A history of cancer was significantly associated with increased in-hospital mortality (OR 1.62) among hospitalized COVID-19 patients, with the largest effect observed in younger patients with lower BMIs and a history of smoking.
Cohort (n=8,222)
Yes
Does a history of cancer increase in-hospital mortality in symptomatic adults hospitalized with COVID-19?
Among hospitalized COVID-19 patients, a history of cancer, particularly with recent chemotherapy or a smoking history, is a significant predictor of in-hospital mortality, whereas underlying CVD itself showed a non-significant trend.
Effect estimate: OR 1.62 (95% CI 1.38-1.91)
Absolute Event Rate: 25.4% vs 17.3%
p-value: p=<0.0001
Abstract Background While pre-existing cardiovascular disease (CVD) appears to be associated with poor outcomes in patients with Coronavirus Disease 2019 (COVID-19), data on patients with CVD and concomitant cancer is limited. The purpose of this study is to evaluate the effect of underlying CVD and CVD risk factors with cancer history on in-hospital mortality in those with COVID-19. Methods Data from symptomatic adults hospitalized with COVID-19 at 86 hospitals in the US enrolled in the American Heart Association’s COVID-19 CVD Registry was analyzed. The primary exposure was cancer history. The primary outcome was in-hospital death. Multivariable logistic regression models were adjusted for demographics, CVD risk factors, and CVD. Interaction between history of cancer with concomitant CVD and CVD risk factors were tested. Results Among 8222 patients, 892 (10.8%) had a history of cancer and 1501 (18.3%) died. Cancer history had significant interaction with CVD risk factors of age, body mass index (BMI), and smoking history, but not underlying CVD itself. History of cancer was significantly associated with increased in-hospital death (among average age and BMI patients, adjusted odds ratio aOR = 3.60, 95% confidence interval CI: 2.07–6.24; p < 0.0001 in those with a smoking history and aOR = 1.33, 95%CI: 1.01—1.76; p = 0.04 in non-smokers). Among the cancer subgroup, prior use of chemotherapy within 2 weeks of admission was associated with in-hospital death (aOR = 1.72, 95%CI: 1.05–2.80; p = 0.03). Underlying CVD demonstrated a numerical but statistically nonsignificant trend toward increased mortality (aOR = 1.18, 95% CI: 0.99—1.41; p = 0.07). Conclusion Among hospitalized COVID-19 patients, cancer history was a predictor of in-hospital mortality. Notably, among cancer patients, recent use of chemotherapy, but not underlying CVD itself, was associated with worse survival. These findings have important implications in cancer therapy considerations and vaccine distribution in cancer patients with and without underlying CVD and CVD risk factors.
Tehrani et al. (Mon,) conducted a cohort in Symptomatic COVID-19 (n=8,222). History of cancer vs. No history of cancer was evaluated on In-hospital death (OR 1.62, 95% CI 1.38-1.91, p=<0.0001). A history of cancer was significantly associated with increased in-hospital mortality (OR 1.62) among hospitalized COVID-19 patients, with the largest effect observed in younger patients with lower BMIs and a history of smoking.