Cancer patients who were fully immunized against COVID-19 had a 13% death rate: study

Health

The COVID-19 and Cancer Consortium conducted the research (CCC19)

Recent research looked at the clinical features and outcomes of completely vaccinated cancer patients who had breakthrough COVID-19 infections and were at high risk of hospitalization and death.

The study was published in the ‘Annals of Oncology Journal.’

According to the research, completely vaccinated individuals who encountered breakthrough infections had a hospitalization rate of 65%, an ICU or mechanical ventilation rate of 19%, and a mortality rate of 13%. The study was carried out by the COVID-19 and Cancer Consortium (CCC19), a collaboration of 129 research centers that has been studying the impact of COVID-19 on cancer patients since the outbreak began.

“Patients with cancer who develop breakthrough COVID-19 even following full vaccination can still experience severe outcomes, including death,” said Toni Choueiri, MD, director of the Lank Center for Genitourinary Care at Dana-Farber Cancer Institute and a senior author on the report.

“That is why a multilayered approach that includes masking and social-distancing, along with vaccination plus booster against COVID-19 remains an essential approach for the foreseeable future,” he added.

Patients were deemed completely vaccinated after receiving two doses of either the BioNTech, Pfizer, or Moderna, NIAD vaccine, or one dose of the J&J vaccine, with the final vaccination dose administered long enough before the COVID-19 breakthrough to be considered fully immunized. The information was gathered between November 1, 2020, and May 31, 2021, before the Centers for Disease Control and Prevention suggested booster immunizations for cancer patients.

“Because measures of immunity are not routinely collected in clinical care, we don’t know whether these were patients who mounted effective immune responses after vaccination; a lot of emerging data have suggested that patients with cancer, especially blood cancers, don’t mount adequate protective antibody responses. It’s important to note that many of the same factors that we identified prior to the availability of vaccination — age, comorbidities, performance status, and progressing cancer — still seem to drive many of the bad outcomes,” said Jeremy Warner, MD, director of the CCC19 Research Coordinating Center, associate professor at Vanderbilt-Ingram Cancer Center and a senior author of the study.

For the investigation, the partnership identified 1,787 individuals with cancer and COVID-19, the great majority of whom were unvaccinated. The number of people who had been totally vaccinated was 54, and 46% of those who had been fully vaccinated had lower levels of lymphocytes, which are T and B cells that are important for immune responses to viruses. Lymphopenia was prevalent in cancer patients who received anti-CD20 monoclonal antibodies or CAR-T cell therapies for hematologic malignancies such as lymphoma and leukemia. The study appears to support prior findings that individuals with hematologic malignancies are at a higher risk of catastrophic COVID-19 outcomes.

However, the researchers emphasized that the number of patients in the study was insufficient to draw clear conclusions regarding certain types of anticancer therapy that could be connected with breakthrough infections. Patients on corticosteroid medication appeared to be more vulnerable to hospitalization.

“Similar results (high mortality rates among fully vaccinated individuals) have been reported in other immunocompromised patient populations, such as organ transplant recipients, prior to the utilization of additional vaccine doses. These findings come at a time of concerns that immune escape mutants such as the omicron strain may emerge from chronically infected patients with weakened immune systems. Thus, the immunosuppressed and their close contacts should be target groups for therapeutic and preventive interventions, including community-level outreach and educational efforts,” said Dimitrios Farmakiotis, MD, an infectious disease clinician at the Warren Alpert Medical School of Brown University and a senior author of the study.

 

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