COVID-19 and Cancer: A Comparison of the Two Important Pandemic Waves in an Indian Cancer Patients' Cohort

 

 Permissions and Reprints

Abstract

It is well known that patients with cancer are at an increased risk of severe COVID-19. There are no reports that depict the differences in outcomes in cancer patients between the two waves of the pandemic. This is a real-world experience aimed at characterizing the differences in demographics, clinical features, treatment details, and outcomes in COVID-19-positive cancer patients between the two pandemic waves. This was a prospective study of all COVID-19-positive cancer patients attending our specialty out-patient department at Rajiv Gandhi Cancer Institute and Research Centre between March 2020 and November 2020 (1st wave) and April 2021 and June 2021 (second wave). All patients diagnosed to have COVID-19 by real-time polymerase chain reaction (RT-PCR) with a biopsy-proven solid organ malignancy attending the medical oncology out-patient department were included during both the waves. A total of 300 patients with proven SARS-CoV-2 infection by either RT-PCR or cartridge based nucleic acid amplification test were encountered, of which 123 were encountered during the first wave of the pandemic and 177 during the second wave. The case fatality rate of the first wave was 9.8%, with a 15-day case fatality rate of 5.6%, whereas for the second wave, it was 13% and 7.2%, respectively. Twelve patients succumbed to COVID-19 disease in the first wave and 23 succumbed in the second. There were no statistically significant correlations; however, the death in the second wave tended to occur more in younger male patients, with comorbidities and history of smoking. There was no relation with ongoing cancer-directed treatment or chemotherapy. Our study is unique in comparing characteristics of the two most important COVID-19 waves and treatment patterns in cancer patients from a single center. The second wave showed a higher CFR, hospital admission rate, and higher frequency of respiratory complications; however, there was no relation to cancer-directed therapy and COVID-19, thus reiterating the fact that cancer treatment should not be halted in the event of a COVID-19 infection.

Publication History

Article published online:
24 August 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

