Impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in patients with soft tissue sarcoma: an analysis from the OnCovid registry

Bruno Vincenzi, Alessio Cortellini, Alessandro Mazzocca, Sarah Orlando, Davide Romandini, Juan Aguilar-Company, Isabel Ruiz-Camps, Claudia Valverde Morales, Simeon Eremiev-Eremiev, Carlo Tondini, Joan Brunet, Rossella Bertulli, Salvatore Provenzano, Mark Bower, Daniele Generali, Ramon Salazar, Anna Sureda, Aleix Prat, Michalarea Vasiliki, Mieke Van HemelrijckAilsa Sita-Lumsden, Alexia Bertuzzi, Sabrina Rossi, Amanda Jackson, Federica Grosso, Alvin J.X. Lee, Cian Murphy, Katherine Belessiotis, Uma Mukherjee, Fanny Pommeret, Angela Loizidou, Gianluca Gaidano, Gino M. Dettorre, Salvatore Grisanti, Marco Tucci, Claudia A.M. Fulgenzi, Alessandra Gennari, Andrea Napolitano, David J. Pinato

Risultato della ricerca: Contributo su rivistaArticolo in rivistapeer review

Abstract

Background: To date, limited evidence exists on the impact of COVID-19 in patients with soft tissue sarcoma (STS), nor about the impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in this specific population. Methods: We described COVID-19 morbidity and mortality among patients with STS across ‘Omicron’ (15 December 2021–31 January 2022), ‘Pre-vaccination’ (27 February 2020–30 November 2020), and ‘Alpha-Delta’ phase (01 December 2020–14 December 2021) using OnCovid registry participants (NCT04393974). Case fatality rate at 28 days (CFR28) and COVID-19 severity were also described according to the SARS-CoV-2 vaccination status, while the impact of the receipt of cytotoxic chemotherapy within 4 weeks prior to COVID-19 on clinical outcomes was assessed with Inverse Probability of Treatment Weighting (IPTW) models adjusted for possible confounders. Results: Out of 3820 patients, 97 patients with STS were included. The median age at COVID-19 diagnosis was 56 years (range: 18–92), with 65 patients (67%) aged < 65 years and most patients had a low comorbidity burden (65, 67.0%). The most frequent primary tumor sites were the abdomen (56.7%) and the gynecological tract (12.4%). In total, 36 (37.1%) patients were on cytotoxic chemotherapy within 4 weeks prior to COVID-19. The overall CFR28 was 25.8%, with 38% oxygen therapy requirement, 34% rate of complications, and 32.3% of hospitalizations due to COVID-19. CFR28 (29.5%, 21.4%, and 12.5%) and all indicators of COVID-19 severity demonstrated a trend toward a numerical improvement across the pandemic phases. Similarly, vaccinated patients demonstrated numerically improved CFR28 (16.7% versus 27.7%) and COVID-19 morbidity compared with unvaccinated patients. Patients who were on chemotherapy experienced comparable CFR28 (19.4% versus 26.0%, p = 0.4803), hospitalizations (50.0% versus 44.4%, p = 0.6883), complication rates (30.6% versus 34.0%, p = 0.7381), and oxygen therapy requirement (28.1% versus 40.0%, p = 0.2755) compared to those who were not on anticancer therapy at COVID-19, findings further confirmed by the IPTW-fitted multivariable analysis. Conclusion: In this study, we demonstrate an improvement in COVID-19 outcomes in patients with STS over time. Recent exposure to chemotherapy does not impact COVID-19 morbidity and mortality and SARS-CoV-2 vaccination confers protection against adverse outcomes from COVID-19 in this patient population.

Lingua originaleInglese
RivistaTherapeutic Advances in Medical Oncology
Volume16
DOI
Stato di pubblicazionePubblicato - 1 gen 2024

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