Young cancer patients may be more likely to die from COVID-19

Young cancer patients may be more likely to die from COVID-19

Younger patients with cancer may be at increased risk of dying from COVID-19, according to a meta-analysis published in JAMA Network is open.

Researchers have found that being younger, having lung cancer, and having a blood malignancy are all associated with an increased risk of death from COVID-19.

The meta-analysis included 81 studies covering 28 countries. The studies were case-control studies or group studies involving 10 or more patients with malignant disease and COVID-19, with or without a control group. Each control group included non-cancer patients with COVID-19.


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The studies included a total of 61,532 patients with cancer, 58,849 of whom had sufficient data available. Half of these patients were men (52%), and the mean age ranged from 35 to 74 years across the studies.

The pooled relative risk of death was 2.12 in patients with cancer and COVID-19, compared to non-cancer patients with COVID-19 (95% CI, 1.71–2.62; s <.001). When cancer patients and control subjects were matched by age and gender, the RR decreased to 1.69 (95% CI, 1.46–1.95; s <.001).

The risk of death from COVID-19 was significantly higher for patients with lung cancer than for patients with other cancers (RR, 1.68; 95% CI, 1.45-1.94; s <.001). The combined case fatality rate for patients with COVID-19 and lung cancer has been 30%.

The risk of death from COVID-19 was higher for patients with hematological malignancies (RR, 1.42; 95% CI, 1.31-1.54; s <.001) of patients with solid tumors. The pooled mortality rate among patients with COVID-19 and hematological malignancies was 32%.

The researchers evaluated the relationship between age and mortality in cancer patients compared with control individuals, and the results showed a significant reduction in the risk of death with age (odds ratio 0.96; 95% CI, 0.92–0.99; s = .03).

“Given these data, younger patients may, in certain circumstances, be considered a high-risk population due to poor outcomes from COVID-19,” the researchers wrote. The team noted that previous studies have reported increased age as a risk factor for poor outcomes from COVID-19.

“To date, all cohort studies, which inherently lack an age-matched control group, have consistently reported increased age as a risk factor for poor clinical outcome,” the researchers wrote. “Although it is true that older patients have worse absolute outcomes than younger patients, the RR data we found were highest for younger patients.”

“The reasons for this finding are likely to be related to the type of cancer, treatment intensity, or behavioral factors, such as increased social mixing versus the admixture of the older population,” the researchers wrote.

They note several limitations of this study, including the fact that the results were only evaluated for seven types of tumors. Other limitations were the lack of a control group for patients with solid tumors and the inability to assess outcomes using different SARS-CoV-2 variants.

“Ongoing studies … will allow for a more comprehensive comparison of patients with cancer versus control patients, with adjustments for age, sex and other comorbidities, and to identify true risks for different tumor types and treatments with patient-level control of factors,” the researchers wrote.

Disclosures: Some study authors announced their association with biotechnology, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

reference

Khoury E, Nevitt S, Madsen WR, et al. Differences in outcomes and mortality-related factors between patients with SARS-CoV-2 infection and cancer compared with those without cancer. Systematic review and meta-analysis. Gamma neto is open. Published online May 2, 2022. doi: 10.1001 / jamanetworkopen.2022.10880

2022-05-16 15:30:00

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