Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

P. Grivas; A. R. Khaki; T. M. Wise-Draper; B. French; C. Hennessy; C. Y. Hsu; Y. Shyr; X. Li; T. K. Choueiri; C. A. Painter; S. Peters; B. I. Rini; M. A. Thompson; S. Mishra; D. R. Rivera; J. D. Acoba; M. Z. Abidi; Z. Bakouny; B. Bashir; T. Bekaii-Saab; S. Berg; E. H. Bernicker; M. A. Bilen; P. Bindal; R. Bishnoi; N. Bouganim; D. W. Bowles; A. Cabal; P. F. Caimi; D. D. Chism; J. Crowell; C. Curran; A. Desai; B. Dixon; D. B. Doroshow; E. B. Durbin; A. Elkrief; D. Farmakiotis; A. Fazio; L. A. Fecher; D. B. Flora; C. R. Friese; J. Fu; S. M. Gadgeel; M. D. Galsky; D. M. Gill; M. J. Glover; S. Goyal; P. Grover; S. Gulati; S. Gupta; S. Halabi; T. R. Halfdanarson; B. Halmos; D. J. Hausrath; J. E. Hawley; E. Hsu; M. Huynh-Le; C. Hwang; C. Jani; A. Jayaraj; D. B. Johnson; A. Kasi; H. Khan; V. S. Koshkin; N. M. Kuderer; D. H. Kwon; P. E. Lammers; A. Li; A. Loaiza-Bonilla; C. A. Low; M. B. Lustberg; G. H. Lyman; R. R. McKay; C. McNair; H. Menon; R. A. Mesa; V. Mico; D. Mundt; G. Nagaraj; E. S. Nakasone; J. Nakayama; A. Nizam; N. L. Nock; C. Park; J. M. Patel; K. G. Patel; P. Peddi; N. A. Pennell; A. J. Piper-Vallillo; M. Puc; D. Ravindranathan; M. E. Reeves; D. Y. Reuben; L. Rosenstein; R. P. Rosovsky; S. M. Rubinstein; M. Salazar; A. L. Schmidt; G. K. Schwartz; M. R. Shah; S. A. Shah; C. Shah; J. A. Shaya; S. R.K. Singh; M. Smits; K. E. Stockerl-Goldstein; D. G. Stover; M. Streckfuss; S. Subbiah; L. Tachiki; E. Tadesse; A. Thakkar; M. D. Tucker; A. K. Verma; D. C. Vinh; M. Weiss; J. T. Wu; E. Wulff-Burchfield; Z. Xie; P. P. Yu; T. Zhang; A. Y. Zhou; H. Zhu; L. Zubiri; D. P. Shah; J. L. Warner; Gd L. Lopes

doi:10.1016/j.annonc.2021.02.024

Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

P. Grivas, A. R. Khaki, T. M. Wise-Draper, B. French, C. Hennessy, C. Y. Hsu, Y. Shyr, X. Li, T. K. Choueiri, C. A. Painter, S. Peters, B. I. Rini, M. A. Thompson, S. Mishra, D. R. Rivera, J. D. Acoba, M. Z. Abidi, Z. Bakouny, B. Bashir, T. Bekaii-SaabS. Berg, E. H. Bernicker, M. A. Bilen, P. Bindal, R. Bishnoi, N. Bouganim, D. W. Bowles, A. Cabal, P. F. Caimi, D. D. Chism, J. Crowell, C. Curran, A. Desai, B. Dixon, D. B. Doroshow, E. B. Durbin, A. Elkrief, D. Farmakiotis, A. Fazio, L. A. Fecher, D. B. Flora, C. R. Friese, J. Fu, S. M. Gadgeel, M. D. Galsky, D. M. Gill, M. J. Glover, S. Goyal, P. Grover, S. Gulati, S. Gupta, S. Halabi, T. R. Halfdanarson, B. Halmos, D. J. Hausrath, J. E. Hawley, E. Hsu, M. Huynh-Le, C. Hwang, C. Jani, A. Jayaraj, D. B. Johnson, A. Kasi, H. Khan, V. S. Koshkin, N. M. Kuderer, D. H. Kwon, P. E. Lammers, A. Li, A. Loaiza-Bonilla, C. A. Low, M. B. Lustberg, G. H. Lyman, R. R. McKay, C. McNair, H. Menon, R. A. Mesa, V. Mico, D. Mundt, G. Nagaraj, E. S. Nakasone, J. Nakayama, A. Nizam, N. L. Nock, C. Park, J. M. Patel, K. G. Patel, P. Peddi, N. A. Pennell, A. J. Piper-Vallillo, M. Puc, D. Ravindranathan, M. E. Reeves, D. Y. Reuben, L. Rosenstein, R. P. Rosovsky, S. M. Rubinstein, M. Salazar, A. L. Schmidt, G. K. Schwartz, M. R. Shah, S. A. Shah, C. Shah, J. A. Shaya, S. R.K. Singh, M. Smits, K. E. Stockerl-Goldstein, D. G. Stover, M. Streckfuss, S. Subbiah, L. Tachiki, E. Tadesse, A. Thakkar, M. D. Tucker, A. K. Verma, D. C. Vinh, M. Weiss, J. T. Wu, E. Wulff-Burchfield, Z. Xie, P. P. Yu, T. Zhang, A. Y. Zhou, H. Zhu, L. Zubiri, D. P. Shah, J. L. Warner, Gd L. Lopes

