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, Shaveta Vinayak, Ali Raza Khaki, Tianyi Sun, Nicole M Kuderer, David M Aboulafia, Jared D Acoba, Joy Awosika, Ziad Bakouny, Nicole B Balmaceda, Ting Bao, Babar Bashir, Stephanie Berg, Mehmet A Bilen, Poorva Bindal, Sibel Blau, Brianne E Bodin, Hala T Borno, Cecilia Castellano, Horyun ChoiJohn Deeken, Aakash Desai, Natasha Edwin, Lawrence E Feldman, Daniel B Flora, Christopher R Friese, Matthew D Galsky, Cyndi J Gonzalez, Petros Grivas, Shilpa Gupta, Marcy Haynam, Hannah Heilman, Dawn L Hershman, Clara Hwang, Chinmay Jani, Sachin R Jhawar, Monika Joshi, Virginia Kaklamani, Elizabeth J Klein, Natalie Knox, Vadim S Koshkin, Amit A Kulkarni, Daniel H Kwon, Chris Labaki, Philip E Lammers, Kate I Lathrop, Mark A Lewis, Xuanyi Li, Gilberto de Lima Lopes, Gary H Lyman, Della F Makower, Abdul-Hai Mansoor, Merry-Jennifer Markham, Sandeep H Mashru, Rana R McKay, Ian Messing, Vasil Mico, Rajani Nadkarni, Swathi Namburi, Ryan H Nguyen, Taylor Kristian Nonato, Tracey Lynn O'Connor, Orestis A Panagiotou, Kyu Park, Jaymin M Patel, Kanishka GopikaBimal Patel, Jeffrey Peppercorn, Hyma Polimera, Matthew Puc, Yuan James Rao, Pedram Razavi, Sonya A Reid, Jonathan W Riess, Donna R Rivera, Mark Robson, Suzanne J Rose, Atlantis D Russ, Lidia Schapira, Pankil K Shah, M Kelly Shanahan, Lauren C Shapiro, Melissa Smits, Daniel G Stover, Mitrianna Streckfuss, Lisa Tachiki, Michael A Thompson, Sara M Tolaney, Lisa B Weissmann, Grace Wilson, Michael T Wotman, Elizabeth M Wulff-Burchfield, Sanjay Mishra, Benjamin French, Jeremy L Warner, Maryam B Lustberg, Melissa K Accordino, Dimpy P Shah

Producción científica: Articlerevisión exhaustiva


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, NCT04354701 .

Idioma originalEnglish (US)
PublicaciónmedRxiv : the preprint server for health sciences
EstadoPublished - mar 10 2023


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