Table 1.

Key references describing patients with a diagnosis of cancer and COVID-19.

Reference	Description	Results	Comments
Lee et al. [6]	•Compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel UK cancer control population from the UK Office for National Statistics not diagnosed with a COVID-19 infection (2017 data).	•319/1044 (30·6%) patients in the UKCCMP cohort died; 295 (92·5%) due to COVID-19 •All-cause case-fatality rate in patients with a diagnosis of cancer after SARS-CoV-2 infection significantly associated with increasing age: 0.10 in patients 40–49 yr old and 0·48 in ≥ 80 yr •Diagnosis of leukemia, lymphoma, and myeloma associated with more severe COVID-19 trajectories than diagnosis of solid organ tumors (OR, 1.57, 95%CI 1.15-2.15; P < .0043). •Compared with rest of the UKCCMP cohort, patients with a diagnosis of leukemia had significantly increased case-fatality rate (OR, 2.25, 95%CI 1.13–4.57; P = .023)	•Patients with hematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2.09, 95% CI 1·09–4.08; P = .028). •Different tumor types appear to confer differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes
Dai et al. [7]	•Multicenter study of 105 patients with cancer and 536 age-matched patients without a diagnosis of cancer with confirmed with COVID-19	•Patients with diagnoses of COVID-19 and cancer had higher risks in all severe outcomes •Patients with diagnoses of hematologic, lung, or metastatic stage IV cancer had the highest frequency of severe events • Compared with patients without cancer – Patients without metastatic cancer had similar frequencies of severe conditions – Patients with a diagnosis of cancer who underwent surgery had higher risks of having severe events – Patients receiving only radiotherapy for their cancer did not demonstrate significant differences in severe events	•Findings indicate that at least some patients with cancer appear more vulnerable to SARS-CoV-2 infection
Garassino et al. [8]	•200 patients with COVID-19 and thoracic cancers from eight countries enrolled between March 26 and April 12, 2020 in the Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry, a multicenter observational study, •Eligibility criteria were any thoracic cancer (NSCLC, SCLC, mesothelioma, thymic epithelial tumors, and other pulmonary neuroendocrine neoplasms) and a diagnosis of COVID-19	•Median age = 68.0 yr (61.8–75.0) •142/196 (72%) with ECOG PS 0-1 •147/199 (74%) on therapy at the time of COVID-19 diagnosis •112/197 (57%) on first-line treatment •152/200 (76%) hospitalized •66/200 (33%) died. •13/134 (10%) admitted to ICU; remaining 121 hospitalized, but not admitted to ICU • Risk factors for death [univariable analysis]: – ≥65 yr (OR, 1.88, 95%CI, 1.00–3.62) – Current or former smoker (OR, 4.24, 95%CI, 1.70–12.95) – Receiving treatment with chemotherapy alone (OR, 2.54, 1.09–6.11) – Presence of any comorbidities (OR, 2.65, 95%CI, 1.09-7.46) were associated with increased risk of death.	•Data suggest high mortality and low admission to intensive care in patients with thoracic cancer Access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference.
Mehta et al. [9]	•218 patients with a diagnosis of cancer and COVID-19 between March 18, 2020, to April 8, 2020,	•61/218 (28%) patients with cancer died from COVID-19 •CFR for hematologic malignancies = 20/54 (37%) •CFR for solid malignancies = 41/164 (25%) •CFR for lung cancer = 6/11 (55%) • In multivariate analysis increased mortality was significantly associated with – Older age – Multiple comorbidities – Need for ICU support – Elevated levels of D-dimer – Elevated levels of lactate dehydrogenase – Elevated levels of lactate •Age-adjusted CFRs in patients with cancer compared with noncancer patients found a significant increase in CFR for patients with cancer.	•Data suggest need for proactive strategies to reduce infection and improve early identification in vulnerable cancer patient population
Kuderer et al. [10]	•De-identified data on 928/1035 records of patients with active or previous malignancy, ≥18 yr old, with confirmed SARS-CoV-2 infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. •Note: This study is registered with ClinicalTrials.gov, NCT04354701 and is ongoing	•Median age = 66 yr (IQR 57–76) •279/928 (30%) ≥75 yr old •At analysis on May 7, 2020, 121/928 (13%) had died • Independent factors associated with increased 30-day mortality: – Increased age (per 10 yr; partially adjusted OR 1.84, 95%CI 1.53–2.21) – Male sex (OR, 1.63, 95%CI, 1.07–2.48) – Smoking status (former smoker versus never smoked: OR, 1.60, 95%CI, 1.03–2.47) – Number of comorbidities (two vs none: OR, 4·50, 95%CI, 1.33–15.28) – ECOG PS ≥ 2 (2 vs 0 or 1: OR, 3.89, 95%CI, 2.11–7.18) – Active cancer (progressing vs remission: OR, 5.20, 95%CI, 2.77–9.77) •Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality.	•Among patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer.
