Characterizing cancer and COVID-19 outcomes using electronic health records

• Published in: PloS one 2022-05, Vol.17 (5), p.e0267584-e0267584
• Main Authors: Kim, Youngran, Zhu, Liang, Zhu, Huili, Li, Xiaojin, Huang, Yan, Gu, Chunhui, Bush, Heather, Chung, Caroline, Zhang, Guo-Qiang
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Auroral kilometric radiation; Blood cancer; Breast cancer; Cancer; Cancer therapies; Chemotherapy; Chronic conditions; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; Diabetes mellitus; Diagnosis; Electronic Health Records; Electronic medical records; Electronic records; Female; Government programs; Health risks; Hospitalization; Humans; Immune system; Infections; Kidney cancer; Liver; Liver diseases; Lung Neoplasms; Male; Medical records; Medicare; Medicine and Health Sciences; Metastases; Mortality; Patients; Prostate cancer; Radiation; Risk assessment; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; United States - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0267584

Patients with cancer often have compromised immune system which can lead to worse COVID-19 outcomes. The purpose of this study is to assess the association between COVID-19 outcomes and existing cancer-specific characteristics. Patients aged 18 or older with laboratory-confirmed COVID-19 between June 1, 2020, and December 31, 2020, were identified (n = 314 004) from the Optum® de-identified COVID-19 Electronic Health Record (EHR) derived from more than 700 hospitals and 7000 clinics in the United States. To allow sufficient observational time, patients with less than one year of medical history in the EHR dataset before their COVID-19 tests were excluded (n = 42 365). Assessed COVID-19 outcomes including all-cause 30-day mortality, hospitalization, ICU admission, and ventilator use, which were compared using relative risks (RRs) according to cancer status and treatments. Among 271 639 patients with COVID-19, 18 460 had at least one cancer diagnosis: 8034 with a history of cancer and 10 426 with newly diagnosed cancer within one year of COVID-19 infection. Patients with a cancer diagnosis were older and more likely to be male, white, Medicare beneficiaries, and have higher prevalences of chronic conditions. Cancer patients had higher risks for 30-day mortality (RR 1.07, 95% CI 1.01-1.14, P = 0.028) and hospitalization (RR 1.04, 95% CI 1.01-1.07, P = 0.006) but without significant differences in ICU admission and ventilator use compared to non-cancer patients. Recent cancer diagnoses were associated with higher risks for worse COVID-19 outcomes (RR for mortality 1.17, 95% CI 1.08-1.25, P