COVID-19 mortality has improved over the course of the pandemic for European patients with cancer, according to a study published in JAMA Oncology.

The 14-day case fatality rate decreased from 29.8% during February-March 2020 to 14.5% during January-February 2021, according to data from the OnCovid registry.

Researchers speculated that this improvement could be associated with earlier diagnosis of COVID-19, improved management of patients with COVID-19 and cancer, and changes in community transmission over time.


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For this study, the researchers analyzed data on patients with solid tumors and hematologic cancers who were diagnosed with COVID-19 between February 27, 2020, and February 14, 2021, and enrolled in the OnCovid registry. The data encompass patients from 35 institutions across Belgium, France, Germany, Italy, Spain, and the United Kingdom.

The researchers calculated case-fatality rates at 14 days and 3 months to measure whether COVID-19 mortality in European cancer patients improved over the course of the pandemic, assessing data from 2 COVID-19 outbreaks.

The first outbreak was defined as the period from February 2020 to June 2020. During this period, there were 1626 patients with cancer and COVID-19 in the registry. A majority of patients (67.2%) had active cancer, 45.4% experienced COVID-19 complications, 59.8% required hospitalization for COVID-19, and 22.3% were already hospitalized. 

The second outbreak was defined as the period from July 2020 to February 2021. During this period, there were 1008 patients with cancer and COVID-19 in the registry. A majority (65.9%) had active cancer, 33.9% experienced COVID-19 complications, 42.1% required hospitalization for COVID-19, and 27.4% were already hospitalized.

The 14-day case-fatality rate during the first outbreak was 25.6%, but that dropped to 16.2% during the second outbreak (P <.001). The 3-month case-fatality rates were 37.5% and 32.1%, respectively (P =.01).

In an adjusted analysis, patients in the first outbreak still had an increased risk of death at 14 days and at 3 months after COVID-19 diagnosis, when compared with patients in the second outbreak. The hazard ratio (HR) was 1.85 (95% CI, 1.47-2.32) for death at 14 days and 1.28 (95% CI, 1.08-1.51) for death at 3 months.

The researchers acknowledged several limitations to this study. They noted that a large-scale population study would provide better evidence to assess the impact of government COVID-19 policies.

The researchers also noted that country-level changes during the study period could have affected the trends they observed between outbreaks. The study also captured limited data on the effectiveness of COVID-19 vaccination campaigns and the impact of emerging SARS-CoV-2 variants.

“Despite the acknowledged limitations, this case series provides an important contemporary portrait of the evolving outcomes of COVID-19 in patients with cancer, highlighting the importance of widespread SARS-CoV-2 testing as a strategy to facilitate early diagnosis of COVID-19 and maintain the appropriate therapeutic pathway for patients with cancer despite the ongoing threat of an unresolved global pandemic,” the researchers wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Pinato DJ, Patel M, Scotti L, et al. Time-dependent COVID-19 mortality in patients with cancer: An updated analysis of the OnCovid registry. JAMA Oncol. Published online November 24, 2021. doi:10.1001/jamaoncol.2021.6199