Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy
Abstract Background Immunotherapy in the presence of COVID-19 infections raises concerns because of potential overlapping clinical complications and immune system enhancement. Further investigation is warranted to establish its safety and to improve clinical decisions. Methods We conducted a retrosp...
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BMC
2025-05-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-025-14318-2 |
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| author | Jacques Raphael Britney Le Simron Singh Phillip Blanchette Maureen Trudeau Melody Lam Matthew Cheung |
| author_facet | Jacques Raphael Britney Le Simron Singh Phillip Blanchette Maureen Trudeau Melody Lam Matthew Cheung |
| author_sort | Jacques Raphael |
| collection | DOAJ |
| description | Abstract Background Immunotherapy in the presence of COVID-19 infections raises concerns because of potential overlapping clinical complications and immune system enhancement. Further investigation is warranted to establish its safety and to improve clinical decisions. Methods We conducted a retrospective cohort study using linked health administrative data from Ontario, Canada to assess 30-day mortality in patients with solid tumors who were treated with immunotherapy within 120 days before testing positive for COVID-19. A stepwise multivariable logistic regression model was used to identify clinical factors associated with 30-day mortality. Results Between January 2020 and April 2023, 281 patients tested positive for COVID-19 and were included in our study. The mean age was 68 (Standard Deviation: 10.3), 45% (127/281) were females and 58% (163/281) had lung cancer. 59% of patients (167/281) were treated with single agent immunotherapy, and almost 80% received at least one dose of COVID-19 vaccine. The 30-day mortality was 22% (63/281) and < 5% of patients were admitted to ICU or required ventilation. Factors associated with higher mortality were older age (Odds Ratio (OR) 1.60, 95% confidence interval (CI) 1.07–2.39), prior radiation therapy (OR 2.38, 95%CI 1.08–5.28), lower hemoglobin (< 10 g/dl) (OR 4.08, 95%CI 1.89–8.82) and higher leucocytes count (> 11,000/mm3) (OR 3.63, 95%CI 1.55–8.52). Conclusions Immunotherapy does not seem to increase the risk of 30-day mortality in patients with COVID-19 infections compared to published outcomes of patients with cancer and COVID-19. Mortality was associated with certain clinical characteristics that need to be carefully examined when prescribing immunotherapy during future comparable pandemics. |
| format | Article |
| id | doaj-art-dbd0cdc37826494fbf3624ba2d9f14a5 |
| institution | DOAJ |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-dbd0cdc37826494fbf3624ba2d9f14a52025-08-20T03:08:25ZengBMCBMC Cancer1471-24072025-05-012511910.1186/s12885-025-14318-2Early mortality in patients with cancer and COVID-19 infection treated with immunotherapyJacques Raphael0Britney Le1Simron Singh2Phillip Blanchette3Maureen Trudeau4Melody Lam5Matthew Cheung6Division of Medical Oncology, Department of Oncology, Verspeeten Family Cancer Centre, Western UniversityICES WesternDivision of Medical Oncology & Hematology, Sunnybrook Odette Cancer CentreDivision of Medical Oncology, Department of Oncology, Verspeeten Family Cancer Centre, Western UniversityDivision of Medical Oncology & Hematology, Sunnybrook Odette Cancer CentreICES WesternDivision of Medical Oncology & Hematology, Sunnybrook Odette Cancer CentreAbstract Background Immunotherapy in the presence of COVID-19 infections raises concerns because of potential overlapping clinical complications and immune system enhancement. Further investigation is warranted to establish its safety and to improve clinical decisions. Methods We conducted a retrospective cohort study using linked health administrative data from Ontario, Canada to assess 30-day mortality in patients with solid tumors who were treated with immunotherapy within 120 days before testing positive for COVID-19. A stepwise multivariable logistic regression model was used to identify clinical factors associated with 30-day mortality. Results Between January 2020 and April 2023, 281 patients tested positive for COVID-19 and were included in our study. The mean age was 68 (Standard Deviation: 10.3), 45% (127/281) were females and 58% (163/281) had lung cancer. 59% of patients (167/281) were treated with single agent immunotherapy, and almost 80% received at least one dose of COVID-19 vaccine. The 30-day mortality was 22% (63/281) and < 5% of patients were admitted to ICU or required ventilation. Factors associated with higher mortality were older age (Odds Ratio (OR) 1.60, 95% confidence interval (CI) 1.07–2.39), prior radiation therapy (OR 2.38, 95%CI 1.08–5.28), lower hemoglobin (< 10 g/dl) (OR 4.08, 95%CI 1.89–8.82) and higher leucocytes count (> 11,000/mm3) (OR 3.63, 95%CI 1.55–8.52). Conclusions Immunotherapy does not seem to increase the risk of 30-day mortality in patients with COVID-19 infections compared to published outcomes of patients with cancer and COVID-19. Mortality was associated with certain clinical characteristics that need to be carefully examined when prescribing immunotherapy during future comparable pandemics.https://doi.org/10.1186/s12885-025-14318-2COVID-19ImmunotherapyMortalitySolid tumorsOntario |
| spellingShingle | Jacques Raphael Britney Le Simron Singh Phillip Blanchette Maureen Trudeau Melody Lam Matthew Cheung Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy BMC Cancer COVID-19 Immunotherapy Mortality Solid tumors Ontario |
| title | Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy |
| title_full | Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy |
| title_fullStr | Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy |
| title_full_unstemmed | Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy |
| title_short | Early mortality in patients with cancer and COVID-19 infection treated with immunotherapy |
| title_sort | early mortality in patients with cancer and covid 19 infection treated with immunotherapy |
| topic | COVID-19 Immunotherapy Mortality Solid tumors Ontario |
| url | https://doi.org/10.1186/s12885-025-14318-2 |
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