Abstract 1570P
Background
These are the final results of a national registry on COVID-19 in Switzerland.
Methods
We collected data on 501 symptomatic COVID-19 infected cancer patients from 23 Swiss sites, starting March 1, 2020. Testing recommendations were set by the Federal Office of Public Health. The main objective of the study was to assess the outcome (i.e. mortality, rate of hospitalization, ICU admission) of COVID-19 infection in cancer patients, the main secondary objective was to define prognostic factors.
Results
With a cutoff date of March 15, 2021 and exclusion of 46 patients who refused consent, 455 patients were included into the final analysis. Most frequent malignancies were breast in 63 cases (14%), lung in 47 (10%), prostate cancer in 25 (6%), myeloma in 19 (4%); 205 patients (45%) had non-curative disease. Systemic treatment within 3 months prior to COVID-19 diagnosis included chemotherapy in 101 cases (23%), targeted therapy in 94 (21%), steroids in 78 (17%) and checkpoint inhibitors in 34 (8%). 285 patients (63%) were hospitalized for COVID-19, 213 (47%) required oxygen, 43 (9%) invasive ventilation, 62 (14%) were admitted to the ICU. Death from COVID-19 infection occurred in 98 patients, resulting in a mortality rate of 21.5%. Age ≥65 versus <65 (OR 3.35, p=0.001), non-curative versus curative disease (OR 2.21, p=0.021), ICU admission (OR 4.53, p <0.001) and oxygen requirement (OR 23.25, p <0.001) were independently associated with increased mortality. Neither male versus female gender (OR 1.20, p=0.56), hematological versus solid malignancy (OR 1.01, p=0.97), pulmonary comorbidity (OR 0.96, p=0.93), cardiovascular comorbidity (OR 1.11, p=0.75), chemotherapy as defined above (OR 1.43, p=0.31) or checkpoint inhibitors (OR=2.81, note p=0.082) were significant risk factors for death.
Conclusions
We found a high COVID-19 mortality rate of 21.5% in real-world cancer patients for the first wave of the pandemic in a country with a decentralized, high-quality health care system with universal access (COVID-19 mortality of 1.7% in the general population during the same time interval). The rate of hospitalization and ICU admission for COVID-19 in cancer patients is substantial.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Swiss Clinical Cancer Research Group (SAKK).
Funding
The study was financially supported by Roche and by research agreements with the following institutions: Swiss State Secretary for Education, Research and Innovation (SERI), Swiss Cancer Research Foundation (SCS) and Swiss Cancer League (SCL).
Disclosure
M. Joerger: Financial Interests, Institutional, Invited Speaker, Clinical trial activity: AstraZeneca; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Basilea; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Bayer; Financial Interests, Institutional, Invited Speaker, Clinical study activity: BMS; Financial Interests, Institutional, Other, Clinical study activity: Daiichi Sankyo; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Immunophotonics; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Innomedica; Financial Interests, Institutional, Invited Speaker, Clinical study activity: MSD; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Novartis; Financial Interests, Institutional, Invited Speaker, Clinical study activity: Roche; Non-Financial Interests, Advisory Role: Novartis; Non-Financial Interests, Advisory Role: AstraZeneca; Non-Financial Interests, Advisory Role: Basilea; Non-Financial Interests, Advisory Role: Bayer; Non-Financial Interests, Advisory Role: BMS; Non-Financial Interests, Advisory Role: Debiopharm; Non-Financial Interests, Advisory Role: MSD; Non-Financial Interests, Advisory Role: Roche; Non-Financial Interests, Advisory Role: Sanofi. K. Zaman: Financial Interests, Institutional, Advisory Board: Daiichi; Financial Interests, Institutional, Advisory Board: Lilly; Financial Interests, Institutional, Advisory Board: MSD Oncology; Financial Interests, Institutional, Advisory Board: Mylan; Financial Interests, Institutional, Advisory Board: Novartis; Financial Interests, Institutional, Advisory Board: Pierre Fabre; Financial Interests, Institutional, Advisory Board: Roche; Financial Interests, Personal, Funding: Roche/Genentech; Financial Interests, Personal, Other, travel expenses: MSD Oncology; Financial Interests, Personal, Other, travel expenses: Pierre Fabre; Financial Interests, Personal, Other, travel expenses: Roche. O.A. Michielin: Financial Interests, Personal, Advisory Board: Bristol-Meyers-Squibb; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Glaxo-Smith-Kline; Financial Interests, Personal, Advisory Board: Pierre-Fabre; Financial Interests, Personal, Funding: Bristol-Meyers-Squibb; Financial Interests, Personal, Funding: MSD; Financial Interests, Personal, Funding: Amgen; Financial Interests, Institutional, Funding: Bristol-Meyers-Squibb; Financial Interests, Institutional, Funding: MSD; Financial Interests, Institutional, Funding: Amgen. N. Mach: Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Institutional, Funding: MSD; Financial Interests, Institutional, Funding: Bristol-Meyers Squibb; Financial Interests, Institutional, Funding: Abbvie; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Merck; Financial Interests, Institutional, Funding: Amgen; Financial Interests, Institutional, Funding: Philogen; Financial Interests, Personal, Stocks/Shares: MaxiVAX. N. Cantoni: Financial Interests, Personal, Advisory Board: AbbVie; Financial Interests, Personal, Advisory Board: Alexion; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Bristol-Meyers Squibb; Financial Interests, Personal, Advisory Board: Celgene; Financial Interests, Personal, Advisory Board: Gilead; Financial Interests, Personal, Advisory Board: Incyte; Financial Interests, Personal, Advisory Board: Janssen-Cilag; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: OrPha Swiss; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Sandoz; Financial Interests, Personal, Advisory Board: Sanofi-Aventis; Financial Interests, Personal, Advisory Board: Shire (Baxter Oncology); Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Funding: AstraZeneca; Financial Interests, Personal, Funding: CLS Behring; Financial Interests, Personal, Funding: Novartis; Financial Interests, Personal, Funding: Pierre-Fabre; Financial Interests, Personal, Funding: Shire (Baxter Oncology). M. Pless: Financial Interests, Personal, Advisory Board: AbbVie; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Bristol-Meyers Squibb; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Other, travel grants: AstraZeneca; Financial Interests, Personal, Other, travel grants: Bristol-Meyers Squibb; Financial Interests, Personal, Other, travel grants: Boehringer Ingelheim. C. Britschgi: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Board: Janssen-Cilag; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim. C. Renner: Financial Interests, Personal, Royalties: Humanigen. D. Koeberle: Financial Interests, Institutional, Funding: Pierre-Fabre; Financial Interests, Institutional, Funding: Bristol-Myers-Squibb; Financial Interests, Institutional, Funding: Roche. A. Stathis: Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Merck; Financial Interests, Institutional, Funding: Bayer; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Institutional, Funding: MEI-Pharma; Financial Interests, Institutional, Funding: Cellestia; Financial Interests, Personal, Other, travel grants: PharmaMar; Financial Interests, Personal, Other, travel grants: AbbVie. R. von Moos: Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Bristol-Meyers-Squibb; Financial Interests, Personal, Advisory Board: Celgene; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Pierre-Fabre; Financial Interests, Personal, Advisory Board: PharmaMar; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Vifor. All other authors have declared no conflicts of interest.