COVID-19 ups risk of hospitalization, treatment disruptions, death among cancer patients

COVID-19 appears to have adverse consequences for patients with cancer, including increased hospitalization, treatment disruption, and death, according to a study.

The study included 1,572 adult patients (median age 60 years, 53.4 percent female) who were receiving active treatment for cancer or had prior stem cell/bone marrow transplant or CAR T-cell treatment. They were enrolled within 14 days of an initial positive SARS-CoV-2 test result.

Researchers determined patient factors, therapy types, and cancer types associated with COVID-19 severity, defined as hospitalization for or death from COVID-19 within 30 and 90 days after the first positive SARS-CoV-2 test result.

Of the patients, 683 (43.4 percent) had a metastatic solid tumour, with cancers of the breast (23.6 percent) and the lung (13.9 percent) being the most common. The most frequent treatment category was chemotherapy (34.3 percent), followed by targeted therapy (27.7 percent), and immunotherapy (10.6 percent). More than half of the patients (64.4 percent) were unvaccinated at the time of their COVID-19 diagnosis.

The 90-day COVID-19–related mortality was 3.0 percent and did not increase at subsequent time points. Patients with lymphoma had the highest incidence of COVID-19–specific deaths in the first 90 days, followed by those with acute leukaemia and lung cancer. The lowest was among patients with other solid tumours and other hematologic cancers.

In multivariable regression analysis, factors associated with a higher risk of hospitalization included receipt of chemotherapy (hazard ratio [HR], 1.97, 95 percent confidence interval [CI, 1.52–2.54) and baseline history of stroke, atrial fibrillation, or pulmonary embolism (HR, 1.78, 95 percent CI, 1.33–2.38). On the other hand, vaccination prior to SARS-CoV-2 infection had a protective benefit (HR, 0.52, 95 percent CI, 0.38–0.70).

Over 2 years of follow-up, a total of 1,739 cancer treatment disruptions were recorded, of which 881 (50.7 percent) were attributed to COVID-19. Most disruptions occurred within the first 30 days.