Hospitalization rates and 30-day all-cause mortality among head and neck cancer patients and survivors with COVID-19

Glenn J. Hanna*, Eleni M. Rettig, Jong C. Park, Mark A. Varvares, Jochen H. Lorch, Danielle N. Margalit, Jonathan D. Schoenfeld, Roy B. Tishler, Laura A. Goguen, Donald J. Annino, Robert I. Haddad, Ravindra Uppaluri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: The impact of COVID-19 on patients with cancer is emerging, but data are urgently needed for head and neck cancer (HNC) patients or survivors who are inherently high-risk for severe illness and mortality with SARS-CoV-2 infection. Methods: This multi-institution, academic cohort study collected comprehensive data on clinical risk factors, COVID-19 symptoms and viral testing patterns, information about hospitalization rates, and predictors of survival among HNC patients with active disease or in remission. The primary endpoint was 30-day all-cause mortality from the date of confirmed COVID-19. We performed multivariate analysis to understand the prognostic value of clinical and laboratory parameters on outcomes. Results: Thirty-two patients with COVID-19 and HNC were included. Median age was 70 (range: 38–91) with 38% aged 75+, and 34% resided in long-term care facilities (LTCF). Thirteen (41%) had active cancer, with 6 (19%) on cancer therapy within 4 weeks of COVID-19 diagnosis. New or worsening cough and fatigue were the most commonly reported presenting symptoms. More than 30% required >1 SARS-CoV-2 test before confirming a positive result. Twenty (63%) required hospitalization. At data cutoff, 7 (22%) had died (1 on active cancer treatment), with a 30-day all-cause mortality of 18.9% (95%CI: 11.4–33.6) among all patients, and 71.5% (95%CI: 38.2–92.3) among those requiring intensive care unit (ICU) admission. ICU admission and residing in a LTCF predicted worse outcomes (p < 0.01), while age, gender, and recent treatment did not. Conclusions: We observed high 30-day all-cause mortality among HNC patients with COVID-19, but most were not on active cancer therapy.

Original languageEnglish (US)
Article number105087
JournalOral Oncology
Volume112
DOIs
StatePublished - Jan 2021
Externally publishedYes

Keywords

  • COVID-19
  • Head and neck cancer
  • Hospitalization
  • Mortality
  • Symptoms

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

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