Therapeutic Advances in Medical Oncology (Sep 2020)

Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience

  • Nalinie Joharatnam-Hogan,
  • Daniel Hochhauser,
  • Kai-Keen Shiu,
  • Hannah Rush,
  • Valerie Crolley,
  • William Wilson,
  • Anand Sharma,
  • Aun Muhammad,
  • Muhammad Anwar,
  • Nikhil Vasdev,
  • Robert Goldstein,
  • Ganna Kantser,
  • Aramita Saha,
  • Fharat Raja,
  • John Bridgewater,
  • Khurum Khan

DOI
https://doi.org/10.1177/1758835920956803
Journal volume & issue
Vol. 12

Abstract

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Background: This study aims to compare the outcomes of COVID-19-positive disease in patients with a history of cancer to those without. Methods: We retrospectively collected clinical data and outcomes of COVID-19 positive cancer patients treated consecutively in five North London hospitals (cohort A). Outcomes recorded included time interval between most recent anti-cancer treatment and admission, severe outcome [a composite endpoint of intensive care unit (ITU) admission, ventilation and/or death] and mortality. Outcomes were compared with consecutively admitted COVID-19 positive patients, without a history of cancer (cohort B), treated at the primary centre during the same time period (1 March–30 April 2020). Patients were matched for age, gender and comorbidity. Results: The median age in both cohorts was 74 years, with 67% male, and comprised of 30 patients with cancer, and 90 without (1:3 ratio). For cohort B, 579 patients without a history of cancer and consecutively admitted were screened from the primary London hospital, 105 were COVID-19 positive and 90 were matched and included. Excluding cancer, both cohorts had a median of two comorbidities. The odds ratio (OR) for mortality, comparing patients with cancer to those without, was 1.05 [95% confidence interval (CI) 0.4–2.5], and severe outcome (OR 0.89, 95% CI 0.4–2.0) suggesting no increased risk of death or a severe outcome in patients with cancer. Cancer patients who received systemic treatment within 28 days had an OR for mortality of 4.05 (95% CI 0.68–23.95), p = 0.12. On presentation anaemia, hypokalaemia, hypoalbuminaemia and hypoproteinaemia were identified predominantly in cohort A. Median duration of admission was 8 days for cancer patients and 7 days for non-cancer. Conclusion: A diagnosis of cancer does not appear to increase the risk of death or a severe outcome in COVID-19 patients with cancer compared with those without cancer. If a second spike of virus strikes, rational decision making is required to ensure optimal cancer care.