tetano
Editor, Senior Moderator
Eur J Cancer
. 2020 Oct 8;141:62-81.
doi: 10.1016/j.ejca.2020.09.035. Online ahead of print.
Risk factors for Coronavirus Disease 2019 (COVID-19) severity and mortality among solid cancer patients and impact of the disease on anticancer treatment: A French nationwide cohort study (GCO-002 CACOVID-19)
Astrid Li?vre[SUP] 1 [/SUP], Anthony Turpin[SUP] 2 [/SUP], Isabelle Ray-Coquard[SUP] 3 [/SUP], Karine Le Malicot[SUP] 4 [/SUP], Juliette Thariat[SUP] 5 [/SUP], Guido Ahle[SUP] 6 [/SUP], Cindy Neuzillet[SUP] 7 [/SUP], Xavier Paoletti[SUP] 7 [/SUP], Olivier Bouch?[SUP] 8 [/SUP], Kais Aldabbagh[SUP] 9 [/SUP], Pierre Michel[SUP] 10 [/SUP], Didier Debieuvre[SUP] 11 [/SUP], Anthony Canellas[SUP] 12 [/SUP], Marie Wislez[SUP] 13 [/SUP], Lucie Laurent[SUP] 14 [/SUP], May Mabro[SUP] 15 [/SUP], Raphael Colle[SUP] 16 [/SUP], Anne-Claire Hardy-Bessard[SUP] 17 [/SUP], Laura Mansi[SUP] 18 [/SUP], Emeline Colomba[SUP] 19 [/SUP], Jean Bourhis[SUP] 20 [/SUP], Philippe Gorphe[SUP] 21 [/SUP], Yoann Pointreau[SUP] 22 [/SUP], Ahmed Idbaih[SUP] 23 [/SUP], Renata Ursu[SUP] 24 [/SUP], Anna Luisa Di Stefano[SUP] 25 [/SUP], G?rard Zalcman[SUP] 26 [/SUP], Thomas Aparicio[SUP] 27 [/SUP], GCO-002 CACOVID-19 collaborators/investigators
Collaborators, Affiliations
Abstract
Background: Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated.
Patients and methods: In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and 11th June 2020. The primary end-point was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary end-points.
Results: From April 4 to 11th June 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18-2.52), The Eastern Cooperative Oncology Group Performance Scale (ECOG PS) ≥ 2 (OR 3.23, 95%CI: 2.27-4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01-1.16) and admission to ICU (OR 3.62, 95%CI 2.14-6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except for cytotoxic chemotherapy in the subgroup of patients with detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00-2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment (such as chemotherapy, targeted or immune therapy) interrupted or stopped following diagnosis of COVID-19.
Conclusions: Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.
Keywords: COVID-19; Cancer; Chemotherapy; Death; Immunotherapy; Intensive care unit; Mechanical ventilation; Mortality; Radiotherapy.
. 2020 Oct 8;141:62-81.
doi: 10.1016/j.ejca.2020.09.035. Online ahead of print.
Risk factors for Coronavirus Disease 2019 (COVID-19) severity and mortality among solid cancer patients and impact of the disease on anticancer treatment: A French nationwide cohort study (GCO-002 CACOVID-19)
Astrid Li?vre[SUP] 1 [/SUP], Anthony Turpin[SUP] 2 [/SUP], Isabelle Ray-Coquard[SUP] 3 [/SUP], Karine Le Malicot[SUP] 4 [/SUP], Juliette Thariat[SUP] 5 [/SUP], Guido Ahle[SUP] 6 [/SUP], Cindy Neuzillet[SUP] 7 [/SUP], Xavier Paoletti[SUP] 7 [/SUP], Olivier Bouch?[SUP] 8 [/SUP], Kais Aldabbagh[SUP] 9 [/SUP], Pierre Michel[SUP] 10 [/SUP], Didier Debieuvre[SUP] 11 [/SUP], Anthony Canellas[SUP] 12 [/SUP], Marie Wislez[SUP] 13 [/SUP], Lucie Laurent[SUP] 14 [/SUP], May Mabro[SUP] 15 [/SUP], Raphael Colle[SUP] 16 [/SUP], Anne-Claire Hardy-Bessard[SUP] 17 [/SUP], Laura Mansi[SUP] 18 [/SUP], Emeline Colomba[SUP] 19 [/SUP], Jean Bourhis[SUP] 20 [/SUP], Philippe Gorphe[SUP] 21 [/SUP], Yoann Pointreau[SUP] 22 [/SUP], Ahmed Idbaih[SUP] 23 [/SUP], Renata Ursu[SUP] 24 [/SUP], Anna Luisa Di Stefano[SUP] 25 [/SUP], G?rard Zalcman[SUP] 26 [/SUP], Thomas Aparicio[SUP] 27 [/SUP], GCO-002 CACOVID-19 collaborators/investigators
Collaborators, Affiliations
- PMID: 33129039
- PMCID: PMC7543792
- DOI: 10.1016/j.ejca.2020.09.035
Abstract
Background: Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated.
Patients and methods: In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and 11th June 2020. The primary end-point was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary end-points.
Results: From April 4 to 11th June 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18-2.52), The Eastern Cooperative Oncology Group Performance Scale (ECOG PS) ≥ 2 (OR 3.23, 95%CI: 2.27-4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01-1.16) and admission to ICU (OR 3.62, 95%CI 2.14-6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except for cytotoxic chemotherapy in the subgroup of patients with detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00-2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment (such as chemotherapy, targeted or immune therapy) interrupted or stopped following diagnosis of COVID-19.
Conclusions: Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.
Keywords: COVID-19; Cancer; Chemotherapy; Death; Immunotherapy; Intensive care unit; Mechanical ventilation; Mortality; Radiotherapy.