Disproportionate impact of COVID-19 disease among racial and ethnic minorities in the U.S. cancer population as seen in CancerLinQ Discovery data.

Abstract

84 Background: Patients with cancer may face difficult care decisions during the COVID-19 outbreak in the US. Understanding COVID-19 risk factors may help patients and oncologists identify high-risk patients and plan for the best cancer treatment in a timely fashion. This analysis provides an assessment of racial and ethnic risk factors for COVID-19 disease within the CancerLinQ (CLQ) Discovery database. Methods: CLQ is a health technology platform developed by ASCO, which collects and aggregates longitudinal electronic health record (EHR) data from oncology practices throughout the United States. Patients with a diagnosis of a malignant neoplasm and at least two encounters in the past year at a reporting CLQ practice were defined as the underlying cancer patient population at risk for SARS-CoV-2 infection. COVID-19 cases were identified via a positive RT-PCR test for SARS-CoV-2 RNA and/or an ICD-10 code for coronavirus (e.g., B97.29, U07.1, or U07.2). Relative risks and 95% CI were calculated using SAS. Results: We identified 232,428 patients with cancer. From 1/1/2020-4/30/2020, we identified 223 COVID-19 cases in patients with cancer. Of these, 203 had a positive RT-PCR, 26 had an ICD-10 diagnosis code for SARS-CoV-2, and 6 had both. SARS-CoV-2 cases were identified from 19 of the 35 CLQ practices (52.8%) reporting data during the study period. Compared to white patients, African Americans were approximately 2 times more likely to have COVID-19 disease (RR = 1.95; 95% CI = 1.40-2.71), and Hispanics were more than 4 times more likely (RR = 4.65; 95% CI = 3.36-6.43). Patients with hematologic cancers were 1.5 times as likely to be diagnosed with COVID-19 (RR = 1.53; 95% CI = 1.09-2.16) compared to patients with solid tumors. At the time of this abstract, 10 patients (4.5%) died. Conclusions: These results are based on data from a sample of CLQ practices and represent an initial analysis of COVID-19 in the CLQ population. The elevated risk for COVID-19 among African Americans and Hispanics with cancer is noteworthy, particularly since these patients often suffer poorer cancer outcomes. The elevated risk among patients with hematologic cancers is also worth noting because these patients often have compromised immune systems and are already susceptible to many other types of infection. Because the US is in the midst of an active outbreak, we are continuing to analyze new cases and additional risk factors, such as geographical location, anti-cancer treatments, and other cancer variables (e.g. stage).