Key Points
Question
What is the COVID-19 in-hospital case fatality risk among female and male patients with a malignant neoplasm?
Findings
In this cohort study of 1.6 million hospitalizations with COVID-19 identified in the National Inpatient Sample from April 1 to December 31, 2020, there were more types of malignant neoplasm associated with a COVID-19 in-house case fatality risk of greater than 2-fold in the group of female patients (5 types: anal cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, lung cancer, and ovarian cancer) compared with the group of male patients (2 types: Kaposi sarcoma and small intestine cancer).
Meaning
The results of this study suggest that the association of a concurrent malignant neoplasm with COVID-19 mortality may be more substantial for women than men.
Abstract
Importance
While the characteristics of COVID-19 infection and mortality among patients with a malignant neoplasm have previously been examined, little data are available for gender-specific COVID-19 mortality.
Objective
To examine the gender-specific COVID-19 case fatality risks among patients with a malignant neoplasm.
Design, Setting, and Participants
In this cohort study using the Healthcare Cost and Utilization Project’s National Inpatient Sample, patients admitted to the hospital from April to December 2020 with a diagnosis of COVID-19 infection were identified by the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code U07.1. Data analysis was performed from November 2022 to January 2023.
Exposure
Diagnosis of malignant neoplasm, identified and classified according to the National Cancer Institute’s definition.
Main Outcome and Measure
COVID-19 in-hospital case fatality rate, defined as the number of deaths that occurred during index hospital admissions.
Results
There were 1 622 755 patients who were admitted to the hospital from April 1 to December 31, 2020, with a diagnosis of COVID-19. The cohort-level COVID-19 in-hospital case fatality rate was 12.9% with a median time to death of 5 days (IQR, 2-11 days). Frequently reported morbidities among the patients with COVID-19 included pneumonia (74.3%), respiratory failure (52.9%), cardiac arrythmia or cardiac arrest (29.3%), acute kidney injury (28.0%), sepsis (24.6%), shock (8.6%), cerebrovascular accident (5.2%), and venous thromboembolism or pulmonary embolism (5.0%). In a multivariable analysis, gender (male vs female, 14.5% vs 11.2%; adjusted odds ratio [aOR], 1.28; 95% CI, 1.27-1.30) and malignant neoplasm (17.9% vs 12.7%; aOR, 1.29; 95% CI, 1.27-1.32) were both associated with increased COVID-19 in-hospital case fatality risk at the cohort level. Among the group of female patients, there were 5 malignant neoplasms in which the COVID-19 in-hospital case fatality risk was greater than 2-fold higher. These included anal cancer (23.8%; aOR, 2.94; 95% CI, 1.84-4.69), Hodgkin lymphoma (19.5%; aOR, 2.79; 95% CI, 1.90-4.08), non-Hodgkin lymphoma (22.4%; aOR, 2.23; 95% CI, 2.02-2.47), lung cancer (24.3%; aOR, 2.21; 95% CI, 2.03-2.39), and ovarian cancer (19.4%; aOR, 2.15; 95% CI, 1.79-2.59). Among the group of male patients, Kaposi sarcoma (33.3%; aOR, 2.08; 95% CI, 1.18-3.66) and malignant neoplasm in the small intestine (28.6%; aOR, 2.04; 95% CI, 1.18-3.53) had a greater than 2-fold increased COVID-19 in-hospital case mortality risk.
Conclusions and Relevance
The results of this cohort study confirmed the substantial case fatality rate among patients with COVID-19 in the early pandemic experience in 2020 in the US. While COVID-19 in-hospital case fatality risks were lower among women compared with men, the associations of a concurrent malignant neoplasm with the COVID-19 case fatality were overall more substantial for women than for men.
This cohort study examines the gender-specific COVID-19 case fatality risks among patients with a malignant neoplasm.
