenzi29, Federica Biello2, Rossella Bertulli30, Diego Ottaviani31, Raquel Liñan16, Sabrina Rossi15, M Carmen Carmona-García16, Carlo Tondini10, Laura Fox32, Alice Baggi22, Vittoria Fotia10, Alessandro Parisi33, Giampero Porzio34, Paola Queirolo35, Claudia Andrea Cruz20, Nadia Saoudi-Gonzalez12, Eudald Felip19, Ariadna Roqué Lloveras16, Thomas Newsom-Davis11, Rachel Sharkey11, Elisa Roldán12, Roxana Reyes20, Federica Zoratto36, Irina Earnshaw31, Daniela Ferrante3, Javier Marco-Hernández37, Isabel Ruiz-Camps13, Gianluca Gaidano38, Andrea Patriarca38, Riccardo Bruna38, Anna Sureda39, Clara Martinez-Vila40, Ana Sanchez de Torre41, Rossana Berardi42, Raffaele Giusti43, Francesca Mazzoni44, Annalisa Guida45, Lorenza Rimassa15,46, Lorenzo Chiudinelli10, Michela Franchi10, Marco Krengli47, Armando Santoro15,46, Aleix Prat20,48, Josep Tabernero49, Mieke Van Hemelrijck27, Nikolaos Diamantis9, Alessandra Gennari2, Alessio Cortellini1,34. 1. Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom. 2. Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. 3. Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy. 4. Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France. 5. Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. 6. Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 7. Medical Oncology, School of Medicine, Cardiff University, Cardiff, United Kingdom. 8. Medical Oncology, Velindre Cancer Centre, Cardiff, United Kingdom. 9. Medical Oncology, Barts Health NHS Trust, London, United Kingdom. 10. Oncology Unit, Azienda Socio Sanitaria Territoriale, Papa Giovanni XXIII, Bergamo, Italy. 11. Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom. 12. Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain. 13. Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain. 14. Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program, CIBERONC, Hospitalet de Llobregat, Spain. 15. Medical Oncology and Hematology Unit, Humanitas Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Rozzano, Milan, Italy. 16. Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain. 17. Medical Oncology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy. 18. Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy. 19. Medical Oncology Department, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Catalan Institute of Oncology-Badalona, Spain. 20. Department of Medical Oncology, Hospital Clinic, Barcelona, Spain. 21. Multidisciplinary Breast Pathology and Translational Research Unit, Azienda Socio Sanitaria Territoriale, Cremona, Italy. 22. Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy. 23. Medical Oncology Unit, Spedali Civili, Brescia, Italy. 24. Medical Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Policlinico San Matteo, Pavia, Italy. 25. Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy. 26. Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. 27. Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom. 28. Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and Comprehensive Cancer Center Munich, University Hospital Munich, Munich, Germany. 29. Policlinico Universitario Campus Bio-Medico, Rome, Italy. 30. Medical Oncology 2, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Humanitas Research Hospital, Istituto Nazionale dei Tumori, Milan, Italy. 31. Cancer Division, University College London Hospitals, London, United Kingdom. 32. Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain. 33. Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy. 34. Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. 35. Melanoma and Sarcoma Medical Treatment Unit, Istituto Europeo di Oncologia, Milan, Italy. 36. Medical Oncology, St Maria Goretti Hospital, Latina, Italy. 37. Department of Internal Medicine, Hospital Clinic, Barcelona, Spain. 38. Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy. 39. Haematology Department, Institut Catala d'Oncologia Hospitalet, Hospitalet de Llobregat, Bellvitge Institute for Biomedical Research, Universitat de Barcelona, Barcelona, Spain. 40. Fundació Althaia Manresa, Manresa, Spain. 41. Hospital Universitario XII de Octubre Madrid, Spain. 42. Medical Oncology, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy. 43. Medical Oncology, St Andrea Hospital, Rome, Italy. 44. Medical Oncology, Careggi University Hospital, Florence, Italy. 45. Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy. 46. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, Milan, Italy. 47. Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore Della Carità, Novara, Italy. 48. Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain. 49. Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, Baselga Oncological Institute at Quiron, Universitat de Vic - Universitat Central de Catalunya, Barcelona, Spain.
