Cancer patients have a much higher risk of hospitalization and death from COVID-19, even if they are fully vaccinated, according to a new small-scale study.
The study, published Friday in Annals of Oncology, found that cancer patients had a 13% death rate if they suffered from a breakthrough infection.
The study was conducted by the COVID-19 and Cancer Consortium (CCC19), a group of 129 research centers that tracked the impact of the virus on cancer patients. This is the first study to examine the levels of risk for cancer patients experiencing breakthrough cases, the researchers say.
“Cancer patients who develop breakthrough COVID-19 even after a full vaccination can still experience serious results, including death,” Dr Toni Choueiri, director of the Lank Center for Genitouriary Care at the Dana-Farber Cancer Institute and main author of the report, said in a press release. “This is why a multi-level approach that includes masking and social distancing, as well as vaccination and a booster against COVID-19 remains an essential approach for the foreseeable future. “
The study used data collected by CCC19 as part of an international investigation conducted on their website, focusing on people with current or past cancer and one laboratory-confirmed case of COVID-19. between November 2020 and the end of May 2021.
A total of 1,787 cancer patients had contracted COVID-19 during this period, most of them not being vaccinated.
Only 54 patients were fully vaccinated when they contracted the virus, with full vaccination counted as those who received two injections of the Pfizer-BioNtech or Moderna COVID-19 vaccine, or one injection of Johnson & Johnson jab.
Of those who had a breakthrough case, 65% had to be hospitalized, 19% were in intensive care on a mechanical ventilator, and 13% died from the virus within 30 days.
Although the researchers noted that the study had a small sample size and therefore may not be entirely accurate, a death rate of 13% for breakthrough cases in cancer patients is still significantly higher than the death rate for the average population. According to Canadian data, more than 88,000 people contracted COVID-19 while they were fully vaccinated, but only 1,017 of those people subsequently died from the virus, corresponding to a death rate of approximately 1.14%.
The researchers noted that previous research has shown that cancer patients may not be able to produce the same immune response as the average person when they are vaccinated.
A June study found that antibody levels were significantly lower in people with blood cancer than in those with solid tumors.
“Because measures of immunity are not routinely collected in clinical care, we do not know if these were patients who developed effective immune responses after vaccination; a lot of emerging data suggests that cancer patients, especially blood cancers, do not develop adequate protective immune responses, ”said Dr Jeremy Warner, director of the CCC19 Research Coordination Center and lead author of the new study, in the Liberation.
He also noted that their study found that having other risk factors in a patient, as well as whether their cancer is active and progressing or not, increased their risk of death.
“It’s important to note that many of the same factors we identified before the vaccine became available – age, co-morbidities, performance status, and progressing cancer – still appear to be behind many of the poor outcomes,” did he declare.
The study appears to support previous research which found that people with blood cancers are at a higher risk of COVID-19. In both vaccinated and unvaccinated patients involved in the new study, ICU and hospitalization rates increased if the patients had blood cancer rather than solid tumors.
The new study also found that among fully vaccinated cancer patients, 46% had reduced levels of lymphocytes, which are a type of white blood cell important for the immune system.
Having lower levels of these types of cells is called lymphopenia, and this is common in patients receiving certain types of cancer treatment, such as treatment for lymphoma and leukemia. According to the study, patients in the vaccinated and unvaccinated groups who had lymphopenia had higher rates of ICUs and hospitalizations than other patients.
Due to the small size of the new study, the researchers say they can’t determine which cancer treatments might be associated with breakthrough infections or what the worst outcomes of a breakthrough infection are.
“Similar results (high mortality rates among fully vaccinated individuals) have been reported in other populations of immunocompromised patients, such as organ transplant recipients, before the use of additional vaccine doses”, Dr Dimitrios Farmakiotis, infectious disease clinician at Warren Alpert. Medical School of Brown University and a lead author of the study, said in the statement.
The researchers say the study results underscore how important it is not only to get the vaccine, but also to implement a multi-pronged response to protect those most at risk, including patients with Cancer.
“These findings come at a time of fears that immune escape mutants such as the Omicron strain may emerge from chronically infected patients with weakened immune systems,” Farmakiotis said. “Thus, the immunocompromised and their close contacts should be target groups for therapeutic and preventive interventions, including outreach and education efforts at the community level.”