Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin.

Journal Article (Journal Article)

BACKGROUND: There is mixed evidence about the relations of current versus past cancer with severe COVID-19 outcomes and how they vary by patient and cancer characteristics. METHODS: Electronic health record data of 104,590 adult hospitalized patients with COVID-19 were obtained from 21 United States health systems from February 2020 through September 2021. In-hospital mortality and ICU admission were predicted from current and past cancer diagnoses. Moderation by patient characteristics, vaccination status, cancer type, and year of the pandemic was examined. RESULTS: 6.8% of the patients had current (n = 7,141) and 6.5% had past (n = 6,749) cancer diagnoses. Current cancer predicted both severe outcomes but past cancer did not; adjusted odds ratios (aORs) for mortality were 1.58 (95% CI: 1.46, 1.70) and 1.04 (95% CI: 0.96, 1.13), respectively. Mortality rates decreased over the pandemic but the incremental risk of current cancer persisted, with the increment being larger among younger vs. older patients. Prior COVID-19 vaccination reduced mortality generally and amongst those with current cancer (aOR = 0.69, 95% CI = 0.53 to 0.90). CONCLUSIONS: Current cancer, especially amongst younger patients, posed a substantially increased risk for death and ICU admission among COVID-19 patients; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types. IMPACT: This study clarifies the characteristics that modify the risk associated with cancer on severe COVID-19 outcomes across the first 20 months of the COVID-19 pandemic.

Full Text

Duke Authors

Cited Authors

  • Nolan, MB; Piasecki, TM; Smith, SS; Baker, TB; Fiore, MC; Adsit, RT; Bolt, DM; Conner, KL; Bernstein, SL; Eng, OD; Lazuk, D; Gonzalez, A; Hayes-Birchler, T; Jorenby, DE; D'Angelo, H; Kirsch, JA; Williams, BS; Kent, S; Kim, H; Lubanski, SA; Yu, M; Suk, Y; Cai, Y; Kashyap, N; Mathew, J; McMahan, G; Rolland, B; Tindle, HA; Warren, GW; Abu-El-Rub, N; An, LC; Boyd, AD; Brunzell, DH; Carrillo, VA; Chen, L-S; Davis, JM; Deshmukh, VG; Dilip, D; Goldstein, A; Ha, PK; Iturrate, E; Jose, T; Khanna, N; King, A; Klass, E; Lui, M; Mermelstein, RJ; Poon, C; Tong, E; Wilson, KM; Theobald, WE; Slutske, WS

Published Date

  • August 15, 2022

Published In

PubMed ID

  • 35965473

Electronic International Standard Serial Number (EISSN)

  • 1538-7755

Digital Object Identifier (DOI)

  • 10.1158/1055-9965.EPI-22-0500

Language

  • eng

Conference Location

  • United States