Cancer Patients With COVID-19 Less Likely to Receive Critical Care Despite Higher Risk of Death

Patients with cancer who are hospitalized for COVID-19 have an increased risk of death but are less likely to receive critical care, when compared with COVID-19 patients who don’t have cancer, according to a large, prospective study.

These results, from the ISARIC WHO CCP-UK study, were presented at the European Society for Medical Oncology (ESMO) Congress 2021 by Tom Drake, MBChB, of the University of Edinburgh in Scotland.

Dr Drake reported results for 195,492 patients who were admitted to the hospital with proven SARS-CoV-2 infection and had complete outcome data. In this group, there were 20,607 cancer patients, including those with a history of cancer (7.8%) and those receiving active anticancer treatment (2.7%).

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In-hospital mortality was significantly higher among patients with cancer. The group without cancer had a mortality rate of 23.6%, compared with 38.9% among patients with a history of cancer (adjusted hazard ratio [aHR], 1.18; 95% CI, 1.10-1.27; P <.001) and 37.6% among patients receiving active anticancer therapy (aHR, 1.57; 95% CI, 1.48-1.66; P <.001).

Despite the increased risk of mortality, patients with cancer were significantly less likely to receive critical care, whether they were receiving active anticancer treatment (adjusted odds ratio [aOR], 0.68; 95% CI, 0.62-0.74; P <.001) or not (aOR, 0.83; 95% CI, 0.72-0.95; P =.008).

There was a reduction in death over time for the non-cancer patients but not for the patients with cancer, “and we’re not sure what is driving this,” Dr Drake said. There were no substantial differences in age or the distribution of comorbidities across the groups.

However, among the cancer patients, increasing age was associated with a decrease in the relative risk of death, compared with non-cancer patients of the same age. For example, the data suggest that an 80-year-old cancer patient has a 1.15-fold higher risk of in-hospital death from COVID-19, when compared with non-cancer patients of the same age. On the other hand, a 20-year-old cancer patient has a 9-fold increase in the risk of in-hospital death compared with non-cancer patients of the same age.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Drake T, Palmieri C, Turtle L, et al. Prospective data of >20,000 hospitalised patients with cancer and COVID-19 derived from the International Severe Acute Respiratory and emerging Infections Consortium WHO Coronavirus Clinical Characterisation  Consortium: CCP-CANCER UK. Presented at: European Society for Medical Oncology (ESMO) Congress 2021; September 16-21, 2021. Abstract LBA60.

This article originally appeared on Cancer Therapy Advisor