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

• Published in: Therapeutic advances in medical oncology 2020, Vol.12, p.1758835920956803-1758835920956803
• Main Authors: Joharatnam-Hogan, Nalinie, Hochhauser, Daniel, Shiu, Kai-Keen, Rush, Hannah, Crolley, Valerie, Wilson, William, Sharma, Anand, Muhammad, Aun, Anwar, Muhammad, Vasdev, Nikhil, Goldstein, Robert, Kantser, Ganna, Saha, Aramita, Raja, Fharat, Bridgewater, John, Khan, Khurum
• Format: Article
• Language: English
• Subjects: Original Research
• ISSN: 1758-8359; 1758-8340; 1758-8359
• DOI: 10.1177/1758835920956803

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.