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. 2024 Jun 15;130(12):2191-2204.
doi: 10.1002/cncr.35247. Epub 2024 Feb 20.

The impact of cancer metastases on COVID-19 outcomes: A COVID-19 and Cancer Consortium registry-based retrospective cohort study

Cecilia A Castellano  1 , Tianyi Sun  2 , Deepak Ravindranathan  1 , Clara Hwang  3 , Nino Balanchivadze  3   4 , Sunny R K Singh  3   5 , Elizabeth A Griffiths  6 , Igor Puzanov  6 , Erika Ruiz-Garcia  7 , Diana Vilar-Compte  7 , Ana I Cárdenas-Delgado  7 , Rana R McKay  8 , Taylor K Nonato  8 , Archana Ajmera  8 , Peter P Yu  9 , Rajani Nadkarni  9 , Timothy E O'Connor  10 , Stephanie Berg  10 , Kim Ma  11 , Dimitrios Farmakiotis  12   13 , Kendra Vieira  12   13 , Panos Arvanitis  12 , Renee M Saliby  14 , Chris Labaki  14 , Talal El Zarif  14 , Trisha M Wise-Draper  15 , Olga Zamulko  15 , Ningjing Li  15 , Brianne E Bodin  16 , Melissa K Accordino  16 , Matthew Ingham  16 , Monika Joshi  17 , Hyma V Polimera  17 , Leslie A Fecher  18 , Christopher R Friese  18 , James J Yoon  18 , Blanche H Mavromatis  19 , Jacqueline T Brown  1 , Karen Russell  20 , Rahul Nanchal  21 , Harpreet Singh  21 , Lisa Tachiki  22 , Feras A Moria  23 , Gayathri Nagaraj  24 , Kimberly Cortez  24 , Saqib H Abbasi  25 , Elizabeth M Wulff-Burchfield  25 , Matthew Puc  26 , Lisa B Weissmann  27 , Padmanabh S Bhatt  27 , Melissa G Mariano  27 , Sanjay Mishra  12   13 , Susan Halabi  28 , Alicia Beeghly  2 , Jeremy L Warner  13 , Benjamin French  2 , Mehmet A Bilen  1 ; COVID‐19 and Cancer Consortium
Affiliations

The impact of cancer metastases on COVID-19 outcomes: A COVID-19 and Cancer Consortium registry-based retrospective cohort study

Cecilia A Castellano et al. Cancer. .

Abstract

Background: COVID-19 can have a particularly detrimental effect on patients with cancer, but no studies to date have examined if the presence, or site, of metastatic cancer is related to COVID-19 outcomes.

Methods: Using the COVID-19 and Cancer Consortium (CCC19) registry, the authors identified 10,065 patients with COVID-19 and cancer (2325 with and 7740 without metastasis at the time of COVID-19 diagnosis). The primary ordinal outcome was COVID-19 severity: not hospitalized, hospitalized but did not receive supplemental O2, hospitalized and received supplemental O2, admitted to an intensive care unit, received mechanical ventilation, or died from any cause. The authors used ordinal logistic regression models to compare COVID-19 severity by presence and specific site of metastatic cancer. They used logistic regression models to assess 30-day all-cause mortality.

Results: Compared to patients without metastasis, patients with metastases have increased hospitalization rates (59% vs. 49%) and higher 30 day mortality (18% vs. 9%). Patients with metastasis to bone, lung, liver, lymph nodes, and brain have significantly higher COVID-19 severity (adjusted odds ratios [ORs], 1.38, 1.59, 1.38, 1.00, and 2.21) compared to patients without metastases at those sites. Patients with metastasis to the lung have significantly higher odds of 30-day mortality (adjusted OR, 1.53; 95% confidence interval, 1.17-2.00) when adjusting for COVID-19 severity.

Conclusions: Patients with metastatic cancer, especially with metastasis to the brain, are more likely to have severe outcomes after COVID-19 whereas patients with metastasis to the lung, compared to patients with cancer metastasis to other sites, have the highest 30-day mortality after COVID-19.

Keywords: COVID‐19; cancer; metastasis.

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Conflict of interest statement

Conflicts of Interest:

C. Hwang has stock holdings in Johnson and Johnson; receives research funding to institution from Merck, Bausch Health, Genentech, Bayer, and AstraZeneca, consultant fees from Tempus, Genzyme, and EMD Sorono, speaking fees from OncLive/MJH Life Sciences, travel fees from Merck, all outside the submitted work.

E.A. Griffiths receives consulting fees from Alexion Inc, Picnic Health, AbbVie, CTI Biopharma, Genentech Inc., Novartis, Celgene/Bristol Myers-Squibb, Takeda oncology, Taiho Oncology and Research Funding from Genentech Inc, Astex Pharmaceuticals, and BluePrint Medicines.

R.R. McKay is on the Consulting/Advisory board for Aveo, AZ, BMS, Bayer, Calithera. Caris, Dendreon, Exelixis, JNJ, Myovant, Merck, Novaritis, Pfizer, Sanofi, SeaGen, Sorrento Therapeutics, Tempus, Telix.

C.R. Friese has prior receipt of institutional research grants from NCCN/Pfizer, Merck Foundation; receives consultation fees from Vanderbilt University/Leukemia and Lymphoma Society; Not pertinent to current manuscript.

S. Mishra reports personal fees from National Geographic for writing articles; outside the submitted work.

J.L. Warner reports funding from NIH/NCI, Consulting Fees from Westat, Roche, Flatiron Health, Melax Tech, and Ownership of HemOnc.org LLC; all outside the submitted work.

M.A. Bilen has acted as a paid consultant for and/or as a member of the advisory boards of Exelixis, Bayer, BMS, Eisai, Pfizer, AstraZeneca, Janssen, Calithera Biosciences, Genomic Health, Nektar, EMD Serono, SeaGen, and Sanofi.

All other authors: nothing to report.

Figures

Figure 1.
Figure 1.
COVID-19 severity by site of metastasis
See this image and copyright information in PMC

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