New research presented at the 2020 ESCMID Conference on Coronavirus Diseases (ECCVID) suggests that poor outcomes and higher mortality in cancer patients with COVID-19 could be due to their older age and having more underlying conditions, rather than having cancer.
The study, by Dr Maria Rüthrich, Germany, and colleagues, used data from the LEOSS (Lean European Open Survey for SARS-CoV-2 Infected Patients) Registry.
The authors retrospectively analysed a cohort of 435 cancer patients and COVID-19 from a total of 3,071 patients enrolled between March and August 2020.
The COVID-19-related mortality rate was 23% in the cancer patients, with men twice as likely to die as women (28% vs 14%). Active cancer disease (eg, recurrent or metastatic cancer, receiving anti-cancer therapy) was associated with higher mortality than in patients without active cancer (27% vs 17%)
Survival at 30 days was worse in cancer patients (70%) versus those without cancer (77%), and mortality was higher (23% vs 14%). However, after adjustments for age, sex and comorbidity, survival and mortality attributed to COVID-19 were comparable to non-cancer patients.
Dr Rüthrich said "It does not appear to be the cancer itself that is leading to these poor outcomes."
Meanwhile, in a separate session on COVID-19 and the lung organised by the European Respiratory Society, Dr J van Meerbeeck reported data showing that patients with thoracic tumours are at higher risk of COVID-19-related death compared to the general population and other cancer types, especially small cell lung cancer and malignant pleural mesothelioma. He also cited age and co-morbidities as key risk factors for mortality in cancer patients with COVID-19.
Question: How do we better protect cancer patients from COVID-19?
van Meerbeeck: The number of outpatient and hospital visits should be restricted where possible, and be cautious about the use of immunosuppressive chemotherapy, but prioritise curative therapy.