Mortality in adult patients with solid or hematological malignancies and SARS-CoV-2 infection with a specific focus on lung and breast cancers: A systematic review and meta-analysis

Tagliamento, Marco; Agostinetto, Elisa; Bruzzone, Marco; Ceppi, Marcello; Saini, Kamal S.; Azambuja, Evandro de; Punie, Kevin; Westphalen, C. Benedikt; Morgan, Gilberto; Pronzato, P.; Mastro, Lucia Del; Poggio, F.; Lambertini, Matteo

doi:10.1016/j.critrevonc.2021.103365

Cited by 53 publications

(47 citation statements)

References 147 publications

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“…In our population, patients with brain or lung tumors had a poor outcome, with up to 43% mortality in patients with lung cancer. An high case-fatality rate of around 33% was also described in recent studies [26,27]. In France, it will be interesting to evaluate the mortality rates of cancer patients during subsequent waves of COVID-19.…”

Section: Discussionmentioning

confidence: 70%

Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study

Benderra

Aparicio²,

Leblanc

et al. 2021

Cancers

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Background: COVID-19 may be more frequent and more severe in cancer patients than in other individuals. Our aims were to assess the rate of COVID-19 in hospitalized cancer patients, to describe their demographic characteristics, clinical features and care trajectories, and to assess the mortality rate. Methods: This multicenter cohort study was based on the Electronic Health Records of the Assistance Publique-Hôpitaux de Paris (AP-HP). Cancer patients with a diagnosis of COVID-19 between 3 March and 19 May 2020 were included. Main outcome was all-cause mortality within 30 days of COVID-19 diagnosis. Results: A total of 29,141 cancer patients were identified and 7791 (27%) were tested for SARS-CoV-2. Of these, 1359 (17%) were COVID-19-positive and 1148 (84%) were hospitalized; 217 (19%) were admitted to an intensive care unit. The mortality rate was 33% (383 deaths). In multivariate analysis, mortality-related factors were male sex (aHR = 1.39 [95% CI: 1.07–1.81]), advanced age (78–86 y: aHR = 2.83 [95% CI: 1.78–4.51] vs. <66 y; 86–103 y: aHR = 2.61 [95% CI: 1.56–4.35] vs. <66 y), more than two comorbidities (aHR = 2.32 [95% CI: 1.41–3.83]) and C-reactive protein >20 ng/mL (aHR = 2.20 [95% CI: 1.70–2.86]). Primary brains tumors (aHR = 2.19 [95% CI: 1.08–4.44]) and lung cancer (aHR = 1.66 [95% CI: 1.02–2.70]) were associated with higher mortality. Risk of dying was lower among patients with metabolic comorbidities (aHR = 0.65 [95% CI: 0.50–0.84]). Conclusions: In a hospital-based setting, cancer patients with COVID-19 had a high mortality rate. This mortality was mainly driven by age, sex, number of comorbidities and presence of inflammation. This is the first cohort of cancer patients in which metabolic comorbidities were associated with a better outcome.

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Section: Discussionmentioning

confidence: 70%

Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study

Benderra

Aparicio²,

Leblanc

et al. 2021

Cancers

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“…The low humoral immune response mounted by oncological patients after being vaccinated against SARS-CoV-2 is of utmost importance due to their higher risk of developing severe disease with consequent poor prognosis if infected. [ 4 , 11 , 55 , 56 ] Immunization against COVID-19 has been widely recommended among cancer patients, regardless of site of disease, setting, and type of treatment, as its benefits outweigh the potential risks. [ 55 , 57 ] Oncological patients should be encouraged to adhere to COVID-19 prevention guidelines and complete their vaccination schemes following the recommended intervals between doses (i.e., 3- or 4-weeks for mRNA vaccines).…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] Cancer patients are a vulnerable group at increased risk of infection and COVID-19-related morbidity and mortality compared to the non-cancer population. [ 2 , 3 ] A 30-day mortality rate of 20-25% has been documented in this group,[ 4 ] which is substantially higher than the estimated 3-4% among the general population. [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

Becerril-Gaitan

Vaca-Cartagena

Ferrigno

et al. 2022

European Journal of Cancer

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103

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BACKGROUND Cancer patients are considered a priority group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination given their high risk of contracting severe coronavirus disease 2019 (COVID-19). However, limited data exists regarding the efficacy of immunization in this population. In this study we assess the immunologic response after COVID-19 vaccination of cancer versus non-cancer population. METHODS PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from March 01, 2020, through August 12, 2021. Primary endpoints were anti-SARS-CoV-2 spike protein (S) immunoglobulin G (IgG) seroconversion rates, T-cell response, and documented SARS-CoV-2 infection after COVID-19 immunization. Data was extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Overall effects were pooled using random effects models. RESULTS This systematic review and meta-analysis included 35 original studies. Overall, 51% (95% confidence interval [CI], 41-62) and 73% (95%CI, 64-81) of cancer patients developed anti-S IgG above the threshold level after partial and complete immunization, respectively. Patients with hematologic malignancies had a significantly lower seroconversion rate than those with solid tumors after complete immunization (65% vs 94%; P <0.0001). Compared to non-cancer controls, oncological patients were less likely to attain seroconversion after incomplete (RR 0.45 [95%CI 0.35-0.58]) and complete (RR 0.69 [95%CI 0.56-0.84]) COVID-19 immunization schemes. Cancer patients had a higher likelihood of having a documented SARS-CoV-2 infection after partial (RR 3.21; 95%CI 0.35-29.04) and complete (RR 2.04; 95%CI 0.38-11.10) immunization. CONCLUSIONS Cancer patients have an impaired immune response to COVID-19 vaccination compared to controls. Strategies that endorse the completion of vaccination schemes are warranted. Future studies should aim to evaluate different approaches that enhance oncological patients’ immune response.

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“…Teleconsultation is already implemented in USA and Northern European countries to ensure healthcare services across long distances, through the use of telecommunications and information technologies. During the past year, an expert consensus has favoured teleconsultation mainly among patients undergoing intravenous chemotherapies for early-stage breast cancer, receiving systemic treatments for metastatic breast cancer or during follow-up for breast cancer [12][13][14]. Given the knowledge gap in evaluating the preference of patients with this approach, we sought to examine the satisfaction of patients with breast cancer who underwent teleconsultations during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Multicenter evaluation of breast cancer patients’ satisfaction and experience with oncology telemedicine visits during the COVID-19 pandemic

et al. 2021

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s Introduction During the COVID-19 pandemic, teleconsultation was implemented in clinical practice to limit patient exposure to COVID-19 while monitoring their treatment and follow-up. We sought to examine the satisfaction of patients with breast cancer (BC) who underwent teleconsultations during this period. Methods Eighteen centres in France and Italy invited patients with BC who had at least one teleconsultation during the first wave of the COVID-19 pandemic to participate in a web-based survey that evaluated their satisfaction (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) with teleconsultation. Results Among the 1299 participants eligible for this analysis, 53% of participants were undergoing standard post-treatment follow-up while 22 and 17% were currently receiving active anticancer therapy for metastatic and localised cancers, respectively. The mean satisfaction scores were 77.4 and 73.3 for the EORTC OUT-PATSAT 35 and TSQ scores, respectively. In all, 52.6% of participants had low/no anxiety. Multivariable analysis showed that the EORTC OUT-PATSAT 35 score correlated to age, anxiety score and teleconsultation modality. The TSQ score correlated to disease status and anxiety score. Conclusion Patients with BC were satisfied with oncology teleconsultations during the COVID-19 pandemic. Teleconsultation may be an acceptable alternative follow-up modality in specific circumstances.

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Mortality in adult patients with solid or hematological malignancies and SARS-CoV-2 infection with a specific focus on lung and breast cancers: A systematic review and meta-analysis

Cited by 53 publications

References 147 publications

Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study

Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

Multicenter evaluation of breast cancer patients’ satisfaction and experience with oncology telemedicine visits during the COVID-19 pandemic

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