Determinants of COVID-19 disease severity in patients with cancer.

As of 10 April 2020, New York State had 180,458 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 9,385 reported deaths. Patients with cancer comprised 8.4% of deceased individuals1. Population-based studies from China and Italy suggested a higher coronavirus disease 2019 (COVID-19) death rate in patients with cancer2,3, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-194. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. From 10 March to 7 April 2020, 423 cases of symptomatic COVID-19 were diagnosed at Memorial Sloan Kettering Cancer Center (from a total of 2,035 patients with cancer tested). Of these, 40% were hospitalized for COVID-19, 20% developed severe respiratory illness (including 9% who required mechanical ventilation) and 12% died within 30 d. Age older than 65 years and treatment with immune checkpoint inhibitors (ICIs) were predictors for hospitalization and severe disease, whereas receipt of chemotherapy and major surgery were not. Overall, COVID-19 in patients with cancer is marked by substantial rates of hospitalization and severe outcomes. The association observed between ICI and COVID-19 outcomes in our study will need further interrogation in tumor-specific cohorts.

Nature medicine. 2020 Jun 24 [Epub]

Elizabeth V Robilotti, N Esther Babady, Peter A Mead, Thierry Rolling, Rocio Perez-Johnston, Marilia Bernardes, Yael Bogler, Mario Caldararo, Cesar J Figueroa, Michael S Glickman, Alexa Joanow, Anna Kaltsas, Yeon Joo Lee, Anabella Lucca, Amanda Mariano, Sejal Morjaria, Tamara Nawar, Genovefa A Papanicolaou, Jacqueline Predmore, Gil Redelman-Sidi, Elizabeth Schmidt, Susan K Seo, Kent Sepkowitz, Monika K Shah, Jedd D Wolchok, Tobias M Hohl, Ying Taur, Mini Kamboj

Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA., Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .

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