Melo et al. [11]	•181 patients with COVID-19 confirmed by RT-PCR identified in a retrospective search of the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 patients	•Mean age = 55.3 yr (SD ± 21.1) •Comorbidities in 110/181 (60.8%) •Metastatic disease accounted for 90/181 (49.7%) • Most common complications: – Respiratory failure 70/181 (38.7%) – Septic shock 40/81 (22.1%) – Acute kidney injury (33/181 (18.2%) – 60/181 (33.1%) died due to COVID-19 complications •CFR solid tumors = 52/138 (37.7%) •CFR hematological malignancies = 8/34 (23.5%) • COVID-19-specific mortality according to univariate analysis significantly associated with: – Age ≥75 yr (P = .002) – Metastatic cancer (P <.001) – Two or more sites of metastases (P < .001) – Presence of lung metastases (P < .001) – Presence of bone metastases (P = .001) – Noncurative treatment or best supportive care intent (P < .001) – Higher C-reactive protein levels (P = .002) – Admission due to COVID-19 (P = .009) – Antibiotics use (P = .02) • COVID-19-specific mortality according to multivariate analysis significantly associated with: – Cases with admission due to symptoms of COVID-19 (P = .027) – Two or more metastatic sites (P < .001)	•The rates of complications and COVID-19-specific death were significantly high in cancer patients
Robilotti et al. [12]	•Patient with a diagnosis of cancer and COVID-19 followed at Memorial Sloan Kettering Cancer Center	•40% out of 423 patients with cancer were hospitalized for COVID-19 illness •20% developed severe respiratory illness •9% required mechanical ventilation •9% died • Factor predictive of hospitalization and severe disease on multivariate analysis: – Age ≥ 65 yr – Treatment with ICI within 90 d • Factors not predictive of hospitalization and severe disease on multivariate analysis: – Receipt of chemotherapy within 30 d – Major surgery	•COVID-19 illness is associated with higher rates of hospitalization and severe outcomes in patients with cancer. •But risk factors may not be uniform. A many patient receiving ICI have lung cancer and its associated predisposing factors, the association between ICI and COVID-19 outcomes will need interrogation in tumor-specific cohorts.
Barlesi et al. [13]	•137 patients with cancer infected with SARS-CoV-2 treated at Institut de Cancérologie Gustave Roussy from March 14 to April 15, 2020. •Median follow-up time 13 d	•119/137 solid tumors •60% had advanced disease; 40% in remission or being treated for localized disease •>20% asymptomatic for COVID-19 •∼25% exhibited clinical worsening •11% admitted to the ICU •∼15% death related to COVID-19 • Predictors of clinical worsening – ECOG PS ≥1 – Diagnosis of a hematological cancer – Having received chemotherapy within the last 3 mo. •Among patients treated with chemotherapy, those with metastatic disease had an increased risk of death; those with localized disease did not	•14.6% mortality rate of patients with cancer and COVID-19 at Gustave Roussy was comparable to estimated 18.3% mortality rates from COVID-19 in the Paris area and 17.9% in France overall at the time of the study.
Venkatesulu et al. [14]	•Systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv for studies on cancer patients with COVID-19 •Meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients	•Cancer patients with COVID-19 had higher likelihood of death (OR 2.54), largely driven by mortality among patients in China. •Cancer patients more likely to be intubated, although ICU admission rates not statistically significant •Mortality highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8) •No association between receipt of a particular type of oncologic therapy and mortality	•Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity
Liang et al. [15]	•A prospective cohort to monitor COVID-19 cases throughout China. As of the data cutoff on Jan 31, 2020, 2007 cases from 575 hospitals in 31 provincial administrative regions. •18/1590 (1%; 95%CI 0.61–1.65) had a history of cancer	•Patients with cancer had higher risk of severe events compared with patients without cancer (7/18 [39%] vs 124/1572 [8%]; Fisher's exact P = .0003) •Patients who underwent chemotherapy or surgery in the previous month had a numerically higher risk (3/4 [75%] of clinically severe events than did those not receiving chemotherapy or surgery (6/14 [43%] •Among patients with cancer, older age only risk factor for severe events (OR 1·43, 95% CI 0.97–2.12; P = .072). •Patients with lung cancer (1/5 [20%]) did not have higher probability of severe events compared with patients with other cancers of 8/13 [62%]; P = .294). •Patients with cancer deteriorated more rapidly than those without cancer (median time to severe events 13 d [IQR 6–15] vs 43 d [20–not reached]; P < .0001; hazard ratio 3·56, 95% CI 1.65–7.69, after adjusting for age).	•Found that patients with cancer might have a higher risk of COVID-19 than individuals without cancer •Patients with cancer had poorer outcomes from COVID-19.
Luo et al. [16]	•102 consecutive patients with lung cancer and confirmed diagnosis of COVID-19 at a single center from 12 March 2020 to 6 May 2020	•COVID-19 severe in patients with lung cancer (62% hospitalized, 25% died); although severe, COVID-19 accounted for only 11% of lung cancer deaths during the pandemic • Determinants of COVID-19 severity largely patient-specific features, including: – Smoking status [OR for severe COVID-19 = 2.9, 95%CI 1.07–9.44 comparing the median (23.5 pack-yr) to never-smoker – Chronic obstructive pulmonary disease (OR, 3.87, 95%CI, 1.35–9.68) • Cancer-specific features that did not impact severity: – Prior thoracic surgery/radiation – Recent systemic therapies •Most patients recovered from COVID-19, including 25% patients initially requiring intubation	•COVID-19 associated with high burden of severity in patients with lung cancer. •Patient-specific features, rather than cancer-specific features or treatments, greatest determinants of severity.
Jee et al. [17]	•Clinical characteristics and outcomes of 309 patients with cancer and concurrent COVID-19 treated at Memorial Sloan Kettering Cancer Center until March 31, 2020 and observed for clinical end points until April 13, 2020.	• Associations consistent in a multivariable model and in multiple sensitivity analyses: – Cytotoxic chemotherapy administration with a severe or critical COVID-19 event (HR, 1.10; 95%CI, 0.73–1.60). – Hematologic malignancy with increased COVID-19 severity (HR, 1.90; 95%CI, 1.30–2.80) – Lung cancer with higher rates of severe or critical COVID-19 events (HR, 2.0; 95%CI, 1.20–3.30). – Lymphopenia at COVID-19 diagnosis a with higher rates of severe or critical illness (HR, 2.10; 95%CI, 1.50–3.10). – Baseline neutropenia 14–90 d before COVID-19 diagnosis with worse outcomes (HR, 4.20; 95%CI, 1.70–11.00). •Rate of adverse events lower in a time-matched population of patients with cancer without COVID-19	•Recent cytotoxic chemotherapy treatment was not associated with adverse COVID-19 outcomes •Patients with active hematologic or lung malignancies, peri-COVID-19 lymphopenia, or baseline neutropenia had worse COVID-19 outcomes.
