COVID - 19 and Chemotherapy related mortality rates in Cancer Patients

A study made Lennard Y W Lee, Jean Baptiste Cazier, T Starkey, C D Turnbull, published under title “COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study” published in Lancet, highlight the higher mortality risk in cancer patients undergoing chemotherapy from covid-19. Patients who used hydroxychloroquine plus azithromycin to treat COVID-19 were nearly three times more likely to die.COVID-19-related mortality in patients with cancer may be driven by age, gender, and other comorbidities not recent anticancer treatment, according to results from a large prospective cohort study published in The Lancet.

This study was a result of the United Kingdom Coronavirus Cancer Monitoring Project (UKCCMP). In a large cohort of cancer-related patients receiving cytotoxic chemotherapies and other anti-cancer treatments, the investigators wanted to describe the clinical and demographic features and COVID-19 outcomes.

The sample pool of 800 patients with cancer and symptomatic COVID-19 were placed under investigation and observation from March 18 till April 26, 2020. The disease course of COVID-19 was mild for 412 (52%) patients, severe for 187 (23%) patients and critical for 173 (22%) . In total, 226 (28%) died.

The enrollment under UKCCMP can be by patient with active cancer and confirmed COVID-19 with a network of cancer centers in the UK. These centers were encouraged to enter on a real-time basis.Mortality or discharge from hospitals was the primary endpoint.

The observations showed that patient of advanced age had significantly higher death risk (odds ratio [OR], 9.42; P <.0001), male gender (OR, 1.67; P =.003; patient deaths, 33% of all men vs 20% of all women), and having other comorbidities, specifically hypertension (OR, 1.95; P <.001; 41% of those who died vs 27% of survivors; P <.001) and cardiovascular disease (OR, 2.32; 21% of those who died vs 11% of survivors; P <.001).

Cytotoxic Chemotherapy was administered to 35% of patients (281 of 800), within 4 weeks of testing positive for COVID-19. The mortality was almost similar between patients who received chemotherapy(27%) as compared with those who had not(29%).

There were no significant differences in mortality from the disease of COVID-19 in a multivariate analysis that were modified for age , gender and comorbidities between patients receiving recent chemotherapy treatment and those not receiving it (OR 1,18; P = 0,380). In addition, there was no additional risk of death in patients who received immunotherapy, hormonal therapy, targeted treatment or radiation therapy in the last four weeks of observation.

The Authors remarked that “Our data are strongly indicative that COVID-19 mortality in patients with cancer is principally driven by advancing age and the presence of other non-cancer comorbidities,”. The authors further conclude by this – “At a population level, our data do not suggest that chemotherapy or anticancer treatments will necessarily increase the risk of mortality from COVID-19, and gives confidence to oncologists and other clinicians that delivery of effective anticancer regimens should continue during this difficult time.”

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