COVID‐19 outcomes of patients with gynecologic cancer in New York City
Background New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is li...
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| Veröffentlicht in: | Cancer 2020-10, Vol.126 (19), p.4294-4303 |
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| creator | Lara, Olivia D. O’Cearbhaill, Roisin E. Smith, Maria J. Sutter, Megan E. Knisely, Anne McEachron, Jennifer Gabor, Lisa R. Jee, Justin Fehniger, Julia E. Lee, Yi‐Chun Isani, Sara S. Wright, Jason D. Pothuri, Bhavana |
| description | Background
New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is limited.
Methods
Patients from 6 NYC‐area hospital systems with known gynecologic cancer and a COVID‐19 diagnosis were identified. Demographic and clinical outcome data were ed through a review of electronic medical records.
Results
Records for 121 patients with gynecologic cancer and COVID‐19 were ed; the median age at the COVID‐19 diagnosis was 64.0 years (interquartile range, 51.0‐73.0 years). Sixty‐six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID‐19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18‐2.51), African American race (RR, 1.56; 95% CI, 1.13‐2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03‐1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08‐11.27) was associated with death due to COVID‐19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID‐19 severity or mortality.
Conclusions
The case fatality rate among gynecologic oncology patients with a COVID‐19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID‐19 infection.
Lay Summary
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.
As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%. There is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death. |
| doi_str_mv | 10.1002/cncr.33084 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2429061056</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2439601279</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4214-8c0002d23148321fdeaca5c2fabaf3d3153c3e8016edae43419f3c62f8ce07453</originalsourceid><addsrcrecordid>eNp90MtKw0AUBuBBFFurGx9ABtyIkDq33JYSLy2UFkRFV2E6OampaabOJJTsfASf0SdxaqsLF64OBz5-fn6EjinpU0LYhaqU6XNOIrGDupTEoUeoYLuoSwiJPF_wpw46sHbu3pD5fB91OAtZ7EwXDZLJ4_Dq8_2Dxlg3tdILsFjneCnrAqra4lVRv-BZW4HSpZ4VCitZKTC4qPAYVvhZm1ecFHV7iPZyWVo42t4eeri5vk8G3mhyO0wuR54SjAovUq4FyxinIuKM5hlIJX3FcjmVOc849bniEBEaQCZBcEHjnKuA5ZECEgqf99DZJndp9FsDtk4XhVVQlrIC3diUCRaTgBI_cPT0D53rxlSunVM8DghlYezU-UYpo601kKdLUyykaVNK0vW-6Xrf9Htfh0-2kc10Adkv_RnUAboBq6KE9p-oNBknd5vQL8D7g_o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2439601279</pqid></control><display><type>article</type><title>COVID‐19 outcomes of patients with gynecologic cancer in New York City</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Free Content</source><source>Alma/SFX Local Collection</source><creator>Lara, Olivia D. ; O’Cearbhaill, Roisin E. ; Smith, Maria J. ; Sutter, Megan E. ; Knisely, Anne ; McEachron, Jennifer ; Gabor, Lisa R. ; Jee, Justin ; Fehniger, Julia E. ; Lee, Yi‐Chun ; Isani, Sara S. ; Wright, Jason D. ; Pothuri, Bhavana</creator><creatorcontrib>Lara, Olivia D. ; O’Cearbhaill, Roisin E. ; Smith, Maria J. ; Sutter, Megan E. ; Knisely, Anne ; McEachron, Jennifer ; Gabor, Lisa R. ; Jee, Justin ; Fehniger, Julia E. ; Lee, Yi‐Chun ; Isani, Sara S. ; Wright, Jason D. ; Pothuri, Bhavana</creatorcontrib><description>Background
New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is limited.
Methods
Patients from 6 NYC‐area hospital systems with known gynecologic cancer and a COVID‐19 diagnosis were identified. Demographic and clinical outcome data were ed through a review of electronic medical records.
