COVID-19 in patients with gynecologic cancer: A preliminary report from the COVID-19 and Cancer Consortium (CCC19).

Authors

null

Alicia Beeghly-Fadiel

Vanderbilt University Medical Center, Nashville, TN

Alicia Beeghly-Fadiel , Lauren S. Prescott , Erika Ruiz-Garcia , Clara Hwang , Hannah Heilman , Rana R. McKay , Renee Maria Saliby , Suzie Lau , Gayathri Nagaraj , Matthew Puc , Emese Zsiros , Sumit Shah , Chinmay Jani , Jonathan Cosin , Elizabeth Nakasone , Roisin Eilish O'Cearbhaill , Marta A. Crispens , Alaina J. Brown

Organizations

Vanderbilt University Medical Center, Nashville, TN, Instituto Nacional de Cancerologia, Mexico City, Mexico, Henry Ford Health System, Detroit, MI, University of Cincinnati Cancer Center, Cincinnati, OH, University of California San Diego Health, La Jolla, CA, Dana-Farber Cancer Institute, Boston, MA, Jewish General, Montréal, QC, Canada, Loma Linda University, Loma Linda, CA, Virtua Health, Marlton, NJ, Roswell Park Comprehensive Cancer Center, Buffalo, NY, Stanford University Medical Center, Stanford, CA, Mount Auburn Hospital, Cambridge, MA, Hartford HealthCare Cancer Institute, Avon, CT, Fred Hutchinson Cancer Research Center, Seattle, WA, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

U.S. National Institutes of Health

Background: Limited information exists regarding the severity of short-term outcomes among patients with gynecologic cancer who are infected with SARS-CoV-2. Methods: Patients with gynecologic cancer and laboratory confirmed SARS-CoV-2 infection were identified from the international CCC19 registry. We estimated odds ratios (OR) from ordinal logistic regression for associations with severity of COVID-19 outcomes, defined from least to most severe as hospitalization, intensive care unit (ICU) admittance, mechanical ventilation, and 30-day mortality. Results: Of 842 patients identified, 48% had endometrial cancer, 24% had ovarian cancer, 22% had cervical cancer, and 6% had dual primary/other gynecologic cancers. The majority were from the United States (86%), most were non-Hispanic White (46%), and the median age was 62 years (IQR 52-72). The majority were diagnosed with localized disease (68%); only 18 (2%) and 15 (2%) were fully or partially vaccinated, respectively. In the 3 months prior to COVID-19, 36% had any cancer treatment, with chemotherapy the most common (23%). When diagnosed with COVID-19, most patients were in remission (50%), while 37% had active disease, including 22% with metastatic disease. Most patients presented with typical COVID-19 symptoms (76%); few had a poor ECOG performance status (PS ≥2, 14%). Outcomes included hospitalization (50%), ICU admittance (12%), mechanical ventilation (8%), and death within 30 days of testing positive for SARS-CoV-2 (10%). In unadjusted models, increasing age (OR: 1.03 1.02-1.04) and Black race (OR 1.91, 1.31-2.77) were associated with increased severity of COVID-19 outcomes. Compared to patients in remission for ≥5 years, those with progressive disease had increased severity (OR 1.88, 1.25-2.82), while those in remission for < 5 years or with stable disease had decreased severity of COVID-19 outcomes (OR 0.55, 0.39-0.76). In multivariable models that included adjustment for age, race, and cancer status, additional factors associated with increased COVID-19 outcome severity included cardiac (OR 1.57, 1.13-2.19) and renal (OR 2.00, 1.33-3.00) comorbidities, an ECOG PS ≥2 (OR 5.15, 3.21-8.27), having pneumonia or pneumonitis (OR 4.08, 2.94-5.66), venous thromboembolism (OR 4.67, 2.49-8.75), sepsis (OR 14.2, 9.05-22.1), or a co-infection within ±2 weeks of SARS-CoV-2 (OR: 4.40, 2.91-6.65); asymptomatic SARS-CoV-2 infection was associated with decreased severity of outcomes (OR: 0.25, 0.16-0.38). The overall case fatality rate was 15.7%. Conclusions: Patients with gynecologic cancer experience significant morbidity and mortality related to infection with SARS-CoV-2. Age, race, cancer status, co-morbidities, and COVID-19 complications were associated with more severe COVID-19 outcomes, along the continuum from least to most, of hospitalization, ICU admittance, mechanical ventilation, and 30-day mortality.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 5508)

DOI

10.1200/JCO.2022.40.16_suppl.5508

Abstract #

5508

Abstract Disclosures

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