Impact of COVID-19 in patients on active melanoma therapy and with history of melanoma
Authors: Johnson Douglas B. , Atkins Michael B. , Hennessy Cassandra , Wise-Draper Trisha , Heilman Hannah , Awosika Joy , Bakouny Ziad , Labaki Chris , Saliby Renee Maria , Hwang Clara , Singh Sunny R. K. , Balanchivadze Nino , Friese Christopher R. , Fecher Leslie A. , Yoon James J. , Hayes-Lattin Brandon , Bilen Mehmet A. , Castellano Cecilia A. , Lyman Gary H. , Tachiki Lisa , Shah Sumit A. , Glover Michael J. , Flora Daniel B. , Wulff-Burchfield Elizabeth , Kasi Anup , Abbasi Saqib H. , Farmakiotis Dimitrios , Viera Kendra , Klein Elizabeth J. , Weissman Lisa B. , Jani Chinmay , Puc Matthew , Fahey Catherine C. , Reuben Daniel Y. , Mishra Sanjay , Beeghly-Fadiel Alicia , French Benjamin , Warner Jeremy L. ,   COVID-19 and Cancer Consortium, Reid Sonya A. , Brown Alaina J. , Cheng Alex , Croessmann Sarah , Davis Elizabeth J. , Enriquez Kyle T. , Gillaspie Erin A. , Hausrath Daniel , Li Xuanyi , Slosky David A. , Solorzano Carmen C. , Tucker Matthew D. , Vega-Luna Karen , Wang Lucy L. , Wise-Draper Trisha M. , Ahmad Syed A. , Grover Punita , Gulati Shuchi , Kharofa Jordan , Latif Tahir , Marcum Michelle , Sohal Davendra P. S. , Zamulko Olga , Choueiri Toni K. , Connors Jean M. , Demetri George D. , Duma Narjust , Freeman Dory A. , Giordano Antonio , Morgans Alicia K. , Nohria Anju , Saliby Renee-Maria , Schmidt Andrew L. , Van Allen Eliezer M. , Xu Wenxin , Zon Rebecca L. , Gadgeel Shirish M. , Tejwani Sheela , Boldt Anne , Cohen Aaron M. , McWeeney Shannon , Nemecek Eneida R. , Williamson Staci P. , Ravindranathan Deepak , Graber Jerome J. , Grivas Petros , Hawley Jessica E. , Loggers Elizabeth T. , Lynch Ryan C. , Nakasone Elizabeth S. , Schweizer Michael T. , Vinayak Shaveta , Wagner Michael J. , Yeh Albert , Cabebe Elwyn C. , Glover Michael J. , Jha Alokkumar , Khaki Ali Raza , Schapira Lidia , Wu Julie Tsu-Yu , Kloecker Goetz , Logan Barbara B. , Mandapakala Chaitanya , Rock Crosby D. , Arvanitis Panos , Egan Pamela C. , Khan Hina , Olszewski Adam J. , Vieira Kendra , Weissmann Lisa B. , Bhatt Padmanabh S. , Mariano Melissa G. , Thomson Carey C. , Carducci Theresa M. , Goldsmith Karen J. , Van Loon Susan , Alexander Mariam , Matar Sara , Mushtaq Sarah , Stockerl-Goldstein Keith E. , Butt Omar , Fiala Mark A. , Henderson Jeffrey P. , Monahan Ryan S. , Zhou Alice Y. , Lammers Philip E. , Revankar Sanjay G. , Del Prete Salvatore A. , Bar Michael H. , Gulati Anthony P. , Lo K. M. Steve , Rose Suzanne J. , Stratton Jamie , Weinstein Paul L. , Gupta Shilpa , Pennell Nathan A. , Ahluwalia Manmeet S. , Dawsey Scott J. , Lemmon Christopher A. , Nizam Amanda , Sharifi Nima , Hoppenot Claire , Li Ang , Halabi Susan , Dzimitrowicz Hannah , Zhang Tian , Goyal Sharad , Huynh-Le Minh-Phuong , Yu Peter Paul , Clement Jessica M. , Daher Ahmad , Dailey Mark E. , Elias Rawad , Jayaraj Asha , Hsu Emily , Menendez Alvaro G. , Serrano Oscar K. , Accordino Melissa K. , Bhutani Divaya , Hershman Dawn , Ingham Matthew A. , Schwartz Gary K. , Bernicker Eric H. , Deeken John F. , Shafer Danielle , Ruíz-García Erika , Ramirez Ana , Vilar-Compte Diana , Lewis Mark A. , Rhodes Terence D. , Gill David M. , Low Clarke A. , Mashru Sandeep H. , Mansoor Abdul-Hai , Lewis Grant C. , Smith Stephanie J. , Zaren Howard A. , Nagaraj Gayathri , Akhtari Mojtaba , Castillo Dan R. , Lau Eric , Reeves Mark E. , Berg Stephanie , Knox Natalie , O’Connor Timothy E. , Durbin Eric B. , Kulkarni Amit A. , Nelson Heather H. , Sachs Zohar , Rosovsky Rachel P. , Reynolds Kerry L. , Bardia Aditya , Boland Genevieve , Gainor Justin F. , Zubiri Leyre , Halfdanarson Thorvardur R. , Bekaii-Saab Tanios S. , Desai Aakash , Riaz Irbaz B. , Shah Surbhi , Smith Katherine E. , Williams Colt , Bouganim Nathaniel , Elkrief Arielle , Panasci Justin , Vinh Donald C. , Riely Gregory J. , Belenkaya Rimma , Philip John , Faller Bryan , McKay Rana R. , Ajmera Archana , Brouha Sharon S. , Choi Sharon , Hsiao Albert , Kligerman Seth , Nonato Taylor K. , Blau Erin G. Reid Sibel , Jhawar Sachin R. , Addison Daniel , Chen James L. , Gatti-Mays Margaret E. , Karivedu Vidhya , Karivedu Vidhya , Palmer Joshua D. , Stover Daniel G. , Wall Sarah , Williams Nicole O. , Joshi Monika , Polimera Hyma V. , Pomerantz Lauren D. , Rovito Marc A. , Griffiths Elizabeth A. , Advani Pragati G. , Puzanov Igor , Jabbour Salma K. , Misdary Christian F. , Shah Mansi R. , Batist Gerald , Cook Erin , Dutra Miriam Santos , Ferrario Cristiano , Miller Wilson H. , Bashir Babar , McNair Christopher , Mahmood Sana Z. , Mico Vasil , Rivera Andrea Verghese , Edwin Natasha C. , Smits Melissa , Doroshow Deborah B. , Galsky Matthew D. , Wotman Michael , Fazio Alyson , Fu Julie C. , Huber Kathryn E. , Sueyoshi Mark H. , Koshkin Vadim S. , Borno Hala T. , Kwon Daniel H. , Small Eric J. , Zhang Sylvia , Rubinstein Samuel M. , Wood William A. , Andermann Tessa M. , Jensen Christopher , Bowles Daniel W. , Geiger Christoper L. , Feldman Lawrence E. , Hoskins Kent F. , Gantt Gerald , Liu Li C. , Khan Mahir , Nguyen Ryan H. , Pasquinelli Mary , Schwartz Candice , Venepalli Neeta K. , Mavromatis Blanche H. , Bijjula Ragneel R. , Zaman Qamar U. , Aboulafiam David M. , Schroeder Brett A. , Topaloglu Umit , Alimohamed Saif I. , Moore Joan K. , Peddi Prakash , Rosen Lane R. , McCollough Briana Barrow , Hafez Navid , Herbst Roy , LoRusso Patricia , Lustberg Maryam B. , Masters Tyler , Stratton Catherine 
Published: March 2023

Abstract
Introduction
COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy.

Methods
Using the COVID-19 and Cancer Consortium (CCC19) registry, we identified 307 patients with melanoma diagnosed with COVID-19. We used multivariable models to assess demographic, cancer-related, and treatment-related factors associated with COVID-19 severity on a 6-level ordinal severity scale. We assessed whether treatment was associated with increased cardiac or pulmonary dysfunction among hospitalized patients and assessed mortality among patients with a history of melanoma compared with other cancer survivors.

Results
Of 307 patients, 52 received immunotherapy (17%), and 32 targeted therapy (10%) in the previous 3 months. Using multivariable analyses, these treatments were not associated with COVID-19 severity (immunotherapy OR 0.51, 95% CI 0.19 – 1.39; targeted therapy OR 1.89, 95% CI 0.64 – 5.55). Among hospitalized patients, no signals of increased cardiac or pulmonary organ dysfunction, as measured by troponin, brain natriuretic peptide, and oxygenation were noted. Patients with a history of melanoma had similar 90-day mortality compared with other cancer survivors (OR 1.21, 95% CI 0.62 – 2.35).

Conclusions
Melanoma therapies did not appear to be associated with increased severity of COVID-19 or worsening organ dysfunction. Patients with history of melanoma had similar 90-day survival following COVID-19 compared with other cancer survivors.