Infectious Disease

Black, low-income patients with cancer at highest risk for serious COVID-19 complications

August 02, 2021

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Brown does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Patients with cancer showed an increased risk of serious COVID-19 complications and mortality, according to study results published in Cancer Reports.

Black race and low-income status appeared to be associated with the highest risk for these outcomes.

Cancer patients showed an increased risk of severe COVID-19 complications and mortality.

Data from Hwang C, et al. Cancer reports. 2021; doi: 10.1002 / cnr2.1388.

“Patients with a history of cancer and those undergoing active treatment for malignancies that contract COVID-19 are prone to poor outcomes. In addition, faster progression to severe events was found in patients with cancer compared to patients without cancer. ” Thomas D. Brown, MD, MBA, Seattle oncologist and chief medical officer at Syapse, said Healio. “Still, in the United States, the data characterizing COVID-19 in cancer patients has been fairly limited and has generally been collected from within individual healthcare systems or from voluntary surveillance registers or surveys. To that end, the effects of race, health status and socio-economic factors on COVID-19-related incidence or outcome in cancer patients have not been well described. “

The researchers compared clinical, demographic, and socio-economic characteristics of patients with cancer with and without COVID-19, and then characterized the clinical outcomes of patients with COVID-19 and cancer.

They used real-world data from two health systems in the Midwestern United States to identify 146,702 adults (mean age 67 years; 57% women; 68% whites) who were diagnosed with cancer between 2015 and 2020 and who did not develop COVID-19 and 1,267 adults (mean age 66 years; 57% women; 44% white) with cancer and COVID-19. All-cause mortality was used as the primary endpoint.

According to study results, patients with cancer who had COVID-19 were more likely to be black, have active cancer and comorbidities, and / or lived in zip codes with a median household income of less than $ 30,000.

The researchers also found higher rates of all-cause mortality (14% vs. 2%), hospital admissions (64% vs. 14%), and invasive respiratory support (11% vs. 1%) in patients with cancer and COVID-19 vs. those without COVID-19.

Among patients with COVID-19, those with active cancer appeared more likely to be male (48% vs. 35%) or had a Charlson comorbidity index of 1 or higher (79% vs. 51%).

Additionally, patients were more likely to be diagnosed with COVID-19 from ICD codes alone when they lived in areas with median household incomes less than $ 30,000 (62% versus 49%).

Mortality, hospitalization, and respiratory aid use were highest among those with COVID-19 and active cancer or those residing in zip codes with median household incomes less than $ 30,000.

Black patients with COVID-19 and cancer were most likely to receive invasive respiratory assistance. They were also hospitalized more frequently than other patients for pneumonia, cough, respiratory failure, acute kidney failure, and fluid and electrolyte imbalances, and they were also more likely to receive hydroxychloroquine.

Multivariable logistic regression models showed associations between male gender, older age, living in areas with a median household income of less than $ 30,000, a history of pulmonary circulatory disorders, and recent use of immune checkpoint inhibitors or chemotherapy with a higher likelihood of all-cause mortality.

Thomas D. Brown, MD, MBA

Thomas D. Brown

“Real-world data can be used quickly to understand pressing healthcare challenges,” said Brown. “We will work to better understand the impact of COVID-19 on cancer care delivery as well as ultimate cancer care outcomes in patients with cancer and COVID-19. It will be important to assess the long-term effects of COVID-19 in this population group. We would also like to evaluate the vaccination status in our population of patients with cancer or with a history of cancer and how this affects clinical outcomes. ”

For more informations:

Thomas D. Brown, mD, reachable at 3410 Cascadia Ave. South, Seattle, WA 98144; Email: tom.brown@syapse.com.

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