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Cancer and COVID 19

Cancer patients diagnosed with COVID-19 who are otherwise generally healthy can and do survive the coronavirus, according to a new study that evaluated 928 patients with both conditions. But there was much bleaker news for cancer patients with COVID-19 who also had other medical issues, such as high blood pressure and diabetes.

Overall, the death rate from COVID-19 for cancer patients over the study's 3-week follow-up was 13%, says study lead author Jeremy Warner, MD, an associate professor of medicine and biomedical informatics at Vanderbilt University, Nashville.

That’s higher than the estimated 5.9% case-fatality rate for the U.S.

When Warner looked at a small group of 86 patients who had no other medical problems in addition to the cancer and the coronavirus and had been functioning normally despite the cancer, he found that all of them survived.

Those at higher risk of dying included:

  • Older patients

  • Men

  • Smokers or former smokers

  • Patients with two other conditions

  • Those with active cancer

  • Patients who had taken the drug combination of hydroxychloroquine and azithromycin

Warner says 270 patients received the drug combination. At the time the study began, in mid-March, ''those were the most used drugs in the treatment of patients with COVID," he says.

Researchers collected information on COVID-19 patients with cancer from 104 institutions as part of a clinical trial. The median age was 66, and breast cancer was the most common type, affecting 21% of patients, followed by prostate, gastrointestinal, and thoracic, including lung cancers. And 39% were on active cancer treatment when diagnosed with COVID-19. Cancer type was not linked to mortality.

Warner's team is continuing to study the effects of COVID-19 on cancer patients. The data base is now over 2,200 patients. The use of the antiviral drug remdesivir is up dramatically, he says. The FDA granted remdesivir emergency use authorization to treat COVID-19 on May 1.

The data suggests that in some instances, COVID-19 patients who are doing well on cancer treatments might be able to continue them, but that others might consider changing to palliative care, Warner says.

“Patients with progressing cancer or impaired performance are at a higher risk of a bad outcome,” he says. “It's pretty clear they shouldn't continue aggressive therapies for the cancer if diagnosed with COVID-19."

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