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Scottish COVID Cancer Immunity Prevalence (SCCAMP) - a Longitudinal Study of Patients with Cancer Receiving Active Anti-Cancer Treatment During the COVID-19 Pandemic

39 Pages Posted: 3 Mar 2022

See all articles by Karin Purshouse

Karin Purshouse

University of Edinburgh - Edinburgh Cancer Centre

John P. Thomson

University of Edinburgh - Edinburgh Cancer Centre

Mahéva Vallet

University of Edinburgh - Edinburgh Cancer Centre

Lorna Alexander

University of Edinburgh - Edinburgh Cancer Centre

Isaac Bonisteel

University of Edinburgh - Edinburgh Medical School

Maree Brennan

University of Edinburgh - Edinburgh Cancer Centre

David Cameron

University of Edinburgh - Edinburgh Cancer Centre

Jonine Figueroa

University of Edinburgh - Institute of Genetics and Cancer

Elizabeth Furrie

Ninewells Hospital and Dundee Medical School - Department of Immunology

Pamela Haig

University of Edinburgh - Edinburgh Cancer Centre

Mattea Heck

University of Edinburgh - Edinburgh Medical School

Hugh McCaughan

Western General Hospital - Clinical Infection Research Group

Paul D. Mitchell

University of Edinburgh - Edinburgh Cancer Centre

Heather McVicars

University of Edinburgh - Edinburgh Cancer Centre

Lorraine Primrose

NHS Lothian - St John’s Hospital

Kate Templeton

Western General Hospital - Clinical Infection Research Group

Natalie Wilson

University of Edinburgh - Edinburgh Cancer Centre

Peter Hall

University of Edinburgh - Edinburgh Cancer Centre

More...

Abstract

Background: Cancer and systemic anti-cancer treatment (SACT) have been identified as possible risk factors for infection and related severe illness associated with SARS-CoV-2 virus as a consequence of immune suppression. The Scottish COVID CAncer iMmunity Prevalence (SCCAMP) study aimed to characterise the incidence and outcomes of SARS-Cov-2 infection in patients undergoing active anti-cancer treatment during the COVID-19 pandemic and their antibody response following vaccination.

Patients and Methods: Eligible patients were those attending secondary care for active anti-cancer treatment for a solid tumour. Blood samples were taken for total SARS-CoV-2 antibody assay (Siemens) at baseline and after 1.5, 3, 6 and 12 months. Data on COVID-19 infection, vaccination, cancer type, treatment and outcome was obtained from routine electronic health records.

Results: The study recruited 766 eligible participants between 28th May 2020 and 31st October 2021. The median age was 62.7 years, and 66.5% were female. Most received cytotoxic chemotherapy (79%), with the remaining 14% receiving immunotherapy and 7% receiving another form of anti-cancer therapy (radiotherapy, other systemic anti-cancer treatment). 48 (6.3%) tested positive for SARS-CoV-2 by PCR during the study period. The overall infection rate matched that of the age-matched local general population until May 2021, after which population levels appeared higher. Antibody testing detected additional evidence of infection prior to vaccination, taking the total number to 58 (7.6%). There was no significant difference in SARS-CoV-2 PCR positive test rates based on type of anti-cancer treatment. Mortality proportion was similar between those who died within 90 days of a positive SARS-CoV-2 PCR and those with no positive PCR (10.4% vs 10.6%). Death from all causes was lowest among vaccinated patients, and of the patients who had a positive SARS-CoV-2 PCR at any time, all of those who died during the study period were unvaccinated. Multivariate analysis correcting for age, gender, socioeconomic status, comorbidities and number of previous medications revealed that vaccination was associated with a significantly lower infection rate regardless of treatment with chemotherapy or immunotherapy with hazard ratios of 0.307 (95% CI 0.144-0.6548) or 0.314 (95% CI 0.041-2.367) in vaccinated patients respectively. Where antibody data was available, 96.3% of patients successfully raised SARS-CoV-2 antibodies at a time point after vaccination. This was unaffected by treatment type.

Conclusion: SCCAMP provides real-world evidence that patients with cancer undergoing SACT have a high antibody response and protection from SARS-CoV-2 infection following COVID-19 vaccination.

Funding Information: This study was supported by grants from the Edinburgh Cancer Centre Research Fund (S07720) and Edinburgh and Lothians Health Foundation (EHLF).

Declaration of Interests: None to declare.

Ethics Approval Statement: Consent was provided when attending for anti-cancer treatment (ACT), primarily SACT, at the Edinburgh Cancer Centre (ECC) either at the Western General Hospital (WGH), Edinburgh or St John’s Hospital (SJH), Livingston (NHS Lothian NRS BioResource, BioBank SR1418, NHS Research Ethics Committee (REC): 20/ES/0061 and SCCAMP, NHS Research Ethics Committee (REC) REC: 20/SS/0109).

Keywords: COVID-19, SARscov2, Cancer, chemotherapy, administrative records, immunity

Suggested Citation

Purshouse, Karin and Thomson, John P. and Vallet, Mahéva and Alexander, Lorna and Bonisteel, Isaac and Brennan, Maree and Cameron, David and Figueroa, Jonine and Furrie, Elizabeth and Haig, Pamela and Heck, Mattea and McCaughan, Hugh and Mitchell, Paul D. and McVicars, Heather and Primrose, Lorraine and Templeton, Kate and Wilson, Natalie and Hall, Peter, Scottish COVID Cancer Immunity Prevalence (SCCAMP) - a Longitudinal Study of Patients with Cancer Receiving Active Anti-Cancer Treatment During the COVID-19 Pandemic. Available at SSRN: https://ssrn.com/abstract=4037264 or http://dx.doi.org/10.2139/ssrn.4037264

Karin Purshouse

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

John P. Thomson

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Mahéva Vallet

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Lorna Alexander

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Isaac Bonisteel

University of Edinburgh - Edinburgh Medical School ( email )

Edinburgh
United Kingdom

Maree Brennan

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

David Cameron

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Jonine Figueroa

University of Edinburgh - Institute of Genetics and Cancer ( email )

Edinburgh
United Kingdom

Elizabeth Furrie

Ninewells Hospital and Dundee Medical School - Department of Immunology ( email )

Dundee, DD1 9SY
United Kingdom

Pamela Haig

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Mattea Heck

University of Edinburgh - Edinburgh Medical School ( email )

Edinburgh
United Kingdom

Hugh McCaughan

Western General Hospital - Clinical Infection Research Group ( email )

Edinburgh
United Kingdom

Paul D. Mitchell

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Heather McVicars

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Lorraine Primrose

NHS Lothian - St John’s Hospital ( email )

Howden Road West
Howden, Livingston EH54 6PP
United Kingdom

Kate Templeton

Western General Hospital - Clinical Infection Research Group ( email )

Edinburgh
United Kingdom

Natalie Wilson

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

Peter Hall (Contact Author)

University of Edinburgh - Edinburgh Cancer Centre ( email )

Edinburgh
United Kingdom

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