Risk of death higher for some cancer patients

June 16, 2021

In the largest study of its kind to date, researchers analyzing national data from more than 63,000 patients with cancer and a positive COVID-19 diagnosis report an increased risk of death among those who were older, male, had a higher number of comorbidities, and had hematologic cancers and recent chemotherapy treatments, according to a news release from the University of Alabama at Birmingham.  

The study was published in the Journal of Clinical Oncology.

The results are one of the first major publications from the National COVID Cohort Collaborative, known as N3C. A total of 55 clinical institutions nationwide have contributed de-identified electronic health record data from 6.2 million patients from 49 states to a secure, cloud-based database to enable first-of-its-kind research. The N3C began curating data in January 2020, and its database contains patient records dating back to 2018. Among the 6 billion rows of data collected are more than 2 million positive COVID diagnoses and more than 400,000 patients with a cancer diagnosis.

From a total of 398,579 adult patients with cancer identified in the N3C cohort, 63,413 (15.9 percent) were diagnosed as COVID-positive. The most common represented cancers were skin (13.8 percent), breast (13.7 percent), prostate (10.6 percent), hematologic (10.5 percent) and GI cancers (10 percent).

COVID-19 positivity was significantly associated with increased risk of all-cause mortality. Among COVID-positive patients, several characteristics were associated with an increased risk of all-cause mortality: age 65 or older, male gender, residents of the Southern or Western United States, adjusted Charlson Comorbidity Index score of 4 or greater, patients with hematologic malignancies, patients with multi-tumor sites, and patients who had recent (within 30 days) chemotherapy treatment.

Consistent with previous literature (including this June 2020 paper in The Lancet and this February 2021 paper in Annals of Oncology), patients with hematological malignancies had higher mortality, while the N3C dataset confirmed that “patients who received recent immunotherapies or targeted therapies did not have higher risk of overall mortality,” Sharafeldin and her co-authors wrote in their Journal of Clinical Oncology manuscript.

Going forward, the researchers aim to dig deeper into the data to “provide further insights into the effects of COVID-19 including effects of vaccinations on cancer outcomes and the ability to continue specific cancer treatments,” the researchers wrote.

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