Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study Journal Article
| Authors: | Nagaraj, G.; Vinayak, S.; Khaki, A. R.; Sun, T.; Kuderer, N. M.; Aboulafia, D. M.; Acoba, J. D.; Awosika, J.; Bakouny, Z.; Balmaceda, N. B.; Bao, T.; Bashir, B.; Berg, S.; Bilen, M. A.; Bindal, P.; Blau, S.; Bodin, B. E.; Borno, H. T.; Castellano, C.; Choi, H.; Deeken, J.; Desai, A.; Edwin, N.; Feldman, L. E.; Flora, D. B.; Friese, C. R.; Galsky, M. D.; Gonzalez, C. J.; Grivas, P.; Gupta, S.; Haynam, M.; Heilman, H.; Hershman, D. L.; Hwang, C.; Jani, C.; Jhawar, S. R.; Joshi, M.; Kaklamani, V.; Klein, E. J.; Knox, N.; Koshkin, V. S.; Kulkarni, A. A.; Kwon, D. H.; Labaki, C.; Lammers, P. E.; Lathrop, K. I.; Lewis, M. A.; Li, X.; de Lima Lopes, G.; Lyman, G. H.; Makower, D. F.; Mansoor, A. H.; Markham, M. J.; Mashru, S. H.; McKay, R. R.; Messing, I.; Mico, V.; Nadkarni, R.; Namburi, S.; Nguyen, R. H.; Nonato, T. K.; O'Connor, T. L.; Panagiotou, O. A.; Park, K.; Patel, J. M.; Patel, K. G.; Peppercorn, J.; Polimera, H.; Puc, M.; Rao, Y. J.; Razavi, P.; Reid, S. A.; Riess, J. W.; Rivera, D. R.; Robson, M.; Rose, S. J.; Russ, A. D.; Schapira, L.; Shah, P. K.; Shanahan, M. K.; Shapiro, L. C.; Smits, M.; Stover, D. G.; Streckfuss, M.; Tachiki, L.; Thompson, M. A.; Tolaney, S. M.; Weissmann, L. B.; Wilson, G.; Wotman, M. T.; Wulff-Burchfield, E. M.; Mishra, S.; French, B.; Warner, J. L.; Lustberg, M. B.; Accordino, M. K.; Shah, D. P.; On behalf of the COVID-19 and Cancer Consortium |
| Article Title: | 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. |
| Keywords: | middle aged; retrospective studies; united states; cohort studies; breast cancer; cohort analysis; breast neoplasms; oncology; retrospective study; breast tumor; epidemiology; global health; pandemic; humans; human; female; severe acute respiratory syndrome coronavirus 2; coronavirus disease 2019; covid-19; sars-cov-2; racial inequities |
| Journal Title: | eLife |
| Volume: | 12 |
| ISSN: | 2050-084X |
| Publisher: | eLife Sciences Publications Ltd. |
| Date Published: | 2023-10-17 |
| Start Page: | e82618 |
| Language: | English |
| DOI: | 10.7554/eLife.82618 |
| PUBMED: | 37846664 |
| PROVIDER: | scopus |
| PMCID: | PMC10637772 |
| DOI/URL: | |
| Notes: | Article -- MSK authors Gregory Riely and Elizabeth Robliotti acknowledged for contributing records to the study -- Source: Scopus |
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