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50% of covid-19 infected in California are Latino 5:17
(CNN) - Researchers are becoming increasingly aware of the risks cancer patients face if they become ill with covid-19, the disease caused by the new coronavirus that has spread worldwide.
Patients whose cancer worsened or spread were more than five times more likely to die within a month if they got covid-19, the researchers said this week during the annual meeting of the American Society for Clinical Oncology.
Even if the patients' cancer was not spreading, coronavirus infection almost doubled the risk of dying, the researchers found.
The first data, published in the medical journal The Lancet, on Thursday, also showed that coronavirus patients treated with the controversial combination of hydroxychloroquine and azithromycin were nearly three times more likely to die in about a month. The researchers found no significant increase in risk for patients who received either drug alone.
Researchers from North America and Europe analyzed data from 928 cases of covid-19 between March and April.
"Cancer patients have twice the risk of dying"
About 20% of patients were treated with the combination of hydroxychloroquine and azithromycin, and approximately 10% took hydroxychloroquine alone, said Dr. Jeremy Warner, who worked in the research and is an associate professor of Medicine and Biomedical Informatics at the Vanderbilt University Medical Center.
“One of the notable things is that only two of these patients received these drugs as part of a clinical trial. The rest of them were given drugs not approved for this use, as these drugs are generally available, at the discretion of the treating provider, but it is still remarkable, ”Warner said. "Patients with all severity levels of covid-19 received these medications, although certainly patients who were hospitalized were more likely to receive these medications."
The US Food and Drug Administration (FDA) and the National Institutes of Health have warned against using the drugs outside of clinical trials. Currently, there is no approved treatment for covid-19.
Overall, 121 patients in total, or 13%, died during the study period, and all deaths occurred within 30 days of covid-19 diagnosis, according to the data.
READ : WHO temporarily halts hydroxychloroquine study due to safety concerns
"While not surprising, it is informative that it appears that cancer patients have twice the risk of dying as people in general," Warner told CNN on Thursday.
The new study has limitations, including the fact that more research is needed to determine if similar findings would emerge among a larger group of patients.
"At this time, we are working to quickly obtain information about why some cancer patients become infected with the SARS-CoV-2 virus and identify factors that affect the severity of illness and death," Warner said in a statement. "We are also interested in the effects of treatments that are used to treat cancer patients who have covid-19."
Warner told CNN that more research is also needed to examine whether and how covid-19 impacts patients with certain types of cancer differently.
"I think people perceive cancer as a general problem, but there are at least 120 different types of cancer, some of which have an essentially normal life expectancy with treatment," said Warner.
A separate study found that patients with lung cancer and other types of breast cancers had a 64% higher risk of dying from the coronavirus if they had been treated with chemotherapy recently, within three months of covid-19 diagnosis. .
Patients who received corticosteroids to reduce inflammation were 1.5 times more likely to die. Other types of cancer treatment, such as immunotherapies and tyrosine kinase inhibitors, were not associated with an increased risk of death among patients.
The study, conducted by an international team of researchers, included data on 400 cancer patients from around the world who had been diagnosed with covid-19.
Patients with chest cancers (lung and other cancers of the chest) are already considered at high risk for severe disease or death from covid-19, as they tend to be older and already have lung damage, among other risk factors. The data showed that 141 of the patients died. Most, or 79%, died from covid-19, and 10% died from their cancer.
READ : How can Americans avoid another 100,000 deaths from coronavirus?
Cancer patients should not abandon their medical care, experts say
The research should not discourage patients from seeking care for their cancer due to fear of being exposed to the new coronavirus in hospitals, said Dr. Toni Choueiri of the Dana-Farber Cancer Institute and a professor of medicine at the Faculty of Medicine. Harvard Medicine in Boston, which worked in the Lancet study.
Patients should also talk to their doctors about what may be best for them, Choueiri said.
"The most important message here is that if you need a treatment for your cancer that could be curative (surgery, radiation, some kind of chemotherapy), you really should receive it," Choueiri told CNN on Thursday.
"I'm really concerned about the next two to three months when we're open, when we're safer, and one patient says, 'Well, my stage three kidney cancer, which needs surgery, or my acute leukemia, which needs chemotherapy, I'm going to delay until next year, '”Choueiri said. "That's what we don't want to happen."
So far, more than 100,000 people in the United States have died from covid-19 during the coronavirus pandemic. The American Cancer Society predicts that more than 600,000 people will die of cancer this year, said Dr. William Cance, the society's medical and scientific director, who was not involved in the new research.
"Cancer is still moving at its own pace. Therefore, we have to get people back to the research laboratories. We have to restart our clinical trials, but in the context of this document, we have to do it safely, and when those patients receiving therapy are infected with covid, it seems that with these data they have a much higher risk ”, Cance told CNN.
“But one of my biggest concerns is the undiagnosed patient, the patients that need to be examined and are not being evaluated. In many areas, colonoscopies just stopped, "he said.
“A positive point is that we are turning more to telehealth and many things can be done very well, if not better, through telehealth. This will force a change in the way we care for cancer patients. "
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