TY - JOUR
T1 - Time-Dependent COVID-19 Mortality in Patients with Cancer
T2 - An Updated Analysis of the OnCovid Registry
AU - Pinato, David J.
AU - Patel, Meera
AU - Scotti, Lorenza
AU - Colomba, Emeline
AU - Dolly, Saoirse
AU - Loizidou, Angela
AU - Chester, John
AU - Mukherjee, Uma
AU - Zambelli, Alberto
AU - Dalla Pria, Alessia
AU - Aguilar-Company, Juan
AU - Bower, Mark
AU - Salazar, Ramon
AU - Bertuzzi, Alexia
AU - Brunet, Joan
AU - Lambertini, Matteo
AU - Tagliamento, Marco
AU - Pous, Anna
AU - Sita-Lumsden, Ailsa
AU - Srikandarajah, Krishnie
AU - Colomba, Johann
AU - Pommeret, Fanny
AU - Seguí, Elia
AU - Generali, Daniele
AU - Grisanti, Salvatore
AU - Pedrazzoli, Paolo
AU - Rizzo, Gianpiero
AU - Libertini, Michela
AU - Moss, Charlotte
AU - Evans, Joanne S.
AU - Russell, Beth
AU - Harbeck, Nadia
AU - Vincenzi, Bruno
AU - Biello, Federica
AU - Bertulli, Rossella
AU - Ottaviani, Diego
AU - Liñan, Raquel
AU - Rossi, Sabrina
AU - Carmona-García, M. Carmen
AU - Tondini, Carlo
AU - Fox, Laura
AU - Baggi, Alice
AU - Fotia, Vittoria
AU - Parisi, Alessandro
AU - Porzio, Giampero
AU - Queirolo, Paola
AU - Cruz, Claudia Andrea
AU - Saoudi-Gonzalez, Nadia
AU - Felip, Eudald
AU - Roqué Lloveras, Ariadna
AU - Newsom-Davis, Thomas
AU - Sharkey, Rachel
AU - Roldán, Elisa
AU - Reyes, Roxana
AU - Zoratto, Federica
AU - Earnshaw, Irina
AU - Ferrante, Daniela
AU - Marco-Hernández, Javier
AU - Ruiz-Camps, Isabel
AU - Gaidano, Gianluca
AU - Patriarca, Andrea
AU - Bruna, Riccardo
AU - Sureda, Anna
AU - Martinez-Vila, Clara
AU - Sanchez De Torre, Ana
AU - Berardi, Rossana
AU - Giusti, Raffaele
AU - Mazzoni, Francesca
AU - Guida, Annalisa
AU - Rimassa, Lorenza
AU - Chiudinelli, Lorenzo
AU - Franchi, Michela
AU - Krengli, Marco
AU - Santoro, Armando
AU - Prat, Aleix
AU - Tabernero, Josep
AU - Van Hemelrijck, Mieke
AU - Diamantis, Nikolaos
AU - Gennari, Alessandra
AU - Cortellini, Alessio
N1 - Publisher Copyright:
© 2022 American Medical Association. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - Importance: Whether the severity and mortality of COVID-19 in patients with cancer have improved in terms of disease management and capacity is yet to be defined. Objective: To test whether severity and mortality from COVID-19 among patients with cancer have improved during the course of the pandemic. Design, Setting, and Participants: OnCovid is a European registry that collects data on consecutive patients with solid or hematologic cancer and COVID-19. This multicenter case series study included real-world data from 35 institutions across 6 countries (UK, Italy, Spain, France, Belgium, and Germany). This update included patients diagnosed between February 27, 2020, and February, 14, 2021. Inclusion criteria were confirmed diagnosis of SARS-CoV-2 infection and a history of solid or hematologic cancer. Exposures: SARS-CoV-2 infection. Main Outcomes and Measures: Deaths were differentiated at 14 days and 3 months as the 2 landmark end points. Patient characteristics and outcomes were compared by stratifying patients across 5 phases (February to March 2020, April to June 2020, July to September 2020, October to December 2020, and January to February 2021) and across 2 major outbreaks (February to June 2020 and July 2020 to February 2021). Results: At data cutoff, 2795 consecutive patients were included, with 2634 patients eligible for analysis (median [IQR] age, 68 [18-77] years; 52.8% men). Eligible patients demonstrated significant time-dependent improvement in 14-day case-fatality rate (CFR) with estimates of 29.8% (95% CI, 0.26-0.33) for February to March 2020; 20.3% (95% CI, 0.17-0.23) for April to June 2020; 12.5% (95% CI, 0.06-22.90) for July to September 2020; 17.2% (95% CI, 0.15-0.21) for October to December 2020; and 14.5% (95% CI, 0.09-0.21) for January to February 2021 (all P <.001) across the predefined phases. Compared with the second major outbreak, patients diagnosed in the first outbreak were more likely to be 65 years or older (974 of 1626 [60.3%] vs 564 of 1008 [56.1%]; P =.03), have at least 2 comorbidities (793 of 1626 [48.8%] vs 427 of 1008 [42.4%]; P =.001), and have advanced tumors (708 of 1626 [46.4%] vs 536 of 1008 [56.1%]; P <.001). Complications of COVID-19 were more likely to be seen (738 of 1626 [45.4%] vs 342 of 1008 [33.9%]; P <.001) and require hospitalization (969 of 1626 [59.8%] vs 418 of 1008 [42.1%]; P <.001) and anti-COVID-19 therapy (1004 of 1626 [61.7%] vs 501 of 1008 [49.7%]; P <.001) during the first major outbreak. The 14-day CFRs for the first and second major outbreaks were 25.6% (95% CI, 0.23-0.28) vs 16.2% (95% CI, 0.13-0.19; P <.001), respectively. After adjusting for country, sex, age, comorbidities, tumor stage and status, anti-COVID-19 and anticancer therapy, and COVID-19 complications, patients diagnosed in the first outbreak had an increased risk of death at 14 days (hazard ratio [HR], 1.85; 95% CI, 1.47-2.32) and 3 months (HR, 1.28; 95% CI, 1.08-1.51) compared with those diagnosed in the second outbreak. Conclusions and Relevance: The findings of this registry-based study suggest that mortality in patients with cancer diagnosed with COVID-19 has improved in Europe; this improvement may be associated with earlier diagnosis, improved management, and dynamic changes in community transmission over time..
