COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Lennard Yw Lee; Jean-Baptiste Cazier; Vasileios Angelis; Roland Arnold; Vartika Bisht; Naomi A Campton; Julia Chackathayil; Vinton Wt Cheng; Helen M Curley; Matthew W Fittall; Luke Freeman-Mills; Spyridon Gennatas; Anshita Goel; Simon Hartley; Daniel J Hughes; David Kerr; Alvin Jx Lee; Rebecca J Lee; Sophie E McGrath; Christopher P Middleton; Nirupa Murugaesu; Thomas Newsom-Davis; Alicia Fc Okines; Anna C Olsson-Brown; Claire Palles; Yi Pan; Ruth Pettengell; Thomas Powles; Emily A Protheroe; Karin Purshouse; Archana Sharma-Oates; Shivan Sivakumar; Ashley J Smith; Thomas Starkey; Chris D Turnbull; Csilla Várnai; Nadia Yousaf; Rachel Kerr; Gary Middleton; Piangfan Naksukpaiboon; Laura Feeney; UK Coronavirus Monitoring Project Team

doi:10.1016/S0140-6736(20)31173-9

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Lennard Yw Lee, Jean-Baptiste Cazier, Vasileios Angelis, Roland Arnold, Vartika Bisht, Naomi A Campton, Julia Chackathayil, Vinton Wt Cheng, Helen M Curley, Matthew W Fittall, Luke Freeman-Mills, Spyridon Gennatas, Anshita Goel, Simon Hartley, Daniel J Hughes, David Kerr, Alvin Jx Lee, Rebecca J Lee, Sophie E McGrath, Christopher P MiddletonNirupa Murugaesu, Thomas Newsom-Davis, Alicia Fc Okines, Anna C Olsson-Brown, Claire Palles, Yi Pan, Ruth Pettengell, Thomas Powles, Emily A Protheroe, Karin Purshouse, Archana Sharma-Oates, Shivan Sivakumar, Ashley J Smith, Thomas Starkey, Chris D Turnbull, Csilla Várnai, Nadia Yousaf, Rachel Kerr, Gary Middleton, Piangfan Naksukpaiboon, Laura Feeney, UK Coronavirus Monitoring Project Team

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

920 Citations (Scopus)

Abstract

BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.

METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.

FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.

INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.

FUNDING: University of Birmingham, University of Oxford.

Original language	English
Pages (from-to)	1919-1926
Number of pages	8
Journal	The Lancet
Volume	395
Issue number	10241
Early online date	28 May 2020
DOIs	https://doi.org/10.1016/S0140-6736(20)31173-9
Publication status	Published - 20 Jun 2020

Bibliographical note

This publication was done under the collaboration with the team at the University of Birmingham under the UK coronavirus cancer monitoring project team (https://ukcoronaviruscancermonitoring.com/covid-19-response-reporting-clinicians/)

Keywords

Age Factors
Aged
Antineoplastic Agents/therapeutic use
Betacoronavirus
COVID-19
Cause of Death
Comorbidity
Coronavirus Infections/complications
Female
Humans
Male
Middle Aged
Neoplasms/complications
Pandemics
Pneumonia, Viral/complications
Prospective Studies
Risk Factors
SARS-CoV-2
Sex Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/S0140-6736(20)31173-9Licence: Unspecified

Construction and analysis of cancer specific interaction networks by co-expression analysis in colorectal cancer
Naksukpaiboon, P. (Author), Orr, N. (Supervisor), Blayney, J. (Supervisor) & Hardiman, G. (Supervisor), Jul 2025
Student thesis: Doctoral Thesis › Doctor of Philosophy

Cite this

Lee, L. Y., Cazier, J.-B., Angelis, V., Arnold, R., Bisht, V., Campton, N. A., Chackathayil, J., Cheng, V. W., Curley, H. M., Fittall, M. W., Freeman-Mills, L., Gennatas, S., Goel, A., Hartley, S., Hughes, D. J., Kerr, D., Lee, A. J., Lee, R. J., McGrath, S. E., ... UK Coronavirus Monitoring Project Team (2020). COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. The Lancet, 395(10241), 1919-1926. https://doi.org/10.1016/S0140-6736(20)31173-9

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title = "COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study",

abstract = "BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.FUNDING: University of Birmingham, University of Oxford.",

keywords = "Age Factors, Aged, Antineoplastic Agents/therapeutic use, Betacoronavirus, COVID-19, Cause of Death, Comorbidity, Coronavirus Infections/complications, Female, Humans, Male, Middle Aged, Neoplasms/complications, Pandemics, Pneumonia, Viral/complications, Prospective Studies, Risk Factors, SARS-CoV-2, Sex Factors",

