COVID-19 hospital mortality rates not reducing in patients with history of cancer, study finds

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A large prospective study of COVID-19 outcomes in people with a history of cancer has found that hospital mortality rates do not appear to have reduced over time, unlike those for people with no history of cancer.

The findings from the Clinical Characterisation Protocol (CCP) CANCER-UK study – which is led by Liverpool researchers in collaboration with colleagues in Edinburgh – are based on anonymised data from more than 195,000 people hospitalised in the UK, including more than 20,000 with a history of cancer, defined as either being on active treatment for cancer or having had a past diagnosis of cancer.

Data being presented at this year’s European Society of Medical Oncology (ESMO) conference shows that, although there has been a steady decline in mortality rates for people with no history of cancer since January 2020, the same is not true for people with a history of cancer.

Furthermore, the gap in mortality between people with a history of cancer and those with no history of cancer widened between February 2021 and July 2021.

The reasons for these results are not yet clear. Further data collection and work is ongoing to understand why mortality for people with a history of cancer who are hospitalised with COVID-19 has not changed over the course of the pandemic, unlike those with no history of cancer.

Professor Carlo Palmieri, from The Clatterbridge Cancer Centre and University of Liverpool, who is co-leading the study, said: “These data show clear trends in mortality. In people with no history of cancer, mortality for hospitalised patients has decreased since January 2020. For people with a history of cancer, however, no reduction in mortality over time was observed, with actual peaks seen across the last year.

“Most noticeably, while COVID-19-related deaths in people with no history of cancer have fallen sharply since January 2021, those for people with a history of cancer have risen.

“We don’t know as yet why we are not seeing an improvement in the mortality of patients hospitalised with COVID-19, and work is ongoing at speed to enable us to explain these results.”

Dr Lance Turtle, from the University of Liverpool and Liverpool University Hospitals, said: “Going forward, it’s clear that people with compromised immune systems, such as people having treatment for cancer, are going to face particular challenges from COVID. It’s really important that as many people as possible get vaccinated, and that we understand who is at greatest risk.”

The CCP CANCER-UK study is one of the largest and most detailed studies in the world of outcomes for people diagnosed both with COVID-19 and cancer.

It is sponsored by The Clatterbridge Cancer Centre NHS Foundation Trust, supported by Liverpool Experimental Cancer Medicine Centre, and funded by UK Research and Innovation (UKRI), the National Institute for Health Research (NIHR) and The Clatterbridge Cancer Charity.

This study is a companion to the highly successful UK arm of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Coronavirus Clinical Characterisation Consortium (ISARIC4C), which is led by researchers from Liverpool, Edinburgh and Imperial College London.

The study is being led by Professor Carlo Palmieri, Consultant in Medical Oncology at The Clatterbridge Cancer Centre and Professor in Translational Oncology at the University of Liverpool and Dr Lance Turtle, Senior Clinical Lecturer at the University of Liverpool and Consultant in Infectious Diseases at Liverpool University Hospitals, in collaboration with ISARIC4C.

CCP CANCER-UK was developed through the Liverpool Health Partners (LHP) Cancer Programme as part of a unique cross-collaborative approach put in place to drive and support the development of cancer/COVID-19 research projects.