People with cancer sickened by COVID-19 have a crude death rate of 13 percent, according to the largest series of data released thus far from a multinational perspective. The data on more than 900 patients, published in The Lancet and simultaneously presented at ASCO20 Virtual, also revealed cancer-specific factors associated with increased mortality.
The information is the first report from an ongoing international initiative by the COVID-19 and Cancer Consortium (CCC19) to track outcomes within this vulnerable population. The CCC19 registry was built and is maintained as an electronic REDCap database housed at Vanderbilt University Medical Center. The data in this first report from CCC19 was gathered from 928 patients in Spain, Canada and the United States.
These early data showed no statistical association between 30-day mortality and cancer treatments, suggesting that surgery, adjuvant chemotherapy and maintenance chemotherapy could continue during the pandemic with “extreme caution.”
The cancer-specific factors associated with increased mortality included having an Eastern Cooperative Oncology Group (ECOG) performance status of two or worse. ECOG is a grading scale for measuring how cancer impacts a patient’s daily living abilities. A score of two designates a patient who is capable of self-care but unable to work and who is up and about more than 50 percent during waking hours. Another factor associated with increased mortality was an active cancer status, particularly progressive cancer.
The mortality risk also increased with the number of comorbidities, such as hypertension or diabetes, particularly with two or more comorbidities. As is the case with the non-cancer population, mortality increased with age. Mortality was 6 percent for cancer patients younger than 65, 11 percent for those 65-74 and 25 percent for those older than 75. Males also had a higher death rate than females, 17 percent compared to 9 percent.
