1986P - Impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in patients with soft tissue sarcoma: An analysis from the OnCovid registry

Background

To date no specific evidence exists on the impact of COVID-19 in pts with soft tissue sarcoma (STS), nor about the impact of SARS-CoV-2 vaccines and chemotherapy on COVID-19 morbidity and mortality in this specific population.

Methods

We described COVID-19 morbidity and mortality among pts with STS across “Omicron” (15/12/21-31/01/22), “Pre-vaccination” (27/02/20-30/11/20) and “Alpha-Delta” phase (01/12/20-14/12/21) using OnCovid registry participants (NCT04393974). Case fatality rate at 28 days (CFR₂₈) and COVID-19 severity were described according to the SARS-CoV-2 vaccination status, whilst the impact of the receipt of cytotoxic chemotherapy within 4 weeks prior to COVID-19 on clinical outcomes was assessed with Inverse Probability of Treatment Weighting (IPTW) models adjusted for possible confounders.

Results

Out of 3820 pts, 97 pts with STS were included. The median age at COVID-19 diagnosis was 56 years, with 65 pts (67%) aged <65 years old and 65 pts had low comorbidity burden (67%). In total, 36 pts were on cytotoxic chemotherapy within 4 weeks prior to COVID-19. The overall CFR₂₈ was 25.8%, with 38% oxygen therapy requirement, 34% rate of complications and 32.3% of hospitalizations due to COVID-19. CFR₂₈ (29,5%, 21.4%, 12.5%) and all indicators of COVID-19 severity demonstrated a trend toward a numerical improvement across the pandemic phases. Similarly, vaccinated pts demonstrated numerically improved CFR₂₈ (16.7% vs 27.7%) and COVID-19 morbidity compared with unvaccinated pts. Pts who were on chemotherapy experienced comparable CFR₂₈ (19.4% vs 26.0%, p=0.4803), hospitalizations (50.0% vs 44.4%, p=0.6883), complication rates (30.6% vs 34.0%, p=0.7381) and oxygen therapy requirement (28.1% vs 40.0%, p=0.2755) compared to those who were not on anticancer therapy at COVID-19, findings further confirmed by the IPTW-fitted multivariable analysis.

Conclusions

This is the first study to demonstrate the time-dependent improvement of COVID-19 outcomes in pts with STS. Exposure to chemotherapy does not impact on COVID-19 morbidity/mortality and SARS-CoV-2 vaccination confers protection against adverse outcome from COVID-19 in this patient population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.