Do cancer patients really do worse? A study in a UK tertiary hospital within a COVID 19 epicentre

Background: The COVID-19 pandemic remains of pressing concern for patients with cancer Mortality from COVID-19 is predicted by age and co-morbidities, but the relative contribution of cancer is poorly understood As a tertiary academic hospital serving a large general and cancer population in a COVID-19 epicentre, we are uniquely placed to investigate this We report data from our study, comparing cancer patients to an age- and sex-matched non-cancer cohort Methods: Patients with laboratory confirmed COVID-19 from 1 March to 31 May 2020 were included Patients with a history of solid cancer were compared to an age- and sex-matched non-cancer cohort Patients with haematological malignancies were excluded Results: We identified 94 patients with cancer and 226 patients without cancer In univariate analysis, age, South Asian ethnicity and co-morbidities predicted mortality (see table) More in the cancer cohort had died compared to the non-cancer cohort (43 6% vs 34 1%) The higher mortality among cancer patients was statistically significant among those aged 70 years and above (OR 2 28, 1 14-4 50, p = 0 02) After adjusting for age, ethnicity and co-morbidities, a history of cancer was an independent predictor of mortality following COVID-19 (HR 1 57, 95% CI:1 04-2 4, p = 0 03) Patients with active malignancy also had similarly increased adjusted mortality (HR 1 64, 95% CI: 1 03 – 2 6, p = 0 04) Increasing age (HR 1 49 every 10 years, 95% CI:1 25-1 8, p \u003c0 001), South Asian ethnicity (HR 2 92, 95% CI:1 73-4 9, p \u003c0 001) and cerebrovascular disease (HR 1 93, 95% CI:1 18-3 2, p = 0 008) were also confirmed as independent predictors of mortality [Formula presented] Conclusions: Along with known risk factors, cancer confers an independent risk for mortality in COVID-19 Taken together, our findings support the need to continue ‘shielding’ patients with cancer from exposure to COVID-19 infection Increasing age and co-morbidity should take precedence when weighing up risk factors for severe COVID-19 infection in cancer patients Legal entity responsible for the study: University College London Hospitals NHS Foundation Trust Funding: Has not received any funding Disclosure: H M Shaw: Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis, BMS, MSD;Advisory/Consultancy: Immunocore, Idera, Iovance, Genmab, Sanofi Genzyme/Regeneron, Macrogenics, Roche;Speaker Bureau/Expert testimony: Sanofi Genzyme All other authors have declared no conflicts of interest