# COVID‐19 Infection Before or After Colorectal Cancer Diagnosis Is an Independent Predictor of Mortality and Treatment Delays Compared to Patients Who Never Tested Positive

## TL;DR

Having COVID-19 before or after a colorectal cancer diagnosis is linked to higher mortality and treatment delays, with socioeconomic factors playing a role.

## Contribution

This study identifies that timing of COVID-19 infection relative to colorectal cancer diagnosis independently affects mortality and treatment delays.

## Key findings

- Patients with a history of COVID-19 had higher mortality rates compared to those who never tested positive.
- Socioeconomic factors like race, insurance, and income influenced outcomes depending on the timing of the COVID-19 infection.
- The findings suggest that CRC patients with a history of COVID-19 may need closer monitoring during treatment.

## Abstract

Given COVID‐19's emergence as a new entity and colorectal cancer's (CRC) rising incidence in certain populations, we conducted this retrospective cohort study to determine the link between COVID‐19 and the mortality of those with CRC and how socioeconomic factors influence it.

Using the National Cancer Database (NCDB), we used logistic regression to get the odds ratio (OR) for delayed treatment and Cox proportional hazards modeling for each stage to get the adjusted hazard ratios (HR) of mortality.

COVID‐19 positivity was associated with higher mortality and delayed treatment. The association of race, ethnicity, insurance, urbanization, comorbidity burden, education levels, and income varied by when the patient tested positive relative to colorectal cancer diagnosis.

This implies that vaccinations may be a part of management and that CRC patients who develop COVID‐19 infection may warrant closer follow‐up during treatment.