In the largest study of its kind to date, researchers analyzing national data from more than 63,000 patients with cancer and a positive COVID-19 diagnosis report an increased risk of death among those who were older, male, had a higher number of comorbidities, and had hematologic cancers and recent chemotherapy treatments.
These findings were shared in an oral presentation June 4 at the annual meeting of the American Society of Clinical Oncology by University of Alabama at Birmingham Assistant Professor Noha Sharafeldin, MBBCh, Ph.D. Sharafeldin is a medical doctor and epidemiologist in the Division of Hematology and Oncology and member of UAB's Institute for Cancer Outcomes and Survivorship and the O'Neal Comprehensive Cancer Center.
A more detailed journal article was published simultaneously in the society's Journal of Clinical Oncology.
The results are one of the first major publications from the National COVID Cohort Collaborative, known as N3C. UAB and 54 other clinical institutions nationwide have contributed de-identified electronic health record data from 6.2 million patients from 49 states to a secure, cloud-based database to enable first-of-its-kind research. The N3C began curating data in January 2020, and its database contains patient records dating back to 2018. Among the 6 billion rows of data collected are more than 2 million positive COVID diagnoses and more than 400,000 patients with a cancer diagnosis.
'A scale that has not been possible before'
"People in the cancer world are very eager to get more information about the effects of
COVID-19 in general and the interaction with specific cancer types and cancer treatments," Sharafeldin said.
Previous studies in relatively small cohorts have found variation in risk for patients with cancer.
"The N3C contains a huge amount of data that has allowed us to investigate these questions at a scale that has not been possible before, using real-world clinical data," Sharafeldin said. "The strength of this first report is that it demonstrates the utility of resources like N3C and the collaborative research that has made it possible. There are other cancer/COVID patient cohorts out there, but nothing the size of N3C, or with the same level of representation of patients from across the country."
From its founding, N3C leadership has encouraged researchers interested in COVID-19's effects on particular health conditions to form clinical domain teams. Along with Umit Topaloglu, Ph.D., an informatician from Wake Forest University, and Benjamin Bates, M.D., a clinician at Rutgers University, Sharafeldin is co-leading the N3C Oncology Domain Team.
"We started by simply investigating the feasibility of answering these questions we had about COVID's effects on patients with cancer using N3C's data resources," Sharafeldin said. "As we went along, the oncology domain team started expanding to include biostatisticians, bioinformatics and analysis experts, and researchers in machine learning and other advanced applications, as well as clinicians -; all under the umbrella of being interested in cancer."