Racial Disparities in COVID-19 Outcomes Among Black and White Patients With Cancer.

Autor:	Fu J; Department of Internal Medicine, Hematology-Oncology, Tufts Medical Center Cancer Center, Stoneham, Massachusetts., Reid SA; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, Tennessee.; Vanderbilt-Ingram Cancer Center at Vanderbilt University Medical Center, Nashville, Tennessee., French B; Department of Biostatistics, Vanderbilt University, Nashville, Tennessee., Hennessy C; Department of Biostatistics, Vanderbilt University, Nashville, Tennessee., Hwang C; Department of Internal Medicine, Division of Hematology-Oncology, Henry Ford Cancer Institute, Detroit, Michigan., Gatson NT; Geisinger Health System, Danville, Danville, Pennsylvania.; Department of Cancer Medicine, Division of Neuro-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona., Duma N; Division of Medical Oncology, Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts., Mishra S; Vanderbilt-Ingram Cancer Center at Vanderbilt University Medical Center, Nashville, Tennessee., Nguyen R; Department of Hematology and Oncology, University of Illinois, Chicago., Hawley JE; Herbert Irving Comprehensive Cancer Center at Columbia University, New York, New York.; Now with Division of Oncology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle., Singh SRK; Department of Internal Medicine, Division of Hematology-Oncology, Henry Ford Cancer Institute, Detroit, Michigan., Chism DD; Thompson Cancer Survival Center, Knoxville, Tennessee., Venepalli NK; Division of Oncology, Department of Medicine, University of North Carolina, Chapel Hill., Warner JL; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, Tennessee.; Vanderbilt-Ingram Cancer Center at Vanderbilt University Medical Center, Nashville, Tennessee.; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee., Choueiri TK; Division of Medical Oncology, Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts., Schmidt AL; Division of Medical Oncology, Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts., Fecher LA; Rogel Cancer Center, University of Michigan, Ann Arbor., Girard JE; Rogel Cancer Center, University of Michigan, Ann Arbor., Bilen MA; Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia., Ravindranathan D; Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia., Goyal S; Department of Radiation Oncology, George Washington University, Washington, DC., Wise-Draper TM; Department of Internal Medicine, Division of Hematology-Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio., Park C; Department of Hematology-Oncology, University of California, Davis., Painter CA; Count Me In, Broad Institute of MIT and Harvard, Cambridge, Massachusetts., McGlown SM; Patient advocate., de Lima Lopes G Jr; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami, Florida., Serrano OK; Department of Surgery, Hartford HealthCare Cancer Institute, Hartford, Connecticut., Shah DP; Population Health Sciences, Mays Cancer Center at University of Texas Health San Antonio MD Anderson, San Antonio.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2022 Mar 01; Vol. 5 (3), pp. e224304. Date of Electronic Publication: 2022 Mar 01.
DOI:	10.1001/jamanetworkopen.2022.4304
Abstrakt:	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.
Databáze:	MEDLINE
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