@article{ae7c02f863be40d4804440087e0838ac,
title = "Dutch Oncology COVID-19 consortium: Outcome of COVID-19 in patients with cancer in a nationwide cohort study",
abstract = "AIM OF THE STUDY: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19.METHODS: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible.RESULTS: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years).CONCLUSION: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered.",
keywords = "Aged, COVID-19/epidemiology, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, Neoplasms/epidemiology, Netherlands/epidemiology, Pandemics, Registries, Risk Factors, Treatment Outcome, Cancer treatment, Pandemic, COVID-19, Coronavirus, Cancer",
author = "{de Joode}, Karlijn and Dumoulin, {Daphne W.} and Jolien Tol and Westgeest, {Hans M.} and Beerepoot, {Laurens V.} and {van den Berkmortel}, {Franchette W.P.J.} and Mutsaers, {Pim G.N.J.} and {van Diemen}, {Nico G.J.} and Visser, {Otto J.} and {Oomen-de Hoop}, Esther and Bloemendal, {Haiko J.} and {van Laarhoven}, {Hanneke W.M.} and Hendriks, {Lizza E.L.} and Haanen, {John B.A.G.} and {de Vries}, {Elisabeth G.E.} and Dingemans, {Anne Marie C.} and {van der Veldt}, {Astrid A.M.} and {van Loenhout}, {C. J.} and {van der Leest}, {C. H.} and A. Becker-Commissaris and Borgers, {J. S.W.} and F. Terhegggen and {van den Borne}, {B. E.E.M.} and {van Warmerdam}, {L. J.C.} and {van Leeuwen}, L. and {van der Meer}, {F. S.} and Tiemessen, {M. A.} and {van Diepen}, {D. M.} and Y. Klaver and Hamberg, {A. P.} and Libourel, {E. J.} and L. Strobbe and M. Cloos and Geraedts, {E. J.} and Drooger, {J. C.} and R. Heller and {de Groot}, {J. W.B.} and Stigt, {J. A.} and Nuij, {V. J.A.A.} and Pitz, {C. C.M.} and M. Slingerland and Borm, {F. J.} and Haberkorn, {B. C.M.} and Westeinde, {S. C.van t.} and Aarts, {M. J.B.} and {van Putten}, {J. W.G.} and M. Youssef and Cirkel, {G. A.} and Herder, {G. J.M.} and {van Rooijen}, {C. R.} and E. Citgez and Barlo, {N. P.} and Scholtes, {B. M.J.} and Koornstra, {R. H.T.} and Claessens, {N. J.M.} and Faber, {L. M.} and Rikers, {C. H.} and {van de Wetering}, {R. A.W.} and Veurink, {G. L.} and Bouter, {B. W.} and I. Houtenbos and Bard, {M. P.L.} and Herbschleb, {K. H.} and Kastelijn, {E. A.} and P. Brocken and G. Douma and M. Jalving and Hiltermann, {T. J.N.} and Schuurbiers-Siebers, {O. C.J.} and Suijkerbuijk, {K. P.M.} and {van Lindert}, {A. S.R.} and {van de Wouw}, {A. J.} and {van den Boogaart}, {V. E.M.} and Bakker, {S. D.} and E. Looysen and Peerdeman, {A. L.} and {de Jong}, {W. K.} and Siemerink, {E. J.M.} and Staal, {A. J.} and B. Franken and {van Geffen}, {W. H.} and Bootsma, {G. P.}",
note = "Funding Information: Although chemotherapy has previously been identified as a risk factor for mortality of COVID-19 in cancer patients [ 21 ], this could not be confirmed in our registry. This is supported by data from a UK registry [ 9 ]. However, steroid use at the time of COVID-19 diagnosis was associated with an increased risk of fatal outcome of COVID-19 in univariable analysis. This result is of particular interest, as a recent randomised clinical trial showed that dexamethasone decreases mortality of COVID-19 in patients requiring respiratory support [ 22 ]. Steroids may contribute to an increased viral load of SARS-CoV-2 by an increase in viral replication and a delay of viral clearance [ 23 ]. Steroid co-medication is usually prescribed as supportive medication for haematological treatment and/or highly emetogenic chemotherapy regimens. Therefore, systemic treatment or disease itself cannot be excluded as confounding factor. Funding Information: Although chemotherapy has previously been identified as a risk factor for mortality of COVID-19 in cancer patients [21], this could not be confirmed in our registry. This is supported by data from a UK registry [9]. However, steroid use at the time of COVID-19 diagnosis was associated with an increased risk of fatal outcome of COVID-19 in univariable analysis. This result is of particular interest, as a recent randomised clinical trial showed that dexamethasone decreases mortality of COVID-19 in patients requiring respiratory support [22]. Steroids may contribute to an increased viral load of SARS-CoV-2 by an increase in viral replication and a delay of viral clearance [23]. Steroid co-medication is usually prescribed as supportive medication for haematological treatment and/or highly emetogenic chemotherapy regimens. Therefore, systemic treatment or disease itself cannot be excluded as confounding factor.This study was supported by a grant from the Dutch Cancer Society, a non-profit organisation. The Dutch Cancer Society had no role in study design, data collection, data analysis, data interpretation or writing of the report. Publisher Copyright: {\textcopyright} 2020 The Author(s)",
year = "2020",
month = dec,
doi = "10.1016/j.ejca.2020.09.027",
language = "English",
volume = "141",
pages = "171--184",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Elsevier Limited",
}