Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.
Identifieur interne : 000002 ( Main/Corpus ); précédent : 000001; suivant : 000003Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.
Auteurs : Clara Hwang ; Monika A. Izano ; Michael A. Thompson ; Shirish M. Gadgeel ; James L. Weese ; Tom Mikkelsen ; Andrew Schrag ; Mahder Teka ; Sheetal Walters ; Frank M. Wolf ; Jonathan Hirsch ; Donna R. Rivera ; Paul G. Kluetz ; Harpreet Singh ; Thomas D. BrownSource :
- Cancer reports (Hoboken, N.J.) [ 2573-8348 ] ; 2021.
Abstract
BACKGROUND
The understanding of the impact of COVID-19 in patients with cancer is evolving, with need for rapid analysis.
AIMS
This study aims to compare the clinical and demographic characteristics of patients with cancer (with and without COVID-19) and characterize the clinical outcomes of patients with COVID-19 and cancer.
METHODS AND RESULTS
Real-world data (RWD) from two health systems were used to identify 146 702 adults diagnosed with cancer between 2015 and 2020; 1267 COVID-19 cases were identified between February 1 and July 30, 2020. Demographic, clinical, and socioeconomic characteristics were extracted. Incidence of all-cause mortality, hospitalizations, and invasive respiratory support was assessed between February 1 and August 14, 2020. Among patients with cancer, patients with COVID-19 were more likely to be Non-Hispanic black (NHB), have active cancer, have comorbidities, and/or live in zip codes with median household income <$30 000. Patients with COVID-19 living in lower-income areas and NHB patients were at greatest risk for hospitalization from pneumonia, fluid and electrolyte disorders, cough, respiratory failure, and acute renal failure and were more likely to receive hydroxychloroquine. All-cause mortality, hospital admission, and invasive respiratory support were more frequent among patients with cancer and COVID-19. Male sex, increasing age, living in zip codes with median household income <$30 000, history of pulmonary circulation disorders, and recent treatment with immune checkpoint inhibitors or chemotherapy were associated with greater odds of all-cause mortality in multivariable logistic regression models.
CONCLUSION
RWD can be rapidly leveraged to understand urgent healthcare challenges. Patients with cancer are more vulnerable to COVID-19 effects, especially in the setting of active cancer and comorbidities, with additional risk observed in NHB patients and those living in zip codes with median household income <$30 000.
DOI: 10.1002/cnr2.1388
PubMed: 34014037
Links to Exploration step
pubmed:34014037Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.</title><author><name sortKey="Hwang, Clara" sort="Hwang, Clara" uniqKey="Hwang C" first="Clara" last="Hwang">Clara Hwang</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Izano, Monika A" sort="Izano, Monika A" uniqKey="Izano M" first="Monika A" last="Izano">Monika A. Izano</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Thompson, Michael A" sort="Thompson, Michael A" uniqKey="Thompson M" first="Michael A" last="Thompson">Michael A. Thompson</name><affiliation><nlm:affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gadgeel, Shirish M" sort="Gadgeel, Shirish M" uniqKey="Gadgeel S" first="Shirish M" last="Gadgeel">Shirish M. Gadgeel</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Weese, James L" sort="Weese, James L" uniqKey="Weese J" first="James L" last="Weese">James L. Weese</name><affiliation><nlm:affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Mikkelsen, Tom" sort="Mikkelsen, Tom" uniqKey="Mikkelsen T" first="Tom" last="Mikkelsen">Tom Mikkelsen</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Schrag, Andrew" sort="Schrag, Andrew" uniqKey="Schrag A" first="Andrew" last="Schrag">Andrew Schrag</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Teka, Mahder" sort="Teka, Mahder" uniqKey="Teka M" first="Mahder" last="Teka">Mahder Teka</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Walters, Sheetal" sort="Walters, Sheetal" uniqKey="Walters S" first="Sheetal" last="Walters">Sheetal Walters</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wolf, Frank M" sort="Wolf, Frank M" uniqKey="Wolf F" first="Frank M" last="Wolf">Frank M. Wolf</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hirsch, Jonathan" sort="Hirsch, Jonathan" uniqKey="Hirsch J" first="Jonathan" last="Hirsch">Jonathan Hirsch</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Rivera, Donna R" sort="Rivera, Donna R" uniqKey="Rivera D" first="Donna R" last="Rivera">Donna R. Rivera</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Kluetz, Paul G" sort="Kluetz, Paul G" uniqKey="Kluetz P" first="Paul G" last="Kluetz">Paul G. Kluetz</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Singh, Harpreet" sort="Singh, Harpreet" uniqKey="Singh H" first="Harpreet" last="Singh">Harpreet Singh</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Brown, Thomas D" sort="Brown, Thomas D" uniqKey="Brown T" first="Thomas D" last="Brown">Thomas D. Brown</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:34014037</idno><idno type="pmid">34014037</idno><idno type="doi">10.1002/cnr2.1388</idno><idno type="wicri:Area/Main/Corpus">000002</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000002</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.