An observational<i> retro</i>-prospective study on patients with head and neck cancer who contracted COVID-19<i> (HERODOTUS:</i> head and neck cancERs international cOviD-19 collabOraTion)

Economopoulou P., Pouliakis A., Kyprianou M., Pantazopoulos A., Spathis A., Kotsantis I., ...More

ORAL ONCOLOGY, vol.175, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 175
  • Publication Date: 2026
  • Doi Number: 10.1016/j.oraloncology.2026.107900
  • Journal Name: ORAL ONCOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Istanbul University-Cerrahpasa Affiliated: Yes

Abstract

Background: We aimed to investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with head and neck cancer (HNC). Methods: The HERODOTUS registry is a multicenter observational study which included patients with any HNC and a COVID-19 diagnosis. Clinical data were extracted from medical records of patients from 3/2019 until 12/ 2022. As the study involved numerous variables that would possibly overlap, a cluster analysis was performed for the prediction of patient death due to COVID-19. Results: Among 403 COVID-19 positive cases, 76 patients died (all-cause fatality rate 18.8%) ;21 deaths were attributed to COVID-19. On multivariate analysis, poor performance status (OR: 8.96, 95% CI: 2.07-47.86), development of sepsis (OR:8.99, 95% CI:1.48-72.4) or ARDS (OR:11.64, 95% CI:2.53--64.42), administration of chemotherapy (OR: 28.08, 95% CI: 5.49-158.92) and hospitalization (OR:7.32, 95% CI: 2.49-23.3) had a negative impact on survival, whereas vaccination was protective (OR: 0.29, 95% CI: 0.11-0.75). The clustering procedure resulted in the automated creation of four clusters and identified the following determinants of death: COPD, autoimmune disease, squamous/adenocarcinoma histology, disease stage, fever, diarrhea, fatigue, first line immunotherapy/immunochemotherapy, second line chemotherapy/cetuximab, cisplatin, chemoradiation, ARDS, coagulopathy, heart failure, treatment modifications due to COVID-19, surgical complications and vaccination. Conclusions: This is the largest cohort of patients with HNC and COVID-19. All-cause fatality rate in patients with HNC and COVID-19 was approximately 19%. Among 41 covariates with discriminatory power analyzed, 20 were identified as major determinants of death. Vaccination was protective against death from COVID-19.