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Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study.


ABSTRACT:

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 non-Hispanic White patients.

Funding

This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.

Clinical trial number

CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.

SUBMITTER: Nagaraj G 

PROVIDER: S-EPMC10637772 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study.

Nagaraj Gayathri G   Vinayak Shaveta S   Khaki Ali Raza AR   Sun Tianyi T   Kuderer Nicole M NM   Aboulafia David M DM   Acoba Jared D JD   Awosika Joy J   Bakouny Ziad Z   Balmaceda Nicole B NB   Bao Ting T   Bashir Babar B   Berg Stephanie S   Bilen Mehmet A MA   Bindal Poorva P   Blau Sibel S   Bodin Brianne E BE   Borno Hala T HT   Castellano Cecilia C   Choi Horyun H   Deeken John J   Desai Aakash A   Edwin Natasha N   Feldman Lawrence E LE   Flora Daniel B DB   Friese Christopher R CR   Galsky Matthew D MD   Gonzalez Cyndi J CJ   Grivas Petros P   Gupta Shilpa S   Haynam Marcy M   Heilman Hannah H   Hershman Dawn L DL   Hwang Clara C   Jani Chinmay C   Jhawar Sachin R SR   Joshi Monika M   Kaklamani Virginia V   Klein Elizabeth J EJ   Knox Natalie N   Koshkin Vadim S VS   Kulkarni Amit A AA   Kwon Daniel H DH   Labaki Chris C   Lammers Philip E PE   Lathrop Kate I KI   Lewis Mark A MA   Li Xuanyi X   Lopes Gilbert de Lima GL   Lyman Gary H GH   Makower Della F DF   Mansoor Abdul-Hai AH   Markham Merry-Jennifer MJ   Mashru Sandeep H SH   McKay Rana R RR   Messing Ian I   Mico Vasil V   Nadkarni Rajani R   Namburi Swathi S   Nguyen Ryan H RH   Nonato Taylor Kristian TK   O'Connor Tracey Lynn TL   Panagiotou Orestis A OA   Park Kyu K   Patel Jaymin M JM   Patel Kanishka GopikaBimal KG   Peppercorn Jeffrey J   Polimera Hyma H   Puc Matthew M   Rao Yuan James YJ   Razavi Pedram P   Reid Sonya A SA   Riess Jonathan W JW   Rivera Donna R DR   Robson Mark M   Rose Suzanne J SJ   Russ Atlantis D AD   Schapira Lidia L   Shah Pankil K PK   Shanahan M Kelly MK   Shapiro Lauren C LC   Smits Melissa M   Stover Daniel G DG   Streckfuss Mitrianna M   Tachiki Lisa L   Thompson Michael A MA   Tolaney Sara M SM   Weissmann Lisa B LB   Wilson Grace G   Wotman Michael T MT   Wulff-Burchfield Elizabeth M EM   Mishra Sanjay S   French Benjamin B   Warner Jeremy L JL   Lustberg Maryam B MB   Accordino Melissa K MK   Shah Dimpy P DP  

eLife 20231017


<h4>Background</h4>Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.<h4>Methods</h4>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 outco  ...[more]

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