Disparities in COVID-19 severity and risk of death in cancer patients: Experiences from a U.K. cancer center.

Authors

null

Beth Russell

King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom

Beth Russell, Charlotte L Moss, Sophie Papa, Harriet Wylie, Anna Haire, Fidelma Cahill, Mary Lei, Sharmistha Ghosh, Richard Sullivan, Anne Sagar Rigg, Saoirse Dolly, Mieke Van Hemelrijck

Organizations

King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom, Guy's And St Thomas NHS Foundation Trust, London, United Kingdom, King's College London, London, United Kingdom, Guy's Cancer Centre, London, United Kingdom, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom, Guys and St Thomas NHS Foundation Trust, London, United Kingdom, King’s Health Partners Comprehensive Cancer Centre, London, United Kingdom, Guys and St Thomas' Hospitals NMS Foundation Trust, Beckenham, United Kingdom

Research Funding

Other
National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) based at Guy's and St Thomas' NHS Foundation Trust and King's College London (IS-BRC-1215-20006), Cancer Research UK King's Health Partners Centre at King's College London and Guy's and St Thomas' NHS Foundation Trust Charity Cancer Fund

Background: There has been widespread evidence emerging regarding disparities between COVID-19 outcomes in patients of varying ethnicities and background. It is, however, unclear how various patient characteristics affect COVID-19 severity and risk of death in a cancer population. Methods: Our Cancer Centre was at the epicentre of the COVID-19 outbreak in the UK. A total of 156 cancer patients had a confirmed COVID-19 diagnosis between the 29th of February through the 12th of May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. The regression models were defined through a directed acyclic graph (DAG) to decide upon the minimal adjustments required for each statistical model. Results: Of the 156 COVID-19 positive cancer patients, the most frequently reported tumour types were urological/gynaecological (29%), followed by haematological (18%) and breast (15%). 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with severe disease. Initial diagnosis of cancer >24m before COVID-19 (OR:1.74 (95%CI: 0.71-4.26)), presenting with fever (6.21 (1.76-21.99)), dyspnoea (2.60 (1.00-6.76)), gastro-intestinal symptoms (7.38 (2.71-20.16)), or higher levels of CRP (9.43 (0.73-121.12)) were linked with greater COVID-19 severity. During median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Asian ethnicity (3.73 (1.28-10.91), palliative treatment (5.74 (1.15-28.79), initial diagnosis of cancer >24m before (2.14 (1.04-4.44), dyspnoea (4.94 (1.99-12.25), and increased CRP levels (10.35 (1.05-52.21)) were positively associated with COVID-19 death. Socioeconomic status (SES) was not found to be associated with either COVID-19 severity or risk of death. We will present updated data with more mature follow-up. Conclusions: In cancer patients, Asian ethnicity was found to be positively associated with COVID-19 death compared to Caucasian patients. However, SES was not associated with COVID-19 severity or risk of death thereby implying this was not due to poor access to healthcare. Future studies hence need to identify the underlying biological and/or societal reasons explaining these ethnic disparities in COVID-19 outcomes for cancer patients.

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Abstract Details

Meeting

2020 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

On-Demand Poster Session: Technology and Innovation in Quality of Care

Track

Technology and Innovation in Quality of Care

Sub Track

Real-World Evidence

Citation

J Clin Oncol 38, 2020 (suppl 29; abstr 285)

DOI

10.1200/JCO.2020.38.29_suppl.285

Abstract #

285

Poster Bd #

Online Only

Abstract Disclosures

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