In a registry of cancer patients with COVID-19, older age, poor performance status, and progressing cancer were strongly associated with increased mortality, especially within patient subsets admitted to the ICU and/or that required intubation.
Jeremy L. Warner (Vanderbilt-Ingram Cancer Center, USA) presented the initial results from the COVID-19 and Cancer Consortium Registry (CCC19). The effects of COVID-19 on patients with cancer are poorly understood. Currently, published reports are limited by small patient cohorts and lack of systematic reporting. A real-world registry capturing data across institutes will help address the specific issues affecting cancer patients.
CCC19 entered its first patient on 17 March 2020 and, at the time of this report, has included 928 cases in this analysis from 104 participating institutions. Of the registered patients, 50% was male, the median age was 66 years, and of note, 30% were older than 75 years. Further, 50% was white, 16% African-American, and 16% Hispanic, which reflects a higher minority presence than census data would suggest. 39% were on active anti-cancer treatment, whereas 43% had active, measurable cancer.
The median follow-up of the patients was 21 days; 121 (13%) of the patients had died in this period. Initial data indicate that factors independently associated with increased mortality in the prognostic model was: the male gender (17% died), being a former smoker (20% died), being 75 or older (25% died), having an active stable or responding cancer (15% died), having an active progressing cancer (25%), and having an ECOG Performance Status of 2 or higher (35% died). Remarkably, being 75 or older or having an ECOG status of 2 or higher was a particular risk factor if admitted to the ICU (54% or 68% died, respectively) or if intubated (59% or 85% died, respectively). All deaths occurred within 30 days of COVID-19 diagnosis.
Although this initial analysis indicates some important trends to follow, larger sample size and longer follow-up are needed to fully understand the impact of COVID-19 on specific cancer patient subsets over time.
Reference:
Warner JL et al, Data from the COVID-19 and Cancer Consortium (CCC19) examining mortality and severe illness among patients with cancer who have contracted COVID-19, and use of azithromycin and hydroxychloroquine. ASCO Virtual Meeting, 29-31 May 2020, Abstract LBA110.