Translational Oncology (Aug 2023)

COVID-19 severity and cardiovascular outcomes in SARS-CoV-2-infected patients with cancer and cardiovascular disease

  • Melissa Y.Y. Moey,
  • Cassandra Hennessy,
  • Benjamin French,
  • Jeremy L. Warner,
  • Matthew D. Tucker,
  • Daniel J. Hausrath,
  • Dimpy P. Shah,
  • Jeanne M. DeCara,
  • Ziad Bakouny,
  • Chris Labaki,
  • Toni K. Choueiri,
  • Susan Dent,
  • Nausheen Akhter,
  • Roohi Ismail-Khan,
  • Lisa Tachiki,
  • David Slosky,
  • Tamar S. Polonsky,
  • Joy A. Awosika,
  • Audrey Crago,
  • Trisha Wise-Draper,
  • Nino Balanchivadze,
  • Clara Hwang,
  • Leslie A. Fecher,
  • Cyndi Gonzalez Gomez,
  • Brandon Hayes-Lattin,
  • Michael J. Glover,
  • Sumit A. Shah,
  • Dharmesh Gopalakrishnan,
  • Elizabeth A. Griffiths,
  • Daniel H. Kwon,
  • Vadim S. Koshkin,
  • Sana Mahmood,
  • Babar Bashir,
  • Taylor Nonato,
  • Pedram Razavi,
  • Rana R. McKay,
  • Gayathri Nagaraj,
  • Eric Oligino,
  • Matthew Puc,
  • Polina Tregubenko,
  • Elizabeth M. Wulff-Burchfield,
  • Zhuoer Xie,
  • Thorvardur R. Halfdanarson,
  • Dimitrios Farmakiotis,
  • Elizabeth J. Klein,
  • Elizabeth V. Robilotti,
  • Gregory J. Riely,
  • Jean-Bernard Durand,
  • Salim S. Hayek,
  • Lavanya Kondapalli,
  • Stephanie Berg,
  • Timothy E. O'Connor,
  • Mehmet A. Bilen,
  • Cecilia Castellano,
  • Melissa K. Accordino,
  • Blau Sibel,
  • Lisa B. Weissmann,
  • Chinmay Jani,
  • Daniel B. Flora,
  • Lawrence Rudski,
  • Miriam Santos Dutra,
  • Bouganim Nathaniel,
  • Erika Ruíz-García,
  • Diana Vilar-Compte,
  • Shilpa Gupta,
  • Alicia Morgans,
  • Anju Nohria

Journal volume & issue
Vol. 34
p. 101709

Abstract

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Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ≥ 55 or female ≥ 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54–74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11–1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p<0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31–1.74] vs. OR 1.04 [95% CI 0.90–1.20], pinteraction <0.001). Conclusions: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701).

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