Introduction
Since the beginning of the COVID-19 pandemic in mid-March 2019, more than 102 million cases and nearly than 1.1 million deaths have been reported in the United States as of late January 2023.1 Worldwide, these statistics increase several-fold to more than 664 million cases and 6.7 million deaths.2 Epidemiological analyses demonstrated that gender is associated with COVID-19 mortality, with male patients more likely to die than female patients.3
While the risk of COVID-19 infection and mortality characteristics among patients with cancer have previously been examined,4,5,6,7,8,9 to our knowledge, little data on the gender-specific COVID-19–associated mortality among patients with a malignant neoplasm are available. Given the distinct differences between the incidence of malignant neoplasms and the mortality associated with malignant neoplasms based on gender,10 the objective of this study was to examine the gender-specific COVID-19 case fatality risks among patients with a malignant neoplasm during the early period of the pandemic in the US.
Methods
This cohort study examined data from the Healthcare Cost and Utilization Project’s National Inpatient Sample.11 The program approximates a stratified sample of 20% of hospital discharges in each center from all the participating hospitals across 48 states and the District of Columbia. By applying the weights for national estimates, the National Inpatient Sample represents more than 95% of hospital discharge data in the US population.
Cohort Characteristics
The study population consisted of patients admitted to the hospital between April 1 and December 31, 2020, with the diagnosis of COVID-19, identified per the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code U07.1.12 This coding was based on the Centers for Disease Control and Prevention’s recommendation that was effective as of March 18, 2020, and was externally validated for accuracy.13
The exposure was diagnosis of malignant neoplasm, identified and classified according to the National Cancer Institute’s definition and followed a prior analytic approach.14,15 The main outcome measure was COVID-19 in-hospital case fatality, defined as the number of deaths that occurred during the index hospital admissions.
The measured study covariates were preselected based on the view of the literature and their relevance to COVID-19 mortality. These included patient age at hospital admission (<30, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years), time (second, third, and fourth quarter of the year), gender (female or male), race and ethnicity (Asian, Black, Hispanic, Native American, White, and other) determined by the program (race and ethnicity were examined because these factors are important in assessing COVID-19 case fatality rates), median household income (every quartile), patient location (large fringe metropolitan, large central metropolitan, medium metropolitan, small metropolitan, micropolitan, and not metropolitan or micropolitan), Charlson Comorbidity Index score (≤1, 2-3, and ≥4), tobacco use (yes or no), hospital relative bed capacity (small, medium, and large), hospital location and teaching status (rural, urban nonteaching, and urban teaching), and hospital region (Northeast, Midwest, South, and West).
Statistical Analysis
Data analysis was performed from November 2022 to January 2023. The first step of analysis was to assess the COVID-19 in-hospital case fatality rates stratified by patient demographic characteristics, comorbidity, and hospital parameters at the cohort level. A binary logistic regression model was fitted for the multivariable analysis, and all the measured covariates were entered into the final model. The effect size for COVID-19 in-hospital case fatality risk was estimated as adjusted odds ratio (aOR) and corresponding 95% CI. Multicollinearity across the measured study covariates was assessed.
The second step of analysis was to assess the association between gender-specific type of malignant neoplasm and COVID-19 in-hospital case fatality risk according to gender (female and male). The exposure-outcome association was adjusted for the measured study covariates in the binary logistic regression model. The types of malignant neoplasm were grouped based on the National Cancer Institute’s schema.14 Cases with multiple diagnoses of malignant neoplasm that were classified as other type were not considered in the analysis. The effect size of malignant neoplasm compared with nonmalignant neoplasm for the COVID-19 in-hospital case fatality risk was estimated as aOR ratio and corresponding 95% CI.
In sensitivity analysis, cohort-level incidence rates of morbidities pertinent to COVID-19 infection and time to death after hospitalization were assessed. In addition, (1) age-specific COVID-19 in-hospital case fatality rates and (2) temporal trends of monthly COVID-19 in-hospital case fatality rates during the study period were assessed according to the gender and type of malignant neoplasm.
