Racial Disparities in COVID-19 Outcomes Among Black and White Patients With Cancer
JAMA network open
Importance: Non-Hispanic Black individuals experience a higher burden of COVID-19 than the general population; hence, there is an urgent need to characterize the unique clinical course and outcomes of COVID-19 in Black patients with cancer. Objective: To investigate racial disparities in severity of COVID-19 presentation, clinical complications, and outcomes between Black patients and non-Hispanic White patients with cancer and COVID-19. Design, Setting, and Participants: This retrospective cohort study used data from the COVID-19 and Cancer Consortium registry from March 17, 2020, to November 18, 2020, to examine the clinical characteristics and outcomes of COVID-19 in Black patients with cancer. Data analysis was performed from December 2020 to February 2021. Exposures: Black and White race recorded in patient's electronic health record. Main Outcomes and Measures: An a priori 5-level ordinal scale including hospitalization intensive care unit admission, mechanical ventilation, and all-cause death. Results: Among 3506 included patients (1768 women [50%]; median [IQR] age, 67 [58-77] years), 1068 (30%) were Black and 2438 (70%) were White. Black patients had higher rates of preexisting comorbidities compared with White patients, including obesity (480 Black patients [45%] vs 925 White patients [38%]), diabetes (411 Black patients [38%] vs 574 White patients [24%]), and kidney disease (248 Black patients [23%] vs 392 White patients [16%]). Despite the similar distribution of cancer type, cancer status, and anticancer therapy at the time of COVID-19 diagnosis, Black patients presented with worse illness and had significantly worse COVID-19 severity (unweighted odds ratio, 1.34 [95% CI, 1.15-1.58]; weighted odds ratio, 1.21 [95% CI, 1.11-1.33]). Conclusions and Relevance: These findings suggest that Black patients with cancer experience worse COVID-19 outcomes compared with White patients. Understanding and addressing racial inequities within the causal framework of structural racism is essential to reduce the disproportionate burden of diseases, such as COVID-19 and cancer, in Black patients.
Fu, Julie; Reid, Sonya A.; French, Benjamin; Hennessy, Cassandra; Hwang, Clara; Gatson, Na Tosha; Duma, Narjust; Mishra, Sanjay; Nguyen, Ryan; Hawley, Jessica E.; Singh, Sunny R.; Chism, David D.; Venepalli, Neeta K.; Warner, Jeremy L.; Choueiri, Toni K.; Schmidt, Andrew L.; Fecher, Leslie A.; Girard, Jennifer E.; Bilen, Mehmet A.; Ravindranathan, Deepak; Goyal, Sharad; Wise-Draper, Trisha M.; Park, Cathleen; Painter, Corrie A.; McGlown, Sheila M.; de Lima Lopes, Gilberto; Serrano, Oscar K.; and Shah, Dimpy P., "Racial Disparities in COVID-19 Outcomes Among Black and White Patients With Cancer" (2022). GW Authored Works. Paper 695.