Cancer and risk of COVID-19 through a general community survey

Background: Data are limited on the risk of coronavirus disease 2019 (COVID-19) among individuals with cancer and whether cancer-related therapy exacerbates this risk. Methods: We evaluated the risk for coronavirus disease 2019 (COVID-19) among patients living with cancer compared to the general community and whether cancer-related treatments influence this risk. Data were collected from the COVID Symptom Study smartphone application since March 24, 2020 (United Kingdom), March 29 (U.S.), and April 29, 2020 (Sweden) through May 8, 2020. We used multivariate-adjusted odds ratios (aORs) of a positive COVID-19 test as well as predicted COVID-19 infection using a validated symptom model. Results: Among 23,266 participants with cancer and 1,784,293 without cancer, we documented 10,404 reports of a positive COVID-19 test. Compared to participants without cancer, those living with cancer had 62% increased risk of a positive COVID-19 test (95% CI: 1.37-1.91). Among patients with cancer, current treatment with chemotherapy/immunotherapy was associated with a nearly 2.5-fold increased risk of a positive test (aOR: 2.42; 95% CI: 1.81-3.25). The association between cancer and COVID-19+ was stronger among participants >65 years (aOR: 1.93; 95%CI: 1.51-2.46) compared to younger participants (aOR: 1.32; 95%CI: 1.06-1.64; Pinteraction<0.001); and among males (aOR: 1.71; 95%CI: 1.36-2.15) compared to females (aOR: 1.43; 95%CI: 1.14-1.79; Pinteraction=0.02). Conclusions: Individuals with cancer had a significantly increased risk of infection compared to the general community. Those treated with chemotherapy or immunotherapy were particularly at-risk of infection. Trial Registration: ClinicalTrials.gov <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT04331509">NCT04331509</ext-link>