The weights for national estimates provided by the National Inpatient Sample were used for analysis. Statistical interpretation followed a 2-tailed hypothesis, and P < .05 was considered statistically significant; SPSS Statistics, version 28.0 (IBM Corp) and Joinpoint Trend Analysis software, version 4.8.0.1 (National Cancer Institute) were used for analysis. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline to outline the performance of the cohort study. The University of Southern California institutional review board deemed this study exempt because it included only publicly available, deidentified data; therefore, informed consent was not required.
Results
Of 21 009 711 patients at hospital admission for national estimates during the 9 months of the study period, 1 622 755 (7.7%) had a diagnosis of COVID-19, and the in-hospital case fatality rate was 12.9% (95% CI, 12.9%-13.0%; 210 085 patients died). Among the patients who died, the median time to death after hospital admission was 5 days (IQR, 2-11 days).
Frequently reported morbidities (≥5.0%) among the patients with COVID-19 infection included pneumonia (74.3%), respiratory failure (52.9%), cardiac arrythmia or cardiac arrest (29.3%), acute kidney injury (28.0%), sepsis (24.6%), shock (8.6%), cerebrovascular accident (5.2%), and venous thromboembolism or pulmonary embolism (5.0%).
Of 1 622 755 patients with COVID-19 infection, 76 655 (4.7%) had a diagnosis of a malignant neoplasm. Early study period, older age, male gender (male vs female, 14.5% vs 11.2%; aOR, 1.28; 95% CI, 1.27-1.30), Native American individuals, higher Charlson Comorbidity Index score, diagnosis of malignant neoplasm (17.9% vs 12.7%; aOR, 1.29; 95% CI, 1.27-1.32), lower household income, and Northeastern region were associated with increased COVID-19 in-hospital case fatality (Table; eFigures 1 and 2 in Supplement 1).
Table. Characteristics of Patients With COVID-19 Infection.
| Characteristic | Patients, No. (%)a | Fatality rateb | aOR (95%CI)c | P value |
|---|---|---|---|---|
| Total No. | 1 622 755 (100) | 12.9 | NA | NA |
| Age, yd | <.001e | |||
| <30 | 96 410 (5.9) | 1.4 | 1 [Reference] | NA |
| 30-39 | 109 595 (6.8) | 2.5 | 1.46 (1.37-1.56) | <.001 |
| 40-49 | 160 595 (9.9) | 4.6 | 2.24 (2.11-2.38) | <.001 |
| 50-59 | 257 615 (15.9) | 7.6 | 3.43 (3.24-3.62) | <.001 |
| 60-69 | 337 330 (20.8) | 12.9 | 5.59 (5.29-5.91) | <.001 |
| 70-79 | 340 780 (21.0) | 17.8 | 7.71 (7.30-8.15) | <.001 |
| ≥80 | 320 430 (19.7) | 23.3 | 10.85 (10.27-11.46) | <.001 |
| Quarter of 2020f | <.001e | |||
| Second | 404 320 (24.9) | 16.4 | 1 [Reference] | NA |
| Third | 415 815 (25.6) | 11.7 | 0.69 (0.68-0.70) | <.001 |
| Fourth | 802 620 (49.5) | 11.8 | 0.65 (0.65-0.66) | <.001 |
| Gender | <.001e | |||
| Female | 782 020 (48.2) | 11.2 | 1 [Reference] | NA |
| Male | 840 665 (51.8) | 14.5 | 1.28 (1.27-1.30) | <.001 |
