COVID-19 Outcomes, Patient Vaccination Status, and Cancer-Related Delays during the Omicron Wave: A Brief Report from the TERAVOLT Analysis

The Thoracic Centers International COVID-19 Collaboration (TERAVOLT) registry found ∼ 30% mortality in patients with thoracic malignancies during the initial COVID surges. Data from South Africa suggested a decrease in severity and mortality with the Omicron wave. Our objective was to assess mortality of patients with thoracic malignancies with the Omicron-predominant wave, and efficacy of vaccination. A prospective, multicenter observational study was conducted. Twenty-eight institutions contributed data from January 14, 2022 through February 4, 2022. Inclusion criteria was any thoracic cancer and a COVID-19 diagnosis on or after November 1, 2021. Endpoints included mortality, hospitalization, symptomatic COVID infection, asymptomatic COVID infection, and delay in cancer therapy. Analysis was done through contingency tables and a multivariable logistic model. We enrolled 346 patients. Median age was 65, 52.3% were female, 74.2% were current or former smokers, 86% had NSCLC, 72% were Stage IV at time of COVID diagnosis, and 66% were receiving therapy. Variant was unknown for 70%; for those known, Omicron represented 82%. Overall mortality was 3.2%. Using multivariate analysis, COVID vaccination with booster compared with no vaccination showed a protective effect on hospitalization or death (OR 0.30, CI 0.15-0.57, p=0.0003), while vaccination without booster did not (OR of 0.64, CI 0.33-1.24, p=0.1864). Cancer care was delayed in 56.4% of patients. TERAVOLT found reduced patient mortality with the most recent COVID surge. COVID vaccination with booster improved outcomes of hospitalization or death. Delays in cancer therapy remain an issue, which has the potential to worsen cancer-related mortality.