COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study
AuthorsLee, L. Y. W.
Cazier, J. B.
Briggs, S. E. W.
Campton, N. A.
Cheng, V. W. T.
Curley, H. M.
Fittall, M. W.
Hughes, D. J.
Lee, A. J. X.
Lee, Rebecca J
Lee, S. M.
Middleton, C. P.
Olsson-Brown, A. C.
Protheroe, E. A.
Smith, A. J.
Turnbull, C. D.
Briggs, A. D. M.
AffiliationInstitute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Department of Oncology, University of Oxford, Oxford, UK; University Hospitals Birmingham, Birmingham, UK.
MetadataShow full item record
AbstractBackground: Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK. Methods: We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models. Findings: 319 (30�6%) of 1044 patients in the UKCCMP cohort died, 295 (92�5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0�10 in patients aged 40-49 years to 0�48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1�57, 95% CI 1�15-2�15; p<0�0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2�25, 1�13-4�57; p=0�023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2�09, 95% CI 1�09-4�08; p=0�028). Interpretation: Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies.
CitationLee LYW, Cazier J-B, Starkey T, Briggs SEW, Arnold R, Bisht V, et al. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. The Lancet Oncology. 2020.
- Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study.
- Authors: Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K, Lu H, Liu J, Yang J, Dong Y, Pan D, Shu C, Li J, Wei J, Huang Y, Peng L, Wu M, Zhang R, Wu B, Li Y, Cai L, Li G, Zhang T, Wu G
- Issue date: 2020 Jul
- COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study.
- Authors: Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, Campton NA, Chackathayil J, Cheng VW, Curley HM, Fittall MW, Freeman-Mills L, Gennatas S, Goel A, Hartley S, Hughes DJ, Kerr D, Lee AJ, Lee RJ, McGrath SE, Middleton CP, Murugaesu N, Newsom-Davis T, Okines AF, Olsson-Brown AC, Palles C, Pan Y, Pettengell R, Powles T, Protheroe EA, Purshouse K, Sharma-Oates A, Sivakumar S, Smith AJ, Starkey T, Turnbull CD, Várnai C, Yousaf N, UK Coronavirus Monitoring Project Team., Kerr R, Middleton G
- Issue date: 2020 Jun 20
- Determinants of COVID-19 disease severity in patients with cancer.
- Authors: Robilotti EV, Babady NE, Mead PA, Rolling T, Perez-Johnston R, Bernardes M, Bogler Y, Caldararo M, Figueroa CJ, Glickman MS, Joanow A, Kaltsas A, Lee YJ, Lucca A, Mariano A, Morjaria S, Nawar T, Papanicolaou GA, Predmore J, Redelman-Sidi G, Schmidt E, Seo SK, Sepkowitz K, Shah MK, Wolchok JD, Hohl TM, Taur Y, Kamboj M
- Issue date: 2020 Aug
- High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR.
- Authors: Assaad S, Avrillon V, Fournier ML, Mastroianni B, Russias B, Swalduz A, Cassier P, Eberst L, Steineur MP, Kazes M, Perol M, Michallet AS, Rey P, Erena-Penet AS, Morel A, Brahmi M, Dufresne A, Tredan O, Chvetzoff G, Fayette J, de la Fouchardiere C, Ray-Coquard I, Bachelot T, Saintigny P, Tabutin M, Dupré A, Nicolas-Virelizier E, Belhabri A, Roux PE, Fuhrmann C, Pilleul F, Basle A, Bouhamama A, Galvez C, Herr AL, Gautier J, Chabaud S, Zrounba P, Perol D, Blay JY
- Issue date: 2020 Aug
- SARS-CoV-2 infection in cancer patients undergoing active treatment: analysis of clinical features and predictive factors for severe respiratory failure and death.
- Authors: Yarza R, Bover M, Paredes D, López-López F, Jara-Casas D, Castelo-Loureiro A, Baena J, Mazarico JM, Folgueira MD, Meléndez-Carmona MÁ, Reyes A, Lumbreras C, Paz-Ares L, Díaz-Pedroche C, Gómez-Martín C
- Issue date: 2020 Aug