Abstract S10-03: Increased risk of COVID-19-related death among cancer survivors

Significant variations in experience of the COVID-19 pandemic have been observed in the United States. Increased risk of COVID-19-related death has been reported among cancer survivors, but due to limited sample size in those studies, to what extent the previous cancer diagnosis may play a role in the determination of COVID-19-related death is still unclear. In this study, using aggregated real-world data extracted from TriNetx electronic medical record data from 34 hospitals around United States, we assessed the relationship between prior cancer diagnosis in the past 5 years and COVID-19-related death within one month after the diagnosis of virus contraction. A total of 24,534 patients aged 18-80 years old who contracted COVID-19 were identified from January 20th to May 4th, 2020. Among them, 3,619 were cancer survivors. In the univariate analysis, we found that cancer patients had 2.55-fold increased risk ratio (RR) of death than those without cancer (RR=2.55, 95% Confidence Interval (CI): 2.25, 2.88), although the risk was decreased but still significant (RR=1.42, 95% CI: 1.21, 1.67) after adjustment for demographics (e.g., age, gender, and race) and other pre-existing chronic diseases, including obesity, diabetes, hypertension, chronic ischemic heart disease, chronic kidney disease, asthma, and COPD. When stratified by cancer sites, significant associations were observed between respiratory and intrathoracic, oral, digestive, breast, male genital, urinary, blood, and skin cancers with COVID-19-related death in the univariate analysis. As expected, the most significant cancer site was respiratory and intrathoracic cancer with an RR of 6.49 (95% CI: 5.21, 8.07). However, after adjustment for demographics and other pre-existing chronic diseases, the significant associations remained for respiratory and intrathoracic, digestive, and blood cancers (RR=1.89, 95% CI: 1.31, 2.73; RR=1.59, 95% CI: 1.06, 2.38; RR=2.08, 95% CI: 1.51, 2.86, respectively). In addition, among cancer survivors, men were found to have higher RR of death than women (RR=1.41, 95% CI: 1.12, 1.78), but the RR did not differ between Blacks and Whites. In summary, our data show significant increased COVID-19-related death among cancer survivors. The elevated risk was particularly evident among those who had respiratory and intrathoracic, digestive, and blood cancers. Citation Format: Jie Shen, Hua Zhao. Increased risk of COVID-19-related death among cancer survivors [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S10-03.