Abstract
Importance: Whether the severity and mortality of COVID-19 in patients with cancer have improved in terms of disease management and capacity is yet to be defined. Objective: To test whether severity and mortality from COVID-19 among patients with cancer have improved during the course of the pandemic. Design, Setting, and Participants: OnCovid is a European registry that collects data on consecutive patients with solid or hematologic cancer and COVID-19. This multicenter case series study included real-world data from 35 institutions across 6 countries (UK, Italy, Spain, France, Belgium, and Germany). This update included patients diagnosed between February 27, 2020, and February, 14, 2021. Inclusion criteria were confirmed diagnosis of SARS-CoV-2 infection and a history of solid or hematologic cancer. Exposures: SARS-CoV-2 infection. Main Outcomes and Measures: Deaths were differentiated at 14 days and 3 months as the 2 landmark end points. Patient characteristics and outcomes were compared by stratifying patients across 5 phases (February to March 2020, April to June 2020, July to September 2020, October to December 2020, and January to February 2021) and across 2 major outbreaks (February to June 2020 and July 2020 to February 2021). Results: At data cutoff, 2795 consecutive patients were included, with 2634 patients eligible for analysis (median [IQR] age, 68 [18-77] years ; 52.8% men). Eligible patients demonstrated significant time-dependent improvement in 14-day case-fatality rate (CFR) with estimates of 29.8% (95% CI, 0.26-0.33) for February to March 2020; 20.3% (95% CI, 0.17-0.23) for April to June 2020; 12.5% (95% CI, 0.06-22.90) for July to September 2020; 17.2% (95% CI, 0.15-0.21) for October to December 2020; and 14.5% (95% CI, 0.09-0.21) for January to February 2021 (all P < .001) across the predefined phases. Compared with the second major outbreak, patients diagnosed in the first outbreak were more likely to be 65 years or older (974 of 1626 [60.3%] vs 564 of 1008 [56.1%]; P = .03), have at least 2 comorbidities (793 of 1626 [48.8%] vs 427 of 1008 [42.4%]; P = .001), and have advanced tumors (708 of 1626 [46.4%] vs 536 of 1008 [56.1%]; P < .001). Complications of COVID-19 were more likely to be seen (738 of 1626 [45.4%] vs 342 of 1008 [33.9%]; P < .001) and require hospitalization (969 of 1626 [59.8%] vs 418 of 1008 [42.1%]; P < .001) and anti-COVID-19 therapy (1004 of 1626 [61.7%] vs 501 of 1008 [49.7%]; P < .001) during the first major outbreak. The 14-day CFRs for the first and second major outbreaks were 25.6% (95% CI, 0.23-0.28) vs 16.2% (95% CI, 0.13-0.19; P < .001), respectively. After adjusting for country, sex, age, comorbidities, tumor stage and status, anti-COVID-19 and anticancer therapy, and COVID-19 complications, patients diagnosed in the first outbreak had an increased risk of death at 14 days (hazard ratio [HR], 1.85; 95% CI, 1.47-2.32) and 3 months (HR, 1.28; 95% CI, 1.08-1.51) compared with those diagnosed in the second outbreak. Conclusions and Relevance: The findings of this registry-based study suggest that mortality in patients with cancer diagnosed with COVID-19 has improved in Europe; this improvement may be associated with earlier diagnosis, improved management, and dynamic changes in community transmission over time.
