Cancer patients have a greater risk of death from COVID-19 and must take extra precautions to avoid infection, according to research led by the Albert Einstein College of Medicine. The study is the largest of its kind to investigate COVID-19 outcomes for individuals with cancer.
Study co-lead author Dr. Vikas Mehta is a surgical oncologist at Montefiore Health System and an associate professor at Einstein.
“Our findings emphasize the need to prevent cancer patients from contracting COVID-19 and – if they do – to identify and closely monitor these individuals for dangerous symptoms,” said Dr. Mehta.
“We hope that our findings can inform states and communities that have not yet been so severely struck by this pandemic about the unique vulnerability cancer patients face.”
The research was focused on 218 cancer patients who tested positive for COVID-19 from March 18 to April 8, 2020 at Montefiore Medical Center in the Bronx. This region of New York City has been hit particularly hard by COVID-19, with a dramatically high number of fatalities that includes a total of 61 cancer patients.
“A key element is that mortality appears to be more closely related to frailty, age, and comorbidities than to active therapy for cancer,” said co-senior author Dr. Balazs Halmos.
“Our data suggest that we should not stop lifesaving cancer therapies, but rather develop strategies to minimize potential COVID-19 exposures and re-evaluate therapies for our most vulnerable cancer populations,” explained co-senior author Dr. Amit Verma.
The high fatality rate within the study population may be partially explained by the timing of the patients’ illness. The individuals contracted the disease at a time when testing and hospitalization was largely reserved for the sickest patients with the most severe symptoms.
However, even when compared to mortality rates in non-cancer patients across New York City during the same time period, cancer patients had a significantly higher risk of dying from COVID-19.
Among COVID-19 patients with blood cancers, such as leukemia and lymphoma, 37 percent lost their lives. The mortality rate for patients with lung cancer was 55 percent, colorectal cancer was 38 percent, breast cancer was 14 percent, and prostate cancer was 20 percent.
There was a significantly greater risk of death from COVID-19 in cancer patients who were older or suffered from hypertension, heart disease, and lung disease.
More than half of the individuals with cancer who died from COVID-19 had been in places with a high risk of exposure, such as nursing homes or hospitals, within 30 days of diagnosis.
As a result of the findings, Montefiore has changed some of its clinical practices by using telemedicine and early and aggressive social distancing for cancer patients. The healthcare system has opened a cancer outpatient and inpatient clinical service, and has deployed social workers and food deliveries to its at-risk population.
The study is published in the journal Cancer Discovery.