Background: Immunocompromised states such as cancer have been established as predictors of worse outcomes in COVID-19. The pandemic affected delivery of healthcare to this subset of the population, resulting in delays in diagnosis and increasing the overall mortality of cancer patients. We examined outcomes of cancer patients who were hospitalized with COVID-19 across the United States during the COVID-19 pandemic. Methods: We conducted a retrospective analysis of the discharge data from National Inpatient Sample (NIS), from 2020. A search was performed using ICD-10 codes for cancer (solid, hematologic and metastatic) and COVID-19. Patients with a primary diagnosis of COVID-19 and secondary diagnosis of cancer were identified. Baseline characteristics were analyzed. Outcomes of in-hospital mortality, length of stay (LOS) and health care costs were compared between patients with cancer and COVID-19, and those with cancer without COVID-19. Multivariate regression analysis was used to adjust for confounders. Results: We identified a total of 1,759,235 hospitalizations related to cancer out of which 45,660(2.6%) also had COVID-19. Cancer patients with COVID-19 were more likely to be older (69.8 vs 65.6 years, P < 0.001), African-American (18.2 vs 13.33 %, P < 0.001), Hispanic (14.3 vs 8.8 %, p = 0.002), and had a median household income in the 1st quartile (30.6 vs 26.2%, p < 0.001). Cancer patients with COVID-19 were also more likely to have diabetes, hypertension, obesity, CKD, chronic pulmonary disease, and heart failure (p-values < 0.001). Multivariate logistic regression analysis of the two groups showed that cancer patients with COVID-19 had higher odds of dying in the hospital (19.2% vs 6.6%) with adjusted odds ratio (aOR) 3.13 (P < 0.001, CI: 2.95-3.31). Cancer patients with COVID-19 also had statistically significant higher LOS (8.6 vs 6.1 days; aOR 2.49; P < 0.001 and CI: 2.12-2.56) and higher rates of mechanical ventilation (10.8 vs 4.4%; aOR 2.49; P < 0.001; CI:2.33-2.66). Mean hospitalization charges were higher in cancer patients with COVD-19 ($101,538 vs $85,756; P < 0.001). Conclusions: In patients hospitalized with cancer, those with COVID-19 had higher odds of in hospital mortality as compared to those without COVID-19. Patients with cancer and COVID-19 were more likely to be older, African American and had a higher comorbidity burden. This data is consistent with previous studies that have established that COVID-19 disproportionally affected people of lower socio-economic status, African Americans and Hispanics. It is noteworthy that these differences persist in the cancer population, even though they are presumably more active participants in healthcare, highlighting the racial and socio-economic disparities in our healthcare system. This study re-enforces the importance of preventative public health measures and investigating the social determinants of health in this high-risk population.