Comparison and impact of COVID-19 for patients with cancer: A survival analysis of fatality rate controlling for age, sex and cancer type
AffiliationDepartment of Biosystems Engineering, The University of Arizona
MetadataShow full item record
PublisherBMJ Publishing Group
CitationLi, H., Baldwin, E., Zhang, X., Kenost, C., Luo, W., Calhoun, E. A., An, L., Bennett, C. L., & Lussier, Y. A. (2021). Comparison and impact of COVID-19 for patients with cancer: A survival analysis of fatality rate controlling for age, sex and cancer type. BMJ Health and Care Informatics, 28(1).
JournalBMJ Health and Care Informatics
RightsCopyright © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractObjectives Prior research has reported an increased risk of fatality for patients with cancer, but most studies investigated the risk by comparing cancer to non-cancer patients among COVID-19 infections, where cancer might have contributed to the increased risk. This study is to understand COVID-19's imposed HR of fatality while controlling for covariates, such as age, sex, metastasis status and cancer type. Methods We conducted survival analyses of 4606 cancer patients with COVID-19 test results from 16 March to 11 October 2020 in UK Biobank and estimated the overall HR of fatality with and without COVID-19 infection. We also examined the HRs of 13 specific cancer types with at least 100 patients using a stratified analysis. Results COVID-19 resulted in an overall HR of 7.76 (95% CI 5.78 to 10.40, p<10-10) by following 4606 patients with cancer for 21 days after the tests. The HR varied among cancer type, with over a 10-fold increase in fatality rate (false discovery rate ≤0.02) for melanoma, haematological malignancies, uterine cancer and kidney cancer. Although COVID-19 imposed a higher risk for localised versus distant metastasis cancers, those of distant metastases yielded higher overall fatality rates due to their multiplicative effects. Discussion The results confirmed prior reports for the increased risk of fatality for patients with COVID-19 plus hematological malignancies and demonstrated similar findings of COVID-19 on melanoma, uterine, and kidney cancers. Conclusion The results highlight the heightened risk that COVID-19 imposes on localised and haematological cancer patients and the necessity to vaccinate uninfected patients with cancer promptly, particularly for the cancer types most influenced by COVID-19. Results also suggest the importance of timely care for patients with localised cancer, whether they are infected by COVID-19 or not. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
NoteOpen access journal
VersionFinal published version
Except where otherwise noted, this item's license is described as Copyright © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC.
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