Immune checkpoint inhibitor (ICI) treatment prior to SARS-CoV-2 infection is not associated with COVID-19 severity or survival outcomes in patients with cancer, according to a study published in The Oncologist

“Given that cancer patients with COVID-19 have elevated risks of disease severity and mortality, there is a compelling need to characterize the impact of various cancer treatments on COVID-19 outcomes to guide clinical decision making,” the researchers wrote. 

With that in mind, the team analyzed adults with cancer and COVID-19 identified from a large electronic health record database. Patients who had received an ICI were matched 1:2 with patients who had no prior ICI treatment.

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There were 17,545 evaluable patients with cancer who tested positive for COVID-19 from February 2020 to January 2021. From this cohort, the researchers matched 228 patients who had been treated with an ICI to 456 patients who had not. Most patients (more than 90% in each cohort) had solid tumor malignancies.

Overall, there were no significant differences in COVID-19 severity or mortality between the ICI group and non-ICI group.

The 30-day mortality rate was 12.7% in the ICI group and 14.9% in the non-ICI group (P =.235). The overall mortality rate was 22.4% in both groups (P =1.000). 

The hospitalization rate was 38.6% in the ICI group and 39.0% in the non-ICI group (P =.912). The rate of emergency room visits was 16.7% and 14.7%, respectively (P =.500) 

The addition of chemotherapy to ICI treatment did not seem to be associated with a difference in COVID-19 outcomes, according to the researchers.

“Our large study of patients with cancer who contracted COVID-19 meaningfully adds to the evidence base that use of ICIs (any class, with or without chemotherapy) before SARS-CoV-2 infection does not affect COVID-19 severity or survival outcomes,” the researchers wrote. 

These data, combined with results from other similar studies, support “the safety of the continued use of ICIs in cancer patients during the pandemic,” the team concluded.

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


Tan R, Yun C, Seetasith A, et al. Impact of immune checkpoint inhibitors on COVID-19 severity in patients with cancer. Oncologist. Published online February 19, 2022. doi:10.1091/oncolo/oyab083