tetano
Editor, Senior Moderator
Cancer Med
. 2022 Mar 9.
doi: 10.1002/cam4.4604. Online ahead of print.
COVID-19 outcomes in patients with cancer: Findings from the University of California health system database
Daniel H Kwon[SUP] 1 [/SUP], Jose Cadena[SUP] 2 [/SUP], Sam Nguyen[SUP] 2 [/SUP], Kwan Ho Ryan Chan[SUP] 2 3 [/SUP], Braden Soper[SUP] 4 [/SUP], Amy L Gryshuk[SUP] 5 [/SUP], Julian C Hong[SUP] 6 7 8 [/SUP], Priyadip Ray[SUP] 2 [/SUP], Franklin W Huang[SUP] 1 6 7 [/SUP]
Affiliations
Abstract
Background: The interaction between cancer diagnoses and COVID-19 infection and outcomes is unclear. We leveraged a state-wide, multi-institutional database to assess cancer-related risk factors for poor COVID-19 outcomes.
Methods: We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at 17 California medical centers. We identified adults tested for SARS-CoV-2 from 2/1/2020-12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS-CoV-2 test. Secondary outcomes were SARS-CoV-2 positivity and severe COVID-19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer-related factors associated with outcomes.
Results: We identified 409,462 patients undergoing SARS-CoV-2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67-0.74, p < 0.001). Among the 1781 SARS-CoV-2-positive patients with cancer, BCR/ABL-negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25-3.41, p = 0.007), venetoclax (RR 2.96, 95% CI: 1.14-5.66, p = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10-5.19, p = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID-19.
Conclusions: In this large, diverse cohort, cancer was associated with a decreased risk of SARS-CoV-2 positivity. Patients with BCR/ABL-negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS-CoV-2 infection. Mechanistic and comparative studies are needed to validate findings.
Keywords: COVID-19; cancer; myeloproliferative neoplasm; outcomes research.
. 2022 Mar 9.
doi: 10.1002/cam4.4604. Online ahead of print.
COVID-19 outcomes in patients with cancer: Findings from the University of California health system database
Daniel H Kwon[SUP] 1 [/SUP], Jose Cadena[SUP] 2 [/SUP], Sam Nguyen[SUP] 2 [/SUP], Kwan Ho Ryan Chan[SUP] 2 3 [/SUP], Braden Soper[SUP] 4 [/SUP], Amy L Gryshuk[SUP] 5 [/SUP], Julian C Hong[SUP] 6 7 8 [/SUP], Priyadip Ray[SUP] 2 [/SUP], Franklin W Huang[SUP] 1 6 7 [/SUP]
Affiliations
- PMID: 35261195
- DOI: 10.1002/cam4.4604
Abstract
Background: The interaction between cancer diagnoses and COVID-19 infection and outcomes is unclear. We leveraged a state-wide, multi-institutional database to assess cancer-related risk factors for poor COVID-19 outcomes.
Methods: We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at 17 California medical centers. We identified adults tested for SARS-CoV-2 from 2/1/2020-12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS-CoV-2 test. Secondary outcomes were SARS-CoV-2 positivity and severe COVID-19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer-related factors associated with outcomes.
Results: We identified 409,462 patients undergoing SARS-CoV-2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67-0.74, p < 0.001). Among the 1781 SARS-CoV-2-positive patients with cancer, BCR/ABL-negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25-3.41, p = 0.007), venetoclax (RR 2.96, 95% CI: 1.14-5.66, p = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10-5.19, p = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID-19.
Conclusions: In this large, diverse cohort, cancer was associated with a decreased risk of SARS-CoV-2 positivity. Patients with BCR/ABL-negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS-CoV-2 infection. Mechanistic and comparative studies are needed to validate findings.
Keywords: COVID-19; cancer; myeloproliferative neoplasm; outcomes research.