TY - JOUR
T1 - Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19
T2 - A COVID-19 and cancer consortium (CCC19) cohort study
AU - COVID-19 and Cancer Consortium
AU - Nagaraj, Gayathri
AU - Vinayak, Shaveta
AU - Khaki, Ali Raza
AU - Sun, Tianyi
AU - Kuderer, Nicole M.
AU - Aboulafia, David M.
AU - Acoba, Jared D.
AU - Awosika, Joy
AU - Bakouny, Ziad
AU - Balmaceda, Nicole B.
AU - Bao, Ting
AU - Bashir, Babar
AU - Berg, Stephanie
AU - Bilen, Mehmet A.
AU - Bindal, Poorva
AU - Blau, Sibel
AU - Bodin, Brianne E.
AU - Borno, Hala T.
AU - Castellano, Cecilia
AU - Choi, Horyun
AU - Deeken, John
AU - Desai, Aakash
AU - Edwin, Natasha
AU - Feldman, Lawrence E.
AU - Flora, Daniel B.
AU - Friese, Christopher R.
AU - Galsky, Matthew D.
AU - Gonzalez, Cyndi J.
AU - Grivas, Petros
AU - Gupta, Shilpa
AU - Haynam, Marcy
AU - Heilman, Hannah
AU - Hershman, Dawn L.
AU - Hwang, Clara
AU - Jani, Chinmay
AU - Jhawar, Sachin R.
AU - Joshi, Monika
AU - Kaklamani, Virginia
AU - Klein, Elizabeth J.
AU - Knox, Natalie
AU - Koshkin, Vadim S.
AU - Kulkarni, Amit A.
AU - Kwon, Daniel H.
AU - Labaki, Chris
AU - Lammers, Philip E.
AU - Lathrop, Kate I.
AU - Lewis, Mark A.
AU - Li, Xuanyi
AU - Lopes, Gilbert de Lima
AU - Makower, Della F.
N1 - Publisher Copyright:
© 2023, eLife Sciences Publications Ltd. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results: 1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32–1.67]); Black patients (aOR 1.74; 95 CI 1.24–2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70–6.79) and Other (aOR 2.97; 95 CI 1.71–5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83–12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63–3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20–2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66–3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89–22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions: Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to nonHispanic White patients.
AB - Background: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results: 1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32–1.67]); Black patients (aOR 1.74; 95 CI 1.24–2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70–6.79) and Other (aOR 2.97; 95 CI 1.71–5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83–12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63–3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20–2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66–3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89–22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions: Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to nonHispanic White patients.
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U2 - 10.7554/ELIFE.82618
DO - 10.7554/ELIFE.82618
M3 - Article
C2 - 37846664
AN - SCOPUS:85176508718
SN - 2050-084X
VL - 12
JO - eLife
JF - eLife
M1 - e82618
ER -
