COVID-19 Outcomes of Patients with Differentiated Thyroid Cancer: A Multi-Center Los Angeles Cohort Study

Kathuria-Prakash, Nikhita; Mosaferi, Tina; Xie, Mindy; Antrim, Lauren; Angell, Trevor E.; In, Gino K.; Su, Maureen A.; Lechner, Melissa G.

OBJECTIVE: Cancer may be a risk factor for worse outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. However, there is significant variability across cancer types in the extent of disease burden and modalities of cancer treatment that may impact morbidity and mortality from COVID-19. Therefore, we evaluated COVID-19 outcomes in patients with a history of differentiated thyroid cancer (DTC). METHODS: This is a retrospective cohort study of patients with a history of DTC and SARS-CoV2 infection from two academic Los Angeles healthcare systems. Demographic, thyroid cancer and treatment data were analyzed for association with COVID-19 outcomes. RESULTS: Of 21 patients with DTC and COVID-19, 8 were hospitalized (38.1%) and 2 died (9.5%) from COVID-19. Thyroid cancer initial disease burden and extent, treatment, or current response to therapy (e.g. excellent vs. incomplete) were not associated with COVID-19 severity among DTC patients. However, older age and the presence of a comorbidity other than DTC were significantly associated with hospitalization for COVID-19 (p=0.047 and p=0.024, respectively). COVID-19 attributed hospitalization and mortality in DTC patients was lower than previously reported in cancer patients, but similar to patients with non-thyroid malignancies in these centers. CONCLUSIONS: These data suggest that among patients with DTC, advanced age and comorbid conditions are significant contributors to the risk of hospitalization from SARS-CoV2 infection, rather than factors associated with thyroid cancer diagnosis, treatment, or burden of disease. This multi-center report of clinical outcomes provides additional data to providers to inform DTC patients regarding their risk of COVID-19.