Lee (2020)
COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study
Concomitant medication (Treated with Palliative first-line chemotherapy vs. Treated with Second-line (other line) chemotherapy)
COVID-19 (death)
Odds ratio: 0.840 (0.360-1.980) Adjusted model


Prospective cohort study

Medical records


All patients with active cancer and presenting to our network of 55 cancer centres from March 18, 2020, to April 26, 2020, with COVID-19 were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). This UKCCMP study is a national monitoring project. We have analysed the interaction between recent anticancer treatments and COVID-19 morbidity and mortality in the largest cohort of patients with cancer with COVID-19 presented to date, consisting of 800 patients.

In terms of the pattern of COVID-19 presentation, most patients (484 [61%]) presented with fever, cough (377 [47%]), or shortness of breath (312 [39%]). However, diarrhoea (51 [6%]), nausea and vomiting (39 [5%]), ageusia (13 [2%]), and anosmia (nine [1%]) were also identified as presenting symptoms. A mild COVID-19 severity category was recorded in 412 (52%) patients, with 96 (12%) patients not requiring hospital admission. 315 (39%) patients required oxygen, and 53 (7%) patients received intensive therapy unit (ITU) level care. Of these 53 patients, six (11%) were discharged, 23 (43%) died and 24 (45%) were either still in ITU or did not have a final recorded outcome. 226 (28%) patients died, with reports stating that the death was principally attributable to COVID-19 in most patients (211 [93%]). Compared with the rest of the cancer cohort, patients who died were significantly older (median 73·0 years vs 66·0 years; p<0·001), , more were male (146 [33%] of 449) than female (80 [20%] of 349), and those who died also displayed higher rates of comorbidities compared with those who did not, including cardiovascular disease (21% vs 11%; p<0·001) and hypertension (41% vs 27%; p<0·001. Patients who died were also more likely to present with symptoms of shortness of breath (57% vs 32%; p<0·001).


40 Day

COVID-19 (death)


Mortality from COVID-19


Concomitant medication

Anticancer treatment within 4 weeks of COVID-19 diagnosis.

Treated with Second-line (other line) chemotherapy

Treated with Palliative first-line chemotherapy

Odds ratio

0.840 (0.360-1.980)




Risk was adjusted for 1) age, 2) gender, and 3) comorbidities like Cardiovascular disease, Chronic obstructive pulmonary disease, Diabetes, Hypertension, 4) Anticancer treatment within 4 weeks of COVID-19 diagnosis including Chemotherapy, Hormone therapy, Immunotherapy, Radiotherapy, Targeted treatment and 5) Cytotoxic chemotherapy including Non-palliative chemo, Palliative first-line chemotherapy, Palliative chemotherapy, Palliative chemotherapy.

We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment.