In a recent study published on the website of the medRxiv*, researchers analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcomes by cancer status, treatment, type, and SARS-CoV-2 vaccination.
context
The 2019 coronavirus (COVID-19) pandemic has resulted in more than two million cases and 35,000 deaths in Michigan. Observational surveys have recognized people with cancer as a subpopulation possibly at increased risk for serious COVID-19 and SARS-CoV-2-related deaths.
Previous studies have shown that cancer patients have a higher risk of death from COVID-19, but it is unclear how this relationship differs by cancer site, cancer treatment, and vaccination status against cancer. against SARS-CoV-2. Given the dramatic drop in the availability of and demand for cancer services, such as urgent referrals and attendance for chemotherapy, during the COVID-19 pandemic, it is critical to determine how the diagnosis and treatments of cancer cancer are linked to SARS-CoV-2 diagnosis and outcomes.
About the study
In the current study, researchers assessed whether a cancer diagnosis increased the likelihood of hospital admission, intensive care unit (ICU) admission, all-cause death at 60 days, and COVID- 19 severe associated with SARS-CoV-2, i.e. one of the previous findings.
From March 10, 2020 through February 2, 2022, the team identified 259,893 people who were tested or diagnosed for SARS-CoV-2 infection using information from the University of Michigan’s electronic medical records (EMRs). , a large academic medical institution.
The team used Firth-corrected and covariate-adjusted logistic regression to analyze the association between cancer type, cancer status, and cancer treatment and four SARS-CoV-2 outcomes: admission to the COVID-related hospital, intensive care unit (ICU) admission, death, and a “serious COVID-19” cumulative outcome that combines the first three. They also investigated the impact of the association of the timing of cancer diagnosis and treatment with the diagnosis of SARS-CoV-2 infection and the influence of vaccination against COVID-19.
Results
The study results indicate that of the 41,218 people who tested positive for SARS-CoV-2 infection, 10,266 had been diagnosed with cancer in the past or currently. The authors found that cancer status was linked to higher rates of severe COVID-19, SARS-CoV-2-related hospitalization, and 60-day death from all causes, consistent with previous studies. Since no relationship was detected in people who had their first diagnosis of cancer more than three years previously, it is patients whose most recent first cancer diagnosis was within the last three years who are considered. origin of these links.
Cancer patients on chemotherapy had strong associations with all four SARS-CoV-2 outcomes, including severe COVID. Moreover, as the time since the last chemotherapy treatment increased, this link weakened but remained substantial after three or more years. In contrast, neither radiation therapy nor surgery was linked to poorer COVID-19 outcomes. However, sensitivity assessments indicated that last radiation therapy could be correlated with severe SARS-CoV-2 infection, COVID-19-related hospitalization, and ICU admission.
Looking at cancer types, lung cancer and hematological malignancies were strongly linked to an increased risk of SARS-CoV-2-related hospitalization. While hematological malignancies were linked to ICU admission and death associated with COVID-19, breast cancer, prostate cancer and melanoma were not linked to poor COVID-19 outcomes. 19. The researchers found that cancer patients receiving chemotherapy were still linked to a higher risk of severe COVID-19, all-cause death at 60 days, and hospitalization, even when excluding hematological malignancies. Although scientists have found these links credible, they are likely exaggerated since chemotherapy could be a substitute for people with advanced cancer.
COVID-19 vaccinations have been observed to minimize the frequency of all four COVID-19 outcomes, independent of cancer status. However, even among those vaccinated, those with cancer were more likely to have severe COVID-19 than those without.
Conclusions
The present study shed light on the link between cancer diagnosis, therapy, cancer type, COVID-19 vaccination and SARS-CoV-2 outcomes. The study results suggest that specific cancer diagnoses, such as lung cancer and hematological malignancies, as well as cancer therapies, such as chemotherapy, are linked to poor outcomes for SARS-CoV-2. Furthermore, COVID-19 vaccines minimize the likelihood of a severe outcome from SARS-CoV-2, in both cancer and non-cancer patients. The present study indicates that, even after vaccination against COVID-19, cancer patients are still at higher risk of developing rupture infections due to SARS-CoV-2 and having a more severe COVID outcome. -19.
These data could contribute to the identification of risks and the development of suitable treatment and prevention efforts for SARS-CoV-2 infection in cancer patients. The authors said future studies should consider post-acute sequelae of COVID-19 (PASC) as a consequence of SARS-CoV-2 and further examine the impact of cancer types, therapies and vaccination. against SARS-CoV-2 on the consequences of COVID-19.
*bird is important
medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered conclusive, guide clinical practice/health behavior, or be treated as established information.
Journal reference:
- Maxwell Salvatore, Miriam M Hu, Lauren J Beesley, Alison Mondul, Celeste Leigh Pearce, Christopher R Friese, Lars G. Fritsche, Bhramar Mukherjee. (2022). COVID-19 study results by cancer status, type, treatment and vaccination. medRxiv. doi: https://doi.org/10.1101/2022.04.19.22274047 https://www.medrxiv.org/content/10.1101/2022.04.19.22274047v1