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Table 1. Key studies highlighting the mortality rates in all cancers and lung cancers
Mortality in patients with Mortality in patients with
Study Study population Study size (N)
any cancer lung cancer
[9]
Dai et al. Chinese 105 (All cancers) 11.4% 18.1%
22 (Lung cancer)
[13]
Yang et al. Chinese 205 (All cancers) 20% 25%
25 (Lung cancer)
[10]
Mehta et al. United States 218 (All cancers) 28% 55%
11 (Lung cancer)
Luo et al. [16] United States 101 (Lung cancer) NA 25%
[8]
Lee et al. United Kingdom 800 (All cancers) 28% 14%
90 (Lung cancer)
[7]
Kuderer et al. United States and Canada 928 (All cancers) 13% 26%
92 (Lung cancer)
[11,20]
Garassino et al. European 400 (Lung cancer) NA 35%
NA: Not applicable.

chemotherapy (but not targeted therapy) within 4 weeks before symptom onset (OR = 3.51, 95%CI: 1.16-
10.59, P = 0.026) and male sex (OR = 3.86, 95%CI: 1.57-9.50, P = 0.0033) were associated with increased
mortality.

In the United States, one of the first studies to report experience with cancer and COVID-19 was the single-
institution study from the Montefiore Health system in New York, NY, the epicenter of infection in the
early stages of the pandemic. In this study, 218 patients with cancer and COVID-19 were included . The
[10]
mortality was 28% across all cancers. Amongst patients with solid tumor malignancies, the eleven patients
with lung cancer had the highest mortality (55%). In the multivariate model, older age (age < 65, OR = 0.23,
95%CI: 0.07-0.6), higher composite comorbidity score (composite score defined as the sum of indicators for
diabetes mellitus, hypertension, chronic lung disease, chronic kidney disease, coronary artery disease, and
congestive heart failure capped at a maximum of 3) (OR = 1.52, 95%CI: 1.02-2.33), ICU admission (OR =
4.83, 95%CI: 1.46-17.15), and elevated inflammatory markers (D-dimer, lactate, and lactate dehydrogenase)
were significantly associated with mortality. Advanced metastatic disease and active disease showed a trend
for increased mortality but did not meet statistical significance. Similarly, active chemotherapy or radiation
treatment was not associated with increased fatality. The number of patients on immunotherapy was
negligible.

Another single-institution study from New York showed that patients with lung cancer (N = 102) and
COVID-19 had high rates of hospitalization (65%) and death (25%) . Similar to other studies, advancing
[16]
age (OR = 2.01, 95%CI: 1.34-3.19), smoking history [OR = 2.9, 95%CI: 1.07-9.44, comparing the median
(23.5 pack-years) to never-smoker], COPD (OR = 3.87, 95%CI: 1.35-9.68), and hypertension (OR = 2.68,
95%CI: 1.14-6.14) were associated with increased risk of severe COVID-19. Active/metastatic lung cancer,
history of prior thoracic radiation or thoracic surgery did not appear to impact the severity of COVID-19
infection. Another smaller study in patients with lung cancer (N = 41) who received immunotherapy
showed numerical increase in COVID-19 severity (univariate OR, 1.18-1.81 for severity outcomes);
however, when adjusted for smoking history, immunotherapy exposure did not significantly impact risk of
hospitalization, ICU admission, or death .
[18]
COVID‐19 and Cancer Consortium (CCC-19) from the US, and the United Kingdom Coronavirus Cancer
Monitoring Project (UKCCMP) are the two largest pan-cancer cohorts to study the impact of cancer on
COVID-19 infection. The UKCCMP study analyzed 800 patients with a diagnosis of cancer and