{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:08:15Z","timestamp":1747148895016,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T00:00:00Z","timestamp":1709424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of both COVID\u201019 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the impact of COVID\u201019 infection and vaccination status on 60\u2010day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID\u201019 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical\/demographic data, vaccination status, and incidence of 60\u2010day mortality, 60\u2010day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60\u2010day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID\u201019 infection, vaccination status, morbidity and mortality were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 14\u2009262 patients with HNSCC who were tested for COVID\u201019 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60\u2010day mortality (4.7% vs. 2.0%, respectively; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and pneumonia (PNA; 20.0% vs. 6.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to those who never tested positive, respectively. Patients who received COVID\u201019 vaccination between 2\u2009weeks and 6\u2009months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034) and PNA (16.7% vs. 20.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) compared to the unvaccinated group. A logistic regression of patients with COVID\u201019 infections who died within 60\u2009days was performed, with no significant survival advantage among patients vaccinated between 2\u2009weeks and 6\u2009months prior to the positive test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>COVID\u201019 infection may significantly increase rates of 60\u2010day mortality and respiratory complications in patients with HNSCC. COVID\u201019 vaccination between 2\u2009weeks and 6\u2009months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27714","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T04:49:50Z","timestamp":1709527790000},"page":"1698-1705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of <scp>COVID<\/scp>\u201019 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma"],"prefix":"10.1002","volume":"46","author":[{"given":"James D.","family":"Johns","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery MedStar Georgetown University Hospital  Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3076-5218","authenticated-orcid":false,"given":"Erica 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Biostatistics, Informatics, and Data Science MedStar Health Research Institute  Hyattsville Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5935-0887","authenticated-orcid":false,"given":"Jessica H.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery MedStar Georgetown University Hospital  Washington, DC USA"},{"name":"Department of Surgery Washington DC Veterans Affairs Medical Center  Washington, DC 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