Black Patients with Cancer, COVID-19 More Likely to Experience Complications, Hospitalization

Black patients with cancer and coronavirus disease 2019 (COVID-19) may be twice as likely to be hospitalized due to complications related to the virus when compared with white patients, according to a study of more than 500 patients with cancer and COVID-19 presented at the virtual 2020 American Society of Clinical Oncology (ASCO) Quality Care Symposium.¹

“In light of these findings, black patients with cancer should exercise more caution and consistently use strategies to prevent COVID-19 infection,” Chintan Pandya, MD, PhD, who led the study while working at Dana-Farber Cancer Institute and is now an assistant scientist at the Johns Hopkins Bloomberg School of Public Health, said in a press release.² “When a vaccine for COVID-19 is available, it should be offered to high-risk patients first. For now, though, preventive measures are the most effective tool.”

In this retrospective observational quality of care study, researchers evaluated electronic health records from patients with cancer who tested positive for COVID-19 between March 1, 2020 and June 10, 2020 and had at least 1 visit in the past year at Dana-Farber Cancer Institute. The primary end point of hospitalization and secondary end point of emergency department visits were assessed from the time of laboratory-confirmed diagnosis of COVID-19 up to 30 days after diagnosis.

Overall, 557 patients tested positive for COVID-19 and had at least 1 visit at the cancer center in the past year. Of these patients, 325 (58%) were females, 79 (14%) were black, and 225 (40%) had 2 or more comorbidities. Moreover, the most common cancer type among the patients who tested positive for COVID-19 was gastrointestinal cancer (n = 105), and 47 patients had received some form of systemic cancer treatment in the 30 days leading up to their COVID-19 test.

In total, 56 patients had to visit the emergency department, of which 26% were black (P = .002), and 96 patients experienced inpatient hospital visits, out of which 19% were black (P = .13). The mean length of hospital stay was 7.86 ± 11.6 days.

On multivariate analysis, after controlling for demographics, comorbidities, and cancer variables, black race was also found to be independently associated with higher odds of hospitalization (OR, 2.19; 95% CI, 1.2-3.8).

“Racial minority patients with cancer and their health care providers might a higher level of and adherence to pandemic mitigation interventions to lower the extent of COVID-19 transmission and morbidity,” Pandya said in a presentation of the data.

“Future research might want to explore health care system, patient, and disease mechanisms contributing to the racial differences in the health outcome of COVID-19 [in] patients with cancer in addition to what we had included in [this] study,” Pandya continued.

Of note, these results are consistent with previous reports that US minority populations encounter greater illness severity and health consequences from COVID-19. However, similar data for patients with a diagnosis of cancer is currently limited.

References:

1. Pandya C, Mwesigwa S, Dougherty DW. Racial differences in hospitalizations associated with COVID-19 in patients with cancer. Presented at: 2020 ASCO Quality Care Symposium. Abstract #: 122.

2. Black Patients With Cancer May Be at Increased Risk for COVID-19 Hospitalization [news release]. Alexandria, Virginia. Published October 5, 2020. Accessed October 12, 2020. https://www.asco.org/about-asco/press-center/news-releases/black-patients-cancer-may-be-increased-risk-covid-19?cid=DM6113&bid=59026103