Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London

Beth Russell; Charlotte Moss; Sophie Papa; Sheeba Irshad; Paul Ross; James Spicer; Shahram Kordasti; Danielle Crawley; Harriet Wylie; Fidelma Cahill; Anna Haire; Kamarul Zaki; Fareen Rahman; Ailsa Sita-Lumsden; Debra Josephs; Deborah Enting; Mary Lei; Sharmistha Ghosh; Claire Harrison; Angela Swampillai; Elinor Sawyer; Andrea D'Souza; Simon Gomberg; Paul Fields; David Wrench; Kavita Raj; Mary Gleeson; Kate Bailey; Richard Dillon; Matthew Streetly; Anne Rigg; Richard Sullivan; Saoirse Dolly; Mieke Van Hemelrijck

doi:10.3389/fonc.2020.01279

Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London

Beth Russell, Charlotte Moss, Sophie Papa, Sheeba Irshad, Paul Ross, James Spicer, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Kamarul Zaki, Fareen Rahman, Ailsa Sita-Lumsden, Debra Josephs, Deborah Enting, Mary Lei, Sharmistha Ghosh, Claire Harrison, Angela SwampillaiElinor Sawyer, Andrea D'Souza, Simon Gomberg, Paul Fields, David Wrench, Kavita Raj, Mary Gleeson, Kate Bailey, Richard Dillon, Matthew Streetly, Anne Rigg, Richard Sullivan, Saoirse Dolly, Mieke Van Hemelrijck^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

41 Citations (Scopus)

48 Downloads (Pure)

Abstract

Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)]. Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.

Original language	English
Article number	1279
Journal	Frontiers in oncology
Volume	26
Issue number	18
DOIs	https://doi.org/10.3389/fonc.2020.01279
Publication status	Published - 22 Jul 2020

Keywords

cancer
COVID-19
directed acyclic graph
outcomes
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3389/fonc.2020.01279

CovidCancerPaper_Update_with TC

Cite this

Russell, B., Moss, C., Papa, S., Irshad, S., Ross, P., Spicer, J., Kordasti, S., Crawley, D., Wylie, H., Cahill, F., Haire, A., Zaki, K., Rahman, F., Sita-Lumsden, A., Josephs, D., Enting, D., Lei, M., Ghosh, S., Harrison, C., ... Van Hemelrijck, M. (2020). Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London. Frontiers in oncology, 26(18), Article 1279. https://doi.org/10.3389/fonc.2020.01279

@article{fb0733d3a942414e8149fc3cb7344014,

title = "Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London",

abstract = "Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)]. Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.",

keywords = "cancer, COVID-19, directed acyclic graph, outcomes, SARS-CoV-2",

author = "Beth Russell and Charlotte Moss and Sophie Papa and Sheeba Irshad and Paul Ross and James Spicer and Shahram Kordasti and Danielle Crawley and Harriet Wylie and Fidelma Cahill and Anna Haire and Kamarul Zaki and Fareen Rahman and Ailsa Sita-Lumsden and Debra Josephs and Deborah Enting and Mary Lei and Sharmistha Ghosh and Claire Harrison and Angela Swampillai and Elinor Sawyer and Andrea D'Souza and Simon Gomberg and Paul Fields and David Wrench and Kavita Raj and Mary Gleeson and Kate Bailey and Richard Dillon and Matthew Streetly and Anne Rigg and Richard Sullivan and Saoirse Dolly and {Van Hemelrijck}, Mieke",

year = "2020",

month = jul,

day = "22",

doi = "10.3389/fonc.2020.01279",

language = "English",

volume = "26",

journal = "Frontiers in oncology",

issn = "2234-943X",

publisher = "Frontiers Media S.A.",

number = "18",

}

Russell, B , Moss, C , Papa, S , Irshad, S , Ross, P , Spicer, J , Kordasti, S , Crawley, D , Wylie, H, Cahill, F, Haire, A, Zaki, K, Rahman, F, Sita-Lumsden, A, Josephs, D , Enting, D , Lei, M, Ghosh, S, Harrison, C, Swampillai, A, Sawyer, E, D'Souza, A, Gomberg, S, Fields, P, Wrench, D, Raj, K, Gleeson, M, Bailey, K, Dillon, R, Streetly, M, Rigg, A, Sullivan, R, Dolly, S & Van Hemelrijck, M 2020, 'Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London', Frontiers in oncology, vol. 26, no. 18, 1279. https://doi.org/10.3389/fonc.2020.01279

TY - JOUR

T1 - Factors Affecting COVID-19 Outcomes in Cancer Patients

T2 - A First Report From Guy's Cancer Center in London

AU - Russell, Beth

AU - Moss, Charlotte

AU - Papa, Sophie

AU - Irshad, Sheeba

AU - Ross, Paul

AU - Spicer, James

AU - Kordasti, Shahram

AU - Crawley, Danielle

AU - Wylie, Harriet

AU - Cahill, Fidelma

AU - Haire, Anna

AU - Zaki, Kamarul

AU - Rahman, Fareen

AU - Sita-Lumsden, Ailsa

AU - Josephs, Debra

AU - Enting, Deborah

AU - Lei, Mary

AU - Ghosh, Sharmistha

AU - Harrison, Claire

AU - Swampillai, Angela

AU - Sawyer, Elinor

AU - D'Souza, Andrea

AU - Gomberg, Simon

AU - Fields, Paul

AU - Wrench, David

AU - Raj, Kavita

AU - Gleeson, Mary

AU - Bailey, Kate

AU - Dillon, Richard

AU - Streetly, Matthew

AU - Rigg, Anne

AU - Sullivan, Richard

AU - Dolly, Saoirse

AU - Van Hemelrijck, Mieke

PY - 2020/7/22

Y1 - 2020/7/22

N2 - Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)]. Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.

AB - Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71–4.26)], presenting with fever [6.21 (1.76–21.99)], dyspnea [2.60 (1.00–6.76)], gastro-intestinal symptoms [7.38 (2.71–20.16)], or higher levels of C-reactive protein [9.43 (0.73–121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01–0.04)]. Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.

KW - cancer

KW - COVID-19

KW - directed acyclic graph

KW - outcomes

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85089082067&partnerID=8YFLogxK

U2 - 10.3389/fonc.2020.01279

DO - 10.3389/fonc.2020.01279

M3 - Article

SN - 2234-943X

VL - 26

JO - Frontiers in oncology

JF - Frontiers in oncology

IS - 18

M1 - 1279

ER -

Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this