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Multicenter Study
. 2023 Jan 30:12:e81127.
doi: 10.7554/eLife.81127.

International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship

Issam I Raad #  1 , Ray Hachem #  1 , Nigo Masayuki  2 , Tarcila Datoguia  3 , Hiba Dagher  1 , Ying Jiang  1 , Vivek Subbiah  4   5 , Bilal Siddiqui  6 , Arnaud Bayle  7 , Robert Somer  8 , Ana Fernández Cruz  9 , Edward Gorak  10 , Arvinder Bhinder  11 , Nobuyoshi Mori  12 , Nelson Hamerschlak  3 , Samuel Shelanski  13 , Tomislav Dragovich  14 , Yee Elise Vong Kiat  15 , Suha Fakhreddine  16 , Abi Hanna Pierre  16 , Roy F Chemaly  1 , Victor Mulanovich  1 , Javier Adachi  1 , Jovan Borjan  1 , Fareed Khawaja  1 , Bruno Granwehr  1 , Teny John  1 , Eduardo Yepez Yepez  1 , Harrys A Torres  1 , Natraj Reddy Ammakkanavar  5 , Marcel Yibirin  1 , Cielito C Reyes-Gibby  17 , Mala Pande  18 , Noman Ali  19 , Raniv Dawey Rojo  20 , Shahnoor M Ali  1 , Rita E Deeba  1 , Patrick Chaftari  17 , Takahiro Matsuo  12 , Kazuhiro Ishikawa  12 , Ryo Hasegawa  12 , Ramón Aguado-Noya  21 , Alvaro Garcia García  22 , Cristina Traseira Puchol  21 , Dong Gun Lee  23 , Monica Slavin  24 , Benjamin Teh  24 , Cesar A Arias  2 ; Data-Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE) Team  25 ; Dimitrios P Kontoyiannis  1 , Alexandre E Malek  1 , Anne-Marie Chaftari #  1
Affiliations
Multicenter Study

International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship

Issam I Raad et al. Elife. .

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 cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries.

Methods: We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers.

Results: We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (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 country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (≥65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). 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: Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality.

Funding: National Cancer Institute and National Institutes of Health.

Keywords: COVID-19; cancer biology; cancer patients; coronavirus; medicine; multicenter study; non-cancer patients; risk factors.

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Conflict of interest statement

IR, RH, NM, TD, HD, YJ, VS, BS, AB, RS, AF, EG, AB, NM, NH, SS, TD, YV, SF, AP, RC, VM, JA, JB, FK, BG, TJ, EY, HT, NA, MY, CR, MP, NA, RR, SA, RD, PC, TM, KI, RH, RA, AG, CP, DL, MS, BT, CA, DK, AM, AC No competing interests declared

Figures

Figure 1.
Figure 1.. Consort diagram of patient attrition.
See this image and copyright information in PMC

Update of

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