TY - JOUR
T1 - International Multicenter Study Comparing COVID-19 in Patients With Cancer to Patients Without Cancer
T2 - Impact of Risk Factors and Treatment Modalities on Survivorship
AU - Data-Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE) Team
AU - Raad, Issam
AU - Hachem, Ray
AU - Masayuki, Nigo
AU - Datoguia, Tarcila
AU - Dagher, Hiba
AU - Jiang, Ying
AU - Subbiah, Vivek
AU - Siddiqui, Bilal
AU - Bayle, Arnaud
AU - Somer, Robert
AU - Cruz, Ana Fernández
AU - Gorak, Edward
AU - Bhinder, Arvinder
AU - Mori, Nobuyoshi
AU - Hamerschlak, Nelson
AU - Shelanski, Samuel
AU - Dragivich, Tomislav
AU - Kiat, Yee Elise Vong
AU - Fakhreddine, Suha
AU - Hanna, Pierre Abi
AU - Chemaly, Roy F.
AU - Mulanovich, Victor
AU - Adachi, Javier
AU - Borjan, Jovan
AU - Khawaja, Fareed
AU - Granwehr, Bruno
AU - John, Teny
AU - Guevara, Eduardo Yepez
AU - Torres, Harrys A.
AU - Ammakkanavar, Natraj Reddy
AU - Yibirin, Marcel
AU - Reyes-Gibby, Cielito C.
AU - Pande, Mala
AU - Ali, Noman
AU - Rojo, Raniv Dawey
AU - Ali, Shahnoor M.
AU - Deeba, Rita E.
AU - Chaftari, Patrick
AU - Matsuo, Takahiro
AU - Ishikawa, Kazuhiro
AU - Hasegawa, Ryo
AU - Aguado-Noya, Ramón
AU - García, Álvaro García
AU - Puchol, Cristina Traseira
AU - Lee, Dong Gun
AU - Slavin, Monica
AU - Teh, Benjamin
AU - Arias, Cesar A.
AU - Kontoyiannis, Dimitrios P.
AU - Malek, Alexandre E.
N1 - Funding Information:
This research is supported by the National Institutes of Health/National Cancer Institute under award number P30CA016672, which supports the MD Anderson Cancer Center Clinical Trials Office. Role of the Funder/Support: The funders had no role the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
A cknowledgments W e thank all the investigators, MD Anderson Cancer Network, and the Data-Driven D eterminants for COVID-19 Oncology Discovery Effort (D3CODE) Team at The University of T exas MD Anderson Cancer Center for assistance in study development and data extraction. W e thank Ms. Meena Medepalli and Mr. Joel Cox from the MD Anderson Cancer Network - E xternal Research at The University of Texas MD Anderson Cancer Center for their support in c oordinating the cancer network sites for protocol participation. W e thank Mr. Joseph P. Thomas at The University of Texas MD Anderson Cancer Center for his a ssistance with data capture in REDCap, Kris Weaver for data quality review, Sheri Rivera for R EDCap build, Regulatory team for the fast activation, Toby and her team for assistance in r esolving IT issues with site EMR. W e thank Anastasia Turin and Drew Goldstein from Syntropy Technologies LLC, Burlington, M A for interfacing with the Syntropy platform: Palantir Foundry. “Foundry” is Syntropy’s fully-m anaged, cloud-based software-as-a-service for governing, structuring, and harmonizing real-w orld data to empower health systems and their collaborators to derive insights from that data. E ditorial assistance was provided by Stephanie P Deming, Research Medical Library at MD A nderson. This assistance was funded by The University of Texas MD Anderson Cancer Center. W e thank Ms. Salli Saxton and Ms Christine Cobb at The University of Texas MD Anderson C ancer Center for helping with the submission of the manuscript. F unding/Support: This research is supported by the National Institutes of Health/National C ancer Institute under award number P30CA016672, which supports the MD Anderson Cancer C enter Clinical Trials Office. R ole of the Funder/Support: The funders had no role the design and conduct of the study; c ollection, management, analysis, and interpretation of the data; preparation, review, or approval o f the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2023, eLife Sciences Publications Ltd. All rights reserved.
PY - 2023/1/30
Y1 - 2023/1/30
N2 - BACKGROUND: In this international multicenter study, we aimed to determine the independent risk factors associated with increased 30 day mortality and the impact of cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries.METHODS: We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers.RESULTS: We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin, and procalcitonin) but were less likely to present with clinical symptoms (p≤0.01). By country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (≥65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30 day mortality rate than those who did not (5.9 vs 17.6%; p=0.03).CONCLUSIONS: Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality.FUNDING: National Cancer Institute and National Institutes of Health.
AB - BACKGROUND: In this international multicenter study, we aimed to determine the independent risk factors associated with increased 30 day mortality and the impact of cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries.METHODS: We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers.RESULTS: We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin, and procalcitonin) but were less likely to present with clinical symptoms (p≤0.01). By country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (≥65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30 day mortality rate than those who did not (5.9 vs 17.6%; p=0.03).CONCLUSIONS: Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality.FUNDING: National Cancer Institute and National Institutes of Health.
KW - COVID-19
KW - cancer
KW - coronavirus
KW - SARS-CoV-2
KW - Oxygen
KW - COVID-19/complications
KW - Lymphopenia
KW - Humans
KW - Risk Factors
KW - Neoplasms/complications
KW - Retrospective Studies
KW - Survivorship
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UR - http://www.scopus.com/inward/citedby.url?scp=85147157203&partnerID=8YFLogxK
U2 - 10.7554/eLife.81127
DO - 10.7554/eLife.81127
M3 - Article
C2 - 36715684
AN - SCOPUS:85147157203
SN - 2050-084X
VL - 12
JO - eLife
JF - eLife
M1 - e81127
ER -