Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2
Year: 2023
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To determine the impact of acute SARS-CoV-2 infection on patient with concomitant active cancer and CVD. METHODS: The researchers extracted and analyzed data from the National COVID Cohort Collaborative (N3C) database between January 1, 2020, and July 22, 2022. They included only patients with acute SARS-CoV-2 infection, defined as a positive test by PCR 21 days before and 5 days after the day of index hospitalization. Active cancers were defined as last cancer drug administered within 30 days of index admission. The "Cardioonc" group consisted of patients with CVD and active cancers. The cohort was divided into four groups: (1) CVD (-), (2) CVD ( +), (3) Cardioonc (-), and (4) Cardioonc ( +), where (-) or ( +) denotes acute SARS-CoV-2 infection status. The primary outcome of the study was major adverse cardiovascular events (MACE), including acute stroke, acute heart failure, myocardial infarction, or all-cause mortality. The researchers analyzed the outcomes by different phases of the pandemic and performed competing-risk analysis for other MACE components and death as a competing event. RESULTS: The study analyzed 418,306 patients, of which 74%, 10%, 15.7%, and 0.3% had CVD (-), CVD ( +), Cardioonc (-), and Cardioonc ( +), respectively. The Cardioonc ( +) group had the highest MACE events in all four phases of the pandemic. Compared to CVD (-), the Cardioonc ( +) group had an odds ratio of 1.66 for MACE. However, during the Omicron era, there was a statistically significant increased risk for MACE in the Cardioonc ( +) group compared to CVD (-). Competing risk analysis showed that all-cause mortality was significantly higher in the Cardioonc ( +) group and limited other MACE events from occurring. When the researchers identified specific cancer types, patients with colon cancer had higher MACE. CONCLUSION: In conclusion, the study found that patients with both CVD and active cancer suffered relatively worse outcomes when they had acute SARS-CoV-2 infection during early and alpha surges in the United States. These findings highlight the need for improved management strategies and further research to better understand the impact of the virus on vulnerable populations during the COVID-19 pandemic.
Source: Cardio-Oncology
Authors: Brijesh Patel, Scott A. Chapman, Jake T. Neumann, Aayush Visaria, Oluwabunmi Ogungbe, Sijin Wen, Maryam Khodaverdi, Priyal Makwana, Jasvinder A. Singh, George Sokos, Adam B. Wilcox, Adam M. Lee, Alexis Graves, Alfred Jerrod Anzalone, Amin Manna, Amit Saha, Amy Olex, Andrea Zhou, Andrew E. Williams, Andrew Southerland, Andrew T. Girvin, Anita Walden, Anjali A. Sharathkumar, Benjamin Amor, Benjamin Bates, Brian Hendricks, Caleb Alexander, Carolyn Bramante, Cavin Ward-Caviness, Charisse Madlock-Brown, Christine Suver, Christopher Chute, Christopher Dillon, Chunlei Wu, Clare Schmitt, Cliff Takemoto, Dan Housman, Davera Gabriel, David A. Eichmann, Diego Mazzotti, Don Brown, Eilis Boudreau, Elaine Hill, Elizabeth Zampino, Emily Carlson Marti, Emily R. Pfaff, Evan French, Farrukh M. Koraishy, Federico Mariona, Fred Prior, Greg Martin, Harold Lehmann, Heidi Spratt, Hemalkumar Mehta, Hongfang Liu, Hythem Sidky, J. W. Awori Hayanga, Jami Pincavitch, Jaylyn Clark, Jeremy Richard Harper, Jessica Islam, Jin Ge, Joel Gagnier, Joel H. Saltz, Joel Saltz, Johanna Loomba, John Buse, Jomol Mathew, Joni L. Rutter, Julie A. McMurry, Justin Guinney, Justin Starren, Karen Crowley, Katie Rebecca Bradwell, Kellie M. Walters, Ken Wilkins, Kenneth R. Gersing, Kenrick Dwain Cato, Kimberly Murray, Kristin Kostka, Lavance Northington, Lee Allan Pyles, Leonie Misquitta, Lesley Cottrell, Lili Portilla, Mariam Deacy, Mark M. Bissell, Marshall Clark, Mary Emmett, Mary Morrison Saltz, Matvey B. Palchuk, Melissa A. Haendel, Meredith Adams, Meredith Temple-O’Connor, Michael G. Kurilla, Michele Morris, Nabeel Qureshi, Nasia Safdar, Nicole Garbarini, Noha Sharafeldin, Ofer Sadan, Patricia A. Francis, Penny Wung Burgoon, Peter Robinson, Philip R. O. Payne, Rafael Fuentes, Randeep Jawa, Rebecca Erwin-Cohen, Rena Patel, Richard A. Moffitt, Richard L. Zhu, Rishi Kamaleswaran, Robert Hurley, Robert T. Miller, Saiju Pyarajan, Sam G. Michael, Samuel Bozzette, Sandeep Mallipattu, Satyanarayana Vedula, Shawn T. O’Neil, Soko Setoguchi, Stephanie S. Hong, Steve Johnson, Tellen D. Bennett, Tiffany Callahan, Umit Topaloglu, Usman Sheikh, Valery Gordon, Vignesh Subbian, Warren A. Kibbe, Wenndy Hernandez, Will Beasley, Will Cooper, William Hillegass, Xiaohan Tanner Zhang
