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1. Outcomes of the SARS-CoV-2 omicron (B.1.1.529) variant outbreak among vaccinated and unvaccinated patients with cancer in Europe: results from the retrospective, multicentre, OnCovid registry study

Author

David J Pinato, Juan Aguilar-Company, Daniela Ferrante, Georgina Hanbury, Mark Bower, Ramon Salazar, Oriol Mirallas, Anna Sureda, Andrea Plaja, Marc Cucurull, Ricard Mesia, Sarah Townsend, Amanda Jackson, Alessia Dalla Pria, Thomas Newsom-Davis, Jasmine Handford, Ailsa Sita-Lumsden, Eleanor Apthorp, Bruno Vincenzi, Alexia Bertuzzi, Joan Brunet, Matteo Lambertini, Clara Maluquer, Paolo Pedrazzoli, Federica Biello, Alasdair Sinclair, Samira Bawany, Saira Khalique, Sabrina Rossi, Lucy Rogers, Cian Murphy, Katherine Belessiotis, M Carmen Carmona-García, Rachel Sharkey, David García-Illescas, Gianpiero Rizzo, Marta Perachino, Nadia Saoudi-Gonzalez, Kris Doonga, Laura Fox, Elisa Roldán, Gianluca Gaidano, Isabel Ruiz-Camps, Riccardo Bruna, Andrea Patriarca, Clara Martinez-Vila, Luca Cantini, Alberto Zambelli, Raffaele Giusti, Francesca Mazzoni, Enrico Caliman, Armando Santoro, Federica Grosso, Alessandro Parisi, Paola Queirolo, Avinash Aujayeb, Lorenza Rimassa, Aleix Prat, Marco Tucci, Michela Libertini, Salvatore Grisanti, Uma Mukherjee, Nikolaos Diamantis, Vittorio Fusco, Daniele Generali, Salvatore Provenzano, Alessandra Gennari, Josep Tabernero, Alessio Cortellini, Joanne S Evans, Judith Swallow, Chris Chung, Meera Patel, Gino Dettorre, Diego Ottaviani, Amani Chowdhury, Eve Merry, Neha Chopra, Alvin JX Lee, Christopher CT Sng, Tamara Yu, Marianne Shawe-Taylor, Hamish DC Bain, Yien Ning Sophia Wong, Myria Galazi, Sarah Benafif, Palma Dileo, Irina Earnshaw, Grisma Patel, Anjui Wu, Gehan Soosaipillai, Lee Cooper, Ramis Andaleeb, Saoirse Dolly, Krishnie Srikandarajah, Eleanor Jones, Mieke Van Hemelrijck, Charlotte Moss, Beth Russell, John Chester, Angela Loizidou, Martine Piccart, Claudia A Cruz, Roxana Reyes, Elia Segui, Javier Marco-Hernández, Margarita Viladot, Simeon Eremiev, Roser Fort-Culillas, Isabel Garcia, Raquel Liñan, Ariadna Roqué Lloveras, Nadia Harbeck, Rachel Wuerstlein, Franziska Henze, Sven Mahner, Eudald Felip, Anna Pous, Francesca D'Avanzo, Lorenza Scotti, Marco Krengli, Andrea Marrari, Sara Delfanti, Antonio Maconi, Marta Betti, Giuseppe Tonini, Giuseppina Rita Di Fazio, Carlo Tondini, Lorenzo Chiudinelli, Michela Franchi, Rossella Bertulli, Alice Baggi, Valeria Tovazzi, Corrado Ficorella, Giampiero Porzio, Maristella Saponara, Marco Filetti, Federica Zoratto, Francesco Paoloni, Rossana Berardi, Annalisa Guida, Sergio Bracarda, Maria Iglesias, Ana Sanchez de Torre, Marco Tagliamento, Emeline Colomba, and Fanny Pommeret

Subjects
Male, SARS-CoV-2, COVID-19, Middle Aged, Disease Outbreaks, Europe, Oxygen, COVID-19 Testing, Oncology, Neoplasms, Humans, Female, Registries, Aged, Retrospective Studies
Abstract

