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COVID-19 outcomes of patients with gynecologic cancer in New York City: an updated analysis

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Mar 20, 2021

Recent chemotherapy or immunotherapy for gynecologic cancer does not raise risk of death due to COVID-19

CHICAGO (March 20, 2021)—Although some studies show that cancer patients have a greater risk of health complications from coronavirus disease 2019 (COVID-19), a new study finds that recent chemotherapy or immunotherapy for gynecologic cancer does not raise the risk of hospitalization or death due to COVID-19. The study results are being presented at the Society of Gynecologic Oncology 2021 Annual Meeting on Women’s Cancer.

“We can reassure women with gynecologic cancer that they can continue anticancer therapy,” said the study’s presenting author, Olivia Lara, MD, MS, gynecologic oncology fellow, New York University (NYU) Langone Health, New York City.

Dr. Lara said she and her colleagues conducted the study because gynecologic cancer was underrepresented in past studies of COVID-19 outcomes in cancer patients. Also, she said some of her patients were concerned that chemotherapy, which can weaken the immune system, would increase their risk of more severe illness if they became infected with the novel coronavirus.

The researchers analyzed data from 193 patients with COVID-19 at eight New York City area hospitals treated between March and May 2020. All patients had gynecologic cancer, primarily endometrial/uterine, ovarian and cervical cancers. Overall, 106 patients (54.9%) required hospitalization.

When the investigators analyzed the odds of death or hospitalization due to COVID-19, they found that use of cytotoxic chemotherapy (drugs that are toxic to cancer cells) did not predict increased risk for either, Dr. Lara said.

The same held true for immunotherapy, drugs that help the immune system fight cancer. Although her research team last year reported that immunotherapy was a risk factor for increased COVID-19-related deaths in women with gynecologic cancer, that was not the case in this larger study, she noted.

However, the researchers did find greater odds of death due to COVID-19 among current or former smokers versus nonsmokers. Smoking is a known risk factor for severe COVID-19 infection.

The need for hospitalization due to COVID-19 was reportedly associated with age 65 years or older, Black race and having three or more additional coexisting long-term health conditions. Additionally, women who had a low performance status score, indicating their ability to independently perform activities of daily living, had an increased odds of hospitalization compared with those with better performance status.

Thirty-four of the 193 patients in this study, or 17.3 percent, died of COVID-19. Dr. Lara said this fatality rate is similar to that of age-matched women with COVID-19 who did not have cancer. She added that fatality rates may be lower now than early in the pandemic when their study took place.