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Showing content from https://pubmed.ncbi.nlm.nih.gov/32473682/ below:

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Observational Study

. 2020 Jun 20;395(10241):1919-1926. doi: 10.1016/S0140-6736(20)31173-9. Epub 2020 May 28. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study Jean-Baptiste Cazier², Vasileios Angelis³, Roland Arnold⁴, Vartika Bisht⁵, Naomi A Campton⁶, Julia Chackathayil⁷, Vinton Wt Cheng⁸, Helen M Curley⁴, Matthew W Fittall³, Luke Freeman-Mills⁹, Spyridon Gennatas³, Anshita Goel⁴, Simon Hartley¹⁰, Daniel J Hughes¹¹, David Kerr¹², Alvin Jx Lee¹³, Rebecca J Lee¹⁴, Sophie E McGrath³, Christopher P Middleton¹⁵, Nirupa Murugaesu¹⁶, Thomas Newsom-Davis¹⁷, Alicia Fc Okines³, Anna C Olsson-Brown¹⁸, Claire Palles⁴, Yi Pan¹⁵, Ruth Pettengell¹⁹, Thomas Powles²⁰, Emily A Protheroe²¹, Karin Purshouse²², Archana Sharma-Oates²³, Shivan Sivakumar²⁴, Ashley J Smith²⁵, Thomas Starkey⁴, Chris D Turnbull²⁶, Csilla Várnai¹⁵, Nadia Yousaf³; UK Coronavirus Monitoring Project Team; Rachel Kerr²⁴, Gary Middleton²⁷

Affiliations

¹ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK. Electronic address: l.lee.2@bham.ac.uk.
² Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK.
³ The Royal Marsden Hospital NHS Foundation Trust, London, UK.
⁴ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
⁵ Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK.
⁶ Institute of Translational Medicine, Birmingham Health Partners, Birmingham, UK.
⁷ Cancer Research Clinical Research Facility, St George's University Hospitals NHS Foundation Trust, London, UK.
⁸ Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
⁹ Glasgow Royal Infirmary, Glasgow, UK.
¹⁰ Centre for Computational Biology, University of Birmingham, Birmingham, UK; Advanced Research Computing, University of Birmingham, Birmingham, UK.
¹¹ Department of Cancer Imaging, King's College London, London, UK.
¹² Nuffield Division of Clinical and Laboratory Services, Oxford University, Oxford, UK.
¹³ UCL Cancer Institute, University College London, London, UK.
¹⁴ University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
¹⁵ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK.
¹⁶ St George's University Hospitals NHS Foundation Trust, London, UK.
¹⁷ Department of Oncology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
¹⁸ The Clatterbridge Cancer Centre, Wirral, UK.
¹⁹ St George's University of London, London, UK.
²⁰ Bart's Cancer Institute, London, UK.
²¹ University of Birmingham Medical School, University of Birmingham, Birmingham, UK.
²² Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
²³ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
²⁴ Department of Oncology, Oxford University, Oxford, UK.
²⁵ Consultancy Support, Oxford, UK.
²⁶ Nuffield Department of Medicine, Oxford University, Oxford, UK.
²⁷ Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK.

PMID: 32473682
PMCID: PMC7255715
DOI: 10.1016/S0140-6736(20)31173-9

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Observational Study

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Lennard Yw Lee et al. Lancet. 2020.

. 2020 Jun 20;395(10241):1919-1926. doi: 10.1016/S0140-6736(20)31173-9. Epub 2020 May 28. Authors Lennard Yw Lee¹, Jean-Baptiste Cazier², Vasileios Angelis³, Roland Arnold⁴, Vartika Bisht⁵, Naomi A Campton⁶, Julia Chackathayil⁷, Vinton Wt Cheng⁸, Helen M Curley⁴, Matthew W Fittall³, Luke Freeman-Mills⁹, Spyridon Gennatas³, Anshita Goel⁴, Simon Hartley¹⁰, Daniel J Hughes¹¹, David Kerr¹², Alvin Jx Lee¹³, Rebecca J Lee¹⁴, Sophie E McGrath³, Christopher P Middleton¹⁵, Nirupa Murugaesu¹⁶, Thomas Newsom-Davis¹⁷, Alicia Fc Okines³, Anna C Olsson-Brown¹⁸, Claire Palles⁴, Yi Pan¹⁵, Ruth Pettengell¹⁹, Thomas Powles²⁰, Emily A Protheroe²¹, Karin Purshouse²², Archana Sharma-Oates²³, Shivan Sivakumar²⁴, Ashley J Smith²⁵, Thomas Starkey⁴, Chris D Turnbull²⁶, Csilla Várnai¹⁵, Nadia Yousaf³; UK Coronavirus Monitoring Project Team; Rachel Kerr²⁴, Gary Middleton²⁷ Affiliations

