COVID -19 infectious cancer patients have a higher risk than non-cancer patients

Patients with inactive cancer who are not currently receiving treatments are also at a much higher risk of serious illness from COVID-19, a new study from Penn Medicine published online today in JNCI Cancer Spectrum performances.

Previous reports have established a higher risk of serious disease and death for sick or hospitalized cancer patients with COVID-19 compared with non-cancer patients, but little is known about patients in the general population.

The findings confirm the importance of COVID-19 mitigation, such as social distance and mask wear, and vaccines for all patients, not just those recently diagnosed or with active disease.

“Patients with cancer must be careful not to be exposed during this time,” said lead author Kara N. Maxwell, MD, Ph.D., assistant professor of Hematology-Oncology and Genetics in School Perelman 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 that they are not just for patients who are hospitalized or treated for cancer. All oncology patients must take serious steps during the pandemic to protect themselves. “

The researchers analyzed the records of more than 4,800 patients tested for COVID-19 from Penn Medicine BioBank, a centralized bank of samples, and combined data from the health system’s electronic health records, for analysis. on the association between cancer status and COVID -19 outcomes.

Of the 328 advanced cases through June 2020, 67 (20.7 percent) had cancer in their medical history (80.6 percent with solid tumor malignancy and 73.1 percent with inactive cancer).

Patients with COVID-19 had higher hospital admissions rates – including both those with active cancer (18) and non-active cancers (49) – compared to non-cancer patients (55.2 per cent vs. 29 per cent), intensive care unit admissions (25.7 per cent vs. 11.7 per cent), and 30-day mortality (13.4 per cent compared to 1.6 per cent).

Although worse outcomes were more strongly associated with those with active cancer, patients with greater relief were more at risk for more severe disease compared with non-cancer COVID-19 patients.

Notably, the proportion of Black patients – who make up 20 percent of patients in the biobank – was significantly higher in COVID-19-positive cancer and non-cancer patients (BVB). 65.7 percent and 64.1 percent, respectively) compared to all patients tested for SARS-CoV-2.

The results are parallel to previous reports showing the disproportionate impact of COVID-19 on minority communities.

We need to think about race as an important factor in trying to get vaccinated as soon as possible. “

Kara N. Maxwell, MD, Ph.D, Principal Author Study and Associate Professor of Hematology-Oncology and Genetics, Perelman School of Medicine, University of Pennsylvania, Member of Abramson Cancer Center, Basser Center for BRCA

Studies show that cancer patients have a higher risk of COVID-19 complications, in part due to factors such as old age, higher smoking rates, comorbidities, frequent health care exposures, and the impact of cancer treatments. These latest results also suggest cancer itself and its effect on the body may play a role in reducing COVID-19 infections.

“Our finding that cancer patients with COVID-19 were more likely than non-cancer patients to experience hospitalization and death even after adjusting for patient level factors supports the notion that cancer is an independent risk factor. for the adverse effects of COVID-19, “they wrote.

In a separate, related study published in the bioRxiv preprint database and not peer-reviewed, Penn Medicine researchers report that cancer patients receiving personal care at a facility with aggressive mitigation efforts very similar to COVID-19 infection.

Out of 124 patients in the study receiving treatment at Penn Medicine, none tested positive for the virus after their clinical visits (an average of 13 per patient).

The results suggest that these efforts, when combined with social distance outside of a health care setting, may help protect vulnerable cancer patients from exposure and suffering. with COVID-19, even when continuous immunomodulatory cancer treatments and health care disclosure are required frequently, the authors said.