Yekedüz et al. [18]	•16 studies included in a meta-analysis drawn from a MEDLINE database searched on September 01, 2020 with primary endpoints of severe disease and death in cancer patients treated within the last 30 d before COVID-19 diagnosis	•Chemotherapy within 30 d before COVID-19 diagnosis increased risk of death in cancer patients after adjusting for confounding variables (OR, 1.85; 95%CI, 1.26–2.71); but not risk of ever COVID disease •Targeted therapies, immunotherapy, surgery and radiotherapy did not increase the severe disease and death risk in cancer patients with COVID-19	•Chemotherapy increased risk of death from COVID-19 in cancer patients, •There was no safety concern for immunotherapy, targeted therapies, surgery and radiotherapy.
Elkrief et al. [19]	•252 patients (N = 249 adult and N = 3 pediatric) patients with cancer and diagnosis of COVID-19 prospectively identified between March 3 and May 23, 2020 in the provinces of Quebec and British Columbia in Canada. •106/252 (42.1%) received active anticancer treatment in the 3 mo before COVID-19 diagnosis	•During a median follow-up of 25 d, 33/252 (13.1%) required admission to the ICU, and 71/252 (28.2%) died •47/252 (19.1%) had hospital-acquired COVID-19 •Median OS shorter with hospital-acquired infection than that in a contemporary community-acquired population (27 d vs unreached (HR, 2.3, 95%CI: 1.2–4.4, P = .0006. • Factors associated with death in a multivariate analysis: – Hospital-acquired COVID-19 – Older age – Low ECOG PS – Advanced stage of cancer	•Important to treat patients with cancer in COVID-free units. •Validated age and advanced cancer as negative predictive factors for COVID-19 severity in patients with cancer.
Zhang et al. [20]	•Multicenter retrospective study to investigate clinical manifestations and outcomes of patients with cancer diagnosed with COVID-19. •107 patients with a diagnosis of cancer treated at 5 hospitals in Wuhan City, China, between January 5 and March 18, 2020.	•37/107 (34.6%) receiving active anticancer treatment when diagnosed with COVID-19; 70/107 (65.4%) on follow-up. •56/107 (52.3%) developed severe COVID-19 • Comparison of outcomes in those receiving and not receiving treatment: – Rate of severe COVID-19 higher in those receiving anticancer treatment (64.9% vs 45.7) – Inferior OS in those receiving anticancer treatment (HR, 3.365; 95%CI, 1.455–7.782 [P = .005]) •Detrimental effect of anticancer treatment on OS independent of exposure to systemic therapy (CFR 33.3% [systemic therapy] vs 43.8% [nonsystemic therapy]	•>50.0% of infected patients with cancer are susceptible to severe COVID-19 •Risk aggravated by simultaneous anticancer treatment and portends for a worse survival
Mato et al. [21]	•198 CLL patients diagnosed with symptomatic COVID-19 across 43 international centers •90% admitted to hospital	•Median age at COVID-19 diagnosis 70.5 yr •90/198 (45%) were receiving active CLL therapy most commonly Bruton tyrosine kinase inhibitors (n = 68/90 [76%) •CFR 33% at median follow-up of 16 d •Comparing those under “watch-and-wait” and those under treatment: •Rates of admission 89% versus. 90% •Intensive care unit admission (35% vs 36%) •Intubation (33% vs 25%) •Mortality (37% vs 32%) •CLL-directed treatment with BTKi's at COVID-19 diagnosis did not impact survival (CFR 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients	•CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death
Saini et al. [22]	•Systematic review and pooled analysis to provide estimates of the mortality rate among patients with both cancer and COVID-19. •Systematic literature search up to July 16, 2020 identified 52 studies in peer-reviewed publications, preprints and conference proceedings •Primary endpoint = CFR, defined as the rate of death among patients with cancer and COVID-19.	•18,650 patients with both COVID-19 and cancer selected for the pooled analysis •4243 deaths were recorded •Probability of death 25.6% (95%CI: 22.0%-29.5%; I2 = 8.9%)	•Patients with cancer who develop COVID-19 have high probability of mortality

CFR = case fatality rate; CI = confidence interval; ECOG PS = Eastern Cooperative Oncology Group performance status; HR = hazard ratio; ICIs = immune checkpoint inhibitors; NCLC = nonsmall cell lung cancer; OR = odds ratio; SCLC = small cell lung cancer; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.