COVID ‐19 outcomes in patients with cancer: Findings from the University of California health system database

Journal Article · Tue Mar 08 23:00:00 EST 2022 · Cancer medicine

DOI:https://doi.org/10.1002/cam4.4604· OSTI ID:1854047

Kwon, Daniel H. ^[1]; Cadena, Jose ^[2]; Nguyen, Sam ^[2]; Chan, Kwan Ho Ryan ^[3]; Soper, Braden ^[4]; Gryshuk, Amy L. ^[5]; Hong, Julian C. ^[6]; Ray, Priyadip ^[2]; Huang, Franklin W. ^[7]

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1. Division of Hematology/Oncology, Department of Medicine University of California San Francisco California USA
2. Computational Engineering, Engineering Directorate Lawrence Livermore National Laboratory California USA
3. Computational Engineering, Engineering Directorate Lawrence Livermore National Laboratory California USA, Department of Electrical and Computer Engineering Johns Hopkins University Baltimore Maryland USA
4. Center for Applied Scientific Computing, Computing Directorate Lawrence Livermore National Laboratory California USA
5. Physical and Life Sciences Directorate Lawrence Livermore National Laboratory California USA
6. Helen Diller Family Comprehensive Cancer Center University of California San Francisco San Francisco California USA, Bakar Computational Health Sciences Institute University of California San Francisco California USA, Department of Radiation Oncology University of California San Francisco California USA
7. Division of Hematology/Oncology, Department of Medicine University of California San Francisco California USA, Helen Diller Family Comprehensive Cancer Center University of California San Francisco San Francisco California USA, Bakar Computational Health Sciences Institute University of California San Francisco California USA

Abstract Background

The interaction between cancer diagnoses and COVID‐19 infection and outcomes is unclear. We leveraged a state‐wide, multi‐institutional database to assess cancer‐related risk factors for poor COVID‐19 outcomes.

Methods

We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at 17 California medical centers. We identified adults tested for SARS‐CoV‐2 from 2/1/2020–12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS‐CoV‐2 test. Secondary outcomes were SARS‐CoV‐2 positivity and severe COVID‐19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer‐related factors associated with outcomes.

Results

We identified 409,462 patients undergoing SARS‐CoV‐2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67–0.74, p  < 0.001). Among the 1781 SARS‐CoV‐2‐positive patients with cancer, BCR/ABL‐negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25–3.41, p  = 0.007), venetoclax (RR 2.96, 95% CI: 1.14–5.66, p  = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10–5.19, p  = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID‐19.

Conclusions

In this large, diverse cohort, cancer was associated with a decreased risk of SARS‐CoV‐2 positivity. Patients with BCR/ABL‐negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS‐CoV‐2 infection. Mechanistic and comparative studies are needed to validate findings.

• Sponsoring Organization: USDOE
• OSTI ID: 1854047
• Alternate ID(s): OSTI ID: 1856065; OSTI ID: 2469742
• Journal Information: Cancer medicine, Journal Name: Cancer medicine Journal Issue: 11 Vol. 11; ISSN 2045-7634
• Publisher: Wiley Blackwell (John Wiley & Sons)
• Country of Publication: United Kingdom
• Language: English