Chemotherapy and COVID-19 outcomes in patients with cancer Journal Article


Authors: Jee, J.; Foote, M. B.; Lumish, M.; Stonestrom, A. J.; Wills, B.; Narendra, V.; Avutu, V.; Murciano-Goroff, Y. R.; Chan, J. E.; Derkach, A.; Philip, J.; Belenkaya, R.; Kerpelev, M.; Maloy, M.; Watson, A.; Fong, C.; Janjigian, Y.; Diaz, L. A. Jr; Bolton, K. L.; Pessin, M. S.
Article Title: Chemotherapy and COVID-19 outcomes in patients with cancer
Abstract: PURPOSE: Coronavirus-2019 (COVID-19) mortality is higher in patients with cancer than in the general population, yet the cancer-associated risk factors for COVID-19 adverse outcomes are not fully characterized. PATIENTS AND METHODS: We reviewed clinical characteristics and outcomes from patients with cancer and concurrent COVID-19 at Memorial Sloan Kettering Cancer Center until March 31, 2020 (n = 309), and observed clinical end points until April 13, 2020. We hypothesized that cytotoxic chemotherapy administered within 35 days of a COVID-19 diagnosis is associated with an increased hazard ratio (HR) of severe or critical COVID-19. In secondary analyses, we estimated associations between specific clinical and laboratory variables and the incidence of a severe or critical COVID-19 event. RESULTS: Cytotoxic chemotherapy administration was not significantly associated with a severe or critical COVID-19 event (HR, 1.10; 95% CI, 0.73 to 1.60). Hematologic malignancy was associated with increased COVID-19 severity (HR, 1.90; 95% CI, 1.30 to 2.80). Patients with lung cancer also demonstrated higher rates of severe or critical COVID-19 events (HR, 2.0; 95% CI, 1.20 to 3.30). Lymphopenia at COVID-19 diagnosis was associated with higher rates of severe or critical illness (HR, 2.10; 95% CI, 1.50 to 3.10). Patients with baseline neutropenia 14-90 days before COVID-19 diagnosis had worse outcomes (HR, 4.20; 95% CI, 1.70 to 11.00). Findings from these analyses remained consistent in a multivariable model and in multiple sensitivity analyses. The rate of adverse events was lower in a time-matched population of patients with cancer without COVID-19. CONCLUSION: Recent cytotoxic chemotherapy treatment was not associated with adverse COVID-19 outcomes. Patients with active hematologic or lung malignancies, peri-COVID-19 lymphopenia, or baseline neutropenia had worse COVID-19 outcomes. Interactions among antineoplastic therapy, cancer type, and COVID-19 are complex and warrant further investigation.
Journal Title: Journal of Clinical Oncology
Volume: 38
Issue: 30
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2020-10-20
Start Page: 3538
End Page: 3546
Language: English
DOI: 10.1200/jco.20.01307
PUBMED: 32795225
PROVIDER: scopus
PMCID: PMC7571792
DOI/URL:
Notes: Article -- Export Date: 2 November 2020 -- Source: Scopus
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