Results
Records for 121 patients with gynecologic cancer and COVID‐19 were ed; the median age at the COVID‐19 diagnosis was 64.0 years (interquartile range, 51.0‐73.0 years). Sixty‐six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID‐19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18‐2.51), African American race (RR, 1.56; 95% CI, 1.13‐2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03‐1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08‐11.27) was associated with death due to COVID‐19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID‐19 severity or mortality.
Conclusions
The case fatality rate among gynecologic oncology patients with a COVID‐19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID‐19 infection.
Lay Summary
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.
As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%. There is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.33084</identifier><identifier>PMID: 32729142</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Cancer ; Cancer therapies ; Chemotherapy ; Comorbidity ; Complications ; Confidence intervals ; Coronaviridae ; coronavirus disease 2019 (COVID‐19) ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - etiology ; COVID-19 - mortality ; COVID-19 - therapy ; Cytotoxicity ; Diagnosis ; Electronic health records ; Electronic medical records ; Fatalities ; Female ; Genital Neoplasms, Female - epidemiology ; Genital Neoplasms, Female - therapy ; gynecologic cancer ; Hospitalization ; Humans ; Immunotherapy ; Infections ; Intensive Care Units ; Invasiveness ; Mechanical ventilation ; Middle Aged ; Mortality ; New York City ; Oncology ; outcomes ; Pandemics ; Patients ; Respiration, Artificial ; Respiratory diseases ; Retrospective Studies ; Risk Factors ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) ; Surgery ; Treatment Outcome ; Ventilation ; Ventilators ; Viral diseases</subject><ispartof>Cancer, 2020-10, Vol.126 (19), p.4294-4303</ispartof><rights>2020 American Cancer Society</rights><rights>2020 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4214-8c0002d23148321fdeaca5c2fabaf3d3153c3e8016edae43419f3c62f8ce07453</citedby><cites>FETCH-LOGICAL-c4214-8c0002d23148321fdeaca5c2fabaf3d3153c3e8016edae43419f3c62f8ce07453</cites><orcidid>0000-0001-9816-9549 ; 0000-0002-3540-5804</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.33084$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.33084$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32729142$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lara, Olivia D.</creatorcontrib><creatorcontrib>O’Cearbhaill, Roisin E.</creatorcontrib><creatorcontrib>Smith, Maria J.</creatorcontrib><creatorcontrib>Sutter, Megan E.</creatorcontrib><creatorcontrib>Knisely, Anne</creatorcontrib><creatorcontrib>McEachron, Jennifer</creatorcontrib><creatorcontrib>Gabor, Lisa R.</creatorcontrib><creatorcontrib>Jee, Justin</creatorcontrib><creatorcontrib>Fehniger, Julia E.</creatorcontrib><creatorcontrib>Lee, Yi‐Chun</creatorcontrib><creatorcontrib>Isani, Sara S.</creatorcontrib><creatorcontrib>Wright, Jason D.</creatorcontrib><creatorcontrib>Pothuri, Bhavana</creatorcontrib><title>COVID‐19 outcomes of patients with gynecologic cancer in New York City</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background
New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is limited.
Methods
Patients from 6 NYC‐area hospital systems with known gynecologic cancer and a COVID‐19 diagnosis were identified. Demographic and clinical outcome data were ed through a review of electronic medical records.
Results
Records for 121 patients with gynecologic cancer and COVID‐19 were ed; the median age at the COVID‐19 diagnosis was 64.0 years (interquartile range, 51.0‐73.0 years). Sixty‐six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID‐19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18‐2.51), African American race (RR, 1.56; 95% CI, 1.13‐2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03‐1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08‐11.27) was associated with death due to COVID‐19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID‐19 severity or mortality.
Conclusions
The case fatality rate among gynecologic oncology patients with a COVID‐19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID‐19 infection.
Lay Summary
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.
As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%. There is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.</description><subject>Aged</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Coronaviridae</subject><subject>coronavirus disease 2019 (COVID‐19)</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - etiology</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - therapy</subject><subject>Cytotoxicity</subject><subject>Diagnosis</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Fatalities</subject><subject>Female</subject><subject>Genital Neoplasms, Female - epidemiology</subject><subject>Genital Neoplasms, Female - therapy</subject><subject>gynecologic cancer</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Infections</subject><subject>Intensive Care Units</subject><subject>Invasiveness</subject><subject>Mechanical ventilation</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>New York City</subject><subject>Oncology</subject><subject>outcomes</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Respiration, Artificial</subject><subject>Respiratory diseases</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Viral diseases</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90MtKw0AUBuBBFFurGx9ABtyIkDq33JYSLy2UFkRFV2E6OampaabOJJTsfASf0SdxaqsLF64OBz5-fn6EjinpU0LYhaqU6XNOIrGDupTEoUeoYLuoSwiJPF_wpw46sHbu3pD5fB91OAtZ7EwXDZLJ4_Dq8_2Dxlg3tdILsFjneCnrAqra4lVRv-BZW4HSpZ4VCitZKTC4qPAYVvhZm1ecFHV7iPZyWVo42t4eeri5vk8G3mhyO0wuR54SjAovUq4FyxinIuKM5hlIJX3FcjmVOc849bniEBEaQCZBcEHjnKuA5ZECEgqf99DZJndp9FsDtk4XhVVQlrIC3diUCRaTgBI_cPT0D53rxlSunVM8DghlYezU-UYpo601kKdLUyykaVNK0vW-6Xrf9Htfh0-2kc10Adkv_RnUAboBq6KE9p-oNBknd5vQL8D7g_o</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Lara, Olivia D.</creator><creator>O’Cearbhaill, Roisin E.</creator><creator>Smith, Maria J.</creator><creator>Sutter, Megan E.</creator><creator>Knisely, Anne</creator><creator>McEachron, Jennifer</creator><creator>Gabor, Lisa R.</creator><creator>Jee, Justin</creator><creator>Fehniger, Julia E.</creator><creator>Lee, Yi‐Chun</creator><creator>Isani, Sara S.</creator><creator>Wright, Jason D.</creator><creator>Pothuri, Bhavana</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9816-9549</orcidid><orcidid>https://orcid.org/0000-0002-3540-5804</orcidid></search><sort><creationdate>20201001</creationdate><title>COVID‐19 outcomes of patients with gynecologic cancer in New York City</title><author>Lara, Olivia D. ; O’Cearbhaill, Roisin E. ; Smith, Maria J. ; Sutter, Megan E. ; Knisely, Anne ; McEachron, Jennifer ; Gabor, Lisa R. ; Jee, Justin ; Fehniger, Julia E. ; Lee, Yi‐Chun ; Isani, Sara S. ; Wright, Jason D. ; Pothuri, Bhavana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4214-8c0002d23148321fdeaca5c2fabaf3d3153c3e8016edae43419f3c62f8ce07453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Coronaviridae</topic><topic>coronavirus disease 2019 (COVID‐19)</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - etiology</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - therapy</topic><topic>Cytotoxicity</topic><topic>Diagnosis</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Fatalities</topic><topic>Female</topic><topic>Genital Neoplasms, Female - epidemiology</topic><topic>Genital Neoplasms, Female - therapy</topic><topic>gynecologic cancer</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Infections</topic><topic>Intensive Care Units</topic><topic>Invasiveness</topic><topic>Mechanical ventilation</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>New York City</topic><topic>Oncology</topic><topic>outcomes</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Respiration, Artificial</topic><topic>Respiratory diseases</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Viral diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lara, Olivia D.</creatorcontrib><creatorcontrib>O’Cearbhaill, Roisin E.</creatorcontrib><creatorcontrib>Smith, Maria J.</creatorcontrib><creatorcontrib>Sutter, Megan E.</creatorcontrib><creatorcontrib>Knisely, Anne</creatorcontrib><creatorcontrib>McEachron, Jennifer</creatorcontrib><creatorcontrib>Gabor, Lisa R.</creatorcontrib><creatorcontrib>Jee, Justin</creatorcontrib><creatorcontrib>Fehniger, Julia E.</creatorcontrib><creatorcontrib>Lee, Yi‐Chun</creatorcontrib><creatorcontrib>Isani, Sara S.</creatorcontrib><creatorcontrib>Wright, Jason D.</creatorcontrib><creatorcontrib>Pothuri, Bhavana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lara, Olivia D.</au><au>O’Cearbhaill, Roisin E.</au><au>Smith, Maria J.</au><au>Sutter, Megan E.</au><au>Knisely, Anne</au><au>McEachron, Jennifer</au><au>Gabor, Lisa R.</au><au>Jee, Justin</au><au>Fehniger, Julia E.</au><au>Lee, Yi‐Chun</au><au>Isani, Sara S.</au><au>Wright, Jason D.</au><au>Pothuri, Bhavana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID‐19 outcomes of patients with gynecologic cancer in New York City</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>126</volume><issue>19</issue><spage>4294</spage><epage>4303</epage><pages>4294-4303</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background
New York City (NYC) is the epicenter of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID‐19]) in the United States. Clinical characteristics and outcomes of vulnerable populations, such as those with gynecologic cancer who develop COVID‐19 infections, is limited.
