In a UK-based prospective cohort study reported in The Lancet Oncology, Turtle et al found that among patients hospitalized due to COVID-19 infection, those receiving cancer treatment had a higher rate of in-hospital mortality vs those without a cancer diagnosis.
Study Details
The study included data from patients aged > 19 years admitted to 306 health-care facilities in the United Kingdom with confirmed SARS–CoV-2 infection who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol (CCP) from April 23, 2020, to February 28, 2022. The primary outcome measure was 30-day in-hospital mortality among patients receiving cancer treatment vs those without a history of cancer.
Key Findings
The study population consisted of 177,871 patients, including 6,568 on cancer treatment and 171,303 with no history of cancer. Death at 30 days occurred in 2,080 (31.7%) of 6,568 patients receiving cancer treatment vs 30,901 (18.0%) of 171,303 without cancer (P < .0001).
Patients aged < 50 years receiving cancer treatment had the highest age-adjusted relative risk of 30-day mortality vs those without cancer in the same age group (hazard ratio [HR] = 5.2, 95% confidence interval [CI] = 4.0–6.6, P < .0001). Hazard ratios were 2.4 (95% CI = 2.2–2.6, P < .0001) among those aged 50 to 69 years, 1.8 (95% CI = 1.6–2.0, P < .0001) among those aged 70 to 79 years, and 1.5 (95% CI = 1.3–1.6, P < .0001) among those aged > 80 years.
Among patients receiving cancer treatment, those aged < 50 years had the lowest absolute risk of 30-day mortality, with death occurring in 51 (6.7%) of 763 patients. In comparison, death occurred in 459 (30.2%) of 1,522 patients aged > 80 years.
Patients receiving cancer treatment with no comorbidities had a greater risk of mortality than patients without cancer who had any comorbidities (odds ratio [OR] = 2.86, 95% CI = 2.51–3.27, P = .010) or two or more comorbidities (OR = 2.35, 95% CI = 2.24–2.46, P = .010).
The investigators concluded, “People with cancer have a higher risk of mortality from COVID-19 than those without cancer. Patients younger than 50 years with cancer treatment have the highest relative risk of death. Continued action is needed to mitigate the poor outcomes in patients with cancer, such as through optimizing vaccination, long-acting passive immunization, and early access to therapeutics. These findings underscore the importance of the ISARIC-WHO pandemic preparedness initiative.”
Carlo Palmieri, PhD, of the Department of Molecular and Clinical Cancer Medicine, University of Liverpool, is the corresponding author for The Lancet Oncology article.
Disclosure: The study was funded by the National Institute for Health Research and Medical Research Council. For full disclosures of the study authors, visit thelancet.com.
