The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma

• Published in: Head & neck 2024-07, Vol.46 (7), p.1698-1705
• Main Authors: Johns, James D., Choe, Erica J., Chisolm, Paul F., Pothast, Morgan J., Randolph, Jackson R., Chou, Jiling, Maxwell, Jessica H.
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular diseases; Cohort Studies; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - mortality; COVID-19 Vaccines; Diagnosis; Female; Head & neck cancer; head and neck cancer; Head and neck carcinoma; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - therapy; Humans; Hypopharynx; Immunization; Infections; Larynx; Male; Middle Aged; Morbidity; Mortality; Myocardial infarction; Nasopharynx; Oral cavity; Oropharynx; Patients; Pneumonia; Respiratory distress syndrome; Respiratory failure; Respiratory tract infection; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - therapy; Squamous Cell Carcinoma of Head and Neck - virology; Stroke; Thromboembolism; United States - epidemiology; Vaccination; Vaccination - statistics & numerical data; Veterans
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27714

Background The impact of both COVID‐19 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown. Objective To determine the impact of COVID‐19 infection and vaccination status on 60‐day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC. Methods This was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID‐19 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical/demographic data, vaccination status, and incidence of 60‐day mortality, 60‐day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60‐day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID‐19 infection, vaccination status, morbidity and mortality were investigated. Results Of the 14 262 patients with HNSCC who were tested for COVID‐19 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60‐day mortality (4.7% vs. 2.0%, respectively; p