</title><author><name sortKey="Hwang, Clara" sort="Hwang, Clara" uniqKey="Hwang C" first="Clara" last="Hwang">Clara Hwang</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Izano, Monika A" sort="Izano, Monika A" uniqKey="Izano M" first="Monika A" last="Izano">Monika A. Izano</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Thompson, Michael A" sort="Thompson, Michael A" uniqKey="Thompson M" first="Michael A" last="Thompson">Michael A. Thompson</name><affiliation><nlm:affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Gadgeel, Shirish M" sort="Gadgeel, Shirish M" uniqKey="Gadgeel S" first="Shirish M" last="Gadgeel">Shirish M. Gadgeel</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Weese, James L" sort="Weese, James L" uniqKey="Weese J" first="James L" last="Weese">James L. Weese</name><affiliation><nlm:affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Mikkelsen, Tom" sort="Mikkelsen, Tom" uniqKey="Mikkelsen T" first="Tom" last="Mikkelsen">Tom Mikkelsen</name><affiliation><nlm:affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Schrag, Andrew" sort="Schrag, Andrew" uniqKey="Schrag A" first="Andrew" last="Schrag">Andrew Schrag</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Teka, Mahder" sort="Teka, Mahder" uniqKey="Teka M" first="Mahder" last="Teka">Mahder Teka</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Walters, Sheetal" sort="Walters, Sheetal" uniqKey="Walters S" first="Sheetal" last="Walters">Sheetal Walters</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wolf, Frank M" sort="Wolf, Frank M" uniqKey="Wolf F" first="Frank M" last="Wolf">Frank M. Wolf</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hirsch, Jonathan" sort="Hirsch, Jonathan" uniqKey="Hirsch J" first="Jonathan" last="Hirsch">Jonathan Hirsch</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Rivera, Donna R" sort="Rivera, Donna R" uniqKey="Rivera D" first="Donna R" last="Rivera">Donna R. Rivera</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Kluetz, Paul G" sort="Kluetz, Paul G" uniqKey="Kluetz P" first="Paul G" last="Kluetz">Paul G. Kluetz</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Singh, Harpreet" sort="Singh, Harpreet" uniqKey="Singh H" first="Harpreet" last="Singh">Harpreet Singh</name><affiliation><nlm:affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Brown, Thomas D" sort="Brown, Thomas D" uniqKey="Brown T" first="Thomas D" last="Brown">Thomas D. Brown</name><affiliation><nlm:affiliation>Syapse, San Francisco, California, USA.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Cancer reports (Hoboken, N.J.)</title><idno type="eISSN">2573-8348</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The understanding of the impact of COVID-19 in patients with cancer is evolving, with need for rapid analysis.</p></div><div type="abstract" xml:lang="en"><p><b>AIMS</b></p><p>This study aims to compare the clinical and demographic characteristics of patients with cancer (with and without COVID-19) and characterize the clinical outcomes of patients with COVID-19 and cancer.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS AND RESULTS</b></p><p>Real-world data (RWD) from two health systems were used to identify 146 702 adults diagnosed with cancer between 2015 and 2020; 1267 COVID-19 cases were identified between February 1 and July 30, 2020. Demographic, clinical, and socioeconomic characteristics were extracted. Incidence of all-cause mortality, hospitalizations, and invasive respiratory support was assessed between February 1 and August 14, 2020. Among patients with cancer, patients with COVID-19 were more likely to be Non-Hispanic black (NHB), have active cancer, have comorbidities, and/or live in zip codes with median household income <$30 000. Patients with COVID-19 living in lower-income areas and NHB patients were at greatest risk for hospitalization from pneumonia, fluid and electrolyte disorders, cough, respiratory failure, and acute renal failure and were more likely to receive hydroxychloroquine. All-cause mortality, hospital admission, and invasive respiratory support were more frequent among patients with cancer and COVID-19. Male sex, increasing age, living in zip codes with median household income <$30 000, history of pulmonary circulation disorders, and recent treatment with immune checkpoint inhibitors or chemotherapy were associated with greater odds of all-cause mortality in multivariable logistic regression models.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>RWD can be rapidly leveraged to understand urgent healthcare challenges. Patients with cancer are more vulnerable to COVID-19 effects, especially in the setting of active cancer and comorbidities, with additional risk observed in NHB patients and those living in zip codes with median household income <$30 000.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34014037</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2573-8348</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>May</Month><Day>20</Day></PubDate></JournalIssue><Title>Cancer reports (Hoboken, N.J.)