BACKGROUND: ESMO-CoCARE is an international collaborative registry-based, cohort study, gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with SARS-CoV-2. METHODS: ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with COVID-19. Data collected since 06/2020 include demographics, co-morbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection. RESULTS: This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 Northern African, 6% from 8 Asian/Oceanian centers), with COVID-19 diagnosis from January 2020 up to May 2021. Median age was 64 years, with 52% female, 57% cancer stage III/IV and 65% receiving active cancer treatment. 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male gender, older age, ECOG PS≥2, BMI<25, presence of co-morbidities, symptomatic disease, as well as haematological malignancies , active/progressive cancer , neutrophil-lymphocyte ratio ≥ 6 and OnCovid inflammatory score (OIS) ≤ 40 were associated with COVID-19 severity (i.e., severe/moderate disease requiring hospitalization). 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. CONCLUSIONS: Selected patient and cancer characteristics related to gender, ethnicity, poor fitness, comorbidities, inflammation, and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.
COVID-19 in patients with cancer: first report of the ESMO international, registry-based, cohort study (ESMO CoCARE)