Women with gynecologic cancer, COVID-19 at high risk for hospitalization, death
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Women with gynecologic cancer and COVID-19 demonstrated a high risk for hospitalization, cancer treatment delays and death, according to a study presented at Society of Gynecologic Oncology 2022 Annual Meeting on Women’s Cancer.
Additionally, “non-white” patients exhibited an increased risk for adverse outcomes.
“While it is well-known that the pandemic has impacted the delivery of care in patients who have conditions other than COVID-19, including cancer, our study is the first to examine how a diagnosis of COVID-19 affects care and outcomes for [patients with gynecologic cancer],” Gretchen E. Glaser, MD, FACOG, FACS, consultant in the division of gynecologic oncology, obstetrics and gynecology, residency program director, and associate professor of obstetrics and gynecology at Mayo Clinic College of Medicine, said in a press release. “We found that concurrent COVID-19 had significant negative effects on these [patients with cancer], especially among those who identified as Black or Asian.”
Background and methodology
The COVID-19 pandemic disrupted care worldwide, including anticancer therapy, and women with gynecologic cancer could have varied responses to COVID-19 infection, as they are often comorbid and require a range of therapies, Glaser and colleagues wrote.
The researchers sought to describe outcomes of women with gynecologic cancers and concurrent COVID-19 infection within the United States.
The analysis included 348 women with gynecologic cancer (71% white, 18% Black, 2% Asian) across seven institutions. Of them, 37% had active malignancies and 25% were receiving active anticancer treatment at time of COVID-19 diagnosis.
Researchers utilized the Society of Gynecologic Oncology COVID-19 and Gynecologic Cancer Registry, a web-based data entry platform, to capture the clinical courses and cancer treatment-related effects among these patients. They analyzed demographics, clinical manifestations, outcomes, treatment types and disease severity.
Key findings
Results showed 28% of patients experienced delays (median duration, 3-4 weeks) or discontinuation of anticancer treatment, including chemotherapy (43%) and surgery (27%). In addition, 101 patients (29%) were hospitalized, with 18 admitted to ICU and eight dying because of COVID-19 complications.
Researchers reported significant associations (P < .05) of older age, having two or more comorbidities and being “non-white” with higher likelihood of hospitalization, including ICU admission.
Among 312 patients in the overall cohort with available data, 17 (5%) died within 30 days of COVID-19 diagnosis.
Patients who died tended to be older (OR = 1.25 per 5-year increase; 95% CI, 1.01-1.55), have an active malignancy (OR = 3.86; 95% CI, 1.16-12.85) or be “non-white” (death rates: 3% white, 8% Black/African American, 25% Asian).
Implications
“Additional studies are needed to examine the long-term outcomes and mortality in [patients with gynecologic cancer] who also have COVID-19,” Glaser said in the press release, “with particular attention given to identifying the reasons for the disproportionate effect that concurrence has on patients of non-white race.”
References:
Glaser GE, et al. Abstract 50. Presented at Society of Gynecologic Oncology 2022 Annual Meeting on Women's Cancer (hybrid meeting); March 18-21, 2022; Phoenix.
Patients with both gynecologic cancer and COVID-19 at high risk of anti-cancer treatment delays, hospitalization and death. Available at: https://www.newswise.com/coronavirus/patients-with-both-gynecologic-cancer-and-covid-19-at-high-risk-of-anti-cancer-treatment-delays-hospitalization-and-death. Published March 19, 2022. Accessed March 19, 2022.
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Glaser GE, et al. Abstract 50. Presented at Society of Gynecologic Oncology 2022 Annual Meeting on Women's Cancer (hybrid meeting); March 18-21, 2022; Phoenix.
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