| Unknown | 70 (<0.1) | 7.1 | 0.77 (0.30-1.96) | .58 |
| Race and ethnicity | <.001e | |||
| Asian | 50 595 (3.1) | 13.6 | 1.32 (1.28-1.36) | <.001 |
| Black | 294 160 (18.1) | 11.5 | 1 [Reference] | NA |
| Hispanic | 341 785 (21.1) | 12.1 | 1.50 (1.47-1.52) | <.001 |
| Native American | 16 445 (1.0) | 16.1 | 1.82 (1.74-1.91) | <.001 |
| White | 806 305 (49.7) | 13.7 | 1.18 (1.17-1.20) | <.001 |
| Other | 66 060 (4.1) | 13.2 | 1.43 (1.39-1.47) | <.001 |
| Unknown | 47 405 (2.9) | 13.6 | 1.47 (1.42-1.51) | <.001 |
| Household income in 2020 | <.001e | |||
| First quartile (lowest) | 548 455 (33.8) | 13.5 | 1 [Reference] | NA |
| Second quartile | 436 835 (26.9) | 12.8 | 0.92 (0.91-0.94) | <.001 |
| Third quartile | 353 940 (21.8) | 12.4 | 0.87 (0.86-0.89) | <.001 |
| Fourth quartile | 258 865 (16.0) | 12.8 | 0.84 (0.83-0.85) | <.001 |
| Unknown | 24 660 (1.5) | 12.5 | 0.94 (0.90-0.98) | .01 |
| Patient location | <.001e | |||
| Metropolitan | ||||
| Large fringe | 380 265 (23.4) | 12.2 | 1 [Reference] | NA |
| Large central | 537 105 (33.1) | 13.1 | 1.00 (0.98-1.01) | .73 |
| Medium | 304 190 (18.7) | 12.9 | 1.02 (1.01-1.04) | .02 |
| Small | 138 475 (8.5) | 13.3 | 1.12 (1.10-1.14) | <.001 |
| Micropolitan | 142 810 (8.8) | 13.3 | 1.45 (1.42-1.49) | <.001 |
| Not metropolitan or micropolitan | 113 750 (7.0) | 13.9 | 1.45 (1.41-1.48) | <.001 |
| Unknown | 6160 (0.4) | 8.5 | 0.78 (0.70-0.87) | <.001 |
| Charlson Comorbidity Index score | <.001e | |||
| ≤1 | 631 675 (38.9) | 6.3 | 1 [Reference] | NA |
| 2-3 | 482 305 (29.7) | 21.4 | 2.54 (2.50-2.58) | <.001 |
| ≥4 | 508 775 (31.4) | 30.6 | 5.06 (4.98-5.13) | <.001 |
| Tobacco use | ||||
| No | 1 520 155 (93.7) | 13.3 | 1 [Reference] | NA |
| Yes | 102 600 (6.3) | 8.0 | 0.68 (0.67-0.70) | <.001 |
| Hospital bed capacity | <.001e | |||
| Small | 394 880 (24.3) | 11.8 | 1 [Reference] | NA |
| Medium | 469 080 (28.9) | 13.7 | 1.15 (1.13-1.17) | <.001 |
| Large | 758 795 (46.8) | 13.1 | 1.15 (1.14-1.17) | <.001 |
| Hospital location | <.001e | |||
| Rural | 161 666 (10.0) | 10.6 | 1 [Reference] | NA |
| Urban nonteaching | 304 200 (18.7) | 12.6 | 1.60 (1.56-1.64) | <.001 |
| Urban teaching | 1 156 889 (71.3) | 13.4 | 1.74 (1.70-1.78) | <.001 |
| Hospital region | <.001e | |||
| Northeast | 280 830 (17.3) | 15.6 | 1.32 (1.30-1.34) | <.001 |
| Midwest | 363 555 (22.4) | 11.8 | 1 [Reference] | NA |
| South | 678 021 (41.8) | 12.3 | 1.17 (1.15-1.18) | <.001 |
| West | 300 349 (18.5) | 13.3 | 1.29 (1.27-1.32) | <.001 |
| Malignant neoplasm (any)g | ||||
| No | 1 546 100 (95.3) | 12.7 | 1 [Reference] | |
| Yes | 76 655 (4.7) | 17.9 | 1.29 (1.27-1.32) | <.001 |
Abbreviations: aOR, adjusted odd ratio; NA, not applicable.
Percentage per column.
In-hospital case fatality rate (percentage) during the index hospital admission per row.
A multivariable binary logistic regression model; all the covariates listed were entered into the analysis.
