Institut za onkologiju i radiologiju Srbije / Institute for Oncology and Radiology of Serbia
Published May 8, 2022 | Version v.1
Journal article Open

COVID-19 in patients with cancer: first report of the ESMO international, registry-based, cohort study (ESMO-CoCARE).

Creators

  • 1. Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal.
  • 2. Frontier Science Foundation-Hellas, Athens, Greece
  • 3. Medical Oncology Department, The Royal Marsden Hospital e NHS Foundation Trust, London, UK
  • 4. Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
  • 5. World-Class Research Center 'Digital Biodesign and Personalized Healthcare', Sechenov First Moscow State Medical University, Moscow, Russia
  • 6. Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
  • 7. Medical Oncology Department, The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
  • 8. Medical Oncology Department, Fundeni Clinical Institute, Bucharest, Romania
  • 9. Servico Oncologia, Hospital Prof. Dr Fernando Fonseca EPE (Hospital Amadora/Sintra), Amadora, Portugal.
  • 10. Medical Oncology Department, South Egypt Cancer Institute (SECI), Assiut University, Assiut, Egypt
  • 11. Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • 12. Department of Surgery, Oncology Division, Sebelas Maret University, Surakarta, Indonesia.
  • 13. Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
  • 14. Oncology Department, Dr Saadane Hospital, Biskra, Algeria.
  • 15. Oncology Deparment, ASO 'SS. Antonio, Biagio e Cesare Arrigo', Alessandria, Italy
  • 16. Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
  • 17. Asian Cancer Institute - Asian Hospital and Medical Center, Metro Manila, the Philippines
  • 18. Vanderbilt University Medical Center, Nashville, USA.
  • 19. The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA.; Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
  • 20. Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
  • 21. Oncology, Haematology, Palliative Care Department, Asklepios Klinik Altona - Asklepios Kliniken, Hamburg, Germany.
  • 22. Division of Radiotherapy and Imaging, The Royal Marsden/The Institute of Cancer Research NIHR Biomedical Research Centre, London, UK.
  • 23. Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens Frontier Science Foundation-Hellas, Athens, Greece.
  • 24. Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland.
  • 25. Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
  • 26. Center for Cancer Immunotherapy, Department of Oncology, PSL Research University, Institut Curie, Paris, France. Electronic address: emanuela.romano@curie.fr.

Description

Abstract

Background: ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection.

Results: This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m2, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. Conclusions: Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.

Notes

Funding: European Society for Medical Oncology (ESMO).

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