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Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study

BACKGROUND: Data on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness. METHODS: In this cohort study, we collected de-identified data on pat...

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Autores principales: Kuderer, Nicole M, Choueiri, Toni K, Shah, Dimpy P, Shyr, Yu, Rubinstein, Samuel M, Rivera, Donna R, Shete, Sanjay, Hsu, Chih-Yuan, Desai, Aakash, de Lima Lopes, Gilberto, Grivas, Petros, Painter, Corrie A, Peters, Solange, Thompson, Michael A, Bakouny, Ziad, Batist, Gerald, Bekaii-Saab, Tanios, Bilen, Mehmet A, Bouganim, Nathaniel, Larroya, Mateo Bover, Castellano, Daniel, Del Prete, Salvatore A, Doroshow, Deborah B, Egan, Pamela C, Elkrief, Arielle, Farmakiotis, Dimitrios, Flora, Daniel, Galsky, Matthew D, Glover, Michael J, Griffiths, Elizabeth A, Gulati, Anthony P, Gupta, Shilpa, Hafez, Navid, Halfdanarson, Thorvardur R, Hawley, Jessica E, Hsu, Emily, Kasi, Anup, Khaki, Ali R, Lemmon, Christopher A, Lewis, Colleen, Logan, Barbara, Masters, Tyler, McKay, Rana R, Mesa, Ruben A, Morgans, Alicia K, Mulcahy, Mary F, Panagiotou, Orestis A, Peddi, Prakash, Pennell, Nathan A, Reynolds, Kerry, Rosen, Lane R, Rosovsky, Rachel, Salazar, Mary, Schmidt, Andrew, Shah, Sumit A, Shaya, Justin A, Steinharter, John, Stockerl-Goldstein, Keith E, Subbiah, Suki, Vinh, Donald C, Wehbe, Firas H, Weissmann, Lisa B, Wu, Julie Tsu-Yu, Wulff-Burchfield, Elizabeth, Xie, Zhuoer, Yeh, Albert, Yu, Peter P, Zhou, Alice Y, Zubiri, Leyre, Mishra, Sanjay, Lyman, Gary H, Rini, Brian I, Warner, Jeremy L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255743/
https://www.ncbi.nlm.nih.gov/pubmed/32473681
http://dx.doi.org/10.1016/S0140-6736(20)31187-9
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author Kuderer, Nicole M
Choueiri, Toni K
Shah, Dimpy P
Shyr, Yu
Rubinstein, Samuel M
Rivera, Donna R
Shete, Sanjay
Hsu, Chih-Yuan
Desai, Aakash
de Lima Lopes, Gilberto
Grivas, Petros
Painter, Corrie A
Peters, Solange
Thompson, Michael A
Bakouny, Ziad
Batist, Gerald
Bekaii-Saab, Tanios
Bilen, Mehmet A
Bouganim, Nathaniel
Larroya, Mateo Bover
Castellano, Daniel
Del Prete, Salvatore A
Doroshow, Deborah B
Egan, Pamela C
Elkrief, Arielle
Farmakiotis, Dimitrios
Flora, Daniel
Galsky, Matthew D
Glover, Michael J
Griffiths, Elizabeth A
Gulati, Anthony P
Gupta, Shilpa
Hafez, Navid
Halfdanarson, Thorvardur R
Hawley, Jessica E
Hsu, Emily
Kasi, Anup
Khaki, Ali R
Lemmon, Christopher A
Lewis, Colleen
Logan, Barbara
Masters, Tyler
McKay, Rana R
Mesa, Ruben A
Morgans, Alicia K
Mulcahy, Mary F
Panagiotou, Orestis A
Peddi, Prakash
Pennell, Nathan A
Reynolds, Kerry
Rosen, Lane R
Rosovsky, Rachel
Salazar, Mary
Schmidt, Andrew
Shah, Sumit A
Shaya, Justin A
Steinharter, John
Stockerl-Goldstein, Keith E
Subbiah, Suki
Vinh, Donald C
Wehbe, Firas H
Weissmann, Lisa B
Wu, Julie Tsu-Yu
Wulff-Burchfield, Elizabeth
Xie, Zhuoer
Yeh, Albert
Yu, Peter P
Zhou, Alice Y
Zubiri, Leyre
Mishra, Sanjay
Lyman, Gary H
Rini, Brian I
Warner, Jeremy L
author_facet Kuderer, Nicole M
Choueiri, Toni K
Shah, Dimpy P
Shyr, Yu
Rubinstein, Samuel M
Rivera, Donna R
Shete, Sanjay
Hsu, Chih-Yuan
Desai, Aakash
de Lima Lopes, Gilberto
Grivas, Petros
Painter, Corrie A
Peters, Solange
Thompson, Michael A
Bakouny, Ziad
Batist, Gerald
Bekaii-Saab, Tanios
Bilen, Mehmet A
Bouganim, Nathaniel
Larroya, Mateo Bover
Castellano, Daniel
Del Prete, Salvatore A
Doroshow, Deborah B
Egan, Pamela C
Elkrief, Arielle
Farmakiotis, Dimitrios
Flora, Daniel
Galsky, Matthew D
Glover, Michael J
Griffiths, Elizabeth A
Gulati, Anthony P
Gupta, Shilpa
Hafez, Navid
Halfdanarson, Thorvardur R
Hawley, Jessica E
Hsu, Emily
Kasi, Anup
Khaki, Ali R
Lemmon, Christopher A
Lewis, Colleen
Logan, Barbara
Masters, Tyler
McKay, Rana R
Mesa, Ruben A
Morgans, Alicia K
Mulcahy, Mary F
Panagiotou, Orestis A
Peddi, Prakash
Pennell, Nathan A
Reynolds, Kerry
Rosen, Lane R
Rosovsky, Rachel
Salazar, Mary
Schmidt, Andrew
Shah, Sumit A
Shaya, Justin A
Steinharter, John
Stockerl-Goldstein, Keith E
Subbiah, Suki
Vinh, Donald C
Wehbe, Firas H
Weissmann, Lisa B
Wu, Julie Tsu-Yu
Wulff-Burchfield, Elizabeth
Xie, Zhuoer
Yeh, Albert
Yu, Peter P
Zhou, Alice Y