Internal Medicine

Research output: Contribution to journal › Article › peer-review

229 Scopus citations

Abstract

Background: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. Patients and methods: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). Results: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. Conclusions: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies.

Original language	English
Pages (from-to)	787-800
Number of pages	14
Journal	Annals of Oncology
Volume	32
Issue number	6
DOIs	https://doi.org/10.1016/j.annonc.2021.02.024
State	Published - Jun 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s)

Funding

REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support ( UL1 TR000445 from NCATS / NIH ). This study was partly supported by grants from the American Cancer Society and Hope Foundation for Cancer Research (No. MRSG-16-152-01 -CCE to DPS); the National Cancer Institute [grant numbers P30 CA068485 to BF, CH, C-YH, BIR, JLW, SM, and YS; U01 CA231840 to JLW; T32CA009515 to ARK; T32CA236621 and P30 CA046592 to CRF; P30 CA177558 to EBD, 2UG1CA189859-06 and 2P30 CA 013330-47 to BH; 5P30CA056036-20 to BB; P30 CA013330 to AKV; P30CA013696 to JEH and GKS; P30 CA196521 to DBD and MDG; P30CA054174 to DPS, MS, and RAM; 1P30CA240139-01 to GdLL; P30CA015704 to GHL and PG; P30CA023100 to RRM; P30CA046934 to DWB and MZA]; National Center for Advancing Translational Sciences of the National Institutes of Health [grant numbers 2UL1TR001425-05A1 to TMW-D; P30 CA168524 to EW-B; 2UG1CA190140-06 to MAT; P30 CA016058 to DGS; UG1 CA189974 to GHL; UL1TR001873 to JEH]; DCV is supported by the Fonds de la récherche en santé du Québec Clinician-Scientist scholar's program (no grant number). MZA is supported by the Merck Investigator Studies Program (no grant number). SG acknowledges an award from North American Thrombosis Forum (NATF; no grant number). LZ is supported by the Spanish Society of Medical Oncology SEOM grant. VSK is supported by a grant from the Prostate Cancer Foundation (no grant number).

Funders	Funder number
Prostate Cancer Foundation
North American Thrombosis Forum
Fonds de la récherche en santé du Québec Clinician-Scientist scholar's program
Vanderbilt Institute for Clinical and Translational Research	UL1 TR000445
Vanderbilt Institute for Clinical and Translational Research
National Childhood Cancer Registry – National Cancer Institute	P30CA046934, T32CA009515, P30 CA046592, P30CA013696, 5P30CA056036-20, 1P30CA240139-01, P30 CA177558, 2P30 CA 013330-47, P30 CA013330, P30 CA196521, P30CA015704, P30 CA068485, P30CA054174, 2UG1CA189859-06, P30CA023100, T32CA236621, U01 CA231840
National Childhood Cancer Registry – National Cancer Institute
National Institutes of Health (NIH)	P30 CA016058, UG1 CA189974, UL1TR001873, 2UL1TR001425-05A1, 2UG1CA190140-06, P30 CA168524
National Institutes of Health (NIH)
National Center for Advancing Translational Sciences (NCATS)
National Institutes of Health (NIH)
Korean Foundation for Cancer Research	MRSG-16-152-01
Korean Foundation for Cancer Research
National Center for Advancing Translational Sciences (NCATS)
Spanish Society of Medical Oncology SEOM
American Cancer Society-Michigan Cancer Research Fund

