TY - JOUR
T1 - Changes over Time in COVID-19 Severity and Mortality in Patients Undergoing Cancer Treatment in the United States
T2 - Initial Report from the ASCO Registry
AU - Mileham, Kathryn F.
AU - Bruinooge, Suanna S.
AU - Aggarwal, Charu
AU - Patrick, Alicia L.
AU - Davis, Christiana
AU - Mesenhowski, Daniel J.
AU - Spira, Alexander
AU - Clayton, Eric J.
AU - Waterhouse, David
AU - Moore, Susan
AU - Jazieh, Abdul Rahman
AU - Chen, Ronald C.
AU - Kaltenbaugh, Melinda
AU - Williams, Jen Hanley
AU - Gralow, Julie R.
AU - Schilsky, Richard L.
AU - Garrett-Mayer, Elizabeth
N1 - Funding Information:
The ASCO Registry is supported by Conquer Cancer, the ASCO Foundation's COVID Impacts Cancer Fund ( https://p2p.conquer.org/covidresponse?cmpid=learn_more_homepage_secondary_pane ). ASCO thanks the oncology practices that are participating in the ASCO Survey on COVID-19 in Oncology (ASCO) Registry ( https://www.asco.org/asco-coronavirus-information/coronavirus-registry ), taking the time to enter data on their patients' experiences with cancer and COVID-19.
Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - 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.
AB - 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.
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U2 - 10.1200/OP.21.00394
DO - 10.1200/OP.21.00394
M3 - Article
C2 - 34694907
AN - SCOPUS:85127331257
SN - 2688-1527
VL - 18
SP - E426-E441
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 4
ER -