Association of patient age (continuous) at hospital admission with COVID-19 in-hospital case fatality rate is shown in eFigure 1 in Supplement 1.
Overall P value.
Temporal trends of monthly COVID-19 in-hospital case fatality rate are shown in eFigure 2 in Supplement 1.
Identified per the National Cancer Institute’s definition.14
Among the 782 020 female patients with COVID-19 infection (Figure 1), 13 malignant neoplasms were associated with increased risk of in-hospital mortality compared with those without a malignant neoplasm (case fatality rate among female patients without a malignant neoplasm, 11.0% [82 415 of 748 745]). Of those, there were 5 malignant neoplasms in which the fatality risk was greater than 2-fold higher. These included anal cancer (in-hospital fatality rate 23.8%; aOR, 2.94; 95% CI, 1.84-4.69), Hodgkin lymphoma (19.5%; aOR, 2.79; 95% CI, 1.90-4.08), non-Hodgkin lymphoma (22.4%; aOR, 2.23; 95% CI, 2.02-2.47), lung cancer (24.3%; aOR, 2.21; 95% CI, 2.03-2.39), and ovarian cancer (19.4%; aOR, 2.15; 95% CI, 1.79-2.59). This top-tier group was followed by 4 malignant neoplasms in which the mortality risk was greater than 1.5-fold higher (pancreatic cancer, myeloid leukemia, multiple myeloma, and liver cancer; Figure 1).
Figure 1. COVID-19 Case Fatality Rates per Type of Malignant Neoplasms in Female Patients.
COVID-19 in-hospital case fatality (rate for horizontal axis and adjusted odds ratio [aOR] for vertical axis) per type of malignant neoplasms is shown. Patients without a malignant neoplasm served as the reference (horizontal dashed line). Malignant neoplasms with increased COVID-19 case fatality risk included anal cancer (fatality rate, 23.8%; aOR, 2.94; 95% CI, 1.84-4.69), Hodgkin lymphoma (19.5%; aOR, 2.79; 95% CI, 1.90-4.08), non-Hodgkin lymphoma (22.4%; aOR, 2.23; 95% CI, 2.02-2.47), lung cancer (24.3%; aOR, 2.21; 95% CI, 2.03-2.39), and ovarian cancer (19.4%; aOR, 2.15; 95% CI, 1.79-2.59), pancreatic cancer (23.0%; aOR, 1.94; 95% CI, 1.59-2.37), myeloid leukemia (19.4%; aOR, 1.94; 95% CI, 1.64-2.31), multiple myeloma (21.9%; aOR, 1.63; 95% CI, 1.46-1.82), liver cancer (26.2%; aOR, 1.59; 95% CI, 1.23-2.06), rectal cancer (18.9%; aOR, 1.42; 95% CI, 1.02-1.97), colon cancer (17.1%; aOR, 1.40; 95% CI, 1.20-1.64), lymphoid leukemia (16.0%; aOR, 1.31; 95% CI, 1.17-1.48), and breast cancer (12.8%; aOR, 1.19; 95% CI, 1.09-1.30). The vertical dashed line indicates the COVID-19 case fatality rate for the cases without a malignant neoplasm. A gray circle indicates the increased risk of mortality (aOR, >1; P < .05). A blue circle indicates the decreased risk of mortality (aOR, <1; P < .05). An orange circle indicates statistically nonsignificant association (P ≥ .05). Anal indicates anal cancer; Breast, breast cancer; Cervix, uterine cervical cancer; Colon, colon cancer; HL, Hodgkin lymphoma; Liver, liver cancer; Lung, lung cancer; LL, lymphoid leukemia; ML, myeloid leukemia; MM, multiple myeloma; NHL, non-Hodgkin lymphoma; Ovary, ovarian cancer; Pancreas, pancreatic cancer; Rectal, rectal cancer; and Soft tissue, soft tissue malignant neoplasm.
