A study of more than 300,000 patients with COVID-19 and a history of cancer provides insights that can inform clinical care and etiologic studies, according to researchers.

The group reported findings from this study in Cancer Epidemiology, Biomarkers & Prevention.

“This in-depth characterization revealed that patients with COVID-19 with a history of cancer are mostly aged above 65 years old and have multiple comorbidities that may explain the high frequency of severe COVID-19 outcomes in this population,” the researchers wrote.

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The study included 366,050 patients with a history of cancer who were diagnosed with COVID-19 and 119,597 patients with a cancer history who were hospitalized with COVID-19. Patient data came from 8 health care databases in the United States and Spain.

In the cohort of patients diagnosed with COVID-19, the most common cancers in 4 databases were prostate and breast cancers. Non-Hodgkin lymphoma (NHL) was among the top 5 most common cancers in all databases. Leukemia and bladder, colorectal, and lung cancers were among the top 10 cancers in at least 7 databases.

For patients hospitalized with COVID-19, prostate cancer was the most common cancer type across all databases, and NHL was among the top 3 most common cancers in all but 1 database. Leukemia, liver cancer, and lung cancer were within the top 10 in most databases.

Comorbidities were common in the diagnosed and hospitalized cohorts but were more frequent in the hospitalized patients. The most common comorbidities were cardiometabolic conditions, which were more frequently seen in US patients.

In the diagnosed cohort, the hospitalization rate was 25% in Spain and ranged from 14% to 35% in the United States. The death rate was 14% in Spain and ranged from 2% to 10% in the United States.

In the hospitalized cohort, the rate of death was 21% in Spain and ranged from 6% to 26% in the United States.

The researchers also looked at 67,743 US patients with a history of cancer who were hospitalized with influenza from 2017 to 2018. When compared with the COVID-19 patients, the influenza patients had a similar distribution of cancer types, sex, age, and comorbidities.

However, the influenza patients were less likely to experience adverse events. Acute respiratory distress syndrome and death were more frequent among the COVID-19 patients.

“These findings are foundational for guiding future studies and highlight the importance of protecting patients with cancer while guaranteeing cancer care continuity during the pandemic,” the researchers wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Roel E, Pistillo A, Recalde M, et al. Characteristics and outcomes of over 300,000 patients with COVID-19 and history of cancer in the United States and Spain. Cancer Epidemiol Biomarkers Prev. 2021;30(10):1884-1894. doi:10.1158/1055-9965.EPI-21-0266