Determinants of COVID-19 disease severity in patients with cancer Research Letter


Authors: Robilotti, E. V.; Babady, N. E.; Mead, P. A.; Rolling, T.; Perez-Johnston, R.; Bernardes, M.; Bogler, Y.; Caldararo, M.; Figueroa, C. J.; Glickman, M. S.; Joanow, A.; Kaltsas, A.; Lee, Y. J.; Lucca, A.; Mariano, A.; Morjaria, S.; Nawar, T.; Papanicolaou, G. A.; Predmore, J.; Redelman-Sidi, G.; Schmidt, E.; Seo, S. K.; Sepkowitz, K.; Shah, M. K.; Wolchok, J. D.; Hohl, T. M.; Taur, Y.; Kamboj, M.
Title: Determinants of COVID-19 disease severity in patients with cancer
Abstract: As of 10 April 2020, New York State had 180,458 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 9,385 reported deaths. Patients with cancer comprised 8.4% of deceased individuals1. Population-based studies from China and Italy suggested a higher coronavirus disease 2019 (COVID-19) death rate in patients with cancer2,3, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-194. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. From 10 March to 7 April 2020, 423 cases of symptomatic COVID-19 were diagnosed at Memorial Sloan Kettering Cancer Center (from a total of 2,035 patients with cancer tested). Of these, 40% were hospitalized for COVID-19, 20% developed severe respiratory illness (including 9% who required mechanical ventilation) and 12% died within 30 d. Age older than 65 years and treatment with immune checkpoint inhibitors (ICIs) were predictors for hospitalization and severe disease, whereas receipt of chemotherapy and major surgery were not. Overall, COVID-19 in patients with cancer is marked by substantial rates of hospitalization and severe outcomes. The association observed between ICI and COVID-19 outcomes in our study will need further interrogation in tumor-specific cohorts. © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.
Keywords: adult; cancer chemotherapy; controlled study; aged; major clinical study; clinical feature; cancer patient; colorectal cancer; protein blood level; breast cancer; cohort analysis; lung cancer; retrospective study; risk factor; age; lymphocytopenia; prostate cancer; hospitalization; disease severity; hematologic malignancy; interleukin 6; hydroxychloroquine; lactate dehydrogenase; corticosteroid; convalescence; azithromycin; lactate dehydrogenase blood level; respiratory tract disease; artificial ventilation; d dimer; plasma transfusion; corticosteroid therapy; mortality rate; tocilizumab; procalcitonin; human; male; female; priority journal; article; solid malignant neoplasm; coronavirus disease 2019; remdesivir
Journal Title: Nature Medicine
Volume: 26
Issue: 8
ISSN: 1078-8956
Publisher: Nature Publishing Group  
Date Published: 2020-08-01
Start Page: 1218
End Page: 1223
Language: English
DOI: 10.1038/s41591-020-0979-0
PUBMED: 32581323
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric
Citation Impact