Journal
INTERNATIONAL JOURNAL OF CANCER
Volume 150, Issue 5, Pages 782-794Publisher
WILEY
DOI: 10.1002/ijc.33846
Keywords
cancer; COVID-19; electronic health record; fatality; SARS-CoV-2
Categories
Funding
- Health Department from the Generalitat de Catalunya
- European Health Data and Evidence Network (EHDEN) project
- Innovative Medicines Initiative 2 Joint Undertaking (JU) [806968]
- European Union
- Bill & Melinda Gates Foundation [INV-016201]
- UK National Institute for Health Research (NIHR) Oxford Biomedical Research Centre
- Instituto de Salud Carlos III [CM20/00174]
- National Institute for Health Research (NIHR) Senior Research Fellowship [SRF-2018-11-ST2-004]
- Bill and Melinda Gates Foundation [INV-016201] Funding Source: Bill and Melinda Gates Foundation
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This study showed that cancer patients have a higher risk of COVID-19 diagnosis, hospitalization, and death compared to non-cancer patients. These associations were stronger for patients recently diagnosed with cancer, under 70 years old, and those with hematological cancers. Therefore, these patients should be prioritized in COVID-19 vaccination campaigns and ongoing non-pharmaceutical interventions.
The relationship between cancer and coronavirus disease 2019 (COVID-19) infection and severity remains poorly understood. We conducted a population-based cohort study between 1 March and 6 May 2020 describing the associations between cancer and risk of COVID-19 diagnosis, hospitalisation and COVID-19-related death. Data were obtained from the Information System for Research in Primary Care (SIDIAP) database, including primary care electronic health records from similar to 80% of the population in Catalonia, Spain. Cancer was defined as any primary invasive malignancy excluding non-melanoma skin cancer. We estimated adjusted hazard ratios (aHRs) for the risk of COVID-19 (outpatient) clinical diagnosis, hospitalisation (with or without a prior COVID-19 diagnosis) and COVID-19-related death using Cox proportional hazard regressions. Models were estimated for the overall cancer population and by years since cancer diagnosis (<1 year, 1-5 years and >= 5 years), sex, age and cancer type; and adjusted for age, sex, smoking status, deprivation and comorbidities. We included 4 618 377 adults, of which 260 667 (5.6%) had a history of cancer. A total of 98 951 individuals (5.5% with cancer) were diagnosed, and 6355 (16.4% with cancer) were directly hospitalised with COVID-19. Of those diagnosed, 6851 were subsequently hospitalised (10.7% with cancer), and 3227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% confidence interval [1.05-1.11]), direct COVID-19 hospitalisation (1.33 [1.24-1.43]) and death following hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions.
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