Prior immune checkpoint inhibitor (ICI) therapy is associated with decreased COVID-19-related hospitalizations and complications in patients with cancer: Results of a propensity-matched analysis of the OnCovid registry

Int J Infect Dis. 2023 Nov 27:S1201-9712(23)00782-8. doi: 10.1016/j.ijid.2023.11.021. Online ahead of print.

ABSTRACT

BACKGROUND: To date, studies have not provided definitive answers regarding whether prior immune checkpoint inhibitor (ICI) treatment alters outcomes for cancer patients with COVID-19.

METHODS: The OnCovid registry (NCT04393974) was searched from 2/27/2020 to 1/31/2022 for patients who received systemic anti-cancer therapy (SACT) in the 4wks before laboratory-confirmed COVID-19 diagnosis. Propensity score matching using country, vaccination status, primary tumor type, sex, age, comorbidity burden, tumor stage, and remission status investigated differences in predefined clinical outcomes comparing those who had or had not received ICIs.

RESULTS: Of 3523 patients screened, 137 ICI-only and 1378 non-ICI met inclusion criteria. Before matching, ICI patients were older, male, enrolled at centers in Italy, and had histories of smoking, thoracic cancers, advanced cancer stages, and active malignancies (p≤0.02). After matching, there were 120 ICI and 322 non-ICI patients. ICI patients had no differences (odds ratio: 95%CI) in presenting COVID-19 symptoms (0.69: 0.37-1.28), receipt of COVID-specific therapy (0.88: 0.54-1.41), 14-day (0.95: 0.56-1.61), or 28-day (0.79: 0.48-1.29) mortalities. However, ICI patients required less COVID-19-related hospitalization (0.37: 0.21-0.67) and oxygen therapy (0.51: 0.31-0.83) and developed fewer complications (0.57: 0.36-0.92).

CONCLUSIONS: In this PSM analysis, prior ICI therapy did not worsen and potentially improved COVID-19-outcomes in patients with cancer.

PMID:38029831 | DOI:10.1016/j.ijid.2023.11.021