Study eyes COVID-cancer link

Patients found to have higher coronavirus death rate

A national study of cancer patients with COVID-19 — which contains data submitted by several Connecticut hospitals — shows they have a higher mortality rate than the general population. Experts said it’s still not clear why.

Last week, The Lancet published a study of 928 patients from the United States, Canada and Spain with “active or previous malignancy” of cancer, who also had COVID-19. Researchers found that about 13 percent of those studied died within 30 days of their COVID-19 diagnosis — significantly higher than the mortality rate among the general population, experts said.

Several Connecticut health organizations contributed data to the study, including Stamford Health’s Bennett Cancer Center, Hartford HealthCare, the Yale New Haven Health System and the University of Connecticut. Experts from those organizations said they were eager to contribute research to the study because so little is known about how COVID-19 affects cancer patients.

“There is a paucity of information when it comes to COVID-19 across the board,” said Dr. Navid Hafez, assistant professor of medical oncology at the Yale University School of Medicine and oncologist at Yale New Haven’s Smilow Cancer Hospital.

He and others confirmed there seems to be higher risk among cancer patients, and patients and their care providers need to be particularly vigilant. “For me, it means if I had a cancer patient during this outbreak, I would watch them more carefully,” said Dr. Salvatore Del Prete, oncologist and director of clinical trials at Stamford’s Bennett Cancer Center.

Dr. Peter Yu, physician-in-chief at the Hartford HealthCare Cancer Institute, echoed those thoughts. “The message for that is if you have a patient with cancer, you have to be very, very careful about social distancing and other protective measures so (they) do

not get infected,” he said.

However, he said most people with cancer should not avoid treatment out of fear of COVID-19. “Obviously, cancer is not something that’s going to wait, and if you do wait, it’s going to get worse,” Yu said.

Also, although immunocompromised people are considered at high risk for COVID-19, the study showed no indication that cancer treatments — which can weaken the immune system — put patients at higher risk for COVID-19 complications.

Of those studied, 366 patients (39 percent) had received anticancer therapy within four weeks of their COVID-19 diagnosis. Of those, 160 (44 percent) were receiving cytotoxic therapy, also known as chemotherapy, and 206 (56 percent) were receiving other anticancer treatment.

But the researchers found no association between cancer treatment, or recent surgery to treat cancer, and increased mortality from COVID-19.

It’s not clear why the COVID-19 death rate was higher among cancer patients in the study. However, of the 121 study participants who died, 70 were older than 75. Older adults have been named as one of the groups at risk for COVID-19 complications.

Many participants in the Lancet study had other COVID-19 risk factors as well. For instance, 326 were former smokers and 43 were current smokers, and the majority had at least one other chronic health problem.

The study also showed that cancer patients who took the drug hydroxychloroquine, particularly in combination with azithromycin, had a higher death rate, but Del Prete said that is likely because patients given those drugs tend to be more seriously ill.

Though it raises interesting questions, Hafez pointed out the Lancet study is far from definitive, and more work needs to be done on the connection between cancer and COVID-19 risk.

“I’ll be honest, I have skepticism (about studies),” he said. “We’re giving a snapshot in a moment of time and that moment is very early. The dust is nowhere near settled for a strong analysis.”