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International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship

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. METHO...

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Detalles Bibliográficos
Autores principales: Raad, Issam I, Hachem, Ray, Masayuki, Nigo, Datoguia, Tarcila, Dagher, Hiba, Jiang, Ying, Subbiah, Vivek, Siddiqui, Bilal, Bayle, Arnaud, Somer, Robert, Fernández Cruz, Ana, Gorak, Edward, Bhinder, Arvinder, Mori, Nobuyoshi, Hamerschlak, Nelson, Shelanski, Samuel, Dragovich, Tomislav, Vong Kiat, Yee Elise, Fakhreddine, Suha, Pierre, Abi Hanna, Chemaly, Roy F, Mulanovich, Victor, Adachi, Javier, Borjan, Jovan, Khawaja, Fareed, Granwehr, Bruno, John, Teny, Yepez, Eduardo Yepez, Torres, Harrys A, Ammakkanavar, Natraj Reddy, Yibirin, Marcel, Reyes-Gibby, Cielito C, Pande, Mala, Ali, Noman, Rojo, Raniv Dawey, Ali, Shahnoor M, Deeba, Rita E, Chaftari, Patrick, Matsuo, Takahiro, Ishikawa, Kazuhiro, Hasegawa, Ryo, Aguado-Noya, Ramón, García, Alvaro Garcia, Puchol, Cristina Traseira, Lee, Dong Gun, Slavin, Monica, Teh, Benjamin, Arias, Cesar A, Kontoyiannis, Dimitrios P, Malek, Alexandre E, Chaftari, Anne-Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: eLife Sciences Publications, Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981148/
https://www.ncbi.nlm.nih.gov/pubmed/36715684
http://dx.doi.org/10.7554/eLife.81127
Descripción
Sumario: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.