Patients With Gynecologic Cancers Not at Increased Risk for Severe COVID-19

By Reuters Staff

August 07, 2020

NEW YORK (Reuters Health) - Women with gynecologic cancer do not appear to be at increased risk of being hospitalized with COVID-19 or dying from the infection, according to a study from New York City.

Three-quarters of the gynecologic-cancer patients with COVID-19 had a mild form of the disease and recovered from their infection, the research team reports in Cancer.

"Our study should be reassuring for women with gynecologic cancers who are worried that having cancer increases their risk of becoming seriously ill if they go to the hospital because of COVID-19," Dr. Olivia Lara of the Perlmutter Cancer Center, NYU Langone Health, said in a news release.

The researchers reviewed the medical records of 121 women with gynecologic cancer and COVID-19. Their median age at COVID-19 diagnosis was 64 years.

A total of 66 women (54.5%) required hospitalization; 45 (68.2%) required respiratory intervention, 20 (30.3%) were admitted to the intensive-care unit, and nine (13.6%) needed invasive mechanical ventilation.

On multivariate analysis, factors associated with a two-fold or greater risk of hospitalization were age over 64, African-American race and having three or more comorbid conditions.

The overall mortality rate among COVID-19-infected patients with gynecologic cancers was 14.0%, while mortality among hospitalized patients was 25.7%.

In contrast, a mortality rate of 34.3% has been reported in the overall population in the NYC region for all COVID-19 patients ages 65 to 74 years who have required hospitalization, the researchers note.

"Gynecologic cancer patients being hospitalized for COVID-19 can be counseled that almost 75% will recover and be discharged," they add.

In addition, most of the women were undergoing systemic anti-cancer treatment. Chemotherapy treatment and recent major surgery were not predictive of COVID-19 severity or death.

"However, an association was seen between immunotherapy and death due to COVID-19. Three of eight patients (37.5%) on immunotherapy died while hospitalized, including two patients with recurrent high-grade serous ovarian carcinoma and one patient with recurrent high-grade uterine carcinoma," the study team says.

Overall, this study revealed "limited associations between the timing of anti-cancer treatment, and type of therapy (except for immunotherapy) with COVID-19 severity and death, supporting the safety of continued cancer treatment during the pandemic," they add.

"Given that the COVID-19 pandemic is not expected to subside for some time, this may help alleviate patient fears and allow them to feel safe in continuing critical cancer treatments including surgery and anti-cancer directed therapy," they conclude.

Coauthor Dr. Bhavana Pothuri, also of Perlmutter Cancer Center, said women should not put off screening, diagnosis or treatment of new cancers due to COVID-19.

"The basic rules of cancer care have not changed during the pandemic. Early detection, screening, and care lead to more people surviving what remains a leading cause of death among American women," she said in the news release.

SOURCE: Cancer, online July 30, 2020.