Itkin B, Straminsky S, Cáceres H, Onassis M, García AE, Avanzi L, Kaminszczik L, Serna Sejas R, Rapaccioli M, Billordo G, Lavaccara D, Lanzavecchia J, Gibbons L, Settecase E, Bardach A. Comparison of mortality in patients on chemotherapy or immunotherapy during and before COVID-19 pandemic. Multicenter matched cohort study in Argentina.
Rev Peru Med Exp Salud Publica 2023;
40:161-169. [PMID:
38232262 DOI:
10.17843/rpmesp.2023.402.12519]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/14/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES.
Motivation for the study. The impact of the COVID-19 pandemic on the risk of death in cancer patients on chemotherapy and immunotherapy is controversial. Published studies mainly compared patients on anti-cancer therapy to those off treatment or COVID-19 positive cancer patients to COVID-19 negative ones. Few studies were conducted in developing countries. Main findings. Mortality didn't increase in unvaccinated outpatients on active intravenous oncology treatment during the COVID-19 pandemic. Implications. This is the first propensity score-matched cohort study evaluating the impact of the COVID-19 pandemic on the population of unvaccinated oncology patients receiving intravenous anticancer therapy. . To compare all-cause mortality of unvaccinated oncology patients who received chemotherapy or immunotherapy during the pandemic with those treated before the pandemic.
MATERIALS AND METHODS.
We conducted a cohort study in four tertiary hospitals in Argentina. Outpatients with a solid neoplasm of any stage under-going cytotoxic or intravenous immunotherapy were eligible. The pandemic cohort was enrolled during the initial phase of the outbreak and compared with a pre-pandemic cohort using propensity score matching (PSM). Subjects were matched for age, sex, health insurance, risk factors for severe COVID-19 complications, performance status, cancer type and treatment, line of treatment, and body mass index. All-cause mortality was estimated for both cohorts after 6 months of follow-up.
RESULTS.
A total of 169 patients were recruited between April and August 2020 for the pandemic cohort and 377 for the pre-pandemic cohort in the same months of 2019; 168 patients were matched. After PSM, all-cause mortality was 17.9% in the pandemic cohort and 18.5% in the pre-pandemic cohort; the Relative Risk was 0.97 (95 % confidence interval: 0.61-1.52; p=0.888). In the pandemic cohort, 30/168 patients died, but none from COVID-19.
CONCLUSIONS.
Our findings show that the mortality rate of unvaccinated ambulatory patients on active intravenous oncology treatment during the COVID-19 pandemic did not increase.
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