TY - JOUR
T1 - Dutch Oncology COVID-19 consortium
T2 - Outcome of COVID-19 in patients with cancer in a nationwide cohort study
AU - de Joode, Karlijn
AU - Dumoulin, Daphne W.
AU - Tol, Jolien
AU - Westgeest, Hans M.
AU - Beerepoot, Laurens V.
AU - van den Berkmortel, Franchette W. P. J.
AU - Mutsaers, Pim G. N. J.
AU - van Diemen, Nico G. J.
AU - Visser, Otto J.
AU - Oomen-de Hoop, Esther
AU - Bloemendal, Haiko J.
AU - van Laarhoven, Hanneke W. M.
AU - Hendriks, Lizza E. L.
AU - Haanen, John B. A. G.
AU - de Vries, Elisabeth G. E.
AU - Dingemans, Anne-Marie C.
AU - van der Veldt, Astrid A. M.
AU - Aarts - Essers, Maureen
AU - DOCC Investigators
N1 - Funding Information:
Although chemotherapy has previously been identified as a risk factor for mortality of COVID-19 in cancer patients [ 21 ], this could not be confirmed in our registry. This is supported by data from a UK registry [ 9 ]. However, steroid use at the time of COVID-19 diagnosis was associated with an increased risk of fatal outcome of COVID-19 in univariable analysis. This result is of particular interest, as a recent randomised clinical trial showed that dexamethasone decreases mortality of COVID-19 in patients requiring respiratory support [ 22 ]. Steroids may contribute to an increased viral load of SARS-CoV-2 by an increase in viral replication and a delay of viral clearance [ 23 ]. Steroid co-medication is usually prescribed as supportive medication for haematological treatment and/or highly emetogenic chemotherapy regimens. Therefore, systemic treatment or disease itself cannot be excluded as confounding factor.
Funding Information:
Although chemotherapy has previously been identified as a risk factor for mortality of COVID-19 in cancer patients [21], this could not be confirmed in our registry. This is supported by data from a UK registry [9]. However, steroid use at the time of COVID-19 diagnosis was associated with an increased risk of fatal outcome of COVID-19 in univariable analysis. This result is of particular interest, as a recent randomised clinical trial showed that dexamethasone decreases mortality of COVID-19 in patients requiring respiratory support [22]. Steroids may contribute to an increased viral load of SARS-CoV-2 by an increase in viral replication and a delay of viral clearance [23]. Steroid co-medication is usually prescribed as supportive medication for haematological treatment and/or highly emetogenic chemotherapy regimens. Therefore, systemic treatment or disease itself cannot be excluded as confounding factor.This study was supported by a grant from the Dutch Cancer Society, a non-profit organisation. The Dutch Cancer Society had no role in study design, data collection, data analysis, data interpretation or writing of the report.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/12
Y1 - 2020/12
N2 - Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19.Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible.Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age >= 65 years (p <0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (>= 65 years).Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered. (C) 2020 The Author(s). Published by Elsevier Ltd.
AB - Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19.Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible.Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age >= 65 years (p <0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (>= 65 years).Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered. (C) 2020 The Author(s). Published by Elsevier Ltd.
KW - Coronavirus
KW - COVID-19
KW - Pandemic
KW - Cancer
KW - Cancer treatment
U2 - 10.1016/j.ejca.2020.09.027
DO - 10.1016/j.ejca.2020.09.027
M3 - Article
C2 - 33161241
SN - 0959-8049
VL - 141
SP - 171
EP - 184
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -