Abstract 174P
Background
Patients with cancer, particularly those receiving anticancer treatment, have a higher risk of severe (C-19) outcomes. We examine the association between BC, recent treatment, and adverse C-19 outcomes.
Methods
Retrospective matched cohort study using the Optum®de-identified COVID-19 Electronic Health Record dataset. Patients diagnosed with C-19 (01/01/2020-12/20/2021) were categorized into 3 groups: No cancer; patients with BC and recent anticancer treatment (surgery, radiation, chemotherapy, immunotherapy, endocrine therapy within 3 months); and BC without recent treatment. Groups were matched based on age, date of C-19 diagnosis, and comorbidity score. We evaluated 30-day mortality, mechanical ventilation, intensive care unit (ICU) stay, and hospitalization. A composite ordinal outcome including all outcomes was analyzed. Multivariable logistic regression models were used. Results are presented as odds ratios (OR 95%CI).
Results
2200 matched triplets (1:1:10) of BC treated, BC not treated, and non-cancer patients were included (median age 65 years). The rates of most adverse outcomes improved in 2021 compared to 2020 (mortality 0.2% vs 2.9%, mechanical ventilation 0.1% vs 3%; ICU stay 0.2 vs 4.5%, hospitalization 22.4% vs 23.6%). Compared to non-cancer patients, those with BC recently treated had a similar risk of adverse outcomes, while patients with BC not recently treated had a lower risk of ICU stay and hospitalization and a similar risk of mortality and mechanical ventilation. Using the composite ordinal variable, BC recently treated had similar outcomes (OR 1.02; 95%CI 0.93-1.11) to non-cancer patients, and BC patients not recently treated had better outcomes (OR 0.66; 95%CI 0.59-0.74). Chemotherapy within 3 months was associated with a higher risk of ICU (OR 1.81; 95%CI 1.02-3.23) and hospitalization (OR 2.3; 95% 1.76-2.99). Vaccination prior to C-19 was reported in 3.6, 5.8, and 5.5% of non-cancer, BC treated, and BC not treated patients; vaccination was associated with improved outcomes.
Conclusions
Patients with BC have a similar risk of adverse C-19 compared to non-cancer patients. Subgroup analysis suggests that patients recently receiving chemotherapy had a higher risk of ICU stay and hospitalization.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Susan G. Komen, American Society of Clinical Oncology (Conquer Cancer, The ASCO Foundation).
Disclosure
All authors have declared no conflicts of interest.