Changes over Time in COVID-19 Severity and Mortality in Patients Undergoing Cancer Treatment in the United States: Initial Report from the ASCO Registry

Kathryn F. Mileham, Suanna S. Bruinooge, Charu Aggarwal, Alicia L. Patrick, Christiana Davis, Daniel J. Mesenhowski, Alexander Spira, Eric J. Clayton, David Waterhouse, Susan Moore, Abdul Rahman Jazieh, Ronald C. Chen, Melinda Kaltenbaugh, Jen Hanley Williams, Julie R. Gralow, Richard L. Schilsky, Elizabeth Garrett-Mayer

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE:People with cancer are at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ASCO's COVID-19 registry promotes systematic data collection across US oncology practices.METHODS:Participating practices enter data on patients with SARS-CoV-2 infection in cancer treatment. In this analysis, we focus on all patients with hematologic or regional or metastatic solid tumor malignancies. Primary outcomes are 30- and 90-day mortality rates and change over time.RESULTS:Thirty-eight practices provided data for 453 patients from April to October 2020. Sixty-two percent had regional or metastatic solid tumors. Median age was 64 years. Forty-three percent were current or previous cigarette users. Patients with B-cell malignancies age 61-70 years had twice mortality risk (hazard ratio = 2.1 [95% CI, 1.3 to 3.3]) and those age > 70 years had 4.5 times mortality risk (95% CI, 1.8 to 11.1) compared with patients age ≤ 60 years. Association between survival and age was not significant in patients with metastatic solid tumors (P =.12). Tobacco users had 30-day mortality estimate of 21% compared with 11% for never users (log-rank P =.005). Patients diagnosed with SARS-CoV-2 before June 2020 had 30-day mortality rate of 20% (95% CI, 14% to 25%) compared with 13% (8% to 18%) for those diagnosed in or after June 2020 (P =.08). The 90-day mortality rate for pre-June patients was 28% (21% to 34%) compared with 21% (13% to 28%; P =.20).CONCLUSION:Older patients with B-cell malignancies were at increased risk for death (unlike older patients with metastatic solid tumors), as were all patients with cancer who smoke tobacco. Diagnosis of SARS-CoV-2 later in 2020 was associated with more favorable 30- and 90-day mortality, likely related to more asymptomatic cases and improved clinical management.

Original languageEnglish (US)
Pages (from-to)E426-E441
JournalJCO Oncology Practice
Volume18
Issue number4
DOIs
StatePublished - Apr 1 2022

ASJC Scopus subject areas

  • Health Policy
  • Oncology(nursing)
  • Oncology

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