The omicron (B.1.1.529) variant of SARS-CoV-2 is highly transmissible and escapes vaccine-induced immunity. We aimed to describe outcomes due to COVID-19 during the omicron outbreak compared with the prevaccination period and alpha (B.1.1.7) and delta (B.1.617.2) waves in patients with cancer in Europe.In this retrospective analysis of the multicentre OnCovid Registry study, we recruited patients aged 18 years or older with laboratory-confirmed diagnosis of SARS-CoV-2, who had a history of solid or haematological malignancy that was either active or in remission. Patient were recruited from 37 oncology centres from UK, Italy, Spain, France, Belgium, and Germany. Participants were followed up from COVID-19 diagnosis until death or loss to follow-up, while being treated as per standard of care. For this analysis, we excluded data from centres that did not actively enter new data after March 1, 2021 (in France, Germany, and Belgium). We compared measures of COVID-19 morbidity, which were complications from COVID-19, hospitalisation due to COVID-19, and requirement of supplemental oxygen and COVID-19-specific therapies, and COVID-19 mortality across three time periods designated as the prevaccination (Feb 27 to Nov 30, 2020), alpha-delta (Dec 1, 2020, to Dec 14, 2021), and omicron (Dec 15, 2021, to Jan 31, 2022) phases. We assessed all-cause case-fatality rates at 14 days and 28 days after diagnosis of COVID-19 overall and in unvaccinated and fully vaccinated patients and in those who received a booster dose, after adjusting for country of origin, sex, age, comorbidities, tumour type, stage, and status, and receipt of systemic anti-cancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974, and is ongoing.As of Feb 4, 2022 (database lock), the registry included 3820 patients who had been diagnosed with COVID-19 between Feb 27, 2020, and Jan 31, 2022. 3473 patients were eligible for inclusion (1640 [47·4%] were women and 1822 [52·6%] were men, with a median age of 68 years [IQR 57-77]). 2033 (58·5%) of 3473 were diagnosed during the prevaccination phase, 1075 (31·0%) during the alpha-delta phase, and 365 (10·5%) during the omicron phase. Among patients diagnosed during the omicron phase, 113 (33·3%) of 339 were fully vaccinated and 165 (48·7%) were boosted, whereas among those diagnosed during the alpha-delta phase, 152 (16·6%) of 915 were fully vaccinated and 21 (2·3%) were boosted. Compared with patients diagnosed during the prevaccination period, those who were diagnosed during the omicron phase had lower case-fatality rates at 14 days (adjusted odds ratio [OR] 0·32 [95% CI 0·19-0·61) and 28 days (0·34 [0·16-0·79]), complications due to COVID-19 (0·26 [0·17-0·46]), and hospitalisation due to COVID-19 (0·17 [0·09-0·32]), and had less requirements for COVID-19-specific therapy (0·22 [0·15-0·34]) and oxygen therapy (0·24 [0·14-0·43]) than did those diagnosed during the alpha-delta phase. Unvaccinated patients diagnosed during the omicron phase had similar crude case-fatality rates at 14 days (ten [25%] of 40 patients vs 114 [17%] of 656) and at 28 days (11 [27%] of 40 vs 184 [28%] of 656) and similar rates of hospitalisation due to COVID-19 (18 [43%] of 42 vs 266 [41%] of 652) and complications from COVID-19 (13 [31%] of 42 vs 237 [36%] of 659) as those diagnosed during the alpha-delta phase.Despite time-dependent improvements in outcomes reported in the omicron phase compared with the earlier phases of the pandemic, patients with cancer remain highly susceptible to SARS-CoV-2 if they are not vaccinated against SARS-CoV-2. Our findings support universal vaccination of patients with cancer as a protective measure against morbidity and mortality from COVID-19.National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.

