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The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma
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...
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| Published in: | Head & neck 2024-07, Vol.46 (7), p.1698-1705 |
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| container_title | Head & neck |
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| creator | Johns, James D. Choe, Erica J. Chisolm, Paul F. Pothast, Morgan J. Randolph, Jackson R. Chou, Jiling Maxwell, Jessica H. |
| description | 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 |
| doi_str_mv | 10.1002/hed.27714 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2937336414</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2937336414</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3134-2014d6610e7e6d058b097ba5a00dd1fb7b3f3bb52687bcfa1cd174c8b241c9df3</originalsourceid><addsrcrecordid>eNp1kctOwzAQRS0E4lFY8APIEhtYpIwfjZMlKk8JqZvC1vIrakoTFzsBseMT-Ea-BLeFDRKrGY3OXN2Zi9AxgSEBoBczZ4dUCMK30D6BUmTAuNhe9ZxlDATfQwcxzgGA5Zzuoj1WcMYYzfdRmM4crpulMh32FR5Pnu6vvj4-SYlVa_GrMqZuVVf7FsdOdX3EqfN9Z3zjIq5b_Oo6F1Qb8VvdzfDMKbtebJ15xvGlV41PO8YtFtiokLR8ow7RTqUW0R391AF6vLmeju-yh8nt_fjyITOMMJ5RINzmOQEnXG5hVOh0mVYjBWAtqbTQrGJaj2heCG0qRYwlgptCU05MaSs2QGcb3WXwL72LnWzquLKiWpdcSVoywdJDCE_o6R907vvQJneSQS6KAsqCJup8Q5ngYwyukstQNyq8SwJyFYRMQch1EIk9-VHsdZOmv-Tv5xNwsQHe6oV7_19J3l1fbSS_ASCHki8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3067880982</pqid></control><display><type>article</type><title>The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma</title><source>Wiley</source><creator>Johns, James D. ; Choe, Erica J. ; Chisolm, Paul F. ; Pothast, Morgan J. ; Randolph, Jackson R. ; Chou, Jiling ; Maxwell, Jessica H.</creator><creatorcontrib>Johns, James D. ; Choe, Erica J. ; Chisolm, Paul F. ; Pothast, Morgan J. ; Randolph, Jackson R. ; Chou, Jiling ; Maxwell, Jessica H.</creatorcontrib><description>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 < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID‐19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID‐19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test.
Conclusion
COVID‐19 infection may significantly increase rates of 60‐day mortality and respiratory complications in patients with HNSCC. COVID‐19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.</description><identifier>ISSN: 1043-3074</identifier><identifier>ISSN: 1097-0347</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.27714</identifier><identifier>PMID: 38433326</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>Head & neck, 2024-07, Vol.46 (7), p.1698-1705</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3134-2014d6610e7e6d058b097ba5a00dd1fb7b3f3bb52687bcfa1cd174c8b241c9df3</cites><orcidid>0000-0002-5935-0887 ; 0000-0003-3076-5218</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38433326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johns, James D.</creatorcontrib><creatorcontrib>Choe, Erica J.</creatorcontrib><creatorcontrib>Chisolm, Paul F.</creatorcontrib><creatorcontrib>Pothast, Morgan J.</creatorcontrib><creatorcontrib>Randolph, Jackson R.</creatorcontrib><creatorcontrib>Chou, Jiling</creatorcontrib><creatorcontrib>Maxwell, Jessica H.</creatorcontrib><title>The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>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 < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID‐19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID‐19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test.