Zubiri, Leyre
Mishra, Sanjay
Lyman, Gary H
Rini, Brian I
Warner, Jeremy L
author_sort Kuderer, Nicole M
collection PubMed
description BACKGROUND: Data on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness. METHODS: In this cohort study, we collected de-identified data on patients with active or previous malignancy, aged 18 years and older, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. We collected data on baseline clinical conditions, medications, cancer diagnosis and treatment, and COVID-19 disease course. The primary endpoint was all-cause mortality within 30 days of diagnosis of COVID-19. We assessed the association between the outcome and potential prognostic variables using logistic regression analyses, partially adjusted for age, sex, smoking status, and obesity. This study is registered with ClinicalTrials.gov, NCT04354701, and is ongoing. FINDINGS: Of 1035 records entered into the CCC19 database during the study period, 928 patients met inclusion criteria for our analysis. Median age was 66 years (IQR 57–76), 279 (30%) were aged 75 years or older, and 468 (50%) patients were male. The most prevalent malignancies were breast (191 [21%]) and prostate (152 [16%]). 366 (39%) patients were on active anticancer treatment, and 396 (43%) had active (measurable) cancer. At analysis (May 7, 2020), 121 (13%) patients had died. In logistic regression analysis, independent factors associated with increased 30-day mortality, after partial adjustment, were: increased age (per 10 years; partially adjusted odds ratio 1·84, 95% CI 1·53–2·21), male sex (1·63, 1·07–2·48), smoking status (former smoker vs never smoked: 1·60, 1·03–2·47), number of comorbidities (two vs none: 4·50, 1·33–15·28), Eastern Cooperative Oncology Group performance status of 2 or higher (status of 2 vs 0 or 1: 3·89, 2·11–7·18), active cancer (progressing vs remission: 5·20, 2·77–9·77), and receipt of azithromycin plus hydroxychloroquine (vs treatment with neither: 2·93, 1·79–4·79; confounding by indication cannot be excluded). Compared with residence in the US-Northeast, residence in Canada (0·24, 0·07–0·84) or the US-Midwest (0·50, 0·28–0·90) were associated with decreased 30-day all-cause mortality. Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality. INTERPRETATION: Among patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer. Longer follow-up is needed to better understand the effect of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments. FUNDING: American Cancer Society, National Institutes of Health, and Hope Foundation for Cancer Research.
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spelling pubmed-72557432020-05-29 Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study Kuderer, Nicole M Choueiri, Toni K Shah, Dimpy P Shyr, Yu Rubinstein, Samuel M Rivera, Donna R Shete, Sanjay Hsu, Chih-Yuan Desai, Aakash de Lima Lopes, Gilberto Grivas, Petros Painter, Corrie A Peters, Solange Thompson, Michael A Bakouny, Ziad Batist, Gerald Bekaii-Saab, Tanios Bilen, Mehmet A Bouganim, Nathaniel Larroya, Mateo Bover Castellano, Daniel Del Prete, Salvatore A Doroshow, Deborah B Egan, Pamela C Elkrief, Arielle Farmakiotis, Dimitrios Flora, Daniel Galsky, Matthew D Glover, Michael J Griffiths, Elizabeth A Gulati, Anthony P Gupta, Shilpa Hafez, Navid Halfdanarson, Thorvardur R Hawley, Jessica E Hsu, Emily Kasi, Anup Khaki, Ali R Lemmon, Christopher A Lewis, Colleen Logan, Barbara Masters, Tyler McKay, Rana R Mesa, Ruben A Morgans, Alicia K Mulcahy, Mary F Panagiotou, Orestis A Peddi, Prakash Pennell, Nathan A Reynolds, Kerry Rosen, Lane R Rosovsky, Rachel Salazar, Mary Schmidt, Andrew Shah, Sumit A Shaya, Justin A Steinharter, John Stockerl-Goldstein, Keith E Subbiah, Suki Vinh, Donald C Wehbe, Firas H Weissmann, Lisa B Wu, Julie Tsu-Yu Wulff-Burchfield, Elizabeth Xie, Zhuoer Yeh, Albert Yu, Peter P Zhou, Alice Y Zubiri, Leyre Mishra, Sanjay Lyman, Gary H Rini, Brian I Warner, Jeremy L Lancet Articles BACKGROUND: Data on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness. METHODS: In this cohort study, we collected de-identified data on patients with active or previous malignancy, aged 18 years and older, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. We