학술논문
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
Document Type
article
Author
Nolan, Margaret B; Piasecki, Thomas M; Smith, Stevens S; Baker, Timothy B; Fiore, Michael C; Adsit, Robert T; Bolt, Daniel M; Conner, Karen L; Bernstein, Steven L; Eng, Oliver D; Lazuk, David; Gonzalez, Alec; Hayes-Birchler, Todd; Jorenby, Douglas E; D'Angelo, Heather; Kirsch, Julie A; Williams, Brian S; Kent, Sean; Kim, Hanna; Lubanski, Stanley A; Yu, Menggang; Suk, Youmi; Cai, Yuxin; Kashyap, Nitu; Mathew, Jomol; McMahan, Gabriel; Rolland, Betsy; Tindle, Hilary A; Warren, Graham W; Abu-el-rub, Noor; An, Lawrence C; Boyd, Andrew D; Brunzell, Darlene H; Carrillo, Victor A; Chen, Li-Shiun; Davis, James M; Deshmukh, Vikrant G; Dilip, Deepika; Goldstein, Adam; Ha, Patrick K; Iturrate, Eduardo; Jose, Thulasee; Khanna, Niharika; King, Andrea; Klass, Elizabeth; Lui, Michelle; Mermelstein, Robin J; Poon, Chester; Tong, Elisa; Wilson, Karen M; Theobald, Wendy E; Slutske, Wendy S
Source
Cancer Epidemiology Biomarkers & Prevention. 32(1)
Subject
Language
Abstract
BackgroundThere 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.MethodsElectronic 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.Results6.8% 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).ConclusionsCurrent 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.ImpactThis 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.