Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.
Adenosine Monophosphate
/ analogs & derivatives
Age Factors
Aged
Alanine
/ analogs & derivatives
Betacoronavirus
/ pathogenicity
COVID-19
Clinical Decision-Making
Coronavirus Infections
/ complications
Drug Therapy, Combination
/ methods
Drug Utilization
/ statistics & numerical data
Follow-Up Studies
Glucocorticoids
/ therapeutic use
Healthcare Disparities
/ statistics & numerical data
Hospital Mortality
Humans
Hydroxychloroquine
/ therapeutic use
Male
Middle Aged
Neoplasms
/ complications
Pandemics
Pneumonia, Viral
/ complications
Risk Factors
SARS-CoV-2
Severity of Illness Index
Sex Factors
Treatment Outcome
United States
/ epidemiology
COVID-19 Drug Treatment
Journal
Cancer discovery
ISSN: 2159-8290
Titre abrégé: Cancer Discov
Pays: United States
ID NLM: 101561693
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
04
07
2020
revised:
13
07
2020
accepted:
20
07
2020
pubmed:
24
7
2020
medline:
21
10
2020
entrez:
24
7
2020
Statut:
ppublish
Résumé
Among 2,186 U.S. adults with invasive cancer and laboratory-confirmed SARS-CoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. Although observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through inclusive prospective controlled trials. SIGNIFICANCE: Evaluating the potential role of COVID-19 treatments in patients with cancer in a large observational study, there was no statistically significant 30-day all-cause mortality benefit with hydroxychloroquine or high-dose corticosteroids alone or in combination; remdesivir showed potential benefit. Treatment receipt reflects clinical decision-making and suggests disparities in medication access.
Identifiants
pubmed: 32699031
pii: 2159-8290.CD-20-0941
doi: 10.1158/2159-8290.CD-20-0941
pmc: PMC7541683
mid: NIHMS1615180
doi:
Substances chimiques
Glucocorticoids
0
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Hydroxychloroquine
4QWG6N8QKH
Alanine
OF5P57N2ZX
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1514-1527Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000445
Pays : United States
Organisme : NHGRI NIH HHS
ID : T32 HG008341
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA231840
Pays : United States
Organisme : NCI NIH HHS
ID : UG1 CA189974
Pays : United States
Organisme : NCI NIH HHS
ID : UG1 CA189828
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA013696
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA068485
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA054174
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA203703
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA009515
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA180888
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA196521
Pays : United States
Informations de copyright
©2020 American Association for Cancer Research.
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