Systemic Anti-Cancer Therapy and Metastatic Cancer Are Independent Mortality Risk Factors during Two UK Waves of the COVID-19 Pandemic at University College London Hospital

• Published in: Cancers Vol. 13; no. 23; p. 6085
• Main Authors: Wong, Yien Ning Sophia, Sng, Christopher C T, Ottaviani, Diego, Patel, Grisma, Chowdhury, Amani, Earnshaw, Irina, Sinclair, Alasdair, Merry, Eve, Wu, Anjui, Galazi, Myria, Benafif, Sarah, Soosaipillai, Gehan, Chopra, Neha, Roylance, Rebecca, Shaw, Heather, Lee, Alvin J X
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.12.2021; MDPI
• Subjects: Cancer; Cancer therapies; Chemotherapy; Coronaviruses; COVID-19; COVID-19 vaccines; Cytotoxicity; Data collection; Death; Demography; Ethics; FDA approval; Hospitals; Immunization; Immunosuppression; Immunotherapy; Infections; Laboratories; Metastases; Morbidity; Mortality; Pandemics; Patients; Risk factors; Severe acute respiratory syndrome coronavirus 2; University colleges; United Kingdom > UK; COVID-19; risk factors; B.1.1.7; co-morbidity; SARS-CoV-2 infection; systemic anti-cancer therapy; second wave; solid cancer; alpha variant
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13236085

An increased mortality risk was observed in patients with cancer during the first wave of COVID-19. Here, we describe determinants of mortality in patients with solid cancer comparing the first and second waves of COVID-19. A retrospective analysis encompassing two waves of COVID-19 (March-May 2020; December 2020-February 2021) was performed. 207 patients with cancer were matched to 452 patients without cancer. Patient demographics and oncological variables such as cancer subtype, staging and anti-cancer treatment were evaluated for association with COVID-19 mortality. Overall mortality was lower in wave two compared to wave one, HR 0.41 (95% CI: 0.30-0.56). In patients with cancer, mortality was 43.6% in wave one and 15.9% in wave two. In hospitalized patients, after adjusting for age, ethnicity and co-morbidities, a history of cancer was associated with increased mortality in wave one but not wave two. In summary, the second UK wave of COVID-19 is associated with lower mortality in hospitalized patients. A history of solid cancer was not associated with increased mortality despite the dominance of the more transmissible B.1.1.7 SARS-CoV-2 variant. In both waves, metastatic disease and systemic anti-cancer treatment appeared to be independent risk factors for death within the combined cancer cohort.