</Title><ISOAbbreviation>Cancer Rep (Hoboken)</ISOAbbreviation></Journal><ArticleTitle>Rapid real-world data analysis of patients with cancer, with and without COVID-19, across distinct health systems.</ArticleTitle><Pagination><MedlinePgn>e1388</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/cnr2.1388</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The understanding of the impact of COVID-19 in patients with cancer is evolving, with need for rapid analysis.</AbstractText><AbstractText Label="AIMS" NlmCategory="OBJECTIVE">This study aims to compare the clinical and demographic characteristics of patients with cancer (with and without COVID-19) and characterize the clinical outcomes of patients with COVID-19 and cancer.</AbstractText><AbstractText Label="METHODS AND RESULTS" NlmCategory="RESULTS">Real-world data (RWD) from two health systems were used to identify 146 702 adults diagnosed with cancer between 2015 and 2020; 1267 COVID-19 cases were identified between February 1 and July 30, 2020. Demographic, clinical, and socioeconomic characteristics were extracted. Incidence of all-cause mortality, hospitalizations, and invasive respiratory support was assessed between February 1 and August 14, 2020. Among patients with cancer, patients with COVID-19 were more likely to be Non-Hispanic black (NHB), have active cancer, have comorbidities, and/or live in zip codes with median household income <$30 000. Patients with COVID-19 living in lower-income areas and NHB patients were at greatest risk for hospitalization from pneumonia, fluid and electrolyte disorders, cough, respiratory failure, and acute renal failure and were more likely to receive hydroxychloroquine. All-cause mortality, hospital admission, and invasive respiratory support were more frequent among patients with cancer and COVID-19. Male sex, increasing age, living in zip codes with median household income <$30 000, history of pulmonary circulation disorders, and recent treatment with immune checkpoint inhibitors or chemotherapy were associated with greater odds of all-cause mortality in multivariable logistic regression models.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">RWD can be rapidly leveraged to understand urgent healthcare challenges. Patients with cancer are more vulnerable to COVID-19 effects, especially in the setting of active cancer and comorbidities, with additional risk observed in NHB patients and those living in zip codes with median household income <$30 000.</AbstractText><CopyrightInformation>© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC. This article has been contributed to by US Government employees and their work is in the public domain in the USA.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hwang</LastName><ForeName>Clara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Izano</LastName><ForeName>Monika A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thompson</LastName><ForeName>Michael A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gadgeel</LastName><ForeName>Shirish M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weese</LastName><ForeName>James L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mikkelsen</LastName><ForeName>Tom</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schrag</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Teka</LastName><ForeName>Mahder</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walters</LastName><ForeName>Sheetal</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wolf</LastName><ForeName>Frank M</ForeName><Initials>FM</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-1684-2889</Identifier><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hirsch</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rivera</LastName><ForeName>Donna R</ForeName><Initials>DR</Initials><AffiliationInfo><Affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kluetz</LastName><ForeName>Paul G</ForeName><Initials>PG</Initials><AffiliationInfo><Affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Harpreet</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Oncology Center of Excellence, United States Food and Drug Administration, Silver Spring, Maryland, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>Thomas D</ForeName><Initials>TD</Initials><AffiliationInfo><Affiliation>Syapse, San Francisco, California, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>20</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Cancer Rep (Hoboken)</MedlineTA><NlmUniqueID>101747728</NlmUniqueID><ISSNLinking>2573-8348</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">cancer risk factors</Keyword><Keyword MajorTopicYN="N">epidemiology</Keyword><Keyword MajorTopicYN="N">medical oncology</Keyword><Keyword MajorTopicYN="N">viral infection</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>03</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>01</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>03</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>20</Day><Hour>9</Hour><Minute>2</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34014037</ArticleId><ArticleId IdType="doi">10.1002/cnr2.1388</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>Johns Hopkins University & Medicine. 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