Importance: Whether the severity and mortality of COVID-19 in patients with cancer have improved in terms of disease management and capacity is yet to be defined. Objective: To test whether severity and mortality from COVID-19 among patients with cancer have improved during the course of the pandemic. Design, Setting, and Participants: OnCovid is a European registry that collects data on consecutive patients with solid or hematologic cancer and COVID-19. This multicenter case series study included real-world data from 35 institutions across 6 countries (UK, Italy, Spain, France, Belgium, and Germany). This update included patients diagnosed between February 27, 2020, and February, 14, 2021. Inclusion criteria were confirmed diagnosis of SARS-CoV-2 infection and a history of solid or hematologic cancer. Exposures: SARS-CoV-2 infection. Main Outcomes and Measures: Deaths were differentiated at 14 days and 3 months as the 2 landmark end points. Patient characteristics and outcomes were compared by stratifying patients across 5 phases (February to March 2020, April to June 2020, July to September 2020, October to December 2020, and January to February 2021) and across 2 major outbreaks (February to June 2020 and July 2020 to February 2021). Results: At data cutoff, 2795 consecutive patients were included, with 2634 patients eligible for analysis (median [IQR] age, 68 [18-77] years ; 52.8% men). Eligible patients demonstrated significant time-dependent improvement in 14-day case-fatality rate (CFR) with estimates of 29.8% (95% CI, 0.26-0.33) for February to March 2020; 20.3% (95% CI, 0.17-0.23) for April to June 2020; 12.5% (95% CI, 0.06-22.90) for July to September 2020; 17.2% (95% CI, 0.15-0.21) for October to December 2020; and 14.5% (95% CI, 0.09-0.21) for January to February 2021 (all P < .001) across the predefined phases. Compared with the second major outbreak, patients diagnosed in the first outbreak were more likely to be 65 years or older (974 of 1626 [60.3%] vs 564 of 1008 [56.1%]; P = .03), have at least 2 comorbidities (793 of 1626 [48.8%] vs 427 of 1008 [42.4%]; P = .001), and have advanced tumors (708 of 1626 [46.4%] vs 536 of 1008 [56.1%]; P < .001). Complications of COVID-19 were more likely to be seen (738 of 1626 [45.4%] vs 342 of 1008 [33.9%]; P < .001) and require hospitalization (969 of 1626 [59.8%] vs 418 of 1008 [42.1%]; P < .001) and anti-COVID-19 therapy (1004 of 1626 [61.7%] vs 501 of 1008 [49.7%]; P < .001) during the first major outbreak. The 14-day CFRs for the first and second major outbreaks were 25.6% (95% CI, 0.23-0.28) vs 16.2% (95% CI, 0.13-0.19; P < .001), respectively. After adjusting for country, sex, age, comorbidities, tumor stage and status, anti-COVID-19 and anticancer therapy, and COVID-19 complications, patients diagnosed in the first outbreak had an increased risk of death at 14 days (hazard ratio [HR], 1.85; 95% CI, 1.47-2.32) and 3 months (HR, 1.28; 95% CI, 1.08-1.51) compared with those diagnosed in the second outbreak. Conclusions and Relevance: The findings of this registry-based study suggest that mortality in patients with cancer diagnosed with COVID-19 has improved in Europe; this improvement may be associated with earlier diagnosis, improved management, and dynamic changes in community transmission over time.
