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1. Patients Recently Treated for B-lymphoid Malignancies Show Increased Risk of Severe COVID-19.

Author

Rubinstein SM, Bhutani D, Lynch RC, Hsu CY, Shyr Y, Advani S, Mesa RA, Mishra S, Mundt DP, Shah DP, Sica RA, Stockerl-Goldstein KE, Stratton C, Weiss M, Beeghly-Fadiel A, Accordino M, Assouline SE, Awosika J, Bakouny Z, Bashir B, Berg S, Bilen MA, Castellano CA, Cogan JC, Kc D, Friese CR, Gupta S, Hausrath D, Hwang C, Johnson NA, Joshi M, Kasi A, Klein EJ, Koshkin VS, Kuderer NM, Kwon DH, Labaki C, Latif T, Lau E, Li X, Lyman GH, McKay RR, Nagaraj G, Nizam A, Nonato TK, Olszewski AJ, Polimera HV, Portuguese AJ, Puc MM, Razavi P, Rosovski R, Schmidt A, Shah SA, Shastri A, Su C, Torka P, Wise-Draper TM, Zubiri L, Warner JL, and Thompson MA

Subjects
COVID-19 Testing, Humans, Risk Factors, SARS-CoV-2, COVID-19 epidemiology, Lymphatic Diseases, Neoplasms epidemiology
Abstract

Patients with B-lymphoid malignancies have been consistently identified as a population at high risk of severe COVID-19. Whether this is exclusively due to cancer-related deficits in humoral and cellular immunity, or whether risk of severe COVID-19 is increased by anticancer therapy, is uncertain. Using data derived from the COVID-19 and Cancer Consortium (CCC19), we show that patients treated for B-lymphoid malignancies have an increased risk of severe COVID-19 compared with control populations of patients with non-B-lymphoid malignancies. Among patients with B-lymphoid malignancies, those who received anticancer therapy within 12 months of COVID-19 diagnosis experienced increased COVID-19 severity compared with patients with non-recently treated B-lymphoid malignancies, after adjustment for cancer status and several other prognostic factors. Our findings suggest that patients recently treated for a B-lymphoid malignancy are at uniquely high risk for severe COVID-19., Significance: Our study suggests that recent therapy for a B-lymphoid malignancy is an independent risk factor for COVID-19 severity. These findings provide rationale to develop mitigation strategies targeted at the uniquely high-risk population of patients with recently treated B-lymphoid malignancies. This article is highlighted in the In This Issue feature, p. 171., (©2022 American Association for Cancer Research.)

Published
2022
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2. Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.

Author

Rivera DR, Peters S, Panagiotou OA, Shah DP, Kuderer NM, Hsu CY, Rubinstein SM, Lee BJ, Choueiri TK, de Lima Lopes G Jr, Grivas P, Painter CA, Rini BI, Thompson MA, Arcobello J, Bakouny Z, Doroshow DB, Egan PC, Farmakiotis D, Fecher LA, Friese CR, Galsky MD, Goel S, Gupta S, Halfdanarson TR, Halmos B, Hawley JE, Khaki AR, Lemmon CA, Mishra S, Olszewski AJ, Pennell NA, Puc MM, Revankar SG, Schapira L, Schmidt A, Schwartz GK, Shah SA, Wu JT, Xie Z, Yeh AC, Zhu H, Shyr Y, Lyman GH, and Warner JL

Subjects
Adenosine Monophosphate analogs & derivatives, Adenosine Monophosphate therapeutic use, Age Factors, Aged, Alanine analogs & derivatives, Alanine therapeutic use, Betacoronavirus pathogenicity, COVID-19, Clinical Decision-Making, Coronavirus Infections complications, Coronavirus Infections diagnosis, Coronavirus Infections mortality, Drug Therapy, Combination methods, Drug Therapy, Combination statistics & numerical data, Follow-Up Studies, Glucocorticoids therapeutic use, Hospital Mortality, Humans, Hydroxychloroquine therapeutic use, Male, Middle Aged, Neoplasms complications, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral diagnosis, Pneumonia, Viral mortality, Risk Factors, SARS-CoV-2, Severity of Illness Index, Sex Factors, Treatment Outcome, United States epidemiology, COVID-19 Drug Treatment, Coronavirus Infections drug therapy, Drug Utilization statistics & numerical data, Healthcare Disparities statistics & numerical data, Neoplasms mortality, Pneumonia, Viral drug therapy
Abstract

Among 2,186 U.S. adults with invasive cancer and laboratory-confirmed SARS-CoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. Although observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through inclusive prospective controlled trials. SIGNIFICANCE: Evaluating the potential role of COVID-19 treatments in patients with cancer in a large observational study, there was no statistically significant 30-day all-cause mortality benefit with hydroxychloroquine or high-dose corticosteroids alone or in combination; remdesivir showed potential benefit. Treatment receipt reflects clinical decision-making and suggests disparities in medication access. This article is highlighted in the In This Issue feature, p. 1426 ., (©2020 American Association for Cancer Research.)

Published
2020
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