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COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study.

Identifieur interne : 000855 ( Main/Exploration ); précédent : 000854; suivant : 000856

COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study.

Auteurs : Lennard Y W. Lee [Royaume-Uni] ; Jean-Baptiste Cazier [Royaume-Uni] ; Thomas Starkey [Royaume-Uni] ; Sarah E W. Briggs [Royaume-Uni] ; Roland Arnold [Royaume-Uni] ; Vartika Bisht [Royaume-Uni] ; Stephen Booth [Royaume-Uni] ; Naomi A. Campton [Royaume-Uni] ; Vinton W T. Cheng [Royaume-Uni] ; Graham Collins [Royaume-Uni] ; Helen M. Curley [Royaume-Uni] ; Philip Earwaker [Royaume-Uni] ; Matthew W. Fittall [Royaume-Uni] ; Spyridon Gennatas [Royaume-Uni] ; Anshita Goel [Royaume-Uni] ; Simon Hartley [Royaume-Uni] ; Daniel J. Hughes [Royaume-Uni] ; David Kerr [Royaume-Uni] ; Alvin J X. Lee [Royaume-Uni] ; Rebecca J. Lee [Royaume-Uni] ; Siow Ming Lee [Royaume-Uni] ; Hayley Mckenzie [Royaume-Uni] ; Chris P. Middleton [Royaume-Uni] ; Nirupa Murugaesu [Royaume-Uni] ; Tom Newsom-Davis [Royaume-Uni] ; Anna C. Olsson-Brown [Royaume-Uni] ; Claire Palles [Royaume-Uni] ; Thomas Powles [Royaume-Uni] ; Emily A. Protheroe [Royaume-Uni] ; Karin Purshouse [Royaume-Uni] ; Archana Sharma-Oates [Royaume-Uni] ; Shivan Sivakumar [Royaume-Uni] ; Ashley J. Smith [Royaume-Uni] ; Oliver Topping [Royaume-Uni] ; Chris D. Turnbull [Royaume-Uni] ; Csilla Várnai [Royaume-Uni] ; Adam D M. Briggs [Royaume-Uni] ; Gary Middleton [Royaume-Uni] ; Rachel Kerr [Royaume-Uni]

Source :

RBID : pubmed:32853557

Descripteurs français

English descriptors

Abstract

BACKGROUND

Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK.

METHODS

We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models.

FINDINGS

319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028).

INTERPRETATION

Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies.

FUNDING

University of Birmingham and University of Oxford.


DOI: 10.1016/S1470-2045(20)30442-3
PubMed: 32853557
PubMed Central: PMC7444972


Affiliations:


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<name sortKey="Lee, Rebecca J" sort="Lee, Rebecca J" uniqKey="Lee R" first="Rebecca J" last="Lee">Rebecca J. Lee</name>
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<name sortKey="Lee, Siow Ming" sort="Lee, Siow Ming" uniqKey="Lee S" first="Siow Ming" last="Lee">Siow Ming Lee</name>
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<name sortKey="Murugaesu, Nirupa" sort="Murugaesu, Nirupa" uniqKey="Murugaesu N" first="Nirupa" last="Murugaesu">Nirupa Murugaesu</name>
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<name sortKey="Newsom Davis, Tom" sort="Newsom Davis, Tom" uniqKey="Newsom Davis T" first="Tom" last="Newsom-Davis">Tom Newsom-Davis</name>
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<name sortKey="Olsson Brown, Anna C" sort="Olsson Brown, Anna C" uniqKey="Olsson Brown A" first="Anna C" last="Olsson-Brown">Anna C. Olsson-Brown</name>
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<name sortKey="Palles, Claire" sort="Palles, Claire" uniqKey="Palles C" first="Claire" last="Palles">Claire Palles</name>
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<name sortKey="Powles, Thomas" sort="Powles, Thomas" uniqKey="Powles T" first="Thomas" last="Powles">Thomas Powles</name>
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<name sortKey="Protheroe, Emily A" sort="Protheroe, Emily A" uniqKey="Protheroe E" first="Emily A" last="Protheroe">Emily A. Protheroe</name>
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<nlm:affiliation>University of Birmingham Medical School, University of Birmingham, Birmingham, UK.</nlm:affiliation>
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<wicri:regionArea>University Hospitals Birmingham, Birmingham</wicri:regionArea>
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<nlm:affiliation>Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation>
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<settlement type="city">Oxford</settlement>
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<title xml:lang="en">COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study.</title>
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<name sortKey="Cazier, Jean Baptiste" sort="Cazier, Jean Baptiste" uniqKey="Cazier J" first="Jean-Baptiste" last="Cazier">Jean-Baptiste Cazier</name>
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<nlm:affiliation>Centre for Computational Biology, University of Birmingham, Birmingham, UK.</nlm:affiliation>
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<orgName type="university">Université d'Oxford</orgName>
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<wicri:regionArea>Institute of Translational Medicine, Birmingham Health Partners, Birmingham</wicri:regionArea>
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<settlement type="city">Birmingham</settlement>
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<nlm:affiliation>Leeds Institute of Medical Research, University of Leeds, Leeds, UK.</nlm:affiliation>
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<wicri:regionArea>Leeds Institute of Medical Research, University of Leeds, Leeds</wicri:regionArea>
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<nlm:affiliation>Department of Haematology, University of Oxford, Oxford, UK.</nlm:affiliation>
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<wicri:regionArea>Department of Haematology, University of Oxford, Oxford</wicri:regionArea>
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<nlm:affiliation>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.</nlm:affiliation>
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<wicri:regionArea>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham</wicri:regionArea>
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<settlement type="city">Birmingham</settlement>
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<orgName type="university">Université de Birmingham</orgName>
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<nlm:affiliation>University Hospitals Birmingham, Birmingham, UK.</nlm:affiliation>
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<wicri:regionArea>University Hospitals Birmingham, Birmingham</wicri:regionArea>
<placeName>
<settlement type="city">Birmingham</settlement>
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<nlm:affiliation>The Royal Marsden Hospital NHS Foundation Trust, London, UK.</nlm:affiliation>
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<wicri:regionArea>The Royal Marsden Hospital NHS Foundation Trust, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
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<region type="région" nuts="1">Grand Londres</region>
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<nlm:affiliation>The Royal Marsden Hospital NHS Foundation Trust, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>The Royal Marsden Hospital NHS Foundation Trust, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
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<author>
<name sortKey="Goel, Anshita" sort="Goel, Anshita" uniqKey="Goel A" first="Anshita" last="Goel">Anshita Goel</name>
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<nlm:affiliation>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<settlement type="city">Birmingham</settlement>
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<orgName type="university">Université de Birmingham</orgName>
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<nlm:affiliation>Centre for Computational Biology, University of Birmingham, Birmingham, UK; Advanced Research Computing, University of Birmingham, Birmingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<settlement type="city">Birmingham</settlement>
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<orgName type="university">Université de Birmingham</orgName>
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<settlement type="city">Londres</settlement>
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<region type="région" nuts="1">Grand Londres</region>
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<name sortKey="Kerr, David" sort="Kerr, David" uniqKey="Kerr D" first="David" last="Kerr">David Kerr</name>
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<orgName type="university">Université d'Oxford</orgName>
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<name sortKey="Lee, Alvin J X" sort="Lee, Alvin J X" uniqKey="Lee A" first="Alvin J X" last="Lee">Alvin J X. Lee</name>
