New research suggests the omicron variant of SARS-CoV-2 is deadlier for patients with cancer than for the general population.

However, the case fatality rate among cancer patients infected with omicron is not as high as rates observed with prior SARS-CoV-2 variants. These findings were published in Cancer Cell.

The retrospective study included COVID-19 cases seen in a New York hospital system between December 1, 2021, and January 17, 2022.


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During this period, 285 patients with COVID-19 and cancer were identified. The cohort included 223 patients with solid tumors and 62 with hematologic malignancies.

Among these patients, 72% were fully vaccinated (2 or 3 doses), 19.5% were unvaccinated, and 3.5% were partially vaccinated (1 dose). Nearly half of patients (48%) had received active cancer treatment within 90 days of SARS-CoV-2 infection, with 27% receiving chemotherapy and 6% receiving immunotherapy.

Results

The case fatality rate was 4.9%. Factors associated with mortality included older age, metastatic involvement, and increased comorbidities.

There was no significant difference in mortality between unvaccinated and vaccinated cancer patients (odds ratio [OR], 2.38; 95% CI, 0.51-22.34; P =.2). However, there was a significantly greater risk of inpatient admission for COVID-19 among unvaccinated cancer patients (OR, 2.01; 95% CI, 1.10-3.67; P =.022).

The researchers compared mortality in the cancer cohort with mortality in a cohort of 10,996 patients without cancer who were diagnosed with COVID-19 during the same time period.

After adjusting for vaccine status, age, and sex, the risk of mortality was higher among the cancer patients than the non-cancer patients (OR, 2.57; 95% CI, 1.35-4.56; P =.0022).

The researchers performed a chart review to pinpoint the reasons for higher mortality among patients with cancer. Of 14 deaths, 8 were considered “likely” related to COVID-19, 5 were considered “unlikely” to be related to COVID-19, and 1 cause of death was unclear.

All patients who had booster vaccinations appeared to die from underlying causes other than COVID-19, according to the researchers.

“[T]he adverse impact of the current omicron COVID-19 wave on cancer patients with advanced age, advanced tumors, and increased comorbidities continues to be demonstrated,” the researchers wrote. “Mortality among patients during the omicron wave appears associated with clearly identifiable and potentially actionable risk factors related to disease status, immune suppression, and vaccination status.”

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Lee M, Quinn R, Pradhan K, et al. Impact of COVID-19 on case fatality rate of patients with cancer during the Omicron wave. Cancer Cell. Published online February 22, 2022. doi:10.1016/j.ccell.2022.02.012