The Ochsner Cancer Institute has announced key findings from a retrospective study comparing COVID-19 mortality rates in positive patients with and without cancer in Louisiana. It was published last week in the prestigious oncology journal, Cancer. The study evaluated 312 Ochsner Health cancer patients who tested positive for COVID-19 between March 1 and April 30, 2020 and compared that group’s mortality rates with 4,833 Ochsner Health COVID-19-positive patients without cancer during that same time period.
Multivariate Mortality Analyses in COVID-19: Comparing Patients With Cancer and Patients Without Cancer in Louisiana is the largest study of COVID-19-positive patients with cancer versus patients without cancer to date and is the first multivariate analysis study comparing these two patient populations. It was an observational analysis that included 36 different Ochsner Health hospitals and clinics across Louisiana. International Classification of Diseases, Tenth Revision codes were used to identify adult patients with active cancer or a history of cancer within the Ochsner Health system. To meet the criteria to be included in the non-cancer population studied, adult patients had to have at least one encounter in the Ochsner Health system between Jan. 1, 2019 and the date of their COVID-19 test and no cancer diagnosis recorded between Jan. 1, 2019 and the date of their COVID-19 test.
Key Findings:
-In the study’s cohort of patients with cancer who were also infected with COVID-19, the mortality rate was 21.2%. In the non-cancer group, the COVID-19 mortality rate was 8.7%.
-Patients with cancer who are 65 years of age or older and those with certain comorbidities have the greatest risk of death.
-Patients with cancer and a history of smoking are four times more likely to die from COVID-19.
-Recent cancer-directed therapy, type of cancer and disease progression also played roles in mortality. This is the first study that suggests cancer patients receiving recent cancer-directed therapy are at increased risk of death.
-Patients with a hematologic cancer (leukemia, lymphoma and other blood-related cancers) had a 31.1% increased mortality versus patients with an oncologic malignancy (breast, prostate and other cancerous masses) who had a 18.7% increase in mortality.
-36.4% of patients who died had active or progressive cancer at the time of infection and 17.7% died during post-treatment follow-up or maintenance therapy.
-Those with a recent diagnosis were more likely to die than those with a distant history of cancer (32.8% vs. 12%).
-Although the majority of patients studied in the cancer population were non-Hispanic Black (63.1%), mortality was not statistically affected by race.
What the Study Tells Us:
Confirms that patients with cancer are at increased risk of death from COVID-19 and there is great potential and necessity to create and adopt strategies to protect this population in future outbreaks.
The COVID-19 pandemic has affected millions of people worldwide and New Orleans was an early hotspot in the virus’ initial emergence in the U.S. According to Ochsner oncology researchers, the impact on cancer patients is an important area of investigation. Cancer is the second most common cause of death globally and Louisiana has the ninth-highest incident rate of cancer in the country according to the U.S. Centers for Disease Control. This made the state a unique population to study during this global pandemic.
Both the study and the published article were written by Principal Investigator Michael Lunski, MD, hematology/medical oncology fellow at The Gayle and Tom Benson Cancer Center at Ochsner Medical Center in New Orleans.
“Although patient-derived data from the COVID-19 pandemic is constantly changing, it is clear that the cancer patient population is at increased risk compared to those without cancer,” said Lunski. “Because we now have data showing that patients on active therapy are at an even more increased risk, extra efforts to protect these patients must be made.”
The Ochsner Cancer Institute, like all Ochsner Health hospitals and clinics, has established “Safe to Return” guidelines for patients undergoing cancer-directed therapy to ensure patient safety while providing optimal cancer care.
Lunski advised, “It is critical that people do not delay their medical care and that includes routine cancer screenings. Since we know that those with cancer are at increased risk for death from COVID-19, our primary goal is to prevent a cancer diagnosis or catch it at its earliest stage to further reduce someone’s risk of the severest consequence of this virus. It’s important to talk with a doctor about when and how often cancer screenings should be done.”