AB - Importance: Whether the severity and mortality of COVID-19 in patients with cancer have improved in terms of disease management and capacity is yet to be defined. Objective: To test whether severity and mortality from COVID-19 among patients with cancer have improved during the course of the pandemic. Design, Setting, and Participants: OnCovid is a European registry that collects data on consecutive patients with solid or hematologic cancer and COVID-19. This multicenter case series study included real-world data from 35 institutions across 6 countries (UK, Italy, Spain, France, Belgium, and Germany). This update included patients diagnosed between February 27, 2020, and February, 14, 2021. Inclusion criteria were confirmed diagnosis of SARS-CoV-2 infection and a history of solid or hematologic cancer. Exposures: SARS-CoV-2 infection. Main Outcomes and Measures: Deaths were differentiated at 14 days and 3 months as the 2 landmark end points. Patient characteristics and outcomes were compared by stratifying patients across 5 phases (February to March 2020, April to June 2020, July to September 2020, October to December 2020, and January to February 2021) and across 2 major outbreaks (February to June 2020 and July 2020 to February 2021). Results: At data cutoff, 2795 consecutive patients were included, with 2634 patients eligible for analysis (median [IQR] age, 68 [18-77] years; 52.8% men). Eligible patients demonstrated significant time-dependent improvement in 14-day case-fatality rate (CFR) with estimates of 29.8% (95% CI, 0.26-0.33) for February to March 2020; 20.3% (95% CI, 0.17-0.23) for April to June 2020; 12.5% (95% CI, 0.06-22.90) for July to September 2020; 17.2% (95% CI, 0.15-0.21) for October to December 2020; and 14.5% (95% CI, 0.09-0.21) for January to February 2021 (all P <.001) across the predefined phases. Compared with the second major outbreak, patients diagnosed in the first outbreak were more likely to be 65 years or older (974 of 1626 [60.3%] vs 564 of 1008 [56.1%]; P =.03), have at least 2 comorbidities (793 of 1626 [48.8%] vs 427 of 1008 [42.4%]; P =.001), and have advanced tumors (708 of 1626 [46.4%] vs 536 of 1008 [56.1%]; P <.001). Complications of COVID-19 were more likely to be seen (738 of 1626 [45.4%] vs 342 of 1008 [33.9%]; P <.001) and require hospitalization (969 of 1626 [59.8%] vs 418 of 1008 [42.1%]; P <.001) and anti-COVID-19 therapy (1004 of 1626 [61.7%] vs 501 of 1008 [49.7%]; P <.001) during the first major outbreak. The 14-day CFRs for the first and second major outbreaks were 25.6% (95% CI, 0.23-0.28) vs 16.2% (95% CI, 0.13-0.19; P <.001), respectively. After adjusting for country, sex, age, comorbidities, tumor stage and status, anti-COVID-19 and anticancer therapy, and COVID-19 complications, patients diagnosed in the first outbreak had an increased risk of death at 14 days (hazard ratio [HR], 1.85; 95% CI, 1.47-2.32) and 3 months (HR, 1.28; 95% CI, 1.08-1.51) compared with those diagnosed in the second outbreak. Conclusions and Relevance: The findings of this registry-based study suggest that mortality in patients with cancer diagnosed with COVID-19 has improved in Europe; this improvement may be associated with earlier diagnosis, improved management, and dynamic changes in community transmission over time..
UR - http://www.scopus.com/inward/record.url?scp=85120565280&partnerID=8YFLogxK
U2 - 10.1001/jamaoncol.2021.6199
DO - 10.1001/jamaoncol.2021.6199
M3 - Article
SN - 2374-2437
VL - 8
SP - 114
EP - 122
JO - JAMA Oncology
JF - JAMA Oncology
IS - 1
ER -