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. 2021 Oct;26(10):e1761-e1773.
doi: 10.1002/onco.13861. Epub 2021 Jul 1.

Impact of COVID-19 Infection on Patients with Cancer: Experience in a Latin American Country: The ACHOCC-19 Study

Aylen Vanessa Ospina  1 , Ricardo Bruges  2 , William Mantilla  3 , Iván Triana  1 , Pedro Ramos  4 , Sandra Aruachan  5 , Alicia Quiroga  6 , Isabel Munevar  7 , Juan Ortiz  8 , Néstor Llinás  9 , Paola Pinilla  10 , Henry Vargas  11 , Henry Idrobo  12 , Andrea Russi  10 , Ray Manneh Kopp  13 , Giovanna Rivas  14 , Héctor González  15 , Daniel Santa  16 , Jesús Insuasty  17 , Laura Bernal  4 , Jorge Otero  1 , Carlos Vargas  18 , Javier Pacheco  19 , Carmen Alcalá  20 , Paola Jiménez  21 , Milton Lombana  14 , Fernando Contreras  22 , Javier Segovia  1 , Luis Pino  1 , José Lobatón  23 , Manuel González  23 , Javier Cuello  9 , Juliana Bogoya  24 , Angela Barrero  24 , Gilberto de Lima Lopes Jr  25
Affiliations

Impact of COVID-19 Infection on Patients with Cancer: Experience in a Latin American Country: The ACHOCC-19 Study

Aylen Vanessa Ospina et al. Oncologist. 2021 Oct.

Abstract

Introduction: The ACHOCC-19 study was performed to characterize COVID-19 infection in a Colombian oncological population.

Methodology: Analytical cohort study of patients with cancer and COVID-19 infection in Colombia. From April 1 to October 31, 2020. Demographic and clinical variables related to cancer and COVID-19 infection were collected. The primary outcome was 30-day mortality from all causes. The association between the outcome and the prognostic variables was analyzed using logistic regression models and survival analysis with Cox regression.

Results: The study included 742 patients; 72% were >51 years. The most prevalent neoplasms were breast (132, 17.77%), colorectal (92, 12.34%), and prostate (81, 10.9%). Two hundred twenty (29.6%) patients were asymptomatic and 96 (26.3%) died. In the bivariate descriptive analysis, higher mortality occurred in patients who were >70 years, patients with lung cancer, ≥2 comorbidities, former smokers, receiving antibiotics, corticosteroids, and anticoagulants, residents of rural areas, low socioeconomic status, and increased acute-phase reactants. In the logistic regression analysis, higher mortality was associated with Eastern Cooperative Oncology Group performance status (ECOG PS) 3 (odds ratio [OR] 28.67; 95% confidence interval [CI], 8.2-99.6); ECOG PS 4 (OR 20.89; 95% CI, 3.36-129.7); two complications from COVID-19 (OR 5.3; 95% CI, 1.50-18.1); and cancer in progression (OR 2.08; 95% CI, 1.01-4.27). In the Cox regression analysis, the statistically significant hazard ratios (HR) were metastatic disease (HR 1.58; 95% CI, 1.16-2.16), cancer in progression (HR 1.08; 95% CI, 1.24-2.61) cancer in partial response (HR 0.31; 95% CI, 0.11-0.88), use of steroids (HR 1.44; 95% CI, 1.01-2.06), and use of antibiotics (HR 2.11; 95% CI, 1.47-2.95).

Conclusion: In our study, patients with cancer have higher mortality due to COVID-19 infection if they have active cancer, metastatic or progressive cancer, ECOG PS >2, and low socioeconomic status.

Implications for practice: This study's findings raise the need to carefully evaluate patients with metastatic cancer, in progression, and with impaired Eastern Cooperative Oncology Group status to define the relevance of cancer treatment during the pandemic, consider the risk/benefit of the interventions, and establish clear and complete communication with the patients and their families about the risk of complications. There is also the importance of offering additional support to patients with low income and residence in rural areas so that they can have more support during cancer treatment.

Keywords: COVID-19; Cancer; Colombia; Latin American country; Mortality; Survival.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1
Figure 1
Survival analysis by cancer status.
Figure 2
Figure 2
Survival analysis by metastatic disease.
Figure 3
Figure 3
Survival analysis by use of corticosteroids in the COVID‐19 treatment.
Figure 4
Figure 4
Survival analysis by use of antibiotics in COVID‐19 treatment.
Figure 5
Figure 5
Forest plot of variables adjusted in the multivariate model for 30‐day mortality from all causes after infection by COVID‐19. Abbreviation: CI, confidence interval; ECOG, Eastern Cooperative Oncology Group.
See this image and copyright information in PMC

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