Among 840 665 male patients with COVID-19 infection (Figure 2), there were 13 malignant neoplasms that were associated with increased risk of in-hospital case fatality compared with patients without cancer (case fatality rate among male patients without a malignant neoplasm, 14.3% [113 910 of 797 285]). Kaposi sarcoma (in-hospital fatality rate, 33.3%; aOR, 2.08; 95% CI, 1.18-3.66) and a malignant neoplasm in the small intestine (28.6%; aOR, 2.04; 95% CI, 1.18-3.53) had a greater than 2-fold increased mortality risk. Additionally, 5 malignant neoplasms had a greater than 50% increased mortality risk (colon cancer, lung cancer, esophageal cancer, myeloid leukemia, and pancreatic cancer; Figure 2).
Figure 2. COVID-19 Case Fatality Rates per Type of Malignant Neoplasms in Male Patients.
COVID-19 in-hospital case fatality (rate for horizontal axis and adjusted-odds ratio [aOR] for vertical axis) per type malignant neoplasms is shown. Patients without a malignant neoplasm served as the reference (horizontal dashed line). Malignant neoplasms with increased COVID-19 case fatality risk included Kaposi sarcoma (fatality rate, 33.3%; aOR, 2.08; 95% CI, 1.18-3.66), malignant neoplasm in small intestine (28.6%; aOR, 2.04; 95% CI, 1.18-3.53), colon cancer (23.7%; aOR, 1.94; 95% CI, 1.72-2.19), lung cancer (25.9%; aOR, 1.80; 95% CI, 1.67-1.95), esophageal cancer (22.0%; aOR, 1.56; 95% CI, 1.26-1.94), myeloid leukemia (21.4%; aOR, 1.54; 95% CI, 1.33-1.78), pancreatic cancer (22.2%; aOR, 1.53; 95% CI, 1.24-1.87), multiple myeloma (22.9%; aOR, 1.43; 95% CI, 1.30-1.58), oral, lip, and pharynx cancer (16.7%; aOR, 1.34; 95% CI, 1.02-1.75), non-Hodgkin lymphoma (18.9%, aOR, 1.32; 95% CI, 1.21-1.45), bladder cancer (25.1%; aOR, 1.29; 95% CI, 1.11-1.48), liver cancer (25.1%; aOR, 1.28; 95% CI, 1.11-1.49), and lymphoid leukemia (17.9%; aOR, 1.27; 95% CI, 1.17-1.38). The vertical dashed line indicates COVID-19 case fatality rate for the cases without a malignant neoplasm. A gray circle indicates the increased risk of mortality (aOR, >1; P < .05). A blue circle indicates the decreased risk of mortality (aOR, <1; P < .05). An orange circle indicates statistically nonsignificant association (P ≥ .05). Bladder, bladder cancer; Colon, colon cancer; Esophag, esophageal cancer; Liver, liver cancer; Lung, lung cancer; LL, lymphoid leukemia; ML, myeloid leukemia; MM, multiple myeloma; NHL, non-Hodgkin lymphoma; Oral, oral, lip, and pharynx cancer; Pancreas, pancreatic cancer; Sml intest, small intestinal cancer; Thyroid, thyroid cancer.
Discussion
The results of the present study confirmed the substantial case fatality rate among patients with COVID-19 infection in the early period of the pandemic in 2020 in the US. While COVID-19 case fatality risks were lower for women with COVID-19 infection than for men with COVID-19 infection, the associations of a concurrent malignant neoplasm with the case fatality risk were overall more robust for women than for men, and there were more malignant neoplasms that had a case fatality risk of greater than 2-fold (5 vs 2 malignant neoplasms in women and men).
Limitations
Key limitations in this study included lack of information on the malignant neoplasms (eg, disease status and type of anticancer therapy), the COVID-19 treatment (eg, antiviral therapy), and the cause of death (COVID-19 or other). This study examined only in-hospital COVID-19 cases, and mortality events after hospital discharge or in a nonhospital setting were not examined.
