TY - JOUR
T1 - COVID-19 outcomes of patients with gynecologic cancer in New York City
T2 - An updated analysis from the initial surge of the pandemic
AU - Lara, Olivia D.
AU - Smith, Maria
AU - Wang, Yuyan
AU - O'Cearbhaill, Roisin E.
AU - Blank, Stephanie V.
AU - Kolev, Valentin
AU - Carr, Caitlin
AU - Knisely, Anne
AU - McEachron, Jennifer
AU - Gabor, Lisa
AU - Chapman-Davis, Eloise
AU - Cohen, Seth
AU - Fehniger, Julia
AU - Lee, Yi Chun
AU - Isani, Sara
AU - Liu, Mengling
AU - Wright, Jason D.
AU - Pothuri, Bhavana
N1 - Funding Information:
R.OC. was supported in part by the NIH/NCI Cancer Center Support Grant P30 CA008748 (Memorial Sloan Kettering Cancer Center support group).
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/2
Y1 - 2022/2
N2 - Background: Despite significant increase in COVID-19 publications, characterization of COVID-19 infection in patients with gynecologic cancer remains limited. Here we present an update of COVID-19 outcomes among people with gynecologic cancer in New York City (NYC) during the initial surge of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]). Methods: Data were abstracted from gynecologic oncology patients with COVID-19 infection among 8 NYC area hospital systems between March and June 2020. Multivariable logistic regression was utilized to estimate associations between factors and COVID-19 related hospitalization and mortality. Results: Of 193 patients with gynecologic cancer and COVID-19, the median age at diagnosis was 65.0 years (interquartile range (IQR), 53.0–73.0 years). One hundred six of the 193 patients (54.9%) required hospitalization; among the hospitalized patients, 13 (12.3%) required invasive mechanical ventilation, 39 (36.8%) required ICU admission. Half of the cohort (49.2%) had not received anti-cancer treatment prior to COVID-19 diagnosis. No patients requiring mechanical ventilation survived. Thirty-four of 193 (17.6%) patients died of COVID-19 complications. In multivariable analysis, hospitalization was associated with an age ≥ 65 years (odds ratio [OR] 2.12, 95% confidence interval [CI] 1.11, 4.07), Black race (OR 2.53, CI 1.24, 5.32), performance status ≥2 (OR 3.67, CI 1.25, 13.55) and ≥ 3 comorbidities (OR 2.00, CI 1.05, 3.84). Only former or current history of smoking (OR 2.75, CI 1.21, 6.22) was associated with death due to COVID-19 in multivariable analysis. Administration of cytotoxic chemotherapy within 90 days of COVID-19 diagnosis was not predictive of COVID-19 hospitalization (OR 0.83, CI 0.41, 1.68) or mortality (OR 1.56, CI 0.67, 3.53). Conclusions: The case fatality rate among patients with gynecologic malignancy with COVID-19 infection was 17.6%. Cancer-directed therapy was not associated with an increased risk of mortality related to COVID-19 infection.
AB - Background: Despite significant increase in COVID-19 publications, characterization of COVID-19 infection in patients with gynecologic cancer remains limited. Here we present an update of COVID-19 outcomes among people with gynecologic cancer in New York City (NYC) during the initial surge of severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]). Methods: Data were abstracted from gynecologic oncology patients with COVID-19 infection among 8 NYC area hospital systems between March and June 2020. Multivariable logistic regression was utilized to estimate associations between factors and COVID-19 related hospitalization and mortality. Results: Of 193 patients with gynecologic cancer and COVID-19, the median age at diagnosis was 65.0 years (interquartile range (IQR), 53.0–73.0 years). One hundred six of the 193 patients (54.9%) required hospitalization; among the hospitalized patients, 13 (12.3%) required invasive mechanical ventilation, 39 (36.8%) required ICU admission. Half of the cohort (49.2%) had not received anti-cancer treatment prior to COVID-19 diagnosis. No patients requiring mechanical ventilation survived. Thirty-four of 193 (17.6%) patients died of COVID-19 complications. In multivariable analysis, hospitalization was associated with an age ≥ 65 years (odds ratio [OR] 2.12, 95% confidence interval [CI] 1.11, 4.07), Black race (OR 2.53, CI 1.24, 5.32), performance status ≥2 (OR 3.67, CI 1.25, 13.55) and ≥ 3 comorbidities (OR 2.00, CI 1.05, 3.84). Only former or current history of smoking (OR 2.75, CI 1.21, 6.22) was associated with death due to COVID-19 in multivariable analysis. Administration of cytotoxic chemotherapy within 90 days of COVID-19 diagnosis was not predictive of COVID-19 hospitalization (OR 0.83, CI 0.41, 1.68) or mortality (OR 1.56, CI 0.67, 3.53). Conclusions: The case fatality rate among patients with gynecologic malignancy with COVID-19 infection was 17.6%. Cancer-directed therapy was not associated with an increased risk of mortality related to COVID-19 infection.
KW - Coronavirus disease 2019 (COVID-19)
KW - Gynecologic cancer
KW - Outcomes
KW - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
UR - http://www.scopus.com/inward/record.url?scp=85121251288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85121251288&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2021.12.004
DO - 10.1016/j.ygyno.2021.12.004
M3 - Article
C2 - 34922769
AN - SCOPUS:85121251288
SN - 0090-8258
VL - 164
SP - 304
EP - 310
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -
