TY - JOUR
T1 - COVID-19 severity and cardiovascular outcomes in SARS-CoV-2-infected patients with cancer and cardiovascular disease
T2 - COVID-19 Outcomes in Patients with Cancer and Cardiovascular Disease
AU - COVID-19 and Cancer Consortium
AU - Moey, Melissa Y.Y.
AU - Hennessy, Cassandra
AU - French, Benjamin
AU - Warner, Jeremy L.
AU - Tucker, Matthew D.
AU - Hausrath, Daniel J.
AU - Shah, Dimpy P.
AU - DeCara, Jeanne M.
AU - Bakouny, Ziad
AU - Labaki, Chris
AU - Choueiri, Toni K.
AU - Dent, Susan
AU - Akhter, Nausheen
AU - Ismail-Khan, Roohi
AU - Tachiki, Lisa
AU - Slosky, David
AU - Polonsky, Tamar S.
AU - Awosika, Joy A.
AU - Crago, Audrey
AU - Wise-Draper, Trisha
AU - Balanchivadze, Nino
AU - Hwang, Clara
AU - Fecher, Leslie A.
AU - Gomez, Cyndi Gonzalez
AU - Hayes-Lattin, Brandon
AU - Glover, Michael J.
AU - Shah, Sumit A.
AU - Gopalakrishnan, Dharmesh
AU - Griffiths, Elizabeth A.
AU - Kwon, Daniel H.
AU - Koshkin, Vadim S.
AU - Mahmood, Sana
AU - Bashir, Babar
AU - Nonato, Taylor
AU - Razavi, Pedram
AU - McKay, Rana R.
AU - Nagaraj, Gayathri
AU - Oligino, Eric
AU - Puc, Matthew
AU - Tregubenko, Polina
AU - Wulff-Burchfield, Elizabeth M.
AU - Xie, Zhuoer
AU - Halfdanarson, Thorvardur R.
AU - Farmakiotis, Dimitrios
AU - Klein, Elizabeth J.
AU - Robilotti, Elizabeth V.
AU - Riely, Gregory J.
AU - Durand, Jean Bernard
AU - Hayek, Salim S.
AU - Kondapalli, Lavanya
N1 - Publisher Copyright:
© 2023
PY - 2023/8
Y1 - 2023/8
N2 - Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ≥ 55 or female ≥ 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54–74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11–1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p<0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31–1.74] vs. OR 1.04 [95% CI 0.90–1.20], pinteraction <0.001). Conclusions: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701).
AB - Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ≥ 55 or female ≥ 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54–74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11–1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p<0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31–1.74] vs. OR 1.04 [95% CI 0.90–1.20], pinteraction <0.001). Conclusions: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701).
KW - Cancer
KW - Cardio-oncology
KW - Cardiovascular disease
KW - COVID-19 outcomes
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UR - http://www.scopus.com/inward/citedby.url?scp=85162090750&partnerID=8YFLogxK
U2 - 10.1016/j.tranon.2023.101709
DO - 10.1016/j.tranon.2023.101709
M3 - Article
C2 - 37302348
AN - SCOPUS:85162090750
SN - 1944-7124
VL - 34
JO - Translational Oncology
JF - Translational Oncology
M1 - 101709
ER -