Keywords

SARS-CoV2
anticancer therapy
cancer
laboratory measurements
neoplasm
outcomes

ASJC Scopus subject areas

Hematology
Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.annonc.2021.02.024

Cite this

Grivas, P., Khaki, A. R., Wise-Draper, T. M., French, B., Hennessy, C., Hsu, C. Y., Shyr, Y., Li, X., Choueiri, T. K., Painter, C. A., Peters, S., Rini, B. I., Thompson, M. A., Mishra, S., Rivera, D. R., Acoba, J. D., Abidi, M. Z., Bakouny, Z., Bashir, B., ... Lopes, G. L. (2021). Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Annals of Oncology, 32(6), 787-800. https://doi.org/10.1016/j.annonc.2021.02.024

@article{3544e0b691194bcd901c4aa3b0e994d3,

title = "Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium",

abstract = "Background: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. Patients and methods: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). Results: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. Conclusions: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies.",

keywords = "SARS-CoV2, anticancer therapy, cancer, laboratory measurements, neoplasm, outcomes",

author = "P. Grivas and Khaki, {A. R.} and Wise-Draper, {T. M.} and B. French and C. Hennessy and Hsu, {C. Y.} and Y. Shyr and X. Li and Choueiri, {T. K.} and Painter, {C. A.} and S. Peters and Rini, {B. I.} and Thompson, {M. A.} and S. Mishra and Rivera, {D. R.} and Acoba, {J. D.} and Abidi, {M. Z.} and Z. Bakouny and B. Bashir and T. Bekaii-Saab and S. Berg and Bernicker, {E. H.} and Bilen, {M. A.} and P. Bindal and R. Bishnoi and N. Bouganim and Bowles, {D. W.} and A. Cabal and Caimi, {P. F.} and Chism, {D. D.} and J. Crowell and C. Curran and A. Desai and B. Dixon and Doroshow, {D. B.} and Durbin, {E. B.} and A. Elkrief and D. Farmakiotis and A. Fazio and Fecher, {L. A.} and Flora, {D. B.} and Friese, {C. R.} and J. Fu and Gadgeel, {S. M.} and Galsky, {M. D.} and Gill, {D. M.} and Glover, {M. J.} and S. Goyal and P. Grover and S. Gulati and S. Gupta and S. Halabi and Halfdanarson, {T. R.} and B. Halmos and Hausrath, {D. J.} and Hawley, {J. E.} and E. Hsu and M. Huynh-Le and C. Hwang and C. Jani and A. Jayaraj and Johnson, {D. B.} and A. Kasi and H. Khan and Koshkin, {V. S.} and Kuderer, {N. M.} and Kwon, {D. H.} and Lammers, {P. E.} and A. Li and A. Loaiza-Bonilla and Low, {C. A.} and Lustberg, {M. B.} and Lyman, {G. H.} and McKay, {R. R.} and C. McNair and H. Menon and Mesa, {R. A.} and V. Mico and D. Mundt and G. Nagaraj and Nakasone, {E. S.} and J. Nakayama and A. Nizam and Nock, {N. L.} and C. Park and Patel, {J. M.} and Patel, {K. G.} and P. Peddi and Pennell, {N. A.} and Piper-Vallillo, {A. J.} and M. Puc and D. Ravindranathan and Reeves, {M. E.} and Reuben, {D. Y.} and L. Rosenstein and Rosovsky, {R. P.} and Rubinstein, {S. M.} and M. Salazar and Schmidt, {A. L.} and Schwartz, {G. K.} and Shah, {M. R.} and Shah, {S. A.} and C. Shah and Shaya, {J. A.} and Singh, {S. R.K.} and M. Smits and Stockerl-Goldstein, {K. E.} and Stover, {D. G.} and M. Streckfuss and S. Subbiah and L. Tachiki and E. Tadesse and A. Thakkar and Tucker, {M. D.} and Verma, {A. K.} and Vinh, {D. C.} and M. Weiss and Wu, {J. T.} and E. Wulff-Burchfield and Z. Xie and Yu, {P. P.} and T. Zhang and Zhou, {A. Y.} and H. Zhu and L. Zubiri and Shah, {D. P.} and Warner, {J. L.} and Lopes, {Gd L.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = jun,

