Non-Hispanic Black patients with cancer associated with worse COVID-19 outcomes compared with White patients

1. Despite similar cancer status, Black patients with cancer and COVID-19 had worse severity of COVID-19 at presentation and clinical outcomes compared with White patients.

2. Compared with White patients, there was also a higher prevalence of preexisting comorbidities in Black patients, including obesity, diabetes, and kidney disease.

Evidence Rating Level: 2 (Good)

Study Rundown: Since the start of the COVID-19 pandemic, clinical and epidemiological data have highlighted the disproportionate burden of COVID-19 infection among racial and ethnic minority groups, particularly non-Hispanic Black individuals. Thus, there is an urgent need to characterize the clinical characteristics and outcomes associated with COVID-19 in Black patients with cancer. This retrospective cohort study investigated racial disparities in severity of COVID-19 presentation, clinical course and complications, and outcomes between Black and non-Hispanic White patients with cancer and COVID-19. The main outcomes included hospitalization, intensive care unit admission, mechanical ventilation, and all-cause death, evaluated using an a priori 5-level ordinal scale. Among 3506 patients with cancer, Black patients presented with significantly worse illness and COVID-19 severity compared with White patients despite similar cancer types, status, and therapies. It is essential to interpret and use this data to better address racial inequities across all minorities in healthcare and reduce the disproportionate burden of diseases experienced by Black patients with cancer. A limitation of this study lies in the incomplete and inaccurate documentation of race and ethnicity within the electronic health record, a commonly encountered issue and potential misclassification and confounding factor in racial disparity analyses.

Click to read the study in JAMA Network Open

Relevant Reading: Cancer health disparities in racial/ethnic minorities in the United States

In-Depth [retrospective cohort]: This study included 3506 patients (median [IQR] age, 67 [58-77] years; 1768 [50%] women; 1068 [30%] Black, 2438 [70%] White) from the COVID-19 and Cancer Consortium registry between March to November 2020 and examined the clinical characteristics and outcomes of COVID-19 in Black patients with cancer. Compared with White patients, there was a higher prevalence of preexisting comorbidities in Black patients, including obesity (480 [45%] Black vs 925 [38%] White), diabetes (411 [38%] Black vs 574 [24%] White), and kidney disease (248 [23%] Black vs 392 [16%] White). Despite a similar distribution of cancer type, status, and therapy at the time of COVID-19 diagnosis, Black patients with cancer experienced significantly more severe COVID-19 outcomes compared to White patients (unweighted OR, 1.34 [95%CI, 1.15-1.58]; weighted OR, 1.21 [95%CI, 1.11-1.33]).

Image: PD

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