Characteristics and Outcomes of Over 300,000 Patients with COVID-19 and History of Cancer in the United States and Spain

Cancer Epidemiol Biomarkers Prev. 2021 Oct;30(10):1884-1894. doi: 10.1158/1055-9965.EPI-21-0266. Epub 2021 Jul 16.

Abstract

Background: We described the demographics, cancer subtypes, comorbidities, and outcomes of patients with a history of cancer and coronavirus disease 2019 (COVID-19). Second, we compared patients hospitalized with COVID-19 to patients diagnosed with COVID-19 and patients hospitalized with influenza.

Methods: We conducted a cohort study using eight routinely collected health care databases from Spain and the United States, standardized to the Observational Medical Outcome Partnership common data model. Three cohorts of patients with a history of cancer were included: (i) diagnosed with COVID-19, (ii) hospitalized with COVID-19, and (iii) hospitalized with influenza in 2017 to 2018. Patients were followed from index date to 30 days or death. We reported demographics, cancer subtypes, comorbidities, and 30-day outcomes.

Results: We included 366,050 and 119,597 patients diagnosed and hospitalized with COVID-19, respectively. Prostate and breast cancers were the most frequent cancers (range: 5%-18% and 1%-14% in the diagnosed cohort, respectively). Hematologic malignancies were also frequent, with non-Hodgkin's lymphoma being among the five most common cancer subtypes in the diagnosed cohort. Overall, patients were aged above 65 years and had multiple comorbidities. Occurrence of death ranged from 2% to 14% and from 6% to 26% in the diagnosed and hospitalized COVID-19 cohorts, respectively. Patients hospitalized with influenza (n = 67,743) had a similar distribution of cancer subtypes, sex, age, and comorbidities but lower occurrence of adverse events.

Conclusions: Patients with a history of cancer and COVID-19 had multiple comorbidities and a high occurrence of COVID-19-related events. Hematologic malignancies were frequent.

Impact: This study provides epidemiologic characteristics that can inform clinical care and etiologic studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • Child
  • Cohort Studies
  • Comorbidity
  • Databases, Factual
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Influenza, Human / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Pandemics
  • Prevalence
  • Risk Factors
  • SARS-CoV-2
  • Spain / epidemiology
  • United States / epidemiology
  • Young Adult