International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship
Authors: Raad Issam , Hachem Ray , Masayuki Nigo , Datoguia Tarcila , Dagher Hiba , Jiang Ying , Subbiah Vivek , Siddiqui Bilal , Bayle Arnaud , Somer Robert , Cruz Ana Fernández , Gorak Edward , Bhinder Arvinder , Mori Nobuyoshi , Hamerschlak Nelson , Shelanski Samuel , Dragivich Tomislav , Kiat Yee Elise Vong , Fakhreddine Suha , Hanna Pierre Abi , Chemaly Roy F. , Mulanovich Victor , Adachi Javier , Borjan Jovan , Khawaja Fareed , Granwehr Bruno , John Teny , Guevara Eduardo Yepez , Torres Harrys , Ammakkanavar Natraj Reddy , Yibirin Marcel , Reyes-Gibby Cielito C , Pande Mala , Ali Noman , Rojo Raniv Dawey , Ali Shahnoor M , Deeba Rita E , Chaftari Patrick , Matsuo Takahiro , Ishikawa Kazuhiro , Hasegawa Ryo , Aguado-Noya Ramón , García-García Álvaro , Puchol Cristina Traseira , Lee Dong-Gun , Slavin Monica , Teh Benjamin , Arias Cesar A ,   Data-Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE) Team, Kontoyiannis Dimitrios P. , Malek Alexandre E. , Chaftari Anne-Marie 
Published: August 2022

Background

In this international multicenter study we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries.

Methods

We retrospectively collected de-identified data on a cohort of cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, from 16 international centers.

Results

We analyzed 3966 COVID-19 confirmed patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were more likely to be pancytopenic, and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding two weeks (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms (p≤0.01). By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46; 95% CI 1.03 to 2.07; p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55; 95% CI 3.34 to6.20; p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58; CI 0.39-0.88; p=0.009). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who did not (5.9% vs 17.6%; p=0.03).

Conclusions

Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality.

Condensed Abstract

In this large multicenter worldwide study of 4015 patients with COVID-19 that included 1115 patients with cancer, we found that cancer is an independent risk factor for increased 30-day all-cause mortality. Remdesivir is a promising treatment modality to reduce 30-day all-cause mortality.