The COVID-19 and Cancer Consortium (CCC19) Registry

Project Summary People with cancer have a higher risk of infections in general because of vulnerabilities arising from their cancer and its treatments. This is especially true for the novel coronavirus, SARS-CoV- 2. People with cancer are twice as likely to die from COVID-19 compared to the general population, with some subgroups appearing to fare much worse. The pandemic has also led to significant disruption in cancer screening, diagnosis, and treatment, which is anticipated to lead to an indirect increase in morbidity and mortality in this population. Thus, studying COVID-19 in people with cancer is highly warranted. In this U01 project, "The COVID-19 and Cancer Consortium (CCC19) Registry", we leverage the established CCC19 registry (NCT04354701), which is the largest registry of adults with COVID-19 and cancer in North America, to answer a number of important scientific questions. In Aim 1, we evaluate how anticancer treatments, anti- COVID-19 treatments, vaccination, and, importantly, their interactions modify short- and long- term complications. We will explore whether race, ethnicity, and sociodemographic factors (e.g., insurance, access to treatment) are associated with outcomes. We will explore whether data- driven feature selection with machine-learning algorithms reveals unrecognized associations. In Aim 2, we hypothesize that there will be measurable changes in cancer recurrence and progression in patients who survive COVID-19. We will also investigate whether anticancer treatment modifications, which we have observed in 40% of patients who were on anticancer therapy at the time of infection, will affect longer-term prognosis. In Aim 3, we will develop methods to measure ascertainment and collider biases, which are some of the most important sources of bias in registry-based study designs. Along with these aims, we will continue to support and maintain the CCC19 registry and promote its use by the general community, following the FAIR principles.