key: cord-0998651-8ys48fm9
authors: Sinclair, A.; Earnshaw, I.; Chowdhury, A.; Patel, G.; Chopra, N.; Merry, E.; Soosaipillai, G.; Galazi, M.; Benafif, S.; Wu, A.; Sng, C.; Wong, Y.N.S.; Ottaviani, D.; Shaw, H.; Lee, A.J.X.; Roylance, R.
title: 1575P Systemic anti-cancer therapy and metastatic cancer are independent mortality risk factors during two UK waves of the COVID-19 pandemic at University College London Hospital
date: 2021-09-30
journal: Annals of Oncology
DOI: 10.1016/j.annonc.2021.08.1568
sha: eca457de30fc4876bb0a332f20851d8c85918245
doc_id: 998651
cord_uid: 8ys48fm9

Background: Data from the first wave of COVID-19 infection demonstrated that a history of cancer and SACT was associated with poorer outcomes. Our study compares outcomes for cancer patients matched to non-cancer patients between the two waves in order to explore further how cancer and its treatment may impact COVID-19 mortality. Methods: Data was collected for patients with positive PCR and history of cancer between 1 Mar to 20 May 2020 and 1 Dec to 8 Feb 2021 for wave 1 and 2, respectively. A contemporaneous cohort of patients without cancer were age- and sex-matched for comparison. Results: The total number of patients presenting with COVID-19 was higher in wave two (1135 vs 626). 207 of these patients had cancer, and were matched to 452 patients without cancer from both waves. There was a significantly improved chance of mortality in wave 2 (HR 0.41, p < 0.0001). When adjusting for age, sex and co-morbidities, cancer was an independent risk factor for mortality amongst patients hospitalised with COVID-19 in wave 1 (HR 1.62, p = 0.02), but not in wave 2. There was a trend towards improved survival for hospitalised patients in wave 2 receiving COVID-19 specific treatment including dexamethasone, remdesivir, tocilizumab (HR 0.75, p = 0.086). For the combined cancer cohort, SACT was an independent predictor of mortality, as was metastatic disease. [Formula presented] Conclusions: The mortality for both cancer and non-cancer patients improved between waves of the pandemic. Advances in detection, prevention and treatment may account for this. Cancer was no longer a risk factor for mortality in the second wave, however SACT and metastatic cancer remained risk factors for mortality within the cancer cohort. This emphasises the need for ongoing protection of patients with advanced cancer and those on SACT, including through their prioritisation for COVID-19 vaccination globally. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: H. Shaw: Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Novartis;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: BMS;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: MSD;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Immunocore;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Idera;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Iovance;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Sanofi Genzyme/Regeneron;Financial Interests, Personal, Invited Speaker, Advisory/Consultancy: Macrogenics;Financi Interests, Personal, Invited Speaker, Advisory/Consultancy: Roche. R. Roylance: Financial Interests, Personal, Other, Personal Fees: Novartis;Financial Interests, Personal, Other, Personal Fees & None-financial support: Daiichi Sankyo;Financial Interests, Personal, Other, Personal Fees: Eli-Lilly;Financial Interests, Personal, Other, Personal Fees: Pfizer;Financial Interests, Personal, Other, Personal Fees & None-financial support: G1 Therapeutics;Non-Financial Interests, Personal, Other, None-financial support: Roche;Non-Financial Interests, Personal, Other, None-financial support: AstraZeneca. All other authors have declared no conflicts of interest.

Results: The total number of patients presenting with COVID-19 was higher in wave two (1135 vs 626). 207 of these patients had cancer, and were matched to 452 patients without cancer from both waves. There was a significantly improved chance of mortality in wave 2 (HR 0.41, p < 0.0001). When adjusting for age, sex and comorbidities, cancer was an independent risk factor for mortality amongst patients hospitalised with COVID-19 in wave 1 (HR 1.62, p ¼ 0.02), but not in wave 2. There was a trend towards improved survival for hospitalised patients in wave 2 receiving COVID-19 specific treatment including dexamethasone, remdesivir, tocilizumab (HR 0.75, p ¼ 0.086). For the combined cancer cohort, SACT was an independent predictor of mortality, as was metastatic disease. Background: During the first year of the SARS-CoV-2 pandemic the management and treatment of COVID-19 have been improved. However, cancer patients continue to be one of the most affected. We evaluate the mortality rate due to COVID-19 and associated risk factors in the cancer population diagnosed in our center during the first year of pandemic.

Methods: We retrospectively reviewed the medical records of 189 cancer patients who were diagnosed with COVID-19 between March 5, 2020 and February 28, 2021. Mortality rate nd associated risk factors were studied. Conclusions: Men with lung cancer under cancer-specific treatment with palliative intention who present, at the diagnosis of SARS-CoV-2 infection with elevated CRP above 115 mg/dl and a decrease in lymphocytes below 600/mm3 have a higher risk of presenting fatal complications.

Legal entity responsible for the study: Medical Oncology department, Hospital Universitario Infanta Leonor.

Funding: Has not received any funding.

Disclosure: All authors have declared no conflicts of interest.

https://doi.org/10.1016/j.annonc.2021.08.1569

Early mortality linked to COVID-19 in cancer patients as compared to historical control in pre-pandemic times

Oncoclínicas Group

The primary endpoint was 30-day mortality after isolation of the SARS-CoV-2 by RT-PCR. As historical control, we selected patients from Oncoclínicas Data Lake treated before December 2019 and propensity score-matched to COVID-19 cases (3:1) based on the following clinical characteristics: age, gender, tumor type, disease setting (curative or palliative)

total, 533 cancer patients with COVID-19 were prospectively registered in the database, with median age 60 years, 67% females, most frequent tumor types breast (34%), hematological (16%), gastrointestinal (15%), genitourinary (12%) and