Prevalence of COVID-19-related risk factors and risk of severe influenza outcomes in cancer survivors: a matched cohort study using linked English electronic health records data

Abstract

Background People with active cancer are recognised as at risk of COVID-19 complications, but it is unclear whether the much larger population of cancer survivors is at elevated risk. We aimed to address this by comparing cancer survivors and cancer-free controls for (i) prevalence of comorbidities considered risk factors for COVID-19; and (ii) risk of severe influenza, as a marker of susceptibility to severe outcomes from epidemic respiratory viruses. Methods We included survivors (≥1 year) of the 20 most common cancers, and age, sex and general practice-matched cancer-free controls, derived from UK primary care data linked to cancer registrations, hospital admissions and death registrations. Comorbidity prevalences were calculated 1 and 5 years from cancer diagnosis. Risk of hospitalisation or death due to influenza was compared using Cox models adjusted for baseline demographics and comorbidities. Findings 108,215 cancer survivors and 523,541 cancer-free controls were included. Cancer survivors had more asthma, other respiratory, cardiac, diabetes, neurological, renal, and liver disease, and less obesity, compared with controls, but there was variation by cancer site. There were 205 influenza hospitalisations/deaths, with cancer survivors at higher risk than controls (adjusted HR 2.78, 95% CI 2.04-3.80). Haematological cancer survivors had large elevated risks persisting for >10 years (HR overall 15.17, 7.84-29.35; HR >10 years from cancer diagnosis 10.06, 2.47-40.93). Survivors of other cancers had evidence of raised risk up to 5 years from cancer diagnosis only (HR 2.22, 1.31-3.74). Interpretation Risks of severe COVID-19 outcomes are likely to be elevated in cancer survivors. This should be taken into account in policies targeted at clinical risk groups, and vaccination for both influenza, and, when available, COVID-19, should be encouraged in cancer survivors.

Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

“…The difference between COVID-19 and non-COVID mortality risk was less stark in haematological cancer survivors, in keeping with evidence that these cancers are likely associated with a larger raised risk of COVID-19 death. [ 4 , 24 ] Chronic liver disease also showed a smaller association with COVID-19 death compared with non-COVID death, perhaps again reflecting shielding behaviour or social interactions during the pandemic; unfortunately we lacked the data to investigate the role of alcohol in this association. Dementia was associated with disproportionately raised risks of COVID-19 death, but this appeared to be driven by data from wave 1 of the pandemic, likely due to significant outbreaks in residential care homes during that period; by wave 2, dementia was associated with similar risks of COVID-19 and non-COVID death.…”

Mathematical model of COVID-19 with comorbidity and controlling using non-pharmaceutical interventions and vaccination

“…within the infected human being. All human beings with comorbidity or medical illness are at high risk to get an infection than normal or healthy people [ 10 – 12 ]. From the statistical data, this is reported that the patients with COVID-19 having comorbidity like kidney disease and type-2 diabetes were transferred to hospital with intensive or critical care unit [ 13 – 15 ].…”

Identificação de grupos prioritários para a vacinação contra COVID-19 no Brasil

“…O presente estudo é uma contribuição para a elaboração do plano nacional de vacinação, mas não deve ser considerado isoladamente, pois existem outros fatores de risco que não foram considerados por não constarem nas bases de dados disponíveis (em pelo menos uma das bases utilizadas nas análises), como, por exemplo, cirrose hepática 32 , doença falciforme 33 , síndrome de Down 34 e câncer 35,36 . Existem evidências também de maior morbidade e mortalidade por doenças de transmissão respiratória em populações como a de indígenas 37 e de privados de liberdade 38 .…”