Poorer outcomes and higher death rates in patients with cancer and COVID‐19 may be attributable more to older age and higher numbers of underlying conditions than the cancer itself, according to a study presented at the Conference on Coronavirus Diseases of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) last September.
Researchers retrospectively analyzed a cohort of 435 patients with cancer and COVID‐19 from a total of 3071 patients enrolled between March and August 2020. The data came from the Lean European Open Survey on SARS‐CoV‐2 Infected Patients registry. The German Society for Infectious Diseases and ESCMID’s Emerging Infections Task Force created the registry to gather reliable clinical data to answer critical questions about COVID‐19.
Led by Maria Rüthrich, MD (Jena University Hospital, Germany), the study’s median observational period of 14 days included baseline characteristics of socio‐demographics, comorbidities, and Eastern Cooperative Oncology Group (ECOG) Performance Status scores (which measured the functional status of patients with cancer), as well as outcomes of COVID‐19. Most patients were aged 76 to 85 years (36.5%) and female (41%) and had an ECOG score of 2, meaning that they were capable of limited self‐care and were confined to a bed or chair for more than 50% of the day. Fifty‐nine percent of the patients had solid tumors, whereas 18% had lymphoma and 11% had leukemia. Additionally, 54% had an active malignant disease and 22% had received anticancer treatment within the last 3 months after testing positive for SARS‐CoV‐2.
Progression to complicated/critical phases of COVID‐19 was observed in 55% of patients; 28% received critical care, with 66% percent of these patients requiring mechanical ventilation. The COVID‐19 mortality rate was 23%, with men twice as likely to die as women (28% vs 14%.) Active cancer disease also was associated with a higher mortality rate from COVID‐19 in comparison with patients who did not have recurrent or metastatic cancer or were actively being treated (27% vs 17%).
Notably, in comparison with patients who did not have cancer, age and comorbidities differed significantly. The patients without cancer were younger and had fewer comorbidities. Furthermore, survival at 30 days was worse for patients with cancer than those without cancer (70% vs 77%), and the mortality rate was higher (23% vs 14%.) When researchers adjusted for age, sex, and comorbidity, however, COVID‐19 survival and mortality from COVID‐19 in patients with cancer were comparable in patients with cancer and those who did not have cancer.
Printz C. Poor COVID‐19 outcomes and deaths linked to advanced age and pre‐existing conditions. Cancer. 2021. 10.1002/cncr.33441