Non-Hispanic Black individuals experience a higher burden of COVID-19 than the general population; hence, there is an urgent need to characterize the unique clinical course and outcomes of COVID-19 in Black patients with cancer.
To investigate racial disparities in severity of COVID-19 presentation, clinical complications, and outcomes between Black patients and non-Hispanic White patients with cancer and COVID-19.
This retrospective cohort study used data from the COVID-19 and Cancer Consortium registry from March 17, 2020, to November 18, 2020, to examine the clinical characteristics and outcomes of COVID-19 in Black patients with cancer. Data analysis was performed from December 2020 to February 2021.
Black and White race recorded in patient's electronic health record.
An a priori 5-level ordinal scale including hospitalization intensive care unit admission, mechanical ventilation, and all-cause death.
Among 3506 included patients (1768 women [50%]; median [IQR] age, 67 [58-77] years), 1068 (30%) were Black and 2438 (70%) were White. Black patients had higher rates of preexisting comorbidities compared with White patients, including obesity (480 Black patients [45%] vs 925 White patients [38%]), diabetes (411 Black patients [38%] vs 574 White patients [24%]), and kidney disease (248 Black patients [23%] vs 392 White patients [16%]). Despite the similar distribution of cancer type, cancer status, and anticancer therapy at the time of COVID-19 diagnosis, Black patients presented with worse illness and had significantly worse COVID-19 severity (unweighted odds ratio, 1.34 [95% CI, 1.15-1.58]; weighted odds ratio, 1.21 [95% CI, 1.11-1.33]).
These findings suggest that Black patients with cancer experience worse COVID-19 outcomes compared with White patients. Understanding and addressing racial inequities within the causal framework of structural racism is essential to reduce the disproportionate burden of diseases, such as COVID-19 and cancer, in Black patients.
JAMA network open. 2022 Mar 01*** epublish ***
Julie Fu, Sonya A Reid, Benjamin French, Cassandra Hennessy, Clara Hwang, Na Tosha Gatson, Narjust Duma, Sanjay Mishra, Ryan Nguyen, Jessica E Hawley, Sunny R K Singh, David D Chism, Neeta K Venepalli, Jeremy L Warner, Toni K Choueiri, Andrew L Schmidt, Leslie A Fecher, Jennifer E Girard, Mehmet A Bilen, Deepak Ravindranathan, Sharad Goyal, Trisha M Wise-Draper, Cathleen Park, Corrie A Painter, Sheila M McGlown, Gilberto de Lima Lopes, Oscar K Serrano, Dimpy P Shah, COVID-19 and Cancer Consortium (CCC19)
Department of Internal Medicine, Hematology-Oncology, Tufts Medical Center Cancer Center, Stoneham, Massachusetts., Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, Tennessee., Department of Biostatistics, Vanderbilt University, Nashville, Tennessee., Department of Internal Medicine, Division of Hematology-Oncology, Henry Ford Cancer Institute, Detroit, Michigan., Geisinger Health System, Danville, Danville, Pennsylvania., Division of Medical Oncology, Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts., Vanderbilt-Ingram Cancer Center at Vanderbilt University Medical Center, Nashville, Tennessee., Department of Hematology and Oncology, University of Illinois, Chicago., Herbert Irving Comprehensive Cancer Center at Columbia University, New York, New York., Thompson Cancer Survival Center, Knoxville, Tennessee., Division of Oncology, Department of Medicine, University of North Carolina, Chapel Hill., Rogel Cancer Center, University of Michigan, Ann Arbor., Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia., Department of Radiation Oncology, George Washington University, Washington, DC., Department of Internal Medicine, Division of Hematology-Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio., Department of Hematology-Oncology, University of California, Davis., Count Me In, Broad Institute of MIT and Harvard, Cambridge, Massachusetts., Patient advocate., Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami, Florida., Department of Surgery, Hartford HealthCare Cancer Institute, Hartford, Connecticut., Population Health Sciences, Mays Cancer Center at University of Texas Health San Antonio MD Anderson, San Antonio.