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

Authors: Nolan, M. B.; Piasecki, T. M.; Smith, S. S.; Baker, T. B.; Fiore, M. C.; Adsit, R. T.; Bolt, D. M.; Conner, K. L.; Bernstein, S. L.; Eng, O. D.; Lazuk, D.; Gonzalez, A.; Hayes-Birchler, T.; Jorenby, D. E.; D'Angelo, H.; Kirsch, J. A.; Williams, B. S.; Kent, S.; Kim, H.; Lubanski, S. A.; Yu, M.; Suk, Y.; Cai, Y.; Kashyap, N.; Mathew, J.; McMahan, G.; Rolland, B.; Tindle, H. A.; Warren, G. W.; Abu-el-rub, N.; An, L. C.; Boyd, A. D.; Brunzell, D. H.; Carrillo, V. A.; Chen, L. S.; Davis, J. M.; Deshmukh, V. G.; Dilip, D.; Goldstein, A. O.; Ha, P. K.; Iturrate, E.; Jose, T.; Khanna, N.; King, A.; Klass, E.; Lui, M.; Mermelstein, R. J.; Poon, C.; Tong, E.; Wilson, K. M.; Theobald, W. E.; Slutske, W. S.
Article Title: 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
Abstract: 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 (aOR) for mortality were 1.58 [95% confidence interval (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 among those with current cancer (aOR, 0.69; 95% CI, 0.53-0.90). CONCLUSIONS: Current cancer, especially among younger patients, posed a substantially increased risk for death and ICU admission among patients with COVID-19; 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. See related commentary by Egan et al., p. 3. ©2022 The Authors; Published by the American Association for Cancer Research.
Keywords: adult; neoplasm; neoplasms; hospitalization; university; universities; pandemic; humans; human; wisconsin; pandemics; covid-19; covid-19 vaccines
Journal Title: Cancer Epidemiology Biomarkers and Prevention
Volume: 32
Issue: 1
ISSN: 1055-9965
Publisher: American Association for Cancer Research  
Date Published: 2023-01-01
Start Page: 12
End Page: 21
Language: English
DOI: 10.1158/1055-9965.Epi-22-0500
PUBMED: 35965473
PROVIDER: scopus
PMCID: PMC9827105
Notes: Article -- Export Date: 1 February 2023 -- Source: Scopus
Citation Impact
MSK Authors
  1. Deepika Dilip
    11 Dilip
  2. Michelle Lui
    6 Lui
  3. Chester Poon
    4 Poon