Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.

Details

Serval ID
serval:BIB_2286AC0B4000
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.
Journal
Cancer discovery
Author(s)
Rivera D.R., Peters S., Panagiotou O.A., Shah D.P., Kuderer N.M., Hsu C.Y., Rubinstein S.M., Lee B.J., Choueiri T.K., de Lima Lopes G., Grivas P., Painter C.A., Rini B.I., Thompson M.A., Arcobello J., Bakouny Z., Doroshow D.B., Egan P.C., Farmakiotis D., Fecher L.A., Friese C.R., Galsky M.D., Goel S., Gupta S., Halfdanarson T.R., Halmos B., Hawley J.E., Khaki A.R., Lemmon C.A., Mishra S., Olszewski A.J., Pennell N.A., Puc M.M., Revankar S.G., Schapira L., Schmidt A., Schwartz G.K., Shah S.A., Wu J.T., Xie Z., Yeh A.C., Zhu H., Shyr Y., Lyman G.H., Warner J.L.
Working group(s)
COVID-19 and Cancer Consortium
ISSN
2159-8290 (Electronic)
ISSN-L
2159-8274
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
10
Number
10
Pages
1514-1527
Language
english
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Among 2,186 U.S. adults with invasive cancer and laboratory-confirmed SARS-CoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. Although observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through inclusive prospective controlled trials. SIGNIFICANCE: Evaluating the potential role of COVID-19 treatments in patients with cancer in a large observational study, there was no statistically significant 30-day all-cause mortality benefit with hydroxychloroquine or high-dose corticosteroids alone or in combination; remdesivir showed potential benefit. Treatment receipt reflects clinical decision-making and suggests disparities in medication access.This article is highlighted in the In This Issue feature, p. 1426.
Keywords
Adenosine Monophosphate/analogs & derivatives, Adenosine Monophosphate/therapeutic use, Age Factors, Aged, Alanine/analogs & derivatives, Alanine/therapeutic use, Betacoronavirus/pathogenicity, Clinical Decision-Making, Coronavirus Infections/complications, Coronavirus Infections/diagnosis, Coronavirus Infections/drug therapy, Coronavirus Infections/mortality, Drug Therapy, Combination/methods, Drug Therapy, Combination/statistics & numerical data, Drug Utilization/statistics & numerical data, Follow-Up Studies, Glucocorticoids/therapeutic use, Healthcare Disparities/statistics & numerical data, Hospital Mortality, Humans, Hydroxychloroquine/therapeutic use, Male, Middle Aged, Neoplasms/complications, Neoplasms/mortality, Pandemics, Pneumonia, Viral/complications, Pneumonia, Viral/diagnosis, Pneumonia, Viral/drug therapy, Pneumonia, Viral/mortality, Risk Factors, Severity of Illness Index, Sex Factors, Treatment Outcome, United States/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
11/08/2020 11:01
Last modification date
23/11/2020 6:24
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