COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors

Abstract

Background We aimed to investigate mortality, severity, and risk of hospitalization in coronavirus disease 2019 (COVID-19) patients with cancer. Methods Data of all patients aged 40–79 years from the Korean Disease Control and Prevention Agency-COVID19-National Health Insurance Service who were diagnosed with COVID-19 between January 1, 2020 and March 31, 2022, in Korea were included. After 1:1 propensity score matching, 397,050 patients with cancer and 397,050 patients without cancer were enrolled in the main analysis. A cancer survivor was defined as a patient who had survived 5 or more years since the diagnosis of cancer. Multiple logistic regression analysis was performed to compare the risk of COVID-19 according to the diagnosis of cancer and time since diagnosis. Results Cancer, old age, male sex, incomplete vaccination against COVID-19, lower economic status, and a higher Charlson comorbidity index were associated with an increased risk of hospitalization, hospitalization with severe state, and death. Compared to patients without cancer, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hospitalization, hospitalization with severe state, and death in patients with cancer were 1.09 (1.08–1.11), 1.17 (1.11–1.24), and 1.94 (1.84–2.05), respectively. Compared to patients without cancer, the ORs (95% CIs) for hospitalization in cancer survivors, patients with cancer diagnosed 2–5 years, 1–2 years, and < 1 year ago were 0.96 (0.94–0.98), 1.10 (1.07–1.13), 1.30 (1.25–1.34), and 1.82 (1.77–1.87), respectively; the ORs (95% CIs) for hospitalization for severe disease among these patients were 0.90 (0.85–0.97), 1.22 (1.12–1.32), 1.60 (1.43–1.79), and 2.29 (2.09–2.50), respectively. Conclusion The risks of death, severe state, and hospitalization due to COVID-19 were higher in patients with cancer than in those without; the more recent the diagnosis, the higher the aforementioned risks. Cancer survivors had a lower risk of hospitalization and hospitalization with severe disease than those without cancer.

Cardiovascular Safety of COVID-19 Vaccination in Patients With Cancer: A Self-Controlled Case Series Study in Korea

“…In this patient population, the mortality risk associated with COVID-19 infection is significantly elevated, indicating a clear vulnerability to the disease. 1 2 Therefore, it is imperative to prevent COVID-19 infection in this population through vaccination. However, cancer patients have largely been excluded from clinical trials assessing the efficacy of COVID-19 vaccination, resulting in a lack of data on the safety of COVID-19 vaccines for patients with active cancer.…”