Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Carreira, Helena, Strongman, Helen, Peppa, Maria, McDonald, Helen I., dos-Santos-Silva, Isabel, Stanway, Susannah, Smeeth, Liam, Bhaskaran, Krishnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788436/
https://www.ncbi.nlm.nih.gov/pubmed/33437952
http://dx.doi.org/10.1016/j.eclinm.2020.100656
_version_ 1783633033345105920
author Carreira, Helena
Strongman, Helen
Peppa, Maria
McDonald, Helen I.
dos-Santos-Silva, Isabel
Stanway, Susannah
Smeeth, Liam
Bhaskaran, Krishnan
author_facet Carreira, Helena
Strongman, Helen
Peppa, Maria
McDonald, Helen I.
dos-Santos-Silva, Isabel
Stanway, Susannah
Smeeth, Liam
Bhaskaran, Krishnan
author_sort Carreira, Helena
collection PubMed
description 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 English 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 diabetes, asthma, other respiratory, cardiac, neurological, renal, and liver diseases, 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 >5 years 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.
format Online
Article
Text
id pubmed-7788436
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-77884362021-01-11 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 Carreira, Helena Strongman, Helen Peppa, Maria McDonald, Helen I. dos-Santos-Silva, Isabel Stanway, Susannah Smeeth, Liam Bhaskaran, Krishnan EClinicalMedicine Research Paper 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 English 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 diabetes, asthma, other respiratory, cardiac, neurological, renal, and liver diseases, 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 >5 years 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. Elsevier 2020-11-30 /pmc/articles/PMC7788436/ /pubmed/33437952 http://dx.doi.org/10.1016/j.eclinm.2020.100656 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research Paper
Carreira, Helena
Strongman, Helen
Peppa, Maria
McDonald, Helen I.
dos-Santos-Silva, Isabel
Stanway, Susannah
Smeeth, Liam
Bhaskaran, Krishnan
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788436/
https://www.ncbi.nlm.nih.gov/pubmed/33437952
http://dx.doi.org/10.1016/j.eclinm.2020.100656
work_keys_str_mv AT carreirahelena prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT strongmanhelen prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT peppamaria prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT mcdonaldheleni prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT dossantossilvaisabel prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT stanwaysusannah prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT smeethliam prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata
AT bhaskarankrishnan prevalenceofcovid19relatedriskfactorsandriskofsevereinfluenzaoutcomesincancersurvivorsamatchedcohortstudyusinglinkedenglishelectronichealthrecordsdata