Authors: Guilherme Haradaa; Fernanda F Antonacio; Aline Bl Gongora; Marina H Behar; Fernanda C Capareli; Diogo A Bastos; Rodrigo R Munhoz; Frederico P Costa; Denis L Jardim; Celso Arrais-Rodrigues; Yana Novis; Artur Katz; Gilberto de Castro Junior Journal: Ecancermedicalscience Date: 2020-09-09
Authors: Jennifer G Whisenant; Annalisa Trama; Valter Torri; Alessandro De Toma; Giuseppe Viscardi; Alessio Cortellini; Olivier Michielin; Fabrice Barlesi; Anne-Marie C Dingemans; Jan Van Meerbeeck; Vera Pancaldi; Ross A Soo; Natasha B Leighl; Solange Peters; Heather Wakelee; Marina Chiara Garassino; Leora Horn Journal: Cancer Cell Date: 2020-05-16 Impact factor: 31.743
Authors: Roger Sun; Samy Ammari; Sophie Bockel; Samir Achkar; Mansouria Merad; Laurent Dercle; Sofia Rivera; Cyrus Chargari; Eric Deutsch Journal: Front Oncol Date: 2020-11-18 Impact factor: 6.244
Authors: Gino M Dettorre; Saoirse Dolly; Angela Loizidou; John Chester; Amanda Jackson; Uma Mukherjee; Alberto Zambelli; Juan Aguilar-Company; Mark Bower; Christopher C T Sng; Ramon Salazar; Alexia Bertuzzi; Joan Brunet; Ricard Mesia; Ailsa Sita-Lumsden; Elia Seguí; Federica Biello; Daniele Generali; Salvatore Grisanti; Pavetha Seeva; Gianpiero Rizzo; Michela Libertini; Antonio Maconi; Charlotte Moss; Beth Russell; Nadia Harbeck; Bruno Vincenzi; Rossella Bertulli; Diego Ottaviani; Raquel Liñan; Andrea Marrari; M Carmen Carmona-García; Neha Chopra; Carlo Alberto Tondini; Oriol Mirallas; Valeria Tovazzi; Vittoria Fotia; Claudia Andrea Cruz; Nadia Saoudi-Gonzalez; Eudald Felip; Ariadna Roqué; Alvin J X Lee; Tom Newsom-Davis; David García-Illescas; Roxana Reyes; Yien Ning Sophia Wong; Daniela Ferrante; Lorenza Scotti; Javier Marco-Hernández; Isabel Ruiz-Camps; Andrea Patriarca; Lorenza Rimassa; Lorenzo Chiudinelli; Michela Franchi; Armando Santoro; Aleix Prat; Alessandra Gennari; Mieke Van Hemelrijck; Josep Tabernero; Nikolaos Diamantis; David J Pinato Journal: J Immunother Cancer Date: 2021-03 Impact factor: 13.751
Authors: David J Pinato; Lorenza Scotti; Alessandra Gennari; Emeline Colomba-Blameble; Saoirse Dolly; Angela Loizidou; John Chester; Uma Mukherjee; Alberto Zambelli; Juan Aguilar-Company; Mark Bower; Myria Galazi; Ramon Salazar; Alexia Bertuzzi; Joan Brunet; Ricard Mesia; Ailsa Sita-Lumsden; Johann Colomba; Fanny Pommeret; Elia Seguí; Federica Biello; Daniele Generali; Salvatore Grisanti; Gianpiero Rizzo; Michela Libertini; Charlotte Moss; Joanne S Evans; Beth Russell; Rachel Wuerstlein; Bruno Vincenzi; Rossella Bertulli; Diego Ottaviani; Raquel Liñan; Andrea Marrari; M C Carmona-García; Christopher C T Sng; Carlo Tondini; Oriol Mirallas; Valeria Tovazzi; Vittoria Fotia; Claudia A Cruz; Nadia Saoudi-Gonzalez; Eudald Felip; Ariadna R Lloveras; Alvin J X Lee; Thomas Newsom-Davis; Rachel Sharkey; Chris Chung; David García-Illescas; Roxana Reyes; Yien N Sophia Wong; Daniela Ferrante; Javier Marco-Hernández; Isabel Ruiz-Camps; Gianluca Gaidano; Andrea Patriarca; Anna Sureda; Clara Martinez-Vila; Ana Sanchez de Torre; Lorenza Rimassa; Lorenzo Chiudinelli; Michela Franchi; Marco Krengli; Armando Santoro; Aleix Prat; Josep Tabernero; Mieke V Hemelrijck; Nikolaos Diamantis; Alessio Cortellini Journal: Eur J Cancer Date: 2021-04-06 Impact factor: 9.162