doi = "10.1016/j.annonc.2021.02.024",

language = "English",

volume = "32",

pages = "787--800",

number = "6",

}

Grivas, P, Khaki, AR, Wise-Draper, TM, French, B, Hennessy, C, Hsu, CY, Shyr, Y, Li, X, Choueiri, TK, Painter, CA, Peters, S, Rini, BI, Thompson, MA, Mishra, S, Rivera, DR, Acoba, JD, Abidi, MZ, Bakouny, Z, Bashir, B, Bekaii-Saab, T, Berg, S, Bernicker, EH, Bilen, MA, Bindal, P, Bishnoi, R, Bouganim, N, Bowles, DW, Cabal, A, Caimi, PF, Chism, DD, Crowell, J, Curran, C, Desai, A, Dixon, B, Doroshow, DB, Durbin, EB, Elkrief, A, Farmakiotis, D, Fazio, A, Fecher, LA, Flora, DB, Friese, CR, Fu, J, Gadgeel, SM, Galsky, MD, Gill, DM, Glover, MJ, Goyal, S, Grover, P, Gulati, S, Gupta, S, Halabi, S, Halfdanarson, TR, Halmos, B, Hausrath, DJ, Hawley, JE, Hsu, E, Huynh-Le, M, Hwang, C, Jani, C, Jayaraj, A, Johnson, DB, Kasi, A, Khan, H, Koshkin, VS, Kuderer, NM, Kwon, DH, Lammers, PE, Li, A, Loaiza-Bonilla, A, Low, CA, Lustberg, MB, Lyman, GH, McKay, RR, McNair, C, Menon, H, Mesa, RA, Mico, V, Mundt, D, Nagaraj, G, Nakasone, ES, Nakayama, J, Nizam, A, Nock, NL, Park, C, Patel, JM, Patel, KG, Peddi, P, Pennell, NA, Piper-Vallillo, AJ, Puc, M, Ravindranathan, D, Reeves, ME, Reuben, DY, Rosenstein, L, Rosovsky, RP, Rubinstein, SM, Salazar, M, Schmidt, AL, Schwartz, GK, Shah, MR, Shah, SA, Shah, C, Shaya, JA, Singh, SRK, Smits, M, Stockerl-Goldstein, KE, Stover, DG, Streckfuss, M, Subbiah, S, Tachiki, L, Tadesse, E, Thakkar, A, Tucker, MD, Verma, AK, Vinh, DC, Weiss, M, Wu, JT, Wulff-Burchfield, E, Xie, Z, Yu, PP, Zhang, T, Zhou, AY, Zhu, H, Zubiri, L, Shah, DP, Warner, JL & Lopes, GL 2021, 'Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium', Annals of Oncology, vol. 32, no. 6, pp. 787-800. https://doi.org/10.1016/j.annonc.2021.02.024

TY - JOUR

T1 - Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer

T2 - a report from the COVID-19 and Cancer Consortium

AU - Grivas, P.

AU - Khaki, A. R.

AU - Wise-Draper, T. M.

AU - French, B.

AU - Hennessy, C.

AU - Hsu, C. Y.

AU - Shyr, Y.

AU - Li, X.

AU - Choueiri, T. K.

AU - Painter, C. A.

AU - Peters, S.

AU - Rini, B. I.

AU - Thompson, M. A.

AU - Mishra, S.

AU - Rivera, D. R.

AU - Acoba, J. D.

AU - Abidi, M. Z.

AU - Bakouny, Z.

AU - Bashir, B.

AU - Bekaii-Saab, T.

AU - Berg, S.

