Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal.
Frontier Science Foundation-Hellas, Athens, Greece.
ESMO Open. 2022 Jun;7(3):100499. doi: 10.1016/j.esmoop.2022.100499. Epub 2022 May 8.
ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection.
This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity.
Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.
ESMO COVID-19 和癌症注册研究（ESMO-CoCARE）是一个国际合作的基于注册的队列研究，从欧洲、亚洲/大洋洲和非洲收集了关于感染严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）的癌症患者的自然史、管理和结局的真实世界数据。
ESMO-CoCARE 收集了诊断为 2019 年冠状病毒病（COVID-19）的实体瘤/血液恶性肿瘤患者的信息。自 2020 年 6 月以来收集的数据包括人口统计学、合并症、实验室测量、癌症特征、COVID-19 临床特征、管理和结局。还研究了影响 COVID-19 严重程度/恢复的参数，以及与 SARS-CoV-2 感染相关的总生存率（OS）相关的因素。
本分析包括来自 20 个国家的 1626 名患者（87%来自 24 个欧洲国家，7%来自 5 个北非国家，6%来自 8 个亚洲/大洋洲中心），COVID-19 诊断时间为 2020 年 1 月至 2021 年 5 月。中位年龄为 64 岁，女性占 52%，癌症分期为 III/IV 期的占 57%，65%正在接受积极的癌症治疗。由于 COVID-19 诊断而需要住院治疗的患者近 64%，其中 11%需要重症监护。多变量分析显示，男性、年龄较大、东部合作肿瘤组（ECOG）体能状态≥2、体重指数（BMI）<25kg/m2、合并症、症状性疾病、以及血液恶性肿瘤、活动/进展性癌症、中性粒细胞与淋巴细胞比值（NLR）≥6 和 OnCovid 炎症评分≤40 与 COVID-19 严重程度（即需要住院治疗的严重/中度疾病）相关。约 98%的轻度 COVID-19 患者康复，而严重/中度疾病患者的康复率为 71%。晚期癌症分期是恢复的另一个不利预后因素。在数据截止时，中位随访 3 个月，COVID-19 相关死亡率为 24.5%（297/1212），共记录了 380 例死亡。几乎所有与 COVID-19 严重程度相关的因素，除 BMI 和 NLR 外，以及吸烟和非亚洲种族，也与较差的 OS 相关。
与性别、种族、身体状况不佳、合并症、炎症和活动性恶性肿瘤相关的选定患者和癌症特征可预测癌症患者 COVID-19 中严重/中度疾病和不良结局。
