Patients with cancer who have coronavirus disease 2019 (COVID-19) infection are at a greater risk of hospitalization and death from COVID-19 infection, according to research published in JAMA Oncology. These risks are even more significant among African American patients.
It has been suggested that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, disproportionately affects people with comorbidities and those from poorer socioeconomic backgrounds. These patients have a higher rate of infection, hospitalization, and death; however, there is little evidence about how cancer subtypes and demographic factors affect patient risks for severe COVID-19.
For this retrospective case-controlled analysis, researchers analyzed data from 73.4 million patient electronic health records from 360 hospitals in the US to determine which particular combinations of cancer subtypes and demographic factors are linked to COVID-19 infection, hospitalization, and death.
Of the cohort, 53.64% of patients were women, 59.88% were aged 18 to 65 years, 54.75% were White, and 10.33% were African American. Patients with cancer were grouped by common cancers (2,523,920 patients) and recent cancer (cancers diagnosed within the preceding year; 273,140 patients).
A total of 16,570 patients were diagnosed with COVID-19, 1200 patients were diagnosed with COVID-19 and a common cancer, and 690 patients were diagnosed with COVID-19 and a recent common cancer. Although African Americans made up 10.23% of the population diagnosed with a common cancer, this group also made up 39.77% of COVID-19 diagnoses.
Patients with a recent cancer diagnosis had an increased risk for COVID-19 infection (adjusted odds radio [aOR], 7.14; P <.001), while those with any cancer diagnosis had an aOR for infection of 1.46 (P < .001).
Among patients with a recent cancer diagnosis, those with leukemia (aOR, 12.16), non-Hodgkin lymphoma (aOR, 8.54), or lung cancer (aOR, 7.66) had the greatest increased risk for COVID-19 infection, while those with thyroid cancer (aOR, 3.10) or endometrial cancer (aOR, 4.70) had the lowest risk (all P <.001).
Patients with both cancer and COVID-19 infection had higher rates of hospitalization (47.46%) and death (14.93%) compared with either patients with COVID-19 without cancer (24.26% and 5.26%, respectively) or patients with cancer without COVID-19 (12.39% and 4.03%, respectively; P <.001).
“Our study provides an independent extension of 2 recent reports by the COVID-19 and Cancer Consortium registry and can serve as a baseline study of initial COVID-19 risk, racial disparity, and outcomes observations in patients with cancer across the US,” the authors wrote.
Wang Q, Berger NA, Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol. Published online December 10, 2020. doi:10.1001/jamaoncol.2020.6178