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<orgName type="university">University College de Londres</orgName>
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<author>
<name sortKey="Lee, Rebecca J" sort="Lee, Rebecca J" uniqKey="Lee R" first="Rebecca J" last="Lee">Rebecca J. Lee</name>
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<author>
<name sortKey="Lee, Siow Ming" sort="Lee, Siow Ming" uniqKey="Lee S" first="Siow Ming" last="Lee">Siow Ming Lee</name>
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<nlm:affiliation>University College London, London, UK.</nlm:affiliation>
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<wicri:regionArea>University College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
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<region type="région" nuts="1">Grand Londres</region>
</placeName>
<orgName type="university">University College de Londres</orgName>
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<author>
<name sortKey="Mckenzie, Hayley" sort="Mckenzie, Hayley" uniqKey="Mckenzie H" first="Hayley" last="Mckenzie">Hayley Mckenzie</name>
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<nlm:affiliation>University Hospital Southampton, UK.</nlm:affiliation>
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<wicri:regionArea>University Hospital Southampton</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Middleton, Chris P" sort="Middleton, Chris P" uniqKey="Middleton C" first="Chris P" last="Middleton">Chris P. Middleton</name>
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<orgName type="university">Université de Birmingham</orgName>
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<name sortKey="Murugaesu, Nirupa" sort="Murugaesu, Nirupa" uniqKey="Murugaesu N" first="Nirupa" last="Murugaesu">Nirupa Murugaesu</name>
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<name sortKey="Newsom Davis, Tom" sort="Newsom Davis, Tom" uniqKey="Newsom Davis T" first="Tom" last="Newsom-Davis">Tom Newsom-Davis</name>
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<placeName>
<settlement type="city">Londres</settlement>
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<name sortKey="Protheroe, Emily A" sort="Protheroe, Emily A" uniqKey="Protheroe E" first="Emily A" last="Protheroe">Emily A. Protheroe</name>
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<name sortKey="Purshouse, Karin" sort="Purshouse, Karin" uniqKey="Purshouse K" first="Karin" last="Purshouse">Karin Purshouse</name>
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<nlm:affiliation>Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.</nlm:affiliation>
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<wicri:regionArea>Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh</wicri:regionArea>
<placeName>
<settlement type="city">Édimbourg</settlement>
<region type="country">Écosse</region>
</placeName>
<orgName type="university">Université d'Édimbourg</orgName>
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<name sortKey="Sharma Oates, Archana" sort="Sharma Oates, Archana" uniqKey="Sharma Oates A" first="Archana" last="Sharma-Oates">Archana Sharma-Oates</name>
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<nlm:affiliation>Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.</nlm:affiliation>
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<wicri:regionArea>Institute of Inflammation and Ageing, University of Birmingham, Birmingham</wicri:regionArea>
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<settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
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<name sortKey="Sivakumar, Shivan" sort="Sivakumar, Shivan" uniqKey="Sivakumar S" first="Shivan" last="Sivakumar">Shivan Sivakumar</name>
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<nlm:affiliation>Department of Oncology, University of Oxford, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Oncology, University of Oxford, Oxford</wicri:regionArea>
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<settlement type="city">Oxford</settlement>
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<region type="comté" nuts="2">Oxfordshire</region>
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<orgName type="university">Université d'Oxford</orgName>
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<name sortKey="Smith, Ashley J" sort="Smith, Ashley J" uniqKey="Smith A" first="Ashley J" last="Smith">Ashley J. Smith</name>
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<nlm:affiliation>Consultancy Support, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Consultancy Support, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
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<name sortKey="Topping, Oliver" sort="Topping, Oliver" uniqKey="Topping O" first="Oliver" last="Topping">Oliver Topping</name>
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<nlm:affiliation>University Hospitals Birmingham, Birmingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>University Hospitals Birmingham, Birmingham</wicri:regionArea>
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<settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Midlands de l'Ouest</region>
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<name sortKey="Turnbull, Chris D" sort="Turnbull, Chris D" uniqKey="Turnbull C" first="Chris D" last="Turnbull">Chris D. Turnbull</name>
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<nlm:affiliation>Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Medicine, University of Oxford, Oxford</wicri:regionArea>
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<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
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<name sortKey="Varnai, Csilla" sort="Varnai, Csilla" uniqKey="Varnai C" first="Csilla" last="Várnai">Csilla Várnai</name>
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<nlm:affiliation>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<settlement type="city">Birmingham</settlement>
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<name sortKey="Briggs, Adam D M" sort="Briggs, Adam D M" uniqKey="Briggs A" first="Adam D M" last="Briggs">Adam D M. Briggs</name>
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<nlm:affiliation>Warwick Medical School, University of Warwick, Coventry, UK.</nlm:affiliation>
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<wicri:regionArea>Warwick Medical School, University of Warwick, Coventry</wicri:regionArea>
