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 - 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 - Croitoru, Adina

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 H.

AU - Joharatnam-Hogan, Nalinie

AU - Khan, Sam

AU - Khan, Umair T.

AU - Khan, Khurum

AU - Lewis, Alexandra

AU - Massard, Christophe

AU - Maynard, Alec

AU - McKenzie, Hayley

AU - Michielin, Olivier

AU - Mosenthal, Anne C.

AU - on behalf of the ESMO Co-Care

N1 - Publisher Copyright: © 2022 by the authors.

PY - 2022

Y1 - 2022

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 - cancer

KW - CORONET

KW - COVID-19

KW - Omicron

KW - outcomes

KW - vaccination

U2 - 10.3390/cancers14163931

DO - 10.3390/cancers14163931

M3 - Journal article

C2 - 36010932

AN - SCOPUS:85137377682

VL - 14

JO - Cancers

JF - Cancers

SN - 2072-6694

IS - 16

M1 - 3931

ER -