Comparison of mortality in patients on chemotherapy or immunotherapy during and before the COVID-19 pandemic. Multicenter matched cohort study in Argentina

ITKIN, BORIS; STRAMINSKY, SAMANTA; CÁCERES, HERNÁN; ONASSIS, MARIANA; GARCÍA, AGUSTÍN EMILIO; AVANZI, LAURA; KAMINSZCZIK, LUCIA; SERNA SEJAS, RICHARD; RAPACCIOLI, MARA; BILLORDO, GUSTAVO; LAVACCARA, DAMIÁN; LANZAVECCHIA, JULIÁN; GIBBONS, LUZ; SETTECASE, EUGENIA; BARDACH, ARIEL

Revista Peruana de Medicina Experimental y Salud Pública

Instituto Nacional de Salud

Año: 2023 p. 161 - 169

1726-4634

Objectives. To compare the 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 on cytotoxic or intravenous immune therapy were eligible. The pandemic cohort was enrolled during the initial phase of the outbreak and compared with a cohort from a pre-pandemic period using propensity score matching (PSM). Subjects were matched for age, sex, health insurance, severe COVID-19 complications risk, performance status, cancer and treatment type, treatment line, and body mass index. All-cause mortality was estimated in both cohorts after the 6-month follow-up. Results. Out of 169 patients recruited between April and August 2020 to the pandemic and 377 to the pre-pandemic cohorts in the same period of 2019, 168 were matched. After PSM, all-cause mortality was 17.9% in the pandemic and 18.5% in the pre-pandemic cohort, Risk Ratio: 0.97 (95% confidence interval: 0.61-1.52, p=0.888). In the pandemic cohort, 30/168 patients died - none of them from COVID-19 infection. Conclusions. We failed to demonstrate an increment in the mortality of unvaccinated, ambulatory patients on active intravenous anticancer treatment exposed to the COVID-19 pandemic.