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<name sortKey="Middleton, Gary" sort="Middleton, Gary" uniqKey="Middleton G" first="Gary" last="Middleton">Gary Middleton</name>
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<settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Midlands de l'Ouest</region>
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<name sortKey="Kerr, Rachel" sort="Kerr, Rachel" uniqKey="Kerr R" first="Rachel" last="Kerr">Rachel Kerr</name>
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<nlm:affiliation>Department of Oncology, University of Oxford, Oxford, UK.</nlm:affiliation>
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<wicri:regionArea>Department of Oncology, University of Oxford, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
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<title level="j">The Lancet. Oncology</title>
<idno type="eISSN">1474-5488</idno>
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<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (pathogenicity)</term>
<term>Coronavirus Infections (complications)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (pathology)</term>
<term>Coronavirus Infections (virology)</term>
<term>Female (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Neoplasms (mortality)</term>
<term>Neoplasms (pathology)</term>
<term>Neoplasms (virology)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (complications)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (pathology)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Prospective Studies (MeSH)</term>
<term>Risk Assessment (MeSH)</term>
<term>Risk Factors (MeSH)</term>
</keywords>
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<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Appréciation des risques (MeSH)</term>
<term>Betacoronavirus (pathogénicité)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Hospitalisation (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (anatomopathologie)</term>
<term>Infections à coronavirus (complications)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (anatomopathologie)</term>
<term>Pneumopathie virale (complications)</term>
<term>Pneumopathie virale (mortalité)</term>
<term>Pneumopathie virale (virologie)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Tumeurs (anatomopathologie)</term>
<term>Tumeurs (mortalité)</term>
<term>Tumeurs (virologie)</term>
<term>Études prospectives (MeSH)</term>
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<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
<term>Tumeurs</term>
</keywords>
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<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<term>Coronavirus Infections</term>
<term>Neoplasms</term>
<term>Pneumonia, Viral</term>
</keywords>
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<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
<term>Tumeurs</term>
</keywords>
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<term>Betacoronavirus</term>
</keywords>
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<term>Betacoronavirus</term>
</keywords>
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<term>Coronavirus Infections</term>
<term>Neoplasms</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
<term>Tumeurs</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Neoplasms</term>
<term>Pneumonia, Viral</term>
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<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Hospitalization</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Prospective Studies</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
</keywords>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Appréciation des risques</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Hospitalisation</term>
<term>Humains</term>
<term>Infections à coronavirus</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Pneumopathie virale</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>FINDINGS</b>
</p>
<p>319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERPRETATION</b>
</p>
<p>Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>FUNDING</b>
</p>
<p>University of Birmingham and University of Oxford.</p>
</div>
</front>
</TEI>
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<DateCompleted>
<Year>2020</Year>
<Month>10</Month>
<Day>13</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>10</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1474-5488</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>21</Volume>
<Issue>10</Issue>
<PubDate>
<Year>2020</Year>
<Month>10</Month>
</PubDate>
</JournalIssue>
<Title>The Lancet. Oncology</Title>
<ISOAbbreviation>Lancet Oncol</ISOAbbreviation>
</Journal>
<ArticleTitle>COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study.</ArticleTitle>
<Pagination>
<MedlinePgn>1309-1316</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S1470-2045(20)30442-3</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/S1470-2045(20)30442-3</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND">Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK.</AbstractText>
<AbstractText Label="METHODS">We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models.</AbstractText>
<AbstractText Label="FINDINGS">319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028).</AbstractText>
<AbstractText Label="INTERPRETATION">Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies.</AbstractText>
<AbstractText Label="FUNDING">University of Birmingham and University of Oxford.</AbstractText>
<CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation>
</Abstract>
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<LastName>Lee</LastName>
<ForeName>Lennard Y W</ForeName>
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<Affiliation>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Department of Oncology, University of Oxford, Oxford, UK; University Hospitals Birmingham, Birmingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Cazier</LastName>
<ForeName>Jean-Baptiste</ForeName>
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</AffiliationInfo>
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<LastName>Starkey</LastName>
<ForeName>Thomas</ForeName>
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<Affiliation>Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.</Affiliation>
</AffiliationInfo>
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<LastName>Briggs</LastName>
<ForeName>Sarah E W</ForeName>
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</AffiliationInfo>
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