|The following article features coverage from the European Society for Medical Oncology 2020 virtual meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
An analysis of data from the COVID-19 and Cancer Consortium (CCC19) registry suggested that 30-day all-cause mortality was substantially increased both overall and for hospitalized patients with progressive cancer, an Eastern Cooperative Oncology Group (ECOG) performance status greater than 1, or more than 2 comorbidities. These findings were presented at the European Society of Medical Oncology (ESMO) Virtual Congress 2020.1
The CCC19 registry (ClinicalTrials.gov Identifier: NCT04354701) was created to prospectively collect deidentified data about patients with cancer or a cancer history who have been diagnosed with COVID-19 in order “to generate hypothesis-generating and hypothesis-supporting findings that are generalizable to the population at large.”2
At the present time, more than 120 cancer centers and other organizations are currently participating in CCC19. Data covering patient demographics and medical history, information on the initial course of infection with SARS-CoV-2, cancer-related history, details specific to the respondent, and additional information to allow for longitudinal patient follow-up are collected through a simple web-based survey.2
An earlier analysis of patient- and disease-related factors involving 928 patients from the CCC19 registry showed older age, male sex, smoking history, at least 2 comorbidities, an Eastern Cooperative Oncology (ECOG) performance status of 2 or higher, and progressive disease were associated with an increased risk of 30-day mortality.3
The aims of this study were to validate the risk of 30-day mortality associated with previously identified demographic and clinical characteristics in an expanded patient cohort, as well as to perform an exploratory analysis of the association between risk of death within 30 days of COVID-19 diagnosis and abnormalities in particular laboratory parameters. Multivariable analyses were performed to calculate odds ratios (OR) adjusted for potential confounding factors for each identified characteristic.
Of the 3899 adult patients in the overall cohort, representing a racially/ethnically diverse patient population, 2221 were hospitalized. All-cause 30-day mortality was 15% and 25% for the overall cohort and the hospitalized cohort, respectively.
Patient-related factors found to be independently associated with increased 30-day mortality included older age (OR, 1.7 [95% CI, 1.5-1.7; overall cohort]; OR, 1.6 [95% CI, 1.4-1.6; hospitalized cohort] compared with younger age), male sex (OR, 1.5; 95% CI, 1.2-1.8; overall cohort]; 1.3 [95% CI, 1.1-1.7; hospitalized cohort] compared with female sex), Black race (OR, 1.5 [95% CI, 1.2-1.9; overall cohort] compared with White race), more than 2 comorbidities (OR, 2.0 [95% CI, 1.3-3.4; overall cohort] compared with no comorbidities), and ECOG performance status greater than 1 (OR, 4.6 [95% CI, 3.3-6.3; overall cohort]; OR, 2.1 [95% CI, 1.6-2.7; hospitalized cohort] compared with an ECOG performance status of 0).
In addition, 30-day mortality risk was also significantly higher in those with progressive cancer (OR, 2.9 [95% CI, 2.1-4.0; overall cohort]; OR, 2.4 [95% CI, 1.7-3.4; hospitalized cohort]) compared with those with no evidence of disease, and patients with hematologic cancers (OR, 1.7 [95% CI, 1.3-2.2 [overall cohort]; OR, 1.4 [95% CI, 1.0-1.8; hospitalized cohort]) compared with solid tumors.
When abnormalities in specific laboratory parameters were considered, statistically significant ORs between 1.5 and 2.5 were observed for the cohort of hospitalized patients with abnormalities identified as absolute lymphocyte count below the lower limit of normal (LLN), absolute neutrophil count either below the LLN or above the upper limit of normal (ULN), platelet count below LLN, as well as abnormalities in assessments of creatinine, D-dimer, high-sensitivity troponin, and C-reactive protein levels when compared with patients without these laboratory abnormalities.
Study limitations mentioned by Petros Grivas, MD, PhD, physician, Seattle Cancer Care Alliance and associate professor, University of Washington School of Medicine in Seattle, Washington, the presenting author, included its retrospective design, some missing data with respect to laboratory parameters, as well as relatively short follow-up.
In his concluding remarks, Dr Grivas stated that “further modeling with multivariable analysis with longer follow-up will be performed” in an attempt to capture more detailed information for each patient.
Disclosures: Some of the presenters reported financial relationships with the pharmaceutical industry. For a full list of disclosures, please refer to the original abstract.
Read more of Cancer Therapy Advisor‘s coverage of the ESMO Virtual Congress 2020 by visiting the conference page.
- Grivas P, Warner JL, Shyr Y, et al. Assessment of clinical and laboratory prognostic factors in patients with cancer and SARS-CoV-2 infection: The COVID-19 and Cancer Consortium (CCC19). Presented at: European Society of Medical Oncology (ESMO) Virtual Congress 2020; September 19-21, 2020. Abstract LBA72.
- The COVID-19 & Cancer Consortium. https://ccc19.org/. Accessed September 20, 2020.
- Kuderer KM, Choueiri TK, Shah DP, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395:1907-1918. doi:10.1016/S0140-6736(20)31187-9