Background In this study, we provide the largest analysis to date of a US-based cancer cohort to characterize death from COVID-19. Methods A total of 4,020,669 patients across 15 subtypes living with cancer in 2020 and included in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database were abstracted. We investigated prognostic factors for death due to COVID-19 using a cox proportional hazards model and calculated hazard ratios (HRs). Standardized mortality ratios (SMRs) were calculated using observed mortality counts from SEER and expected mortality based on U.S. mortality rates. Results 291,323 patients died, with 14,821 (5.1%) deaths attributed to COVID-19 infection. The COVID-19 disease-specific mortality rate was 11.81/10,000-persons years, and SMR of COVID-19 was 2.30 (95% CI: 2.26-2.34, p < .0001). COVID-19 ranked as the second leading cause of death following ischemic heart disease (5.2%) among 26 non-cancer causes of death. Patients who are older (80+ vs < =49 years old: HR 21.47, 95% CI: 19.34-23.83), male (vs female: HR 1.46, 95% CI: 1.40-1.51), unmarried (vs married: HR 1.47, 95% CI: 1.42-1.53), and Hispanic or Non-Hispanic African American (vs Non-Hispanic White: HR 2.04, 95% CI: 1.94-2.14 and HR 2.03, 95% CI: 1.94-2.14, respectively) were at greatest risk of COVID-19 mortality. Conclusions and Relevance We observed that people living with cancer are at two times greater risk of dying from COVID-19 compared to the general US population. This work may be used by physicians and public health officials in the creation of survivorship programs that mitigate the risk of COVID-19 mortality.

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美国癌症患者 COVID-19 死亡风险的人群研究

背景 在这项研究中，我们提供了迄今为止对美国癌症队列的最大分析，以描述 COVID-19 死亡的特征。方法 提取 2020 年美国国家癌症研究所监测、流行病学和最终结果 (SEER) 数据库中 15 个亚型的 4,020,669 名癌症患者。我们使用 Cox 比例风险模型并计算了风险比 (HR)，研究了 COVID-19 导致的死亡的预后因素。使用 SEER 观察到的死亡率计数和基于美国死亡率的预期死亡率计算标准化死亡率 (SMR)。结果 291,323 名患者死亡，其中 14,821 名患者 (5.1%) 死于 COVID-19 感染。 COVID-19 疾病特异性死亡率为 11.81/10,000 人年，COVID-19 的 SMR 为 2.30（95% CI：2.26-2.34，p < .0001）。在 26 种非癌症死因中，COVID-19 是继缺血性心脏病（5.2%）之后的第二大死因。年龄较大的患者（80+ vs < = 49 岁：HR 21.47，95% CI：19.34-23.83）、男性（与女性：HR 1.46，95% CI：1.40-1.51）、未婚（与已婚：HR 1.47，95% CI：1.42-1.53​​)，西班牙裔或非西班牙裔非裔美国人（分别与非西班牙裔白人：HR 2.04，95% CI：1.94-2.14 和 HR 2.03，95% CI：1.94-2.14）面临着最大的 COVID-19 死亡风险。结论和相关性 我们观察到，癌症患者死于 COVID-19 的风险是美国普通人群的两倍。医生和公共卫生官员可以利用这项工作来制定生存计划，以降低 COVID-19 死亡风险。