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      The Effect of Vaccination against COVID-19 in Cancer Patients: Final Results of the COICA Trial

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          Abstract

          Background: The COICA study is an ambispective, observational trial that was conceived to assess the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in cancer patients. A recently published, population-based, case-control study reported a reduced vaccine efficacy at 3–6 months in cancer patients compared to individuals without cancer. Objectives: The aim of the study was to describe coronavirus disease 19 (COVID-19) outcomes in cancer patients and analyze differences in SARS-CoV-2 outcomes between vaccinated and unvaccinated patients. Methods: Descriptive statistics and frequency counts were used to summarize characteristics of the study population. χ<sup>2</sup> test and the log-rank test were used to compare outcomes between vaccinated and unvaccinated patients. Results: A total of 141 cancer patients (80 males, 61 females) were recruited at two participating Institutions from March 2020 until April 2022 and observed from the time of positive SARS-CoV-2 test to the time of negativization or death. Approximately 35% of patients had been vaccinated at the time of infection with 2 (16 patients) or 3 (33 patients) vaccine doses. Vaccinated patients consistently and significantly showed improved COVID-19 outcomes compared to unvaccinated patients, with CT-diagnosed pneumonia, hospitalization, O<sub>2</sub> therapy, and death reported in 0% versus 48.6%, 2.0% versus 15.2%, 0% versus 14.1%, and 0% versus 7.6%, respectively, of assessable patients ( p < 0.05). Vaccinated versus unvaccinated patients showed a significantly shorter time to negativization, with a median (95% confidence interval) time of 12 (10–14) versus 20 (17–23) days, respectively ( p < 0.001). Conclusions: Vaccination consistently improved all COVID-19 outcomes. No death was recorded among vaccinated patients. Additional research is especially warranted to establish optimal timing and patient selection for administration of the fourth vaccination dose.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2022
          September 2022
          11 July 2022
          : 100
          : 9
          : 512-518
          Affiliations
          [_a] aOncology Unit, “Andrea Tortora” Hospital, ASL Salerno, Pagani, Italy
          [_b] bDepartment of Medicine and Health Sciences “Vincenzo Tiberio,” University of Molise, Campobasso, Italy
          [_c] cAssociazone O.R.A. – Oncology Research Assistance, Somma Vesuviana, Italy
          [_d] dGeneral Directorate, ASL Salerno, Salerno, Italy
          [_e] eMedical Directorate, ASL Salerno, Salerno, Italy
          [_f] fDepartment of Health Sciences, University of Florence, Florence, Italy
          Article
          525962 Oncology 2022;100:512–517
          10.1159/000525962
          35817009
          beb23538-5b14-4f5d-90ce-ca2ee904dc36
          © 2022 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 01 June 2022
          : 17 June 2022
          Page count
          Figures: 1, Tables: 2, Pages: 6
          Funding
          No funding was obtained for this work.
          Categories
          Clinical Study

          Oncology & Radiotherapy,Pathology,Surgery,Obstetrics & Gynecology,Pharmacology & Pharmaceutical medicine,Hematology
          Coronavirus 19,Cancer,Severe acute respiratory syndrome coronavirus 2,Vaccination,Molecular screening

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