International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship

Issam Raad; Ray Hachem; Masayuki Nigo; Tarcila Datoguia; Hiba Dagher; Ying Jiang; Vivek Subbiah; Bilal Siddiqui; Arnaud Bayle; Robert Somer; Ana Fernandez-Cruz; Edward Gorak; Arvinder Bhinder; Mori Nobuyoshi; Nelson Hamerschlak; Samuel Shelanski; Tomislav Dragovich; Yee Elise Vong Kiat; Suha Fakhreddine; Pierre Abi Hanna; Roy F Chemaly; Victor Mulanovich; Javier A Adachi; Jovan Borjan; Fareed Khawaja; Bruno Granwehr; Teny John; Eduardo Yepez Guevara; Harrys Torres; Natraj Reddy Ammakkanavar; Marcel Yibirin; Cielito Reyes; Mala Pande; Noman Ali; Raniv Rojo; Shahnoor Ali; Rita Deeba; Patrick Chaftari; Takahiro Matsuo; Kazuhiro Ishikawa; Ryo Hasegawa; Ramon Aguado-Noya; Alvaro Garcia Garcia; Cristina Traseira Puchol; Dong-Gun Lee; Monica Slavin; Benjamin W Teh; Cesar A Arias; Dimitrios Kontoyiannis; Alexandre E. Malek; Anne Marie Chaftari

Issam Raad, Ray Hachem, Nigo Masayuki, Tarcila Datoguia, Hiba Dagher, Ying Jiang, Vivek Subbiah, Bilal Siddiqui, Arnaud Bayle, Robert Somer, Ana Fernández Cruz, Edward Gorak, Arvinder Bhinder, Nobuyoshi Mori, Nelson Hamerschlak, Samuel Shelanski, Tomislav Dragivich, Yee Elise Vong Kiat, Suha Fakhreddine, Pierre Abi Hanna, Roy F Chemaly, Victor Mulanovich, Javier Adachi, Jovan Borjan, Fareed Khawaja, Bruno Granwehr, Teny John, Eduardo Yepez Guevara, Harrys Torres, Natraj Reddy Ammakkanavar, Marcel Yibirin, Cielito C Reyes-Gibby, Mala Pande, Noman Ali, Raniv Dawey Rojo, Shahnoor M Ali, Rita E Deeba, Patrick Chaftari, Takahiro Matsuo, Kazuhiro Ishikawa, Ryo Hasegawa, Ramón Aguado-Noya, Álvaro García-García, Cristina Traseira Puchol, Dong-Gun Lee, Monica Slavin, Benjamin Teh, Cesar A Arias, Dimitrios P Kontoyiannis, Alexandre E Malek, Anne-Marie Chaftari

doi:10.1101/2022.08.25.22279181

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 30day 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. .

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DOI record: { "DOI": "10.1101/2022.08.25.22279181", "URL": "http://dx.doi.org/10.1101/2022.08.25.22279181", "abstract": "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.\n 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.\nResults: 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). \nConclusions: Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. 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