Cancer patients are at a higher risk for worse outcomes, including mortality, from coronavirus disease 2019 (COVID-19) compared to non-cancer patients, according to a study presented at IDWeek, held virtually from October 21 to 25, 2020. Limited data had previously suggested that increased risks in cancer patients was attributable to increased comorbidities and type of treatment rather than cancer diagnosis itself.

Investigators performed an international retrospective cohort study of COVID-19 confirmed cases from January to August. Patients were divided into cancer and non-cancer groups. Investigators followed up with patients for up to 30 days to measure clinical characteristics, clinical course, hospitalization, and outcomes.

Cancer patients were more likely to have chronic obstructive pulmonary disease (29% vs 19%; P <.0001) and receive steroids within 2 weeks of COVID-19 diagnosis (23% vs 4%; P <.0001), but less likely to exhibit COVID-related symptoms (84% vs. 97%; P <.0001) compared to non-cancer patients.  In both groups, the rates of pneumonia with hypoxia, non-invasive ventilation, and mechanical ventilation were similar. Hospital admission were significantly higher in non-cancer patients (93% vs. 87%; P <.0001).

Cancer patients more commonly used therapies such as remdesivir (18% vs 3%; P <.0001), convalescent plasma (11% vs 4%; P < .0001), tocilizumab (11% vs 4%; P <.0001), and steroids (31% vs 24%; P =.006) compared to non-cancer patients. COVID-associated mortality rate was higher in cancer patients (20% vs. 11%, P =.006). Other  independent factors associated with mortality in COVID-19 patients include age 60 years or older (P <.0001), history of hypertension (P =.016), history of heart failure (P =.004), hypoxia (P <.0001), and platelets less than 50,000/µL at diagnosis (P <.001).


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Despite cancer patients more frequently receiving antiviral and immune-related therapy, their mortality rate was significantly higher as was their higher risk for a worse outcome, investigators concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Hachem RY, Datoguia T, Siddiqui B, et al. Comparing the outcome of COVID-19 in cancer and non-cancer patients: an international multicenter study. Presented at: IDWeek 2020; October 21-25, 2020. Poster 372.