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. 2020 May:6:752-760.
doi: 10.1200/GO.20.00156.

Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America

Alejandro Ruiz-Patiño  1   2 , Oscar Arrieta  3 , Luis E Pino  4 , Christian Rolfo  5 , Luisa Ricaurte  1   2 , Gonzalo Recondo  6 , Zyanya-Lucia Zatarain-Barron  3 , Luis Corrales  7 , Claudio Martín  8 , Feliciano Barrón  3 , Carlos Vargas  1   2   9 , Hernán Carranza  1   2   9 , Jorge Otero  1   2   9 , July Rodriguez  1   2 , Carolina Sotelo  1   2 , Lucia Viola  10 , Alessandro Russo  5   11 , Rafael Rosell  12   13 , Andrés F Cardona  1   2   9
Affiliations

Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America

Alejandro Ruiz-Patiño et al. JCO Glob Oncol. 2020 May.

Abstract

Purpose: In the midst of a global pandemic, evidence suggests that similar to other severe respiratory viral infections, patients with cancer are at higher risk of becoming infected by COVID-19 and have a poorer prognosis.

Methods: We have modeled the mortality and the intensive care unit (ICU) requirement for the care of patients with cancer infected with COVID-19 in Latin America. A dynamic multistate Markov model was constructed. Transition probabilities were estimated on the basis of published reports for cumulative probability of complications. Basic reproductive number (R0) values were modeled with R using the EpiEstim package. Estimations of days of ICU requirement and absolute mortality were calculated by imputing number of cumulative cases in the Markov model.

Results: Estimated median time of ICU requirement was 12.7 days, median time to mortality was 16.3 days after infection, and median time to severe event was 8.1 days. Peak ICU occupancy for patients with cancer was calculated at 16 days after infection. Deterministic sensitivity analysis revealed an interval for mortality between 18.5% and 30.4%. With the actual incidence tendency, Latin America would be expected to lose approximately 111,725 patients with cancer to SARS-CoV-2 (range, 87,116-143,154 patients) by the 60th day since the start of the outbreak. Losses calculated vary between < 1% to 17.6% of all patients with cancer in the region.

Conclusion: Cancer-related cases and deaths attributable to SARS-CoV-2 will put a great strain on health care systems in Latin America. Early implementation of interventions on the basis of data given by disease modeling could mitigate both infections and deaths among patients with cancer.

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Conflict of interest statement

Oscar Arrieta

Honoraria: AstraZeneca, Merck Sharp & Dohme, Roche

Consulting or Advisory Role: Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Pfizer

Research Funding: AstraZeneca (Inst), Roche (Inst), Merck Sharp & Dohme (Inst)

Luis E. Pino

Consulting or Advisory Role: AstraZeneca

Speakers’ Bureau: Roche

Travel, Accommodations, Expenses: MSD Oncology

Christian Rolfo

Consulting or Advisory Role: Mylan, Archer Biosciences, Oncopass, Inivata, Merck Serono

Speakers’ Bureau: Novartis, MSD, Boehringer Ingelheim, Guardant Health, AstraZeneca

Research Funding: Pfizer

Travel, Accommodations, Expenses: AstraZeneca

Uncompensated Relationships: OncoDNA, Biomark, Guardant Health,

Gonzalo Recondo

Consulting or Advisory Role: Roche, Amgen, Pfizer

Travel, Accommodations, Expenses: AstraZeneca, Pfizer

Luis Corrales

Consulting or Advisory Role: AstraZeneca, Roche, MSD Oncology, Pfizer

Speakers’ Bureau: Roche, AstraZeneca, MSD Oncology

Research Funding: Roche

Travel, Accommodations, Expenses: Roche, AstraZeneca, MSD Oncology

Claudio Martín

Consulting or Advisory Role: MSD Oncology, Boehringer Ingelheim, AstraZeneca, Bristol Myers Squibb, Pfizer, Roche

Speakers’ Bureau: Bristol Myers Squibb, Roche, Boehringer Ingelheim, Pfizer, MSD Oncology, AstraZeneca

Feliciano Barrón

Speakers’ Bureau: AstraZeneca

Travel, Accommodations, Expenses: AstraZeneca

Carlos Vargas

Honoraria: Roche, Novartis Institutes for BioMedical Research

Consulting or Advisory Role: Roche, Pfizer, MSD, Bristol Myers Squibb

Speakers’ Bureau: Roche

Travel, Accommodations, Expenses: Roche

Hernán Carranza

Consulting or Advisory Role: Roche, Amgen, Pfizer

Speakers’ Bureau: Roche

Travel, Accommodations, Expenses: Roche, Merck

Jorge Otero

Consulting or Advisory Role: AstraZeneca

Speakers’ Bureau: AstraZeneca

Travel, Accommodations, Expenses: AstraZeneca

July Rodriguez

Speakers’ Bureau: Bayer AG, AstraZeneca

Carolina Sotelo

Travel, Accommodations, Expenses: American Association for Cancer Research

Lucia Viola

Consulting or Advisory Role: AstraZeneca

Travel, Accommodations, Expenses: Mundipharma, Boehringer Ingelheim, AstraZeneca

Andrés F. Cardona

Honoraria: Bristol Myers Squibb, Roche, Boehringer Ingelheim, AbbVie, Merck Sharp & Dohme, Celldex

Consulting or Advisory Role: Roche, Merck Sharp & Dohme, Novartis, AstraZeneca, Bristol-Myers Squibb, Foundation Medicine, Boehringer Ingelheim, Foundation for Clinical and Applied Cancer Research

Speakers’ Bureau: Merck Sharp & Dohme, Roche, Bristol Myers Squibb, Novartis, Foundation for Clinical and Applied Cancer Research, Foundation Medicine

Travel, Accommodations, Expenses: Merck Sharp & Dohme, Bristol Myers Squibb, Roche, Boehringer Ingelheim, Foundation Medicine

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Disease state model. C, complementary probability; pmP, probability for complication.
FIG 2
FIG 2
Cohort transition and dynamics among states.
FIG 3
FIG 3
Map for Latin American distribution of cases among patients with cancer and expected mortality. COVID-19 mortality rate for patients with cancer estimated for Latin America. Circle size corresponds to number of cases. Percentage of blue for each nation corresponds to the proportion of all patients with cancer in each nation who could die as a result of SARS-CoV-2 on base 10. (A total blue circle therefore corresponds to 10% of all patients with cancer.)
See this image and copyright information in PMC

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