Conclusion
COVID‐19 infection may significantly increase rates of 60‐day mortality and respiratory complications in patients with HNSCC. COVID‐19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.</description><subject>Aged</subject><subject>Cardiovascular diseases</subject><subject>Cohort Studies</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 Vaccines</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Head & neck cancer</subject><subject>head and neck cancer</subject><subject>Head and neck carcinoma</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - therapy</subject><subject>Humans</subject><subject>Hypopharynx</subject><subject>Immunization</subject><subject>Infections</subject><subject>Larynx</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Nasopharynx</subject><subject>Oral cavity</subject><subject>Oropharynx</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory failure</subject><subject>Respiratory tract infection</subject><subject>Retrospective Studies</subject><subject>Squamous cell carcinoma</subject><subject>Squamous Cell Carcinoma of Head and Neck - mortality</subject><subject>Squamous Cell Carcinoma of Head and Neck - therapy</subject><subject>Squamous Cell Carcinoma of Head and Neck - virology</subject><subject>Stroke</subject><subject>Thromboembolism</subject><subject>United States - epidemiology</subject><subject>Vaccination</subject><subject>Vaccination - statistics & numerical data</subject><subject>Veterans</subject><issn>1043-3074</issn><issn>1097-0347</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kctOwzAQRS0E4lFY8APIEhtYpIwfjZMlKk8JqZvC1vIrakoTFzsBseMT-Ea-BLeFDRKrGY3OXN2Zi9AxgSEBoBczZ4dUCMK30D6BUmTAuNhe9ZxlDATfQwcxzgGA5Zzuoj1WcMYYzfdRmM4crpulMh32FR5Pnu6vvj4-SYlVa_GrMqZuVVf7FsdOdX3EqfN9Z3zjIq5b_Oo6F1Qb8VvdzfDMKbtebJ15xvGlV41PO8YtFtiokLR8ow7RTqUW0R391AF6vLmeju-yh8nt_fjyITOMMJ5RINzmOQEnXG5hVOh0mVYjBWAtqbTQrGJaj2heCG0qRYwlgptCU05MaSs2QGcb3WXwL72LnWzquLKiWpdcSVoywdJDCE_o6R907vvQJneSQS6KAsqCJup8Q5ngYwyukstQNyq8SwJyFYRMQch1EIk9-VHsdZOmv-Tv5xNwsQHe6oV7_19J3l1fbSS_ASCHki8</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Johns, James D.</creator><creator>Choe, Erica J.</creator><creator>Chisolm, Paul F.</creator><creator>Pothast, Morgan J.</creator><creator>Randolph, Jackson R.</creator><creator>Chou, Jiling</creator><creator>Maxwell, Jessica H.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5935-0887</orcidid><orcidid>https://orcid.org/0000-0003-3076-5218</orcidid></search><sort><creationdate>202407</creationdate><title>The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma</title><author>Johns, James D. ; Choe, Erica J. ; Chisolm, Paul F. ; Pothast, Morgan J. ; Randolph, Jackson R. ; Chou, Jiling ; Maxwell, Jessica H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3134-2014d6610e7e6d058b097ba5a00dd1fb7b3f3bb52687bcfa1cd174c8b241c9df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Cardiovascular diseases</topic><topic>Cohort Studies</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 Vaccines</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Head & neck cancer</topic><topic>head and neck cancer</topic><topic>Head and neck carcinoma</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - therapy</topic><topic>Humans</topic><topic>Hypopharynx</topic><topic>Immunization</topic><topic>Infections</topic><topic>Larynx</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Nasopharynx</topic><topic>Oral cavity</topic><topic>Oropharynx</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Respiratory distress syndrome</topic><topic>Respiratory failure</topic><topic>Respiratory tract infection</topic><topic>Retrospective Studies</topic><topic>Squamous cell carcinoma</topic><topic>Squamous Cell Carcinoma of Head and Neck - mortality</topic><topic>Squamous Cell Carcinoma of Head and Neck - therapy</topic><topic>Squamous Cell Carcinoma of Head and Neck - virology</topic><topic>Stroke</topic><topic>Thromboembolism</topic><topic>United States - epidemiology</topic><topic>Vaccination</topic><topic>Vaccination - statistics & numerical data</topic><topic>Veterans</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johns, James D.</creatorcontrib><creatorcontrib>Choe, Erica J.</creatorcontrib><creatorcontrib>Chisolm, Paul F.</creatorcontrib><creatorcontrib>Pothast, Morgan J.</creatorcontrib><creatorcontrib>Randolph, Jackson R.</creatorcontrib><creatorcontrib>Chou, Jiling</creatorcontrib><creatorcontrib>Maxwell, Jessica H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johns, James D.</au><au>Choe, Erica J.</au><au>Chisolm, Paul F.</au><au>Pothast, Morgan J.</au><au>Randolph, Jackson R.</au><au>Chou, Jiling</au><au>Maxwell, Jessica H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>2024-07</date><risdate>2024</risdate><volume>46</volume><issue>7</issue><spage>1698</spage><epage>1705</epage><pages>1698-1705</pages><issn>1043-3074</issn><issn>1097-0347</issn><eissn>1097-0347</eissn><abstract>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 < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID‐19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID‐19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test.
Conclusion
COVID‐19 infection may significantly increase rates of 60‐day mortality and respiratory complications in patients with HNSCC. COVID‐19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>38433326</pmid><doi>10.1002/hed.27714</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5935-0887</orcidid><orcidid>https://orcid.org/0000-0003-3076-5218</orcidid></addata></record> |
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| 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 |
| title | The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma |
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