Patients with inactive cancer who are not currently undergoing treatment also face a significantly higher risk of severe illness from COVID-19, according to a new study published by Sun et al in JNCI Cancer Spectrum. The findings underscore the importance of COVID-19 mitigation, like social distancing and mask-wearing, and vaccinations for all patients, not just those recently diagnosed or with active disease.
“Patients who have cancer need to be careful not to become exposed during this time,” said senior author Kara N. Maxwell, MD, PhD, Assistant Professor of Hematology-Oncology and Genetics in the Perelman School of Medicine at the University of Pennsylvania and a member of the Abramson Cancer Center and the Basser Center for BRCA. “That message has been out there, but these latest findings show us it’s not only for patients hospitalized or on treatment for their cancer. All oncology patients need to take significant precautions during the pandemic to protect themselves.”
Study Methods
The researchers analyzed the records of more than 4,800 patients who had been tested for COVID-19 from the Penn Medicine BioBank, a centralized bank of samples and linked data from the health system’s electronic health records, to investigate the association between cancer status and COVID-19 outcomes. Of the 328 positive cases through June 2020, 67 (20.7%) had a cancer diagnosis in their medical history (80.6% with solid tumor malignancy and 73.1% with inactive cancer).
Results
Patients with COVID-19—including both those with active cancer (n = 18) and inactive cancer (n = 49)—had higher rates of hospitalizations compared to patients without cancer (55.2% vs 29%), intensive care unit admissions (25.7% vs 11.7%), and 30-day mortality (13.4% vs 1.6%). Although worse outcomes were more likely in patients with active cancer, patients in remission also faced an overall increased risk of more severe disease compared to COVID-19 patients without cancer.
Notably, the proportion of Black patients—who make up 20% of the patients in the biobank—was significantly higher in both cancer and noncancer COVID-19–positive cohorts (65.7% and 64.1%, respectively) compared to all patients tested for SARS-CoV-2. The findings parallel prior reports showing the disproportionate impact of COVID-19 on minority communities.
“We really need to be thinking about race as a significant factor in trying to get people vaccinated as soon as we can,” said Dr. Maxwell.
The study authors concluded, “These results emphasize the critical importance of preventing SARS-CoV-2 exposure and mitigating infection in [patients with] cancer.”
Disclosure: For full disclosures of the study authors, visit academic.oup.com.
