Chemotherapy doesn’t increase the risk of death from COVID-19

Cancer patients on systemic anticancer treatments (SACT) have overall similar outcomes from COVID-19 infection as those who have not had recent SACT. However, those with specific tumour types, certain comorbidities and older age still fare worse from COVID-19. This is according a study recently in published in JAMA Open Network by researchers from the University of Birmingham in the UK Using data from the U.K. Coronavirus Cancer Monitoring Project (UKCCMP), researchers investigated whether mortality was associated with SACTs, tumour subtype, patient demographic characteristics (age and sex), and comorbidities in cancer patients who were hospitalized with COVID19. UKCCMP includes data from across the U.K. “Early data suggested patients with cancer had a two-fold higher risk of COVID-19–related mortality,” the study said. Read: Long-term cardiovascular risks are substantial in COVID-19 survivors The researchers noted that “early data identified that COVID-19 mortality in patients with cancer was primarily associated with age, sex, and comorbidities rather than recent (SACTs).” The study was conducted to better tease out some of the details. The researchers were unavailable for comments. The study was launched on March 18, 2020, before vaccines were developed, and data collection concluded August 1, 2020. Patients 18 years and older with any type of active cancer and a clinical diagnosis of COVID-19 were included. Active cancer was defined as metastatic disease, people undergoing active treatment, or those treated in the last 12 months. They were included in study if they presented at hospital for either cancer treatment (which led to COVID-19 testing), or had COVID-19 infection that needed treatment. Patients were excluded if outcome information, age, sex, and comorbidity data were not available or complete. Details pertaining to comorbidities were collected and included chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), diabetes, hypertension, or vascular diseases, Data for a total of 2,515 patients were included in the analyses. Of these, 1,464 (58%) were male, and the median age was 72 years. Overall, 1,463 (58%) presented with at least one of the key comorbidities, and 272 (11%) were identified as Black, Asian, or other ethnic group. The population had an overall mortality rate of 38% (966 patients); median follow-up for all-cause death was seven (three to13) days. Fewer than half the patients, 1,108 (44%) presented with mild COVID-19 symptoms. Another 701 (28%) had severe symptoms, 539 (21%) were critical, and 119 (5%) presented with no symptoms. Of the patients who died, 493 (51%) had presented with critical symptoms, compared to only 46 (3%) of those who survived. A total of 131 (5%) patients were admitted to intensive care. To help determine the potential impact of SACT, analyses were conducted which looked at variables as age, sex, comorbidities and other factors to determine what factors were associated with higher risk of mortality. It was found that male sex, older age, and presence of specific comorbidities had were associated with higher mortality. In fact, male sex was associated with a slight 1.5 times increased risk, older age with 1.4 times increased risk, and comorbidities with almost twice the risk. The association between specific comorbidities and outcomes was also tested. Looking at all the patients, CKD and CVD were generally associated with higher all-cause mortality (1.56 and 1.26 odds of increased risk of death respectively). The presence of solid tumor cancer, CKD, CVD, COPD, and diabetes “were significantly associated with higher mortality,” the study said. Higher body mass index (BMI) was also significantly associated with higher mortality, as was a history of smoking. It was also found that patients with hematological malignant neoplasms, irrespective of recent SACT, had higher mortality rates. People who had acute leukemias or myelodysplastic syndrome had about two times the risk of dying, those with and myeloma or plasmacytoma had about one and a half times increased risk. Lung cancer was also significantly associated with higher COVID-19–related mortality. The study also looked at whether there was an association between recent chemotherapy and patient outcome and types pf cancer. In the analysis of those with solid cancers, recent chemotherapy was associated with a slight improvement in survival in patients with non-colorectal digestive organ, female genital organ cancer, and breast cancers. There was no association between recent chemotherapy and death for any individual hematological cancers, the researchers said. Findings in the study may “facilitate better risk stratification of patients with cancer who may be exposed to COVID-19 and will permit clinicians to devise individualized care plans with patients that minimize disruption to cancer care,” the researchers said. They added that “while patients with cancer had poorer COVID-19 outcomes than other individuals with COVID-19 such difference in outcome may be associated with age, sex, comorbidities, and cancer subtype rather than anticancer treatments.” Some studies suggest some anti-cancer drugs may actually help fight COVID. A study in the journal Drug Design, Development and Treatment stated that “Treatments for cancer and COVID-19 often have similar goals of controlling inflammation, inhibiting cell division, and modulating the host microenvironment to control the disease”. It also noted that several anti-cancer drugs that could potentially be used to treat COVID-19 are being tested in clinical trials. According to the Canadian Cancer Society website, patients with cancer have a higher risk for more serious outcomes of COVID-19. And that “some cancer treatments, such as surgery, chemotherapy, immunotherapy and radiation therapy, can weaken your immune system.”

Chemotherapy doesn’t increase the risk of death from COVID-19

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