Conclusions
Despite these limitations, the reevaluation of the initial pandemic period in this large cohort study demonstrates the significant mortality of COVID-19 among patients with cancer and highlights the importance of prevention of COVID-19 for those with an active malignant neoplasm (https://www.nccn.org/covid-19).
eFigure 1. Association Between Patient Age and COVID-19 In-Hospital Case-Fatality per Gender
eFigure 2. COVID-19 In-Hospital Case-Fatality Over Time per Gender
Data Sharing Statement
References
- 1.COVID data tracker. Daily update for the United States. Centers for Disease Control and Prevention. Accessed January 27, 2023. https://covid.cdc.gov/covid-data-tracker/#datatracker-home
- 2.WHO coronavirus disease (COVID-19) dashboard. World Health Organization (WHO). Accessed January 27, 2023. https://covid19.who.int/
- 3.COVID-19. Risk of COVID-19-related mortality. Centers for Disease Control and Prevention. Accessed December 19, 2022. https://www.cdc.gov/coronavirus/2019-ncov/science/data-review/risk.html
- 4.Han X, Hu X, Zhao J, Jemal A, Yabroff KR. Identification of deaths caused by cancer and COVID-19 in the US during March to December 2020. JAMA Oncol. 2022;8(11):1696-1698. doi: 10.1001/jamaoncol.2022.4315 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Wang Q, Berger NA, Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol. 2021;7(2):220-227. doi: 10.1001/jamaoncol.2020.6178 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Desai A, Mohammed TJ, Duma N, et al. COVID-19 and cancer: a review of the registry-based pandemic response. JAMA Oncol. 2021;7(12):1882-1890. doi: 10.1001/jamaoncol.2021.4083 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Chavez-MacGregor M, Lei X, Zhao H, Scheet P, Giordano SH. Evaluation of COVID-19 mortality and adverse outcomes in US patients with or without cancer. JAMA Oncol. 2022;8(1):69-78. doi: 10.1001/jamaoncol.2021.5148 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Pinato DJ, Patel M, Scotti L, et al. ; OnCovid Study Group . Time-dependent COVID-19 mortality in patients with cancer: an updated analysis of the OnCovid Registry. JAMA Oncol. 2022;8(1):114-122. doi: 10.1001/jamaoncol.2021.6199 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Bakouny Z, Labaki C, Grover P, et al. ; COVID-19 and Cancer Consortium . Interplay of immunosuppression and immunotherapy among patients with cancer and COVID-19. JAMA Oncol. 2023;9(1):128-134. doi: 10.1001/jamaoncol.2022.5357 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi: 10.3322/caac.21763 [DOI] [PubMed] [Google Scholar]
- 11.NIS overview. Overview of the National (Nationwide) Inpatient Sample (NIS). Agency for Healthcare Research and Quality. Accessed December 19, 2022. https://www.hcup-us.ahrq.gov/nisoverview.jsp
- 12.New ICD-10-CM code for the 2019 novel coronavirus (COVID-19), April 1, 2020. Centers for Disease Control and Prevention. Accessed December 19, 2022. https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavirus-3-18-2020.pdf
- 13.Bhatt AS, McElrath EE, Claggett BL, et al. Accuracy of ICD-10 diagnostic codes to identify COVID-19 among hospitalized patients. J Gen Intern Med. 2021;36(8):2532-2535. doi: 10.1007/s11606-021-06936-w [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.ICD 10. National cancer Institute. Office of Cancer Centers. National Institutes of Heath. Accessed December 19, 2022. https://cancercenters.cancer.gov/grantsfunding/ICD10
- 15.Matsuo K, Klar M, Youssefzadeh AC, et al. Assessment of severe maternal morbidity and mortality in pregnancies complicated by cancer in the US. JAMA Oncol. 2022;8(8):1213-1216. doi: 10.1001/jamaoncol.2022.1795 [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eFigure 1. Association Between Patient Age and COVID-19 In-Hospital Case-Fatality per Gender
eFigure 2. COVID-19 In-Hospital Case-Fatality Over Time per Gender
Data Sharing Statement
