tetano
Editor, Senior Moderator
Elife
. 2023 Oct 17:12:e82618.
doi: 10.7554/eLife.82618. Online ahead of print. Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: a COVID-19 and cancer consortium (CCC19) cohort study
Gayathri Nagaraj[SUP] 1 [/SUP], Shaveta Vinayak[SUP] 2 [/SUP], Ali Raza Khaki[SUP] 3 [/SUP], Tianyi Sun[SUP] 4 [/SUP], Nicole M Kuderer[SUP] 5 [/SUP], David M Aboulafia[SUP] 6 [/SUP], Jared D Acoba[SUP] 7 [/SUP], Joy Awosika[SUP] 8 [/SUP], Ziad Bakouny[SUP] 9 [/SUP], Nicole B Balmaceda[SUP] 10 [/SUP], Ting Bao[SUP] 11 [/SUP], Babar Bashir[SUP] 12 [/SUP], Stephanie Berg[SUP] 13 [/SUP], Mehmet A Bilen[SUP] 14 [/SUP], Poorva Bindal[SUP] 15 [/SUP], Sibel Blau[SUP] 16 [/SUP], Brianne E Bodin[SUP] 17 [/SUP], Hala T Borno[SUP] 18 [/SUP], Cecilia Castellano[SUP] 14 [/SUP], Horyun Choi[SUP] 7 [/SUP], John Deeken[SUP] 19 [/SUP], Aakash Desai[SUP] 20 [/SUP], Natasha Edwin[SUP] 21 [/SUP], Lawrence E Feldman[SUP] 22 [/SUP], Daniel B Flora[SUP] 23 [/SUP], Christopher R Friese[SUP] 24 [/SUP], Matthew D Galsky[SUP] 25 [/SUP], Cyndi J Gonzalez[SUP] 24 [/SUP], Petros Grivas[SUP] 2 [/SUP], Shilpa Gupta[SUP] 26 [/SUP], Marcy Haynam[SUP] 27 [/SUP], Hannah Heilman[SUP] 8 [/SUP], Dawn L Hershman[SUP] 17 [/SUP], Clara Hwang[SUP] 28 [/SUP], Chinmay Jani[SUP] 29 [/SUP], Sachin R Jhawar[SUP] 27 [/SUP], Monika Joshi[SUP] 30 [/SUP], Virginia Kaklamani[SUP] 31 [/SUP], Elizabeth J Klein[SUP] 32 [/SUP], Natalie Knox[SUP] 33 [/SUP], Vadim S Koshkin[SUP] 18 [/SUP], Amit A Kulkarni[SUP] 34 [/SUP], Daniel H Kwon[SUP] 18 [/SUP], Chris Labaki[SUP] 9 [/SUP], Philip E Lammers[SUP] 35 [/SUP], Kate I Lathrop[SUP] 31 [/SUP], Mark A Lewis[SUP] 36 [/SUP], Xuanyi Li[SUP] 4 [/SUP], Gilbert de Lima Lopes[SUP] 37 [/SUP], Gary H Lyman[SUP] 2 [/SUP], Della F Makower[SUP] 38 [/SUP], Abdul-Hai Mansoor[SUP] 39 [/SUP], Merry-Jennifer Markham[SUP] 40 [/SUP], Sandeep H Mashru[SUP] 39 [/SUP], Rana R McKay[SUP] 41 [/SUP], Ian Messing[SUP] 42 [/SUP], Vasil Mico[SUP] 43 [/SUP], Rajani Nadkarni[SUP] 44 [/SUP], Swathi Namburi[SUP] 16 [/SUP], Ryan H Nguyen[SUP] 22 [/SUP], Taylor Kristian Nonato[SUP] 41 [/SUP], Tracey Lynn O'Connor[SUP] 45 [/SUP], Orestis A Panagiotou[SUP] 32 [/SUP], Kyu Park[SUP] 1 [/SUP], Jaymin M Patel[SUP] 15 [/SUP], Kanishka GopikaBimal Patel[SUP] 46 [/SUP], Jeffrey Peppercorn[SUP] 47 [/SUP], Hyma Polimera[SUP] 48 [/SUP], Matthew Puc[SUP] 