International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship
- Author(s)
- Raad, II; Hachem, R; Masayuki, N; Datoguia, T; Dagher, H; Jiang, Y; Subbiah, V; Siddiqui, B; Bayle, A; Somer, R; Fernandez Cruz, A; Gorak, E; Bhinder, A; Mori, N; Hamerschlak, N; Shelanski, S; Dragovich, T; Vong Kiat, YE; Fakhreddine, S; Pierre, AH; Chemaly, RF; Mulanovich, V; Adachi, J; Borjan, J; Khawaja, F; Granwehr, B; John, T; Yepez, EY; Torres, HA; Ammakkanavar, NR; Yibirin, M; Reyes-Gibby, CC; Pande, M; Ali, N; Rojo, RD; Ali, SM; Deeba, RE; Chaftari, P; Matsuo, T; Ishikawa, K; Hasegawa, R; Aguado-Noya, R; Garcia, AG; Puchol, CT; Lee, DG; Slavin, M; Teh, B; Arias, CA; Data-Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE) Team; Kontoyiannis, DP; Malek, AE; Chaftari, AM;
- Journal Title
- eLife
- Publication Type
- Research article
- Abstract
- BACKGROUND: In this international multicenter study, we aimed to determine the independent risk factors associated with increased 30 day mortality and the impact of cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries. METHODS: We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers. RESULTS: We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (p</=0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin, and procalcitonin) but were less likely to present with clinical symptoms (p</=0.01). By country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (>/=65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30 day mortality rate than those who did not (5.9 vs 17.6%; p=0.03). CONCLUSIONS: Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality. FUNDING: National Cancer Institute and National Institutes of Health.
- Publisher
- eLife Sciences Publications
- Keywords
- Humans; *COVID-19/complications/therapy; Retrospective Studies; SARS-CoV-2; Survivorship; Risk Factors; *Neoplasms/complications/epidemiology; *Lymphopenia; Oxygen
- Department(s)
- Infectious Diseases
- PubMed ID
- 36715684
- Publisher's Version
- https://doi.org/10.7554/eLife.81127
- Open Access at Publisher's Site
https://doi.org/10.7554/eLife.81127- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2023-12-22 03:50:30
Last Modified: 2023-12-22 03:51:23