Methods
Patients from 6 NYC‐area hospital systems with known gynecologic cancer and a COVID‐19 diagnosis were identified. Demographic and clinical outcome data were ed through a review of electronic medical records.
Results
Records for 121 patients with gynecologic cancer and COVID‐19 were ed; the median age at the COVID‐19 diagnosis was 64.0 years (interquartile range, 51.0‐73.0 years). Sixty‐six of the 121 patients (54.5%) required hospitalization; among the hospitalized patients, 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive care unit, and 9 (13.6%) underwent invasive mechanical ventilation. Seventeen patients (14.0%) died of COVID‐19 complications. No patient requiring mechanical ventilation survived. On multivariable analysis, hospitalization was associated with an age ≥64 years (risk ratio [RR], 1.73; 95% confidence interval [CI], 1.18‐2.51), African American race (RR, 1.56; 95% CI, 1.13‐2.15), and 3 or more comorbidities (RR, 1.43; 95% CI, 1.03‐1.98). Only recent immunotherapy use (RR, 3.49; 95% CI, 1.08‐11.27) was associated with death due to COVID‐19 on multivariable analysis; chemotherapy treatment and recent major surgery were not predictive of COVID‐19 severity or mortality.
Conclusions
The case fatality rate among gynecologic oncology patients with a COVID‐19 infection is 14.0%. Recent immunotherapy use is associated with an increased risk of mortality related to COVID‐19 infection.
Lay Summary
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%; there is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.
As such, patients can be counseled regarding the safety of continued anticancer treatments during the pandemic. This is important because the ability to continue cancer therapies for cancer control and cure is critical.
The case fatality rate among gynecologic oncology patients with a coronavirus disease 2019 (COVID‐19) infection is 14.0%. There is no association between cytotoxic chemotherapy and cancer‐directed surgery and COVID‐19 severity or death.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32729142</pmid><doi>10.1002/cncr.33084</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9816-9549</orcidid><orcidid>https://orcid.org/0000-0002-3540-5804</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Cancer, 2020-10, Vol.126 (19), p.4294-4303 |
| issn | 0008-543X 1097-0142 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Free Content; Alma/SFX Local Collection |
| subjects | Aged Cancer Cancer therapies Chemotherapy Comorbidity Complications Confidence intervals Coronaviridae coronavirus disease 2019 (COVID‐19) Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - etiology COVID-19 - mortality COVID-19 - therapy Cytotoxicity Diagnosis Electronic health records Electronic medical records Fatalities Female Genital Neoplasms, Female - epidemiology Genital Neoplasms, Female - therapy gynecologic cancer Hospitalization Humans Immunotherapy Infections Intensive Care Units Invasiveness Mechanical ventilation Middle Aged Mortality New York City Oncology outcomes Pandemics Patients Respiration, Artificial Respiratory diseases Retrospective Studies Risk Factors Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Surgery Treatment Outcome Ventilation Ventilators Viral diseases |
| title | COVID‐19 outcomes of patients with gynecologic cancer in New York City |
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