The risk of in-hospital death from COVID-19 for patients with cancer differs by sex and cancer type, according to research published in JAMA Oncology.
Researchers found that, among women, 5 cancers were associated with a more than 2-fold higher risk of in-hospital COVID-19 death. Among men, 2 cancers were associated with a more than 2-fold higher risk of in-hospital COVID-19 death.
This study included data from 1,622,755 patients from the Healthcare Cost and Utilization Project’s National Inpatient Sample. All patients were admitted to the hospital with COVID-19 between April 1, 2020, and December 31, 2020. The primary outcome was in-hospital COVID-19 case fatality rate.
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A total of 76,655 patients had cancer (4.7%). In the entire cohort, 51.8% of patients were men, and 48.2% were women. The most common comorbidities were pneumonia (74.3%), respiratory failure (52.9%), cardiac arrhythmia or arrest (29.3%), acute kidney injury (28.0%), and sepsis (24.6%).
The in-hospital COVID-19 case fatality rate for the entire cohort was 12.9%, and the median time to death was 5 days (interquartile range, 2-11 days).
The in-hospital COVID-19 case fatality rate was higher in patients with cancer than in those without it — 17.9% and 12.7%, respectively (adjusted odds ratio [aOR], 1.29; 95% CI, 1.27-1.32). It was also higher in men than in women — 14.5% and 11.2%, respectively (aOR, 1.28; 95% CI, 1.27-1.30).
In women and men, there were 13 cancers associated with an increased risk of in-hospital death from COVID-19. Women with 5 cancers — lung cancer, Hodgkin and non-Hodgkin lymphoma, anal cancer, and ovarian cancer — had a more than 2-fold higher risk of in-hospital death from COVID-19.
Men with 2 cancers — Kaposi sarcoma and malignant neoplasm of the small intestine — had a more than 2-fold higher risk of in-hospital death from COVID-19. More details can be seen in the table below.
|
Results in Women |
||
|
Cancer Type |
COVID-19 Case Fatality Rate |
Adjusted Odds Ratio |
|
Anal cancer |
23.8% |
2.94 (95% CI, 1.84-4.69) |
|
Hodgkin lymphoma |
19.5% |
2.79 (95% CI, 1.90-4.08) |
|
Non-Hodgkin lymphoma |
22.4% |
2.23 (95% CI, 2.02-2.47) |
|
Lung cancer |
24.3% |
2.21 (95% CI, 2.03-2.39) |
|
Ovarian cancer
|
19.4% |
2.15 (95% CI, 1.79-2.59) |
|
Pancreatic cancer
|
23.0% |
1.94 (95% CI, 1.59-2.37) |
|
Myeloid leukemia |
19.4% |
1.94 (95% CI, 1.64-2.31) |
|
Multiple myeloma |
21.9% |
1.63 (95% CI, 1.46-1.82) |
|
Liver cancer |
26.2% |
1.59 (95% CI, 1.23-2.06) |
|
Rectal cancer |
18.9% |
1.42 (95% CI, 1.02-1.97) |
|
Colon cancer |
17.1% |
1.40 (95% CI, 1.20-1.64) |
|
Lymphoid leukemia |
16.0% |
1.31 (95% CI, 1.17-1.48) |
|
Breast cancer |
12.8% |
1.19 (95% CI, 1.09-1.30) |
|
Results in Men |
||
|
Cancer Type |
COVID-19 Case Fatality Rate |
Adjusted Odds Ratio |
|
Kaposi sarcoma |
33.3% |
2.08 (95% CI, 1.18-3.66) |
|
Malignant neoplasm in small intestine |
28.6% |
2.04 (95% CI, 1.18-3.53) |
|
Colon cancer
|
23.7% |
1.94 (95% CI, 1.72-2.19) |
|
Lung cancer
|
25.9% |
1.80 (95% CI, 1.67-1.95) |
|
Esophageal cancer |
22.0% |
1.56 (95% CI, 1.26-1.94) |
|
Myeloid leukemia |
21.4% |
1.54 (95% CI, 1.33-1.78) |
|
Pancreatic cancer |
22.2% |
1.53 (95% CI, 1.24-1.87) |
|
Multiple myeloma |
22.9% |
1.43 (95% CI, 1.30-1.58) |
|
Oral, lip, and pharynx cancer |
16.7% |
1.34 (95% CI, 1.02-1.75) |
|
Non-Hodgkin lymphoma |
18.9% |
1.32 (95% CI, 1.21-1.45) |
|
Bladder cancer
|
25.1% |
1.29 (95% CI, 1.11-1.48) |
|
Liver cancer |
25.1% |
1.28 (95% CI, 1.11-1.49) |
|
Lymphoid leukemia |
17.9% |
1.27 (95% CI, 1.17-1.38) |
“While COVID-19 in-hospital case fatality risks were lower among women compared with men, the associations of a concurrent malignant neoplasm with the COVID-19 case fatality were overall more substantial for women than for men,” the researchers wrote.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Matsuo K, Mandelbaum RS, Vallejo A, Klar M, Roman LD, Wright JD. Assessment of gender-specific COVID-19 case fatality risk per malignant neoplasm type. JAMA Oncol. Published online April 27, 2023. doi:10.1001/jamaoncol.2023.0768
This article originally appeared on Cancer Therapy Advisor