author = "Lee, {Lennard Yw} and Jean-Baptiste Cazier and Vasileios Angelis and Roland Arnold and Vartika Bisht and Campton, {Naomi A} and Julia Chackathayil and Cheng, {Vinton Wt} and Curley, {Helen M} and Fittall, {Matthew W} and Luke Freeman-Mills and Spyridon Gennatas and Anshita Goel and Simon Hartley and Hughes, {Daniel J} and David Kerr and Lee, {Alvin Jx} and Lee, {Rebecca J} and McGrath, {Sophie E} and Middleton, {Christopher P} and Nirupa Murugaesu and Thomas Newsom-Davis and Okines, {Alicia Fc} and Olsson-Brown, {Anna C} and Claire Palles and Yi Pan and Ruth Pettengell and Thomas Powles and Protheroe, {Emily A} and Karin Purshouse and Archana Sharma-Oates and Shivan Sivakumar and Smith, {Ashley J} and Thomas Starkey and Turnbull, {Chris D} and Csilla V{\'a}rnai and Nadia Yousaf and Rachel Kerr and Gary Middleton and Piangfan Naksukpaiboon and Laura Feeney and {UK Coronavirus Monitoring Project Team}",

note = "This publication was done under the collaboration with the team at the University of Birmingham under the UK coronavirus cancer monitoring project team (https://ukcoronaviruscancermonitoring.com/covid-19-response-reporting-clinicians/)",

year = "2020",

month = jun,

day = "20",

doi = "10.1016/S0140-6736(20)31173-9",

language = "English",

volume = "395",

pages = "1919--1926",

journal = "The Lancet",

issn = "0140-6736",

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Lee, LY, Cazier, J-B, Angelis, V, Arnold, R, Bisht, V, Campton, NA, Chackathayil, J, Cheng, VW, Curley, HM, Fittall, MW, Freeman-Mills, L, Gennatas, S, Goel, A, Hartley, S, Hughes, DJ, Kerr, D, Lee, AJ, Lee, RJ, McGrath, SE, Middleton, CP, Murugaesu, N, Newsom-Davis, T, Okines, AF, Olsson-Brown, AC, Palles, C, Pan, Y, Pettengell, R, Powles, T, Protheroe, EA, Purshouse, K, Sharma-Oates, A, Sivakumar, S, Smith, AJ, Starkey, T, Turnbull, CD, Várnai, C, Yousaf, N, Kerr, R, Middleton, G, Naksukpaiboon, P , Feeney, L & UK Coronavirus Monitoring Project Team 2020, 'COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study', The Lancet, vol. 395, no. 10241, pp. 1919-1926. https://doi.org/10.1016/S0140-6736(20)31173-9

TY - JOUR

T1 - COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

AU - Lee, Lennard Yw

AU - Cazier, Jean-Baptiste

AU - Angelis, Vasileios

AU - Arnold, Roland

AU - Bisht, Vartika

AU - Campton, Naomi A

AU - Chackathayil, Julia

AU - Cheng, Vinton Wt

AU - Curley, Helen M

AU - Fittall, Matthew W

AU - Freeman-Mills, Luke

AU - Gennatas, Spyridon

AU - Goel, Anshita

AU - Hartley, Simon

AU - Hughes, Daniel J

AU - Kerr, David

AU - Lee, Alvin Jx

AU - Lee, Rebecca J

AU - McGrath, Sophie E

AU - Middleton, Christopher P

AU - Murugaesu, Nirupa

AU - Newsom-Davis, Thomas

AU - Okines, Alicia Fc

AU - Olsson-Brown, Anna C

AU - Palles, Claire

AU - Pan, Yi

AU - Pettengell, Ruth

AU - Powles, Thomas

AU - Protheroe, Emily A

AU - Purshouse, Karin

AU - Sharma-Oates, Archana

AU - Sivakumar, Shivan

AU - Smith, Ashley J

AU - Starkey, Thomas

AU - Turnbull, Chris D

AU - Várnai, Csilla

AU - Yousaf, Nadia

AU - Kerr, Rachel

AU - Middleton, Gary

AU - Naksukpaiboon, Piangfan

AU - Feeney, Laura

AU - UK Coronavirus Monitoring Project Team

N1 - This publication was done under the collaboration with the team at the University of Birmingham under the UK coronavirus cancer monitoring project team (https://ukcoronaviruscancermonitoring.com/covid-19-response-reporting-clinicians/)

PY - 2020/6/20

Y1 - 2020/6/20

N2 - BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.FUNDING: University of Birmingham, University of Oxford.

AB - BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks.INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.FUNDING: University of Birmingham, University of Oxford.

KW - Age Factors

KW - Aged

KW - Antineoplastic Agents/therapeutic use

KW - Betacoronavirus

KW - COVID-19

KW - Cause of Death

KW - Comorbidity

KW - Coronavirus Infections/complications

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasms/complications

KW - Pandemics

KW - Pneumonia, Viral/complications

KW - Prospective Studies

KW - Risk Factors

KW - SARS-CoV-2

KW - Sex Factors

U2 - 10.1016/S0140-6736(20)31173-9

DO - 10.1016/S0140-6736(20)31173-9

M3 - Article

C2 - 32473682

SN - 0140-6736

VL - 395

SP - 1919

EP - 1926

JO - The Lancet

JF - The Lancet

IS - 10241

ER -

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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Student theses

Construction and analysis of cancer specific interaction networks by co-expression analysis in colorectal cancer

Cite this