A Clatterbridge consultant and cancer researcher has led a team which has found evidence that people with the disease face a higher risk of death from COVID-19 compared with those without cancer.
Researchers from the University of Liverpool and the University of Edinburgh, headed by Prof Carlo Palmieri – a consultant at The Clatterbridge Cancer Centre – and Prof Lance Turtle, have found that during the pandemic patients aged under 50 having cancer treatment had the highest risk of in-hospital death when compared to patients of the same age without cancer.
The findings – published in Lancet Oncology – are from one of the largest studies of its kind, comparing more than 6,500 cancer patients receiving treatment with more than 177,000 non-cancer patients.
The results show that 31.7% of cancer treatment patients died at 30 days, significantly more than for non-cancer patients, where 18% died 30 days after contracting COVID-19.
The evidence shows patients under 50 have the highest risk of mortality when compared to a non-cancer group of the same age. This higher risk of death is despite this age group being treated in the same way as other patients, for example, cancer patients aged under 50 who were admitted to intensive care and ventilated just as much as patients without cancer of the same age.
The study aimed to find out how various factors that influence the risk of death from COVID-19 might affect patients having cancer treatment differently.
The researchers found that the number of other heath conditions did not affect the risk of death from COVID in cancer patients, unlike patients without cancer. Patients who were frail, on the other hand, were more likely to die from COVID if they were also having cancer treatment.
Measures that hospitals routinely record to determine how sick patients are, were similar between patients with cancer and non-cancer patients, but despite this the cancer patients were still more likely to die.
The study also examined changes in hospital mortality during the first two years of the COVID-19 pandemic in the UK. The death rate of patients in hospital fell in both cancer and non-cancer patients over this period. However, the rate of fall was not constant, and the situation for cancer patients improved more slowly overall.
The study found that deaths were always higher in cancer patients on treatment compared to patients without cancer. While deaths reduced in cancer patients over the pandemic, they never reached the levels seen for patients without cancer. In addition, there were two periods when the difference in mortality between patients with and without cancer increased before decreasing.
Prof Palmieri said: “Cancer patients are at greater risk of death from COVID-19 than many other patient groups. However, how this risk has evolved during the pandemic remains unclear.
"This large-scale study helps us better understand these risks and illustrates that more action is needed – for example through optimising vaccination, long-acting passive immunisation, and early access to therapeutics.
“Further work is also now required to understand the differences seen between cancer patients receiving treatment and non-cancer patients, and how age, cancer type and treatment may have impacted on mortality or escalation of care, as well as the possible influence of vaccination and socio-economic factors.”
The paper, ‘Changes in hospital mortality during the SARS-CoV-2 pandemic in patients with cancer: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol UK’ is published in Lancet Oncology – https://
