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Abstract S09-03: Factors affecting COVID-19 outcomes in cancer patients: A first report from Guy’s Cancer Centre in London

2020· article· en· W3108808294 on OpenAlexaboutno aff
Beth Russell, Charlotte Moss, Sophie Papa, Sheeba Irshad, Paul J. Ross, James Spicer, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Kamarul Zaki, Fareen Rahman, Ailsa Sita-Lumsden, Debra H. Josephs, Deborah Enting, Mary Lei, Sharmista Ghosh, Claire Harrison, Angela Swampillai, Richard Sullivan, Anne Rigg, Saoirse Dolly, Mieke Van Hemelrijck

Bibliographic record

VenueClinical Cancer Research · 2020
Typearticle
Languageen
FieldMedicine
TopicCOVID-19 and healthcare impacts
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineCancerCoronavirus disease 2019 (COVID-19)Internal medicineDiseaseProportional hazards modelLogistic regressionInfectious disease (medical specialty)

Abstract

fetched live from OpenAlex

Abstract Background: Current precautionary management decisions being made for cancer patients are based on assumptions supported by limited evidence, based on small case series from China and Italy and larger series from New York and a recent consortium of 900 patients from over 85 hospitals in the USA, Canada, and Spain. Hence, there is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Centre to assess demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February-12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with severe disease. Initial diagnosis of cancer >24m before COVID-19 (OR:1.74 (95%CI: 0.71-4.26)), presenting with fever (6.21 (1.76-21.99)), dyspnea (2.60 (1.00-6.76)), gastrointestinal symptoms (7.38 (2.71-20.16)), or higher levels of CRP (9.43 (0.73-121.12)) were linked with greater COVID-19 severity. During median follow-up of 47d, 34 patients had died of COVID-19 (22%). Asian ethnicity (3.73 (1.28-10.91), palliative treatment (5.74 (1.15-28.79), initial diagnosis of cancer >24m before (2.14 (1.04-4.44), dyspnea (4.94 (1.99-12.25), and increased CRP levels (10.35 (1.05-52.21)) were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin (0.04 (0.01-0.04). Conclusions: Our analysis of one of the largest single-center series of COVID-19-positive cancer patients to date confirms a similar distribution of age, sex, and comorbidities as reported for other populations. With respect to cancer-specific observations, patients who have lived longer with their cancer were found to be more susceptible to a greater infection severity, possibly reflecting the effect of more advanced malignant disease, as almost half of the severe cohort were on third-line metastatic treatment, or the impact of this infection. The latter was also found to be associated with COVID-19 death in cancer patients, as were Asian ethnicity and palliative treatment. Further validation will be provided from other large case series, as well as from those including longer follow-up, to provide more definite guidance for oncologic care. Citation Format: Beth Russell, Charlotte Moss, Sophie Papa, Sheeba Irshad, Paul Ross, James Spicer, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Kamarul Zaki, Fareen Rahman, Ailsa Sita-Lumsden, Debra Josephs, Deborah Enting, Mary Lei, Sharmista Ghosh, Claire Harrison, Angela Swampillai, Richard Sullivan, Anne Rigg, Saoirse Dolly, Mieke Van Hemelrijck, Guy's Cancer Real World Evidence Programme. Factors affecting COVID-19 outcomes in cancer patients: A first report from Guy’s Cancer Centre in London [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S09-03.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.082
Threshold uncertainty score0.164

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0020.003
Science and technology studies0.0010.000
Scholarly communication0.0010.000
Open science0.0000.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.492
GPT teacher head0.615
Teacher spread0.122 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations2
Published2020
Admission routes1
Has abstractyes

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