¹ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK. Electronic address: l.lee.2@bham.ac.uk.
² Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK.
³ The Royal Marsden Hospital NHS Foundation Trust, London, UK.
⁴ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
⁵ Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK.
⁶ Institute of Translational Medicine, Birmingham Health Partners, Birmingham, UK.
⁷ Cancer Research Clinical Research Facility, St George's University Hospitals NHS Foundation Trust, London, UK.
⁸ Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
⁹ Glasgow Royal Infirmary, Glasgow, UK.
¹⁰ Centre for Computational Biology, University of Birmingham, Birmingham, UK; Advanced Research Computing, University of Birmingham, Birmingham, UK.
¹¹ Department of Cancer Imaging, King's College London, London, UK.
¹² Nuffield Division of Clinical and Laboratory Services, Oxford University, Oxford, UK.
¹³ UCL Cancer Institute, University College London, London, UK.
¹⁴ University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
¹⁵ Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK.
¹⁶ St George's University Hospitals NHS Foundation Trust, London, UK.
¹⁷ Department of Oncology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
¹⁸ The Clatterbridge Cancer Centre, Wirral, UK.
¹⁹ St George's University of London, London, UK.
²⁰ Bart's Cancer Institute, London, UK.
²¹ University of Birmingham Medical School, University of Birmingham, Birmingham, UK.
²² Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.
²³ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
²⁴ Department of Oncology, Oxford University, Oxford, UK.
²⁵ Consultancy Support, Oxford, UK.
²⁶ Nuffield Department of Medicine, Oxford University, Oxford, UK.
²⁷ Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK.

PMID: 32473682
PMCID: PMC7255715
DOI: 10.1016/S0140-6736(20)31173-9

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Erratum in

Department of Error.
[No authors listed] [No authors listed] Lancet. 2020 Aug 22;396(10250):534. doi: 10.1016/S0140-6736(20)31758-X. Lancet. 2020. PMID: 32828184 Free PMC article. No abstract available.

Abstract

Background: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.

Methods: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.

Findings: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.

Interpretation: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.

Funding: University of Birmingham, University of Oxford.

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Figures
Figure 1

Prevalence of COVID-19 in Scotland,…

Figure 1

Prevalence of COVID-19 in Scotland, Wales, and regions of England Data are the…

Figure 1

Prevalence of COVID-19 in Scotland, Wales, and regions of England Data are the average numbers of cases from reports per cancer centre region, up to April 26, 2020. Grey indicates no data available.

Figure 2

Age distribution of patients with…

Figure 2

Age distribution of patients with cancer in the cohort and relation to patient…

Figure 2

Age distribution of patients with cancer in the cohort and relation to patient mortality

Figure 3

Relationship of chemotherapy use within…

Figure 3

Relationship of chemotherapy use within 4 weeks of confirmed COVID-19 and mortality and…

Figure 3

Relationship of chemotherapy use within 4 weeks of confirmed COVID-19 and mortality and severity of disease course The vertical coloured bars denote the patient cohort, split into different groups. The grey horizontal bars denote associations between the different groups, with wider bars denoting more overlap.

Figure 4

Forest plots showing effect of…

Figure 4

Forest plots showing effect of anticancer treatments and mortality from COVID-19 Odds ratios…

Figure 4

Forest plots showing effect of anticancer treatments and mortality from COVID-19 Odds ratios were adjusted for age, gender, and comorbidities. Whiskers indicated 95% CI.

Comment in

Cancer and COVID-19: what do we really know?
Poortmans PM, Guarneri V, Cardoso MJ. Poortmans PM, et al. Lancet. 2020 Jun 20;395(10241):1884-1885. doi: 10.1016/S0140-6736(20)31240-X. Epub 2020 May 29. Lancet. 2020. PMID: 32479827 Free PMC article. No abstract available.