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  • International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship.
    Raad II, Hachem R, Masayuki N, Datoguia T, Dagher H, Jiang Y, Subbiah V, Siddiqui B, Bayle A, Somer R, Fernández Cruz A, Gorak E, Bhinder A, Mori N, Hamerschlak N, Shelanski S, Dragovich T, Vong Kiat YE, Fakhreddine S, Pierre AH, Chemaly RF, Mulanovich V, Adachi J, Borjan J, Khawaja F, Granwehr B, John T, Yepez EY, Torres HA, Ammakkanavar NR, Yibirin M, Reyes-Gibby CC, Pande M, Ali N, Rojo RD, Ali SM, Deeba RE, Chaftari P, Matsuo T, Ishikawa K, Hasegawa R, Aguado-Noya R, García AG, Puchol CT, Lee DG, Slavin M, Teh B, Arias CA; Data-Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE) Team; Kontoyiannis DP, Malek AE, Chaftari AM. Raad II, et al. Elife. 2023 Jan 30;12:e81127. doi: 10.7554/eLife.81127. Elife. 2023. PMID: 36715684 Free PMC article.

Abstract

Background: In this international multicenter study we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries.

Methods: We retrospectively collected de-identified data on a cohort of cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, from 16 international centers.

Results: We analyzed 3966 COVID-19 confirmed patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were more likely to be pancytopenic, and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding two weeks (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms (p≤0.01). By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46; 95% CI 1.03 to 2.07; p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55; 95% CI 3.34 to6.20; p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58; CI 0.39-0.88; p=0.009). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who did not (5.9% vs 17.6%; p=0.03).

Conclusions: Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality.

Condensed abstract: In this large multicenter worldwide study of 4015 patients with COVID-19 that included 1115 patients with cancer, we found that cancer is an independent risk factor for increased 30-day all-cause mortality. Remdesivir is a promising treatment modality to reduce 30-day all-cause mortality.

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