5/20/2023 0 Comments Surviving the aftermath reviews![]() Patients with cancer types other than melanoma were excluded when assessing the associations between modality of systemic anti-cancer therapy with COVID-19 severity among patients with melanoma. The analysis also excluded patients with inadequate data quality (quality score ≥ 5 according to our previously defined metric ) and those with incomplete follow-up to assess the outcomes of interest. Patients with non-invasive cancers including non-melanoma skin cancer, in situ carcinoma, or precursor hematologic neoplasms were excluded. Records for the present study were accrued from March 17, 2020, to December 31, 2021, and included patients with a diagnosis of SARS-CoV-2 infection confirmed by serology or polymerase chain reaction tests. The registry is maintained as an electronic database using REDCap Software at Vanderbilt University Medical Center, and its schema and format have been previously described. This was a registry-based retrospective cohort study that used data from the CCC19 registry, a centralized multi-institutional registry of patients who had COVID-19 and a diagnosis of cancer (either past or current). Finally, we compared survival following COVID-19 among patients with melanoma to those with all other cancer types in the database. We also assessed whether these therapies synergized with COVID-19 to produce exacerbated organ dysfunction. Leveraging detailed patient reports to the COVID-19 and Cancer Consortium (CCC-19) registry-consisting of 12,661 patients with cancer and COVID-19 reported from 93 different centers, including 307 patients with melanoma-we sought to assess the factors, including recent targeted or immunotherapy, that were associated with COVID-19 severity and survival. In addition, melanoma have unique risk factors that differ from those for other malignancies (e.g., exposure to ultraviolet light rather than cigarette smoke, alcohol, obesity, or chronic inflammation), thus theoretically conferring a better prognosis. Melanoma was the first malignancy where many checkpoint inhibitors were first approved and most aggressively combined (including agents targeting programmed death-1, cytotoxic T lymphocyte antigen-4, and lymphocyte antigen gene-3 ). Melanoma is the most lethal type of skin cancer and is an archetypal malignancy for the development of both targeted therapy (with BRAF and MEK inhibitors) and especially immunotherapy. Given the diverse types of malignancy and treatment scenarios, many questions remain, particularly in less common tumor types. A growing number of large studies have assessed the impact of COVID-19 among patients with various types of cancer, and among patients with various modalities of anti-cancer therapy. SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has resulted in particularly severe morbidity and mortality for patients at increased age, and with health co-morbidities, such as obesity, diabetes, cardiovascular disease including cardiomyopathy, and cancer. Patients with history of melanoma had similar 90-day survival following COVID-19 compared with other cancer survivors. Melanoma therapies did not appear to be associated with increased severity of COVID-19 or worsening organ dysfunction. Patients with a history of melanoma had similar 90-day mortality compared with other cancer survivors (OR 1.21, 95% CI 0.62 – 2.35). Among hospitalized patients, no signals of increased cardiac or pulmonary organ dysfunction, as measured by troponin, brain natriuretic peptide, and oxygenation were noted. Using multivariable analyses, these treatments were not associated with COVID-19 severity (immunotherapy OR 0.51, 95% CI 0.19 – 1.39 targeted therapy OR 1.89, 95% CI 0.64 – 5.55). Of 307 patients, 52 received immunotherapy (17%), and 32 targeted therapy (10%) in the previous 3 months. We assessed whether treatment was associated with increased cardiac or pulmonary dysfunction among hospitalized patients and assessed mortality among patients with a history of melanoma compared with other cancer survivors. We used multivariable models to assess demographic, cancer-related, and treatment-related factors associated with COVID-19 severity on a 6-level ordinal severity scale. Using the COVID-19 and Cancer Consortium (CCC19) registry, we identified 307 patients with melanoma diagnosed with COVID-19. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy. Patients with melanoma have not been specifically studied in large numbers. Impact of COVID-19 in patients on active melanoma therapy and with history of melanomaīMC Cancer volume 23, Article number: 265 ( 2023)ĬOVID-19 particularly impacted patients with co-morbid conditions, including cancer.
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