COVID-19 vaccination and survival of cancer patients in Northwestern Russia: a historical registry-based cohort study
Abstract
BackgroundCancer patients face a significantly elevated risk of severe COVID-19 outcomes. Although vaccination is a cornerstone of prevention, data on vaccination coverage and association with survival among Russian cancer patients remain scarce. We assessed COVID-19 vaccination coverage and its association with overall survival in a population-based cohort of cancer patients in Northwest Russia.
MethodsThis retrospective registry-based cohort study integrated data from the Population-Based Cancer Registry (PBCR) of the Arkhangelsk Region and the Nenets Autonomous Okrug, regional vaccination records, and an artificial intelligence (AI)-based analysis of chest computed tomography (CT) scans. The cohort consisted of 1,144 cancer patients who underwent CT between August 2020 and April 2021. Vaccination status was ascertained via data linkage. Overall survival (OS) was compared between vaccinated and unvaccinated patients using Kaplan-Meier analysis and multivariable Cox proportional hazards regression, adjusted for demographic, clinical, and AI-derived CT biomarkers. To mitigate immortal time bias, the primary analysis used a landmark approach restricted to patients alive on March 1, 2021 (N = 1,136). A sensitivity analysis used a November 1, 2021 landmark (N = 894). Vaccination status was defined as receipt of at least one dose before the landmark date.
ResultsOnly 6.6% (n=76) of patients received at least one dose of a COVID-19 vaccine (Sputnik V or Sputnik Light). Vaccinated patients were more likely to have earlier-stage cancer and were less likely to be receiving active treatment. In the primary landmark analysis, vaccination was associated with a significantly higher 3-year OS (80.3% vs. 45.7%, p < 0.001). In multivariable analysis, vaccination was independently associated with a 60% lower hazard of all-cause mortality (adjusted HR 0.40, 95% CI 0.25-0.64). AI-detected COVID-19 pneumonia on baseline CT was also an independent predictor of poorer survival (adjusted HR 1.32, 95% CI 1.09-1.59). In the sensitivity analysis (November 1, 2021 landmark), the adjusted HR for vaccination was 0.56 (95% CI 0.34-0.92), showing a consistent but attenuated association.
ConclusionThis study reveals critically low COVID-19 vaccination coverage among cancer patients in Northwest Russia. Nevertheless, vaccination was strongly associated with a substantial survival benefit, underscoring its importance as a potentially lifesaving intervention for this vulnerable population.
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BibTeX
@misc{dyachenko2026covid19,
title = {{COVID-19 vaccination and survival of cancer patients in Northwestern Russia: a historical registry-based cohort study}},
author = {A. A. Dyachenko and M. A. Bogdanov and D. V. Bogdanov and A. A. Meldo and V. Y. Chernina and V. A. Gombolevskiy and A. M. Grjibovski and M. Y. Valkov},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.12.26365129},
url = {https://www.medrxiv.org/content/10.64898/2026.10.12.26365129v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - COVID-19 vaccination and survival of cancer patients in Northwestern Russia: a historical registry-based cohort study
AU - A. A. Dyachenko
AU - M. A. Bogdanov
AU - D. V. Bogdanov
AU - A. A. Meldo
AU - V. Y. Chernina
AU - V. A. Gombolevskiy
AU - A. M. Grjibovski
AU - M. Y. Valkov
PY - 2026
DA - 2026/10/12
PB - medRxiv
DO - 10.64898/2026.10.12.26365129
UR - https://www.medrxiv.org/content/10.64898/2026.10.12.26365129v1
AB - BackgroundCancer patients face a significantly elevated risk of severe COVID-19 outcomes. Although vaccination is a cornerstone of prevention, data on vaccination coverage and association with survival among Russian cancer patients remain scarce. We assessed COVID-19 vaccination coverage and its association with overall survival in a population-based cohort of cancer patients in Northwest Russia. MethodsThis retrospective registry-based cohort study integrated data from the Population-Based Cancer Registry (PBCR) of the Arkhangelsk Region and the Nenets Autonomous Okrug, regional vaccination records, and an artificial intelligence (AI)-based analysis of chest computed tomography (CT) scans. The cohort consisted of 1,144 cancer patients who underwent CT between August 2020 and April 2021. Vaccination status was ascertained via data linkage. Overall survival (OS) was compared between vaccinated and unvaccinated patients using Kaplan-Meier analysis and multivariable Cox proportional hazards regression, adjusted for demographic, clinical, and AI-derived CT biomarkers. To mitigate immortal time bias, the primary analysis used a landmark approach restricted to patients alive on March 1, 2021 (N = 1,136). A sensitivity analysis used a November 1, 2021 landmark (N = 894). Vaccination status was defined as receipt of at least one dose before the landmark date. ResultsOnly 6.6% (n=76) of patients received at least one dose of a COVID-19 vaccine (Sputnik V or Sputnik Light). Vaccinated patients were more likely to have earlier-stage cancer and were less likely to be receiving active treatment. In the primary landmark analysis, vaccination was associated with a significantly higher 3-year OS (80.3% vs. 45.7%, p < 0.001). In multivariable analysis, vaccination was independently associated with a 60% lower hazard of all-cause mortality (adjusted HR 0.40, 95% CI 0.25-0.64). AI-detected COVID-19 pneumonia on baseline CT was also an independent predictor of poorer survival (adjusted HR 1.32, 95% CI 1.09-1.59). In the sensitivity analysis (November 1, 2021 landmark), the adjusted HR for vaccination was 0.56 (95% CI 0.34-0.92), showing a consistent but attenuated association. ConclusionThis study reveals critically low COVID-19 vaccination coverage among cancer patients in Northwest Russia. Nevertheless, vaccination was strongly associated with a substantial survival benefit, underscoring its importance as a potentially lifesaving intervention for this vulnerable population.
ER -