COVID-19: Matched analysis finds no increased morbidity, mortality in cancer patients
medwireNews: Intensive care admission, ventilation, and mortality rates among people with cancer and SARS-CoV-2 infection do not significantly differ to those among infected people without cancer, US study findings indicate.
Manish Shah and colleagues from Weill Cornell Medicine in New York say that “COVID-19–infected patients with cancer were reported initially to have worse outcomes; however, these studies were not controlled for comorbidities that have been shown to significantly influence outcomes.”
They add: “Our findings suggest that older age is the most contributive risk factor for poor outcomes in patients with COVID-19 and that a diagnosis of cancer itself, or its treatment, may not influence severe outcomes.”
They analyzed data for 585 patients (mean age 71 years, 55% men) who were admitted to two New York hospitals with COVID-19 between March 3 and May 15, 2020. Of these, 117 had an active hematologic or solid tumor malignancy, defined as receiving cancer-directed therapy or being under active surveillance within 6 months of admission, and 468 were cancer-free controls matched by age, sex, and number of comorbidities.
The researchers found that the most common presenting symptoms were similar for patients with and without cancer and included cough (60.7 vs 67.5%), fever (59.8 vs 63.5%), dyspnea (53.9 vs 59.0%), and diarrhea (24.8 vs 21.6%).
The mortality rates among the hospitalized patients were 24.8% in the cancer cohort and 21.4% in the noncancer cohort, a nonsignificant difference.
There was also no difference between the two groups in the composite outcome of intensive care admission, ventilation, and death, nor in the rates of complications such as myocardial infarction, vasopressor requirements, and bacteremia.
The 37% of individuals with cancer who were treated with cytotoxic therapy within 90 days of admission were no more likely to die or reach the composite outcome than those who were not receiving cancer treatment.
After adjusting for age, sex, ethnicity, comorbidities and other potential confounders, the study authors showed that age was the only variable significantly associated with an increased risk for both death (hazard ratio [HR]=2.05) and the composite outcome (HR=1.19), while obesity, which occurred in 25% of the patient population, was significantly associated with an increased risk only for the composite outcome (HR=1.85)
Shah and co-investigators note that unlike earlier studies with high rates of multiple comorbidity, three-quarters of the patients included in the current study either had one or no comorbidities, which “may explain why other medical conditions were not independently associated with a worse composite outcome or death.”
Writing in the Journal of Clinical Oncology, the authors conclude that their findings “suggest that patients with cancer with limited comorbidities may continue their cancer care with caution.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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