Key result
CV disease or risk factors linked to ~25% higher COVID-19 severity in cancer patients.
Why the study?
Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease or cardiovascular risk factors after SARS-CoV-2 infection were limited.
Does the presence of co-morbid CVD/CVRF increase COVID-19 severity in patients with cancer and SARS-CoV-2 infection?
Cohort (n=10,876)
Yes
Does the presence of co-morbid CVD/CVRF increase COVID-19 severity in patients with cancer and SARS-CoV-2 infection?
Effect estimate: OR 1.25 (95% CI 1.11-1.40)
Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy.
May warrant closer monitoring in cancer patients with CVD/CVRF off active therapy; extends observational data but leaves causal inference open.
Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. 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. 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). 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).
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Moey et al. (2023) conducted a cohort in COVID-19 in patients with cancer (n=10,876). Co-morbid cardiovascular disease or cardiovascular risk factors (CVD/CVRF) vs. No co-morbid CVD/CVRF was evaluated on Ordinal scale of COVID-19 severity (OR 1.25, 95% CI 1.11-1.40). Co-morbid cardiovascular disease or cardiovascular risk factors were associated with higher COVID-19 severity (adjusted OR 1.25) among patients with cancer, particularly those not receiving active cancer therapy.
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