Abstract S11-03: The impact of COVID-19 in the cancer population stratified by age: A real-world data study from Guy’s Cancer Center
Authors: Sylva Rushan , Russell Beth , Moss Charlotte , George Gincy , Palmer Kieran , Shah Vallari , Ko Thinzar Ko , Kalsi Tania , Harari Danielle , De Michele Luigi , Kordasti Shahram , Crawley Danielle , Wylie Harriet , Cahill Fidelma , Haire Anna , D'Souza Andrea , Gomberg Simon , Kulasekararaj Austin , Van Hemelrijck Mieke , Dolly Saoirse 
Published: March 2021

Abstract
Background It is widely accepted that advancing age is associated with worse COVID-19 outcomes. However, there is insufficient data analyzing the impact of COVID-19 in the older cancer population. The aim of the study is to establish if age has an influence on severity and mortality of COVID-19 in cancer patients. Methods We reviewed 306 oncology patients with PCR-confirmed COVID-19 from Guy’s Cancer Centre and its partner Trust King’s College Hospital, between 29 February – 31 July 2020. Demographic and tumor characteristics in relation to COVID-19 severity and death were assessed with logistic and Cox proportional hazards regression models, stratified by age (≤65 and &gt;65 years). Severity of COVID-19 was classified by World Health Organization (WHO) grading. Results A total of 135 patients were aged ≤65 years (44%) and 171 aged &gt;65 (56%). Severe COVID-19 presentation was seen in 27% of those aged ≤65 and 30% of those aged &gt;65. The COVID-19 mortality rate was 19% in those aged ≤65 and 27% in those aged &gt;65. In the older cohort, there was an increased incidence of severe disease in Caucasian ethnicity compared to the younger cohort (55% vs 43%) and compared to severe disease in Black and Asian ethnicities. There were increased co-morbidities in the older cohort including hypertension (54% vs 32%), diabetes (30% vs 12%) with increased rate of poly-pharmacy (62% vs 40%) compared to the younger cohort. In terms of cancer characteristics in the older cohort, there was a higher rate of patients with cancer for more than 2 years (53% vs 32%) and performance status of 3 (22% vs 6%). In terms of severity, Asian ethnicity [OR: 3.1 (95% CI: 0.88-10.96) p=0.64] had greater association with increasing COVID-19 severity in those aged &gt;65. Interestingly, there were no positive associations between number of co-morbidities, treatment paradigm or performance status with severity of disease in the older group. The risk of mortality was greater in the elderly cohort with hematological cancer types [HR: 2.69 (1.31-5.53) p=0.85] and having cancer for more than 2 years [2.20 (1.09-4.42) p=0.28] compared to the younger cohort. Conclusions In our study we demonstrate that severity and mortality of COVID-19 did not significantly differ between the two age cohorts except in regards to Asian ethnicity, hematological malignancies and having cancer for more than 2 years. As expected, the older population had more co-morbidities and polypharmacy. Despite this, the incidence of severe COVID-19 was similar regardless of age. Further analyses for other geriatric presentations are ongoing to understand their interaction with COVID-19 in the cancer population.
Citation Format: Rushan Sylva, Beth Russell, Charlotte Moss, Gincy George, Kieran Palmer, Vallari Shah, Thinzar Ko Ko, Tania Kalsi, Danielle Harari, Luigi De Michele, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Andrea D'Souza, Simon Gomberg, Austin Kulasekararaj, Mieke Van Hemelrijck, Saoirse Dolly. The impact of COVID-19 in the cancer population stratified by age: A real-world data study from Guy’s Cancer Center [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S11-03.