An International Comparison of Presentation, Outcomes and CORONET Predictive Score Performance in Patients with Cancer Presenting with COVID-19 across Different Pandemic Waves

Patients with cancer have been shown to have increased risk of COVID-19 severity. We previously built and validated the COVID-19 Risk in Oncology Evaluation Tool (CORONET) to predict the likely severity of COVID-19 in patients with active cancer who present to hospital. We assessed the differences i...

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Bibliographic Details
Published in:	Cancers Vol. 14; no. 16; p. 3931
Main Authors:	Wysocki, Oskar, Zhou, Cong, Rogado, Jacobo, Huddar, Prerana, Shotton, Rohan, Tivey, Ann, Albiges, Laurence, Angelakas, Angelos, Arnold, Dirk, Aung, Theingi, Banfill, Kathryn, Baxter, Mark, Barlesi, Fabrice, Bayle, Arnaud, Besse, Benjamin, Bhogal, Talvinder, Boyce, Hayley, Britton, Fiona, Calles, Antonio, Castelo-Branco, Luis, Copson, Ellen, Croitoru, Adina, Dani, Sourbha S, Dickens, Elena, Eastlake, Leonie, Fitzpatrick, Paul, Foulon, Stephanie, Frederiksen, Henrik, Ganatra, Sarju, Gennatas, Spyridon, Glenthøj, Andreas, Gomes, Fabio, Graham, Donna M, Hague, Christina, Harrington, Kevin, Harrison, Michelle, Horsley, Laura, Hoskins, Richard, Hudson, Zoe, Jakobsen, Lasse H, Joharatnam-Hogan, Nalinie, Khan, Sam, Khan, Umair T, Khan, Khurum, Lewis, Alexandra, Massard, Christophe, Maynard, Alec, McKenzie, Hayley, Michielin, Olivier, Mosenthal, Anne C, Obispo, Berta, Palmieri, Carlo, Patel, Rushin, Pentheroudakis, George, Peters, Solange, Rieger-Christ, Kimberly, Robinson, Timothy, Romano, Emanuela, Rowe, Michael, Sekacheva, Marina, Sheehan, Roseleen, Stockdale, Alexander, Thomas, Anne, Turtle, Lance, Viñal, David, Weaver, Jamie, Williams, Sophie, Wilson, Caroline, Dive, Caroline, Landers, Donal, Cooksley, Timothy, Freitas, André, Armstrong, Anne C, Lee, Rebecca J, On Behalf Of The Esmo Co-Care
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 16-08-2022 MDPI
Subjects:	Cancer Care and treatment Coronaviruses COVID-19 COVID-19 vaccines Data collection Decision making Hematology Hospitals Immunization Infections Laboratories Life Sciences Mortality Oncology Oxygen Pandemics Patients Severe acute respiratory syndrome coronavirus 2 Steroid hormones Steroids Vaccination United Kingdom United Kingdom > UK United States > US Spain COVID-19 cancer Omicron CORONET outcomes vaccination
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Summary:	Patients with cancer have been shown to have increased risk of COVID-19 severity. We previously built and validated the COVID-19 Risk in Oncology Evaluation Tool (CORONET) to predict the likely severity of COVID-19 in patients with active cancer who present to hospital. We assessed the differences in presentation and outcomes of patients with cancer and COVID-19, depending on the wave of the pandemic. We examined differences in features at presentation and outcomes in patients worldwide, depending on the waves of the pandemic: wave 1 D614G (n = 1430), wave 2 Alpha (n = 475), and wave 4 Omicron variant (n = 63, UK and Spain only). The performance of CORONET was evaluated on 258, 48, and 54 patients for each wave, respectively. We found that mortality rates were reduced in subsequent waves. The majority of patients were vaccinated in wave 4, and 94% were treated with steroids if they required oxygen. The stages of cancer and the median ages of patients significantly differed, but features associated with worse COVID-19 outcomes remained predictive and did not differ between waves. The CORONET tool performed well in all waves, with scores in an area under the curve (AUC) of >0.72. We concluded that patients with cancer who present to hospital with COVID-19 have similar features of severity, which remain discriminatory despite differences in variants and vaccination status. Survival improved following the first wave of the pandemic, which may be associated with vaccination and the increased steroid use in those patients requiring oxygen. The CORONET model demonstrated good performance, independent of the SARS-CoV-2 variants.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 See acknowledgements for members of the ESMO Co-Care.
ISSN:	2072-6694 2072-6694
DOI:	10.3390/cancers14163931