49 [/SUP], Yuan James Rao[SUP] 50 [/SUP], Pedram Razavi[SUP] 41 [/SUP], Sonya A Reid[SUP] 4 [/SUP], Jonathan W Riess[SUP] 46 [/SUP], Donna R Rivera[SUP] 51 [/SUP], Mark Robson[SUP] 11 [/SUP], Suzanne J Rose[SUP] 52 [/SUP], Atlantis D Russ[SUP] 40 [/SUP], Lidia Schapira[SUP] 3 [/SUP], Pankil K Shah[SUP] 31 [/SUP], M Kelly Shanahan[SUP] 53 [/SUP], Lauren C Shapiro[SUP] 54 [/SUP], Melissa Smits[SUP] 55 [/SUP], Daniel G Stover[SUP] 56 [/SUP], Mitrianna Streckfuss[SUP] 57 [/SUP], Lisa Tachiki[SUP] 58 [/SUP], Michael A Thompson[SUP] 57 [/SUP], Sara M Tolaney[SUP] 9 [/SUP], Lisa B Weissmann[SUP] 29 [/SUP], Grace Wilson[SUP] 34 [/SUP], Michael T Wotman[SUP] 25 [/SUP], Elizabeth M Wulff-Burchfield[SUP] 10 [/SUP], Sanjay Mishra[SUP] 4 [/SUP], Benjamin French[SUP] 4 [/SUP], Jeremy L Warner[SUP] 4 [/SUP], Maryam B Lustberg[SUP] 59 [/SUP], Melissa K Accordino[SUP] 17 [/SUP], Dimpy P Shah[SUP] 31 [/SUP]; COVID-19 and Cancer Consortium
Collaborators, Affiliations
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: 1,383 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; 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: epidemiology; global health; human.
. 2023 Oct 17:12:e82618.
doi: 10.7554/eLife.82618. Online ahead of print. Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: a COVID-19 and cancer consortium (CCC19) cohort study
Gayathri Nagaraj[SUP] 1 [/SUP], Shaveta Vinayak[SUP] 2 [/SUP], Ali Raza Khaki[SUP] 3 [/SUP], Tianyi Sun[SUP] 4 [/SUP], Nicole M Kuderer[SUP] 5 [/SUP], David M Aboulafia[SUP] 6 [/SUP], Jared D Acoba[SUP] 7 [/SUP], Joy Awosika[SUP] 8 [/SUP], Ziad Bakouny[SUP] 9 [/SUP], Nicole B Balmaceda[SUP] 10 [/SUP], Ting Bao[SUP] 11 [/SUP], Babar Bashir[SUP] 12 [/SUP], Stephanie Berg[SUP] 13 [/SUP], Mehmet A Bilen[SUP] 14 [/SUP], Poorva Bindal[SUP] 15 [/SUP], Sibel Blau[SUP] 16 [/SUP], Brianne E Bodin[SUP] 17 [/SUP], Hala T Borno[SUP] 18 [/SUP], Cecilia Castellano[SUP] 14 [/SUP], Horyun Choi[SUP] 7 [/SUP], John Deeken[SUP] 19 [/SUP], Aakash Desai[SUP] 20 [/SUP], Natasha Edwin[SUP] 21 [/SUP], Lawrence E Feldman[SUP] 22 [/SUP], Daniel B Flora[SUP] 23 [/SUP], Christopher R Friese[SUP] 24 [/SUP], Matthew D Galsky[SUP] 25 [/SUP], Cyndi J Gonzalez[SUP] 24 [/SUP], Petros Grivas[SUP] 2 [/SUP], Shilpa Gupta[SUP] 26 [/SUP], Marcy Haynam[SUP] 27 [/SUP], Hannah Heilman[SUP] 8 [/SUP], Dawn L Hershman[SUP] 17 [/SUP], Clara Hwang[SUP] 28 [/SUP], Chinmay Jani[SUP] 29 [/SUP], Sachin R Jhawar[SUP] 27 [/SUP], Monika Joshi[SUP] 30 [/SUP], Virginia Kaklamani[SUP] 31 [/SUP], Elizabeth J Klein[SUP] 32 [/SUP], Natalie Knox[SUP] 33 [/SUP], Vadim S Koshkin[SUP] 18 [/SUP], Amit A Kulkarni[SUP] 34 [/SUP], Daniel H Kwon[SUP] 18 [/SUP], Chris Labaki[SUP] 9 [/SUP], Philip E Lammers[SUP] 35 [/SUP], Kate I Lathrop[SUP] 31 [/SUP], Mark A Lewis[SUP] 36 [/SUP], Xuanyi Li[SUP] 4 [/SUP], Gilbert de Lima Lopes[SUP] 37 [/SUP], Gary H Lyman[SUP] 2 [/SUP], Della F Makower[SUP] 38 [/SUP], Abdul-Hai Mansoor[SUP] 39 [/SUP], Merry-Jennifer Markham[SUP] 40 [/SUP], Sandeep H Mashru[SUP] 39 [/SUP], Rana R McKay[SUP] 41 [/SUP], Ian Messing[SUP] 42 [/SUP], Vasil Mico[SUP] 43 [/SUP], Rajani Nadkarni[SUP] 44 [/SUP], Swathi Namburi[SUP] 16 [/SUP], Ryan H Nguyen[SUP] 22 [/SUP], Taylor Kristian Nonato[SUP] 41 [/SUP], Tracey Lynn O'Connor[SUP] 45 [/SUP], Orestis A Panagiotou[SUP] 32 [/SUP], Kyu Park[SUP] 1 [/SUP], Jaymin M Patel[SUP] 15 [/SUP], Kanishka GopikaBimal Patel[SUP] 46 [/SUP], Jeffrey Peppercorn[SUP] 47 [/SUP], Hyma Polimera[SUP] 48 [/SUP], Matthew Puc[SUP] 49 [/SUP], Yuan James Rao[SUP] 50 [/SUP], Pedram Razavi[SUP] 41 [/SUP], Sonya A Reid[SUP] 4 [/SUP], Jonathan W Riess[SUP] 46 [/SUP], Donna R Rivera[SUP] 51 [/SUP], Mark Robson[SUP] 11 [/SUP], Suzanne J Rose[SUP] 52 [/SUP], Atlantis D Russ[SUP] 40 [/SUP], Lidia Schapira[SUP] 3 [/SUP], Pankil K Shah[SUP] 31 [/SUP], M Kelly Shanahan[SUP] 53 [/SUP], Lauren C Shapiro[SUP] 54 [/SUP], Melissa Smits[SUP] 55 [/SUP], Daniel G Stover[SUP] 56 [/SUP], Mitrianna Streckfuss[SUP] 57 [/SUP], Lisa Tachiki[SUP] 58 [/SUP], Michael A Thompson[SUP] 57 [/SUP], Sara M Tolaney[SUP] 9 [/SUP], Lisa B Weissmann[SUP] 29 [/SUP], Grace Wilson[SUP] 34 [/SUP], Michael T Wotman[SUP] 25 [/SUP], Elizabeth M Wulff-Burchfield[SUP] 10 [/SUP], Sanjay Mishra[SUP] 4 [/SUP], Benjamin French[SUP] 4 [/SUP], Jeremy L Warner[SUP] 4 [/SUP], Maryam B Lustberg[SUP] 59 [/SUP], Melissa K Accordino[SUP] 17 [/SUP], Dimpy P Shah[SUP] 31 [/SUP]; COVID-19 and Cancer Consortium
Collaborators, Affiliations
- PMID: 37846664
- DOI: 10.7554/eLife.82618
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: 1,383 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; 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: epidemiology; global health; human.