Published
2022

2. Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study

Author

David J Pinato, Josep Tabernero, Mark Bower, Lorenza Scotti, Meera Patel, Emeline Colomba, Saoirse Dolly, Angela Loizidou, John Chester, Uma Mukherjee, Alberto Zambelli, Alessia Dalla Pria, Juan Aguilar-Company, Diego Ottaviani, Amani Chowdhury, Eve Merry, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Matteo Lambertini, Marco Tagliamento, Anna Pous, Ailsa Sita-Lumsden, Krishnie Srikandarajah, Johann Colomba, Fanny Pommeret, Elia Seguí, Daniele Generali, Salvatore Grisanti, Paolo Pedrazzoli, Gianpiero Rizzo, Michela Libertini, Charlotte Moss, Joanne S Evans, Beth Russell, Nadia Harbeck, Bruno Vincenzi, Federica Biello, Rossella Bertulli, Raquel Liñan, Sabrina Rossi, Maria Carmen Carmona-García, Carlo Tondini, Laura Fox, Alice Baggi, Vittoria Fotia, Alessandro Parisi, Giampero Porzio, Maristella Saponara, Claudia Andrea Cruz, David García-Illescas, Eudald Felip, Ariadna Roqué Lloveras, Rachel Sharkey, Elisa Roldán, Roxana Reyes, Irina Earnshaw, Daniela Ferrante, Javier Marco-Hernández, Isabel Ruiz-Camps, Gianluca Gaidano, Andrea Patriarca, Riccardo Bruna, Anna Sureda, Clara Martinez-Vila, Ana Sanchez de Torre, Luca Cantini, Marco Filetti, Lorenza Rimassa, Lorenzo Chiudinelli, Michela Franchi, Marco Krengli, Armando Santoro, Aleix Prat, Mieke Van Hemelrijck, Nikolaos Diamantis, Thomas Newsom-Davis, Alessandra Gennari, Alessio Cortellini, Judith Swallow, Chris Chung, Gino Dettorre, Neha Chopra, Alvin JX Lee, Christopher CT Sng, Yien Ning Sophia Wong, Myria Galazi, Sarah Benafif, Palma Dileo, Grisma Patel, Anjui Wu, Alasdair Sinclair, Gehan Soosaipillai, Eleanor Jones, Amanda Jackson, Martine Piccart, Emeline Colomba-Blameble, Claudia A Cruz, Elia Segui, David Garcia Illescas, Oriol Mirallas, Anna Carbó, Isabel Garcia, Rachel Wuerstlein, Ricard Mesia, Clara Maluquer, Francesca D'Avanzo, Giuseppe Tonini, Salvatore Provenzano, Valeria Tovazzi, Corrado Ficorella, Paola Queirolo, Raffaele Giusti, Francesca Mazzoni, Federica Zoratto, Marco Tucci, Rossana Berardi, Annalisa Guida, Sergio Bracarda, Maria Iglesias, Pinato, D. J., Tabernero, J., Bower, M., Scotti, L., Patel, M., Colomba, E., Dolly, S., Loizidou, A., Chester, J., Mukherjee, U., Zambelli, A., Dalla Pria, A., Aguilar-Company, J., Ottaviani, D., Chowdhury, A., Merry, E., Salazar, R., Bertuzzi, A., Brunet, J., Lambertini, M., Tagliamento, M., Pous, A., Sita-Lumsden, A., Srikandarajah, K., Colomba, J., Pommeret, F., Segui, E., Generali, D., Grisanti, S., Pedrazzoli, P., Rizzo, G., Libertini, M., Moss, C., Evans, J. S., Russell, B., Harbeck, N., Vincenzi, B., Biello, F., Bertulli, R., Linan, R., Rossi, S., Carmona-Garcia, M. C., Tondini, C., Fox, L., Baggi, A., Fotia, V., Parisi, A., Porzio, G., Saponara, M., Cruz, C. A., Garcia-Illescas, D., Felip, E., Roque Lloveras, A., Sharkey, R., Roldan, E., Reyes, R., Earnshaw, I., Ferrante, D., Marco-Hernandez, J., Ruiz-Camps, I., Gaidano, G., Patriarca, A., Bruna, R., Sureda, A., Martinez-Vila, C., Sanchez de Torre, A., Cantini, L., Filetti, M., Rimassa, L., Chiudinelli, L., Franchi, M., Krengli, M., Santoro, A., Prat, A., Van Hemelrijck, M., Diamantis, N., Newsom-Davis, T., Gennari, A., Cortellini, A., Swallow, J., Chung, C., Dettorre, G., Chopra, N., Lee, A. J., Sng, C. C., Wong, Y. N. S., Galazi, M., Benafif, S., Dileo, P., Patel, G., Wu, A., Sinclair, A., Soosaipillai, G., Jones, E., Jackson, A., Piccart, M., Colomba-Blameble, E., Garcia Illescas, D., Mirallas, O., Carbo, A., Garcia, I., Wuerstlein, R., Mesia, R., Maluquer, C., D'Avanzo, F., Tonini, G., Provenzano, S., Tovazzi, V., Ficorella, C., Queirolo, P., Giusti, R., Mazzoni, F., Zoratto, F., Tucci, M., Berardi, R., Guida, A., Bracarda, S., and Iglesias, M.

Subjects
Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Belgium, COVID-19, Disease Progression, Female, France, Germany, Hospitalization, Humans, Italy, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasms, Prevalence, Registries, Retrospective Studies, Spain, United Kingdom, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Registry study, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), OnCovid, cancer treatment, Post-Acute COVID-19 Syndrome, Internal medicine, medicine, 80 and over, In patient, business.industry, Cancer, Retrospective cohort study, Articles, medicine.disease, Oncology, Research centre, Population study, business
Abstract

Background: The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection. Methods: OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974. Findings: 2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p

Published
2021

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