Dutch Oncology COVID-19 consortium: Outcome of COVID-19 in patients with cancer in a nationwide cohort study

Abstract

Aim of the study Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients’ characteristics, cancer diagnosis, and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible. Results Between March 27 th and May 4 th , 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years ( p <0.001), male gender ( p =0.035), prior or other malignancy ( p =0.045), and active diagnosis of haematological malignancy ( p =0.046) or lung cancer ( p =0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years). Conclusion The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to SARS-CoV-2, whereas treatment adjustments and prioritizing vaccination, when available, should also be considered.

Impacts of COVID‐19 on caregivers of childhood cancer survivors

“…Existing evidence in the general population indicates older individuals and those with comorbid chronic conditions are at higher risk for SARS‐CoV‐2 infection, severe disease, and death 2–5 . Cancer patients may also be at increased risk of adverse outcomes if infected, 6–10 though morbidity and mortality appear to vary across tumor histology and treatment status 11–16 . While recent small studies suggest that pediatric patients with cancer may not be more vulnerable than other children to infection or morbidity from SARS‐CoV‐2, 17,18 other studies suggest that children with hematologic malignancies may have a more severe course of COVID‐19 illness 19 …”

Prolonged SARS-CoV-2 viral shedding in patients with solid tumours and associated factors

“…In our study, we observed that patients with advanced cancer at COVID-19 diagnosis have a greater risk of continuing to present positive RT-PCR with prolonged COVID-19 symptoms, similar to that observed in hematological patients undergoing transplant or CAR-T cell therapy 7 . In addition, we observed that these patients with advanced disease have the worst prognosis 1 , 2 , like lung cancer patients and hematologic cancer patients 2 , 8 . The advanced state of immunosuppression induced by their cancer and by the specifical oncological treatments received, it could may justify our findings.…”

“…SARS-CoV-2 is a highly contagious virus and can cause potentially fatal complications in cancer patients 1 , 2 , 3 , 4 . Until now, the most accurate and common methods to detect active viral infection are: (1) a positive RT-PCR, (2) a serological test (IgM+ and IgG-), (3) or a positive antigen test 5 .…”

“…For this reason, as is suggested in two studies 7 , 10 , we consider a priority to review the current management recommendations in oncological patients to define when it is safe to finish isolation as well as to restart treatment. Also, there is a need for further research in reactivations, especially in advanced cancer patients, hematologic and lung cancer patients, as they have had the worst prognosis in published series 1 , 2 , 9 .…”

Epidemiology and clinical course of severe acute respiratory syndrome coronavirus 2 infection in cancer patients in the Veneto Oncology Network: The Rete Oncologica Veneta covID19 study

“…Starting from the first retrospective cohort in China, describing a higher risk of severe events for cancer versus non-cancer patients, data from several multicentric registries including hundreds of cancer patients reported a mortality rate in the range of 10-33%. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 It is important to note, however, the huge heterogeneity of the clinical course of SARS-CoV-2 infection across different countries. Mortality, the most important measure of COVID-19 disease burden, largely differs across countries.…”