collected data on baseline clinical conditions, medications, cancer diagnosis and treatment, and COVID-19 disease course. The primary endpoint was all-cause mortality within 30 days of diagnosis of COVID-19. We assessed the association between the outcome and potential prognostic variables using logistic regression analyses, partially adjusted for age, sex, smoking status, and obesity. This study is registered with ClinicalTrials.gov, NCT04354701, and is ongoing. FINDINGS: Of 1035 records entered into the CCC19 database during the study period, 928 patients met inclusion criteria for our analysis. Median age was 66 years (IQR 57–76), 279 (30%) were aged 75 years or older, and 468 (50%) patients were male. The most prevalent malignancies were breast (191 [21%]) and prostate (152 [16%]). 366 (39%) patients were on active anticancer treatment, and 396 (43%) had active (measurable) cancer. At analysis (May 7, 2020), 121 (13%) patients had died. In logistic regression analysis, independent factors associated with increased 30-day mortality, after partial adjustment, were: increased age (per 10 years; partially adjusted odds ratio 1·84, 95% CI 1·53–2·21), male sex (1·63, 1·07–2·48), smoking status (former smoker vs never smoked: 1·60, 1·03–2·47), number of comorbidities (two vs none: 4·50, 1·33–15·28), Eastern Cooperative Oncology Group performance status of 2 or higher (status of 2 vs 0 or 1: 3·89, 2·11–7·18), active cancer (progressing vs remission: 5·20, 2·77–9·77), and receipt of azithromycin plus hydroxychloroquine (vs treatment with neither: 2·93, 1·79–4·79; confounding by indication cannot be excluded). Compared with residence in the US-Northeast, residence in Canada (0·24, 0·07–0·84) or the US-Midwest (0·50, 0·28–0·90) were associated with decreased 30-day all-cause mortality. Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality. INTERPRETATION: Among patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer. Longer follow-up is needed to better understand the effect of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments. FUNDING: American Cancer Society, National Institutes of Health, and Hope Foundation for Cancer Research. Elsevier Ltd. 2020 2020-05-28 /pmc/articles/PMC7255743/ /pubmed/32473681 http://dx.doi.org/10.1016/S0140-6736(20)31187-9 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Articles
Kuderer, Nicole M
Choueiri, Toni K
Shah, Dimpy P
Shyr, Yu
Rubinstein, Samuel M
Rivera, Donna R
Shete, Sanjay
Hsu, Chih-Yuan
Desai, Aakash
de Lima Lopes, Gilberto
Grivas, Petros
Painter, Corrie A
Peters, Solange
Thompson, Michael A
Bakouny, Ziad
Batist, Gerald
Bekaii-Saab, Tanios
Bilen, Mehmet A
Bouganim, Nathaniel
Larroya, Mateo Bover
Castellano, Daniel
Del Prete, Salvatore A
Doroshow, Deborah B
Egan, Pamela C
Elkrief, Arielle
Farmakiotis, Dimitrios
Flora, Daniel
Galsky, Matthew D
Glover, Michael J
Griffiths, Elizabeth A
Gulati, Anthony P
Gupta, Shilpa
Hafez, Navid
Halfdanarson, Thorvardur R
Hawley, Jessica E
Hsu, Emily
Kasi, Anup
Khaki, Ali R
Lemmon, Christopher A
Lewis, Colleen
Logan, Barbara
Masters, Tyler
McKay, Rana R
Mesa, Ruben A
Morgans, Alicia K
Mulcahy, Mary F
Panagiotou, Orestis A
Peddi, Prakash
Pennell, Nathan A
Reynolds, Kerry
Rosen, Lane R
Rosovsky, Rachel
Salazar, Mary
Schmidt, Andrew
Shah, Sumit A
Shaya, Justin A
Steinharter, John
Stockerl-Goldstein, Keith E
Subbiah, Suki
Vinh, Donald C
Wehbe, Firas H
Weissmann, Lisa B
Wu, Julie Tsu-Yu
Wulff-Burchfield, Elizabeth
Xie, Zhuoer
Yeh, Albert
Yu, Peter P
Zhou, Alice Y
Zubiri, Leyre
Mishra, Sanjay
Lyman, Gary H
Rini, Brian I
Warner, Jeremy L
Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title_full Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title_fullStr Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title_full_unstemmed Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title_short Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
title_sort clinical impact of covid-19 on patients with cancer (ccc19): a cohort study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255743/
https://www.ncbi.nlm.nih.gov/pubmed/32473681
http://dx.doi.org/10.1016/S0140-6736(20)31187-9
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