Determinants of Severity in Cancer Patients with COVID-19 Illness.
Elizabeth V RobilottiN Esther BabadyPeter A MeadThierry RollingRocio Perez-JohnstonMarilia BernardesYael BoglerMario CaldararoCesar Figueroa-OrtizMichael S GlickmanAlexa JoanowAnna KaltsasYeon Joo LeeAnabella Lucca BianchiAmanda MarianoSejal MorjariaTamara NawarGenofeva A PapanicolaouJacqueline PredmoreGil Redelman-SidiElizabeth SchmidtSusan K SeoKent SepkowitzMonika ShahJedd D WolchokTobias M HohlYing TaurMini KambojPublished in: medRxiv : the preprint server for health sciences (2020)
New York State had 180,458 cases of SARS-CoV-2 and 9385 reported deaths as of April 10th, 2020. Patients with cancer comprised 8.4% of deceased individuals1. Population-based studies from China and Italy suggested a higher COVID-19 death rate in patients with cancer2,3, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-19 disease4. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. Since March 10th, 2020 Memorial Sloan Kettering Cancer Center performed diagnostic testing for SARS-CoV-2 in symptomatic patients. Overall, 40% out of 423 patients with cancer were hospitalized for COVID-19 illness, 20% developed severe respiratory illness, including 9% that required mechanical ventilation, and 9% that died. On multivariate analysis, age ≥ 65 years and treatment with immune checkpoint inhibitors (ICI) within 90 days were predictors for hospitalization and severe disease, while receipt of chemotherapy within 30 days and major surgery were not. Overall, COVID-19 illness is associated with higher rates of hospitalization and severe outcomes in patients with cancer. Association between ICI and COVID-19 outcomes will need interrogation in tumor-specific cohorts.
Keyphrases
- sars cov
- respiratory syndrome coronavirus
- coronavirus disease
- papillary thyroid
- mechanical ventilation
- early onset
- squamous cell
- healthcare
- end stage renal disease
- intensive care unit
- acute respiratory distress syndrome
- ejection fraction
- chronic kidney disease
- newly diagnosed
- type diabetes
- adipose tissue
- radiation therapy
- social media
- metabolic syndrome
- combination therapy
- health information
- patient reported outcomes
- acute coronary syndrome
- prognostic factors
- respiratory tract