TY - JOUR
T1 - An International Comparison of Presentation, Outcomes and CORONET Predictive Score Performance in Patients with Cancer Presenting with COVID-19 across Different Pandemic Waves
AU - ESMO Co-Care
AU - Wysocki, Oskar
AU - Zhou, Cong
AU - Rogado, Jacobo
AU - Huddar, Prerana
AU - Shotton, Rohan
AU - Tivey, Ann
AU - Albiges, Laurence
AU - Angelakas, Angelos
AU - Arnold, Dirk
AU - Aung, Theingi
AU - Banfill, Kathryn
AU - Baxter, Mark
AU - Barlesi, Fabrice
AU - Bayle, Arnaud
AU - Besse, Benjamin
AU - Bhogal, Talvinder
AU - Boyce, Hayley
AU - Britton, Fiona
AU - Calles, Antonio
AU - Castelo-Branco, Luis
AU - Copson, Ellen
AU - Dani, Sourbha S.
AU - Dickens, Elena
AU - Eastlake, Leonie
AU - Fitzpatrick, Paul
AU - Foulon, Stephanie
AU - Frederiksen, Henrik
AU - Ganatra, Sarju
AU - Gennatas, Spyridon
AU - Glenthøj, Andreas
AU - Gomes, Fabio
AU - Graham, Donna M.
AU - Hague, Christina
AU - Harrington, Kevin
AU - Harrison, Michelle
AU - Horsley, Laura
AU - Hoskins, Richard
AU - Hudson, Zoe
AU - Jakobsen, Lasse
AU - Joharatnam-Hogan, Nalinie
AU - Lewis, Alexandra
AU - Robinson, Timothy
AU - Williams, Sophie T
AU - Wilson, Caroline
AU - Dive, Caroline
AU - Landers, Donal
AU - Cooksley, Timothy
AU - Freitas, André
AU - Armstrong, Anne C.
AU - Lee, Rebecca
N1 - Funding Information:
R.J.L., T.R., and J.W. were supported by the National Institute for Health Research as Clinical Lecturers. T.B. was supported by the National Institute for Health Research as an academic clinical fellow. U.K. was supported by by the North West England Medical Research Council Fellowship Scheme in Clinical Pharmacology and Therapeutics, which is funded by the Medical Research Council (Award Ref. MR/N025989/1). The Liverpool Experimental Cancer Medicine Centre provided infrastructure support (Grant Reference: C18616/A25153) and The Clatterbridge Cancer charity (North West Cancer Research) provided funding to C.P. C.D. was funded by CRUK Core funding to Manchester Institute (C5757/A27412) and was supported by the CRUK Manchester Centre Award (C5759/A25254) and by the NIHR Manchester Biomedical Research Centre. C.Z. was funded by the CRUK Manchester Centre Award (C5759/A25254). P.F. was funded by the CRUK Accelerator Award (29374). This research was funded, in part, by the Wellcome Trust [205228/Z/16/Z]. LT was supported by the National Institute for Health Research Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections (NIHr100907) at the University of Liverpool in partnership with Public Health England (PHE), in collaboration with the Liverpool School of Tropical Medicine and the University of Oxford. MS was supported by the Ministry of Science and Higher Education of the Russian Federation within the framework of state support for the creation and development of World-Class Research Centers’ “Digital biodesign and personalized healthcare” № 075-15-2020-926. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health, or Public Health England. Funding for COVID-19 work was provided by The Christie Charitable Fund (1049751).
Publisher Copyright:
© 2022 by the authors.
PY - 2022/8/16
Y1 - 2022/8/16
N2 - Patients with cancer have been shown to have increased risk of COVID-19 severity. We previously built and validated the COVID-19 Risk in Oncology Evaluation Tool (CORONET) to predict the likely severity of COVID-19 in patients with active cancer who present to hospital. We assessed the differences in presentation and outcomes of patients with cancer and COVID-19, depending on the wave of the pandemic. We examined differences in features at presentation and outcomes in patients worldwide, depending on the waves of the pandemic: wave 1 D614G (n = 1430), wave 2 Alpha (n = 475), and wave 4 Omicron variant (n = 63, UK and Spain only). The performance of CORONET was evaluated on 258, 48, and 54 patients for each wave, respectively. We found that mortality rates were reduced in subsequent waves. The majority of patients were vaccinated in wave 4, and 94% were treated with steroids if they required oxygen. The stages of cancer and the median ages of patients significantly differed, but features associated with worse COVID-19 outcomes remained predictive and did not differ between waves. The CORONET tool performed well in all waves, with scores in an area under the curve (AUC) of >0.72. We concluded that patients with cancer who present to hospital with COVID-19 have similar features of severity, which remain discriminatory despite differences in variants and vaccination status. Survival improved following the first wave of the pandemic, which may be associated with vaccination and the increased steroid use in those patients requiring oxygen. The CORONET model demonstrated good performance, independent of the SARS-CoV-2 variants.
AB - Patients with cancer have been shown to have increased risk of COVID-19 severity. We previously built and validated the COVID-19 Risk in Oncology Evaluation Tool (CORONET) to predict the likely severity of COVID-19 in patients with active cancer who present to hospital. We assessed the differences in presentation and outcomes of patients with cancer and COVID-19, depending on the wave of the pandemic. We examined differences in features at presentation and outcomes in patients worldwide, depending on the waves of the pandemic: wave 1 D614G (n = 1430), wave 2 Alpha (n = 475), and wave 4 Omicron variant (n = 63, UK and Spain only). The performance of CORONET was evaluated on 258, 48, and 54 patients for each wave, respectively. We found that mortality rates were reduced in subsequent waves. The majority of patients were vaccinated in wave 4, and 94% were treated with steroids if they required oxygen. The stages of cancer and the median ages of patients significantly differed, but features associated with worse COVID-19 outcomes remained predictive and did not differ between waves. The CORONET tool performed well in all waves, with scores in an area under the curve (AUC) of >0.72. We concluded that patients with cancer who present to hospital with COVID-19 have similar features of severity, which remain discriminatory despite differences in variants and vaccination status. Survival improved following the first wave of the pandemic, which may be associated with vaccination and the increased steroid use in those patients requiring oxygen. The CORONET model demonstrated good performance, independent of the SARS-CoV-2 variants.
KW - CORONET
KW - COVID-19
KW - Omicron
KW - cancer
KW - outcomes
KW - vaccination
U2 - 10.3390/cancers14163931
DO - 10.3390/cancers14163931
M3 - Article
C2 - 36010932
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 16
M1 - 3931
ER -