• References

• 1 Shah SGS, Farrow A. A commentary on “World Health Organization declares global emergency: a review of the 2019 novel Coronavirus (COVID-19)”. Int J Surg 2020; 76: 128-129
  CrossrefPubMedGoogle Scholar
• 2 Wang Q, Berger NA, Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol 2021; 7 (02) 220-227
  CrossrefPubMedGoogle Scholar
• 3 Philip M, Ray D, Subramanian S. Decoding India's low COVID-19 case Fatality Rate. J Hum Dev Capab 2021; 22 (01) 27-51
  CrossrefGoogle Scholar
• 4 Pramesh CS, Badwe RA. Cancer management in India during Covid-19. N Engl J Med 2020; 382 (20) e61
  CrossrefPubMedGoogle Scholar
• 5 Ranganathan P, Sengar M, Chinnaswamy G. et al; National Cancer Grid of India. Impact of COVID-19 on cancer care in India: a cohort study. Lancet Oncol 2021; 22 (07) 970-976
  CrossrefPubMedGoogle Scholar
• 6 Gupta N, Chauhan AS, Prinja S, Pandey AK. Impact of COVID-19 on outcomes for patients with cervical cancer in India. JCO Glob Oncol 2021; 7 (07) 716-725
  CrossrefPubMedGoogle Scholar
• 7 Roy S, Ghosh J, Ganguly S. et al. Outcome of COVID-19 in solid organ malignancies: experience from a tertiary cancer center in eastern India. JCO Glob Oncol 2021; 7 (07) 1374-1379
  CrossrefPubMedGoogle Scholar
• 8 Mehta A, Vasudevan S, Parkash A, Sharma A, Vashist T, Krishna V. COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India. PeerJ 2021; 9: e10599
  CrossrefPubMedGoogle Scholar
• 9 Desai A, Gainor JF, Hegde A. et al; COVID19 and Cancer Clinical Trials Working Group. Author correction: COVID-19 vaccine guidance for patients with cancer participating in oncology clinical trials. Nat Rev Clin Oncol 2021; 18 (05) 320-320
  CrossrefPubMedGoogle Scholar
• 10 Corti C, Curigliano G. Commentary: SARS-CoV-2 vaccines and cancer patients. Ann Oncol 2021; 32 (04) 569-571
  CrossrefPubMedGoogle Scholar
• 11 Batra U, Nathany S, Bansal N, Sharma M. COVID-19 vaccination status in Indian patients with cancer: an observational study. Cancer Res Stat Treat 2021; 4 (02) 219
  CrossrefGoogle Scholar
• 12 Noronha V, Abraham G, Bondili S. et al. COVID-19 vaccine uptake and vaccine hesitancy in Indian patients with cancer: a questionnaire-based survey Cancer Res Stat Treat 2021; 4 (02) 211
  Crossref
• 13 Han S, Zhuang Q, Chiang J. et al. Impact of cancer diagnoses on the outcomes of patients with COVID-19: a systematic review and meta-analysis. BMJ Open 2022; 12 (02) e044661
  CrossrefPubMedGoogle Scholar
• 14 Nahshon C, Segev Y, Schmidt M, Bar-Noy T, Ostrovsky L, Lavie O. Outcomes of diagnosed COVID-19 cancer patients: concerning results of a systematic review. J Chemother 2021; 33 (08) 528-538
  CrossrefPubMedGoogle Scholar
• 15 Government of India. 2020 . Accessed January 27, 2023: https://www.mygov.in/aarogya-setu-app/
  PubMed
• 16 Saini KS, Tagliamento M, Lambertini M. et al. Mortality in patients with cancer and coronavirus disease 2019: a systematic review and pooled analysis of 52 studies. Eur J Cancer 2020; 139: 43-50
  CrossrefPubMedGoogle Scholar
• 17 Madan A, Siglin J, Khan A. Comprehensive review of implications of COVID-19 on clinical outcomes of cancer patients and management of solid tumors during the pandemic. Cancer Med 2020; 9 (24) 9205-9218
  CrossrefPubMedGoogle Scholar
• 18 Ramaswamy A, Nayak L, Roy Moulik N. et al. COVID-19 in cancer patients on active systemic therapy-outcomes from LMIC scenario with an emphasis on need for active treatment. Cancer Med 2020; 9 (23) 8747-8753
  CrossrefPubMedGoogle Scholar
• 19 Ma J, Yin J, Qian Y, Wu Y. Clinical characteristics and prognosis in cancer patients with COVID-19: a single center's retrospective study. J Infect 2020; 81 (02) 318-356
  CrossrefPubMedGoogle Scholar
• 20 Lee LY, Cazier J-B, Angelis V. et al; UK Coronavirus Monitoring Project Team. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet 2020; 395 (10241): 1919-1926
  CrossrefPubMedGoogle Scholar
• 21 Mehta V, Goel S, Kabarriti R. et al. Case fatality rate of cancer patients with COVID-19 in a New York Hospital system. Cancer Discov 2020; 10 (07) 935-941
  CrossrefPubMedGoogle Scholar
• 22 Booth S, Willan J, Wong H. et al. Regional outcomes of severe acute respiratory syndrome coronavirus 2 infection in hospitalised patients with haematological malignancy. Eur J Haematol 2020; 105 (04) 476-483
  CrossrefPubMedGoogle Scholar
• 23 Fernandes GA, Feriani D, França E Silva ILA. et al. Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center. Semin Oncol 2021; 48 (02) 171-180
  CrossrefPubMedGoogle Scholar
• 24 Iftimie S, López-Azcona AF, Vallverdú I. et al. First and second waves of coronavirus disease-19: a comparative study in hospitalized patients in Reus, Spain. Di Gennaro F, ed. PLoS One 2021; 16 (03) e0248029
  CrossrefPubMedGoogle Scholar