Authors: Peter Horby; Wei Shen Lim; Jonathan R Emberson; Marion Mafham; Jennifer L Bell; Louise Linsell; Natalie Staplin; Christopher Brightling; Andrew Ustianowski; Einas Elmahi; Benjamin Prudon; Christopher Green; Timothy Felton; David Chadwick; Kanchan Rege; Christopher Fegan; Lucy C Chappell; Saul N Faust; Thomas Jaki; Katie Jeffery; Alan Montgomery; Kathryn Rowan; Edmund Juszczak; J Kenneth Baillie; Richard Haynes; Martin J Landray Journal: N Engl J Med Date: 2020-07-17 Impact factor: 91.245
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: Maximilian J Mair; Manfred Mitterer; Pia Gattinger; Julia M Berger; Rudolf Valenta; Dominic Fong; Matthias Preusser Journal: JAMA Oncol Date: 2022-09-22 Impact factor: 33.006
Authors: Jennifer G Whisenant; Javier Baena; Alessio Cortellini; Li-Ching Huang; Giuseppe Lo Russo; Luca Porcu; Selina K Wong; Christine M Bestvina; Matthew D Hellmann; Elisa Roca; Hira Rizvi; Isabelle Monnet; Amel Boudjemaa; Jacobo Rogado; Giulia Pasello; Natasha B Leighl; Oscar Arrieta; Avinash Aujayeb; Ullas Batra; Ahmed Y Azzam; Mojca Unk; Mohammed A Azab; Ardak N Zhumagaliyeva; Carlos Gomez-Martin; Juan B Blaquier; Erica Geraedts; Giannis Mountzios; Gloria Serrano-Montero; Niels Reinmuth; Linda Coate; Melina Marmarelis; Carolyn J Presley; Fred R Hirsch; Pilar Garrido; Hina Khan; Alice Baggi; Celine Mascaux; Balazs Halmos; Giovanni L Ceresoli; Mary J Fidler; Vieri Scotti; Anne-Cécile Métivier; Lionel Falchero; Enriqueta Felip; Carlo Genova; Julien Mazieres; Umit Tapan; Julie Brahmer; Emilio Bria; Sonam Puri; Sanjay Popat; Karen L Reckamp; Floriana Morgillo; Ernest Nadal; Francesca Mazzoni; Francesco Agustoni; Jair Bar; Federica Grosso; Virginie Avrillon; Jyoti D Patel; Fabio Gomes; Ehab Ibrahim; Annalisa Trama; Anna C Bettini; Fabrice Barlesi; Anne-Marie Dingemans; Heather Wakelee; Solange Peters; Leora Horn; Marina Chiara Garassino; Valter Torri Journal: J Thorac Oncol Date: 2022-02-01 Impact factor: 20.121
Authors: Brianna M Jones; Eric J Lehrer; Anurag Saraf; Zahra Shafaee; Lucas Resende Salgado; Virginia W Osborn Journal: Curr Oncol Date: 2022-02-16 Impact factor: 3.677
Authors: Maximilian J Mair; Manfred Mitterer; Pia Gattinger; Julia M Berger; Wolfgang Trutschnig; Arne C Bathke; Margaretha Gansterer; Anna S Berghoff; Severin Laengle; Lynn Gottmann; Thomas Buratti; Helmuth Haslacher; Wolfgang W Lamm; Markus Raderer; Selma Tobudic; Thorsten Fuereder; Rudolf Valenta; Dominic Fong; Matthias Preusser Journal: Cancer Cell Date: 2022-04-12 Impact factor: 38.585
Authors: Annika Fendler; Elisabeth G E de Vries; Corine H GeurtsvanKessel; John B Haanen; Bernhard Wörmann; Samra Turajlic; Marie von Lilienfeld-Toal Journal: Nat Rev Clin Oncol Date: 2022-03-11 Impact factor: 65.011