Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin

Margaret B. Nolan, Thomas M. Piasecki, Stevens S. Smith, Timothy B. Baker, Michael C. Fiore, Robert T. Adsit, Daniel M. Bolt, Karen L. Conner, Steven L. Bernstein, Oliver D. Eng, David Lazuk, Alec Gonzalez, Todd Hayes-Birchler, Douglas E. Jorenby, Heather D'Angelo, Julie A. Kirsch, Brian S. Williams, Sean Kent, Hanna Kim, Stanley A. LubanskiMenggang Yu, Youmi Suk, Yuxin Cai, Nitu Kashyap, Jomol Mathew, Gabriel McMahan, Betsy Rolland, Hilary A. Tindle, Graham W. Warren, Noor Abu-El-Rub, Lawrence C. An, Andrew D. Boyd, Darlene H. Brunzell, Victor A. Carrillo, Li Shiun Chen, James M. Davis, Vikrant G. Deshmukh, Deepika Dilip, Adam O. Goldstein, Patrick K. Ha, Eduardo Iturrate, Thulasee Jose, Niharika Khanna, Andrea King, Elizabeth Klass, Michelle Lui, Robin J. Mermelstein, Chester Poon, Elisa Tong, Karen M. Wilson, Wendy E. Theobald, Wendy S. Slutske

Research output: Contribution to journalArticlepeer-review


BACKGROUND: There is mixed evidence about the relations of current versus past cancer with severe COVID-19 outcomes and how they vary by patient and cancer characteristics. METHODS: Electronic health record data of 104,590 adult hospitalized patients with COVID-19 were obtained from 21 United States health systems from February 2020 through September 2021. In-hospital mortality and ICU admission were predicted from current and past cancer diagnoses. Moderation by patient characteristics, vaccination status, cancer type, and year of the pandemic was examined. RESULTS: 6.8% of the patients had current (n = 7,141) and 6.5% had past (n = 6,749) cancer diagnoses. Current cancer predicted both severe outcomes but past cancer did not; adjusted odds ratios (aOR) for mortality were 1.58 [95% confidence interval (CI), 1.46-1.70] and 1.04 (95% CI, 0.96-1.13), respectively. Mortality rates decreased over the pandemic but the incremental risk of current cancer persisted, with the increment being larger among younger vs. older patients. Prior COVID-19 vaccination reduced mortality generally and among those with current cancer (aOR, 0.69; 95% CI, 0.53-0.90). CONCLUSIONS: Current cancer, especially among younger patients, posed a substantially increased risk for death and ICU admission among patients with COVID-19; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types. IMPACT: This study clarifies the characteristics that modify the risk associated with cancer on severe COVID-19 outcomes across the first 20 months of the COVID-19 pandemic. See related commentary by Egan et al., p. 3.


Dive into the research topics of 'Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin'. Together they form a unique fingerprint.

Cite this