The risks of hospital admission for COVID-19-related conditions and all-cause death of SARS-CoV-2 infected cancer patients were investigated according to vaccination status.
A population-based cohort study was carried out on 9754 infected cancer patients enrolled from January 1, 2021 to June 30, 2022. Subdistribution hazard ratio (SHRs) or hazard ratios (HRs) with 95 % confidence intervals (CI), adjusted for sex, age, comorbidity index, and time since cancer incidence, were computed to assess the risk of COVID-19 hospital admission or death of unvaccinated vs. patients with at least one dose of vaccine (i.e., vaccinated).
2485 unvaccinated patients (25.5 %) were at a 2.57 elevated risk of hospital admission (95 % CI: 2.13–2.87) and at a 3.50 elevated risk of death (95 % CI: 3.19–3.85), as compared to vaccinated patients. Significantly elevated hospitalizations and death risks emerged for both sexes, across all age groups and time elapsed since cancer diagnosis. For unvaccinated patients, SHRs for hospitalization were particularly elevated in those with solid tumors (SHR = 2.69 vs. 1.66 in patients with hematologic tumors) while HRs for the risk of death were homogeneously distributed. As compared to boosted patients, SHRs for hospitalization and HRs for death increased with decreasing number of doses.
Study findings stress the importance of SARS-CoV-2 vaccines to reduce hospital admission and death risk in cancer patients.
- • Unvaccinated patients have a higher risk of COVID19-related hospitalization than vaccinated patients.
- • Unvaccinated patients have a higher all-death risk than vaccinated patients.
- • Booster doses reduce the frequency of all-cause death and COVID-19 hospitalization.
It has been well documented since the early phase of the COVID-19 pandemic that cancer patients with SARS-CoV-2 infection were at increased risk of hospital admission and death, particularly elderly ones, those with major medical comorbidities and those under immunosuppressive anti-cancer therapies . An elevated 30-day mortality was documented among 928 patients with COVID-19 and cancer enrolled in The COVID-19 and Cancer Consortium (CCC19) cohort , while among 1557 cancer patients with COVID-19 enrolled in the OnCovid multicenter study, 72.2 % of those with sequelae required hospitalization, as compared to 41.2 % of those without sequelae . According to early evidence, cancer patients were among the prioritized population groups for vaccination against SARS-CoV-2 infection.
The impact of SARS-CoV-2 infection on clinical outcomes of cancer patients in northeastern Italy has been already investigated . In this investigation, we updated the previous analysis by focusing on the impact of SARS-CoV-2 vaccination on infected cancer patients. The study objective was to assess the risk of COVID-19 hospitalization or death in infected cancer patients according to SARS-CoV-2 vaccination status.