Risk of Coronavirus Disease 2019 Occurrence, Severe Presentation, and Mortality in Patients with Lung Cancer

Abstract

Purpose: This study aimed to analyze whether patients with lung cancer have a higher incidence of coronavirus disease (COVID-19), severe presentation, and higher mortality than those without lung cancer.

Materials and methods: A nationwide cohort of confirmed COVID-19 (n=8,070) between January 1, 2020, and May 30, 2020, and a 1:15 age-, sex-, and residence-matched cohort (n=121,050) were constructed. A nested case-control study to compare the proportion of patients with lung cancer between the COVID-19 cohort and the matched cohort.

Results: The proportion of patients with lung cancer was significantly higher in the COVID-19 cohort (0.5% [37/8,070]) than in the matched cohort (0.3% [325/121,050]) (p=0.002). The adjusted odds ratio [OR] of having lung cancer was significantly higher in the COVID-19 cohort than in the matched cohort (adjusted OR = 1.51, 95% confidence interval [CI] = 1.05-2.10). Among patients in the COVID-19 cohort, compared to patients without lung cancer, those with lung cancer were more likely to have severe COVID-19 (54.1% vs. 13.2%, p < 0.01), including mortality (18.5% vs. 2.8%, p < 0.01). The adjusted OR for the occurrence of severe COVID-19 in patients with lung cancer relative to those without lung cancer was 2.24 (95% CI = 1.08-4.74).

Conclusion: The risk of COVID-19 incidence and severe presentation, including mortality, may be higher in patients with lung cancer than in those without lung cancer.