AU - Bernicker, E. H.

AU - Bilen, M. A.

AU - Bindal, P.

AU - Bishnoi, R.

AU - Bouganim, N.

AU - Bowles, D. W.

AU - Cabal, A.

AU - Caimi, P. F.

AU - Chism, D. D.

AU - Crowell, J.

AU - Curran, C.

AU - Desai, A.

AU - Dixon, B.

AU - Doroshow, D. B.

AU - Durbin, E. B.

AU - Elkrief, A.

AU - Farmakiotis, D.

AU - Fazio, A.

AU - Fecher, L. A.

AU - Flora, D. B.

AU - Friese, C. R.

AU - Fu, J.

AU - Gadgeel, S. M.

AU - Galsky, M. D.

AU - Gill, D. M.

AU - Glover, M. J.

AU - Goyal, S.

AU - Grover, P.

AU - Gulati, S.

AU - Gupta, S.

AU - Halabi, S.

AU - Halfdanarson, T. R.

AU - Halmos, B.

AU - Hausrath, D. J.

AU - Hawley, J. E.

AU - Hsu, E.

AU - Huynh-Le, M.

AU - Hwang, C.

AU - Jani, C.

AU - Jayaraj, A.

AU - Johnson, D. B.

AU - Kasi, A.

AU - Khan, H.

AU - Koshkin, V. S.

AU - Kuderer, N. M.

AU - Kwon, D. H.

AU - Lammers, P. E.

AU - Li, A.

AU - Loaiza-Bonilla, A.

AU - Low, C. A.

AU - Lustberg, M. B.

AU - Lyman, G. H.

AU - McKay, R. R.

AU - McNair, C.

AU - Menon, H.

AU - Mesa, R. A.

AU - Mico, V.

AU - Mundt, D.

AU - Nagaraj, G.

AU - Nakasone, E. S.

AU - Nakayama, J.

AU - Nizam, A.

AU - Nock, N. L.

AU - Park, C.

AU - Patel, J. M.

AU - Patel, K. G.

AU - Peddi, P.

AU - Pennell, N. A.

AU - Piper-Vallillo, A. J.

AU - Puc, M.

AU - Ravindranathan, D.

AU - Reeves, M. E.

AU - Reuben, D. Y.

AU - Rosenstein, L.

AU - Rosovsky, R. P.

AU - Rubinstein, S. M.

AU - Salazar, M.

AU - Schmidt, A. L.

AU - Schwartz, G. K.

AU - Shah, M. R.

AU - Shah, S. A.

AU - Shah, C.

AU - Shaya, J. A.

AU - Singh, S. R.K.

AU - Smits, M.

AU - Stockerl-Goldstein, K. E.

AU - Stover, D. G.

AU - Streckfuss, M.

AU - Subbiah, S.

AU - Tachiki, L.

AU - Tadesse, E.

AU - Thakkar, A.

AU - Tucker, M. D.

AU - Verma, A. K.

AU - Vinh, D. C.

AU - Weiss, M.

AU - Wu, J. T.

AU - Wulff-Burchfield, E.

AU - Xie, Z.

AU - Yu, P. P.

AU - Zhang, T.

AU - Zhou, A. Y.

AU - Zhu, H.

AU - Zubiri, L.

AU - Shah, D. P.

AU - Warner, J. L.

AU - Lopes, Gd L.

PY - 2021/6

Y1 - 2021/6

N2 - Background: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. Patients and methods: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). Results: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. Conclusions: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies.

AB - Background: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. Patients and methods: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). Results: A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. Conclusions: Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies.

KW - SARS-CoV2

KW - anticancer therapy

KW - cancer

KW - laboratory measurements

KW - neoplasm

KW - outcomes

UR - http://www.scopus.com/inward/record.url?scp=85104157172&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85104157172&partnerID=8YFLogxK

U2 - 10.1016/j.annonc.2021.02.024

DO - 10.1016/j.annonc.2021.02.024

M3 - Article

C2 - 33746047

AN - SCOPUS:85104157172

SN - 0923-7534

VL - 32

SP - 787

EP - 800

JO - Annals of Oncology

JF - Annals of Oncology

IS - 6

ER -

Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium

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