Institutions: West Virginia University, West Virginia University Hospitals, University of Minnesota, West Virginia School of Osteopathic Medicine, Rutgers, The State University of New Jersey, Johns Hopkins University, West Virginia Clinical and Translational Science Institute, University of Alabama at Birmingham, Birmingham VA Medical Center, UAB Medicine
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,490
Funders: Yale University, Brown University, Children's Hospital of Philadelphia, Emory University, George Washington University, Cincinnati Children's Hospital Medical Center, Harvard Catalyst, Loyola University Chicago, Institute for Translational Medicine and Therapeutics, Rutgers, The State University of New Jersey, University of Texas Health Science Center at Houston, NorthShore University HealthSystem, Georgia Clinical and Translational Science Alliance, Children's National Hospital, Louisiana Clinical and Translational Science Center, Ochsner Health, National Institutes of Health, University of California, Los Angeles, Weill Cornell Medical College, University of California, Davis, University of California, San Diego, University of California, San Francisco, University at Buffalo, University of Texas Health Science Center at San Antonio, University of California, Irvine, Center for Clinical and Translational Research, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Translational Research Institute, University of Arkansas for Medical Sciences, Clinical and Translational Science Institute, Boston University, Frontiers Clinical and Translational Science Institute, University of Kansas, Clinical and Translational Science Center, University of New Mexico, National Institute of General Medical Sciences, National Center for Advancing Translational Sciences, Institute for Integration of Medicine and Science, Yale Center for Clinical Investigation, Yale School of Medicine, Institute for Clinical and Translational Science, University of California, Irvine
Awards: G1110702752, G112449207, G1133842343, Center for Clinical and Translational Sciences (CCTS), G1198907661, G1717162763, G2008237588, G2101559773, G2191929784, G2761940466, The Harvard Clinical and Translational Science Center, G2985381359, Stanford Center for Clinical & Translational Education and Research (Spectrum), G3075846822, G3125251562, UNM HSC Clinical and Translational Science Center, G3667826151, Institute for Clinical and Translational Science, G3876554349, G4045563614, MSHS Translational Science Hub, A National Center for Digital Health Informatics Innovation, G4924162002, Center for Clinical and Translational Science and Training, G536197267, G55941084, G5627382572, G584478153, Expanding Translational Research in Arkansas, G6036981074, G6090519289, G6107751520, G611660658, G6292001676, Clinical and Translational Science Award, G687203789, G7406577712, G7473568262, Scripps Translational Science Institute, New Jersey Alliance for Clinical Translational Science: NJ ACTS, Clinical and Translational Science Institute at Childrens National, G7672581523, Indiana Clinical and Translational Sciences Institute, G7768549844, Clinical and Translational Science Award, University of Buffalo Clinical and Translational Science Institute, Institute for Integration of Medicine & Science: A Partnership to Improve Health, G8013765, G8021374757, Boston University Clinical and Translational Science Institute, UC San Diego Clinical and Translational Research Institute, Frontiers Clinical and Translational Science Institute at the University of Kansas, Advance Clinical and Translational Research (Advance-CTR), UC Davis Clinical and Translational Science Center, Northern New England Clinical and Translational Research Network, University of Wisconsin Institute for Clinical and Translational Research, Clinical and Translational Science Center, West Virginia Clinical and Translational Science Institute: A Statewide Organization Building Research Excellence and Engaging Communities to Improve Health, Clinical and Translational Science Award, Institutional Clinical and Translational Science Award, The Institute for Translational Medicine, Georgia Clinical & Translational Science Alliance (Georgia CTSA), Louisiana Clinical and Translational Science Center, Yale Clinical and Translational Science Award, Developing, Demonstrating, and Disseminating Innovative Programs to Achieve Translational Success, UCLA Clinical and Translational Science Institute, Clinical and Translational Science Institute
OpenAlex ID: W4387406172