EPID-26. THE IMPACT OF COVID-19 POSITIVITY AND PREVALENCE ON TREATMENT UTILIZATION FOR GLIOBLASTOMA PATIENTS

Abstract

Abstract OBJECTIVES Glioblastoma (GBM) is the most common (46.1%) and aggressive malignant primary brain tumor. We propose to explore the pandemic effect on the change of health care delivery for glioblastoma patients using the National Cancer Database (NCDB) and validate the findings in primary brain tumors using one of the largest COVID-19 real-time centralized data in the world - the National COVID Cohort Collaborative (N3C) database. METHODS Multivariable binary logistic regression models were performed to investigate whether the pandemic (including COVID-19 positivity and density of COVID-19 prevalence based on zip code-level) affected the receipt of GBM care including surgical procedure, radiation, and chemotherapy. RESULTS A total of 4093 GBM patients and 4481 primary brain tumor patients were derived from the NCDB and N3C, respectively. Seventy-nine percent of GBM patients received the COVID-19 test (3241/4093) and 290 patients were COVID-19 positive. Black, Hispanic, lower education-level, and higher Charlson/Deyo Score ( >=2) were significant factors related to COVID-19 positivity. The proportions of receiving GBM care significantly decreased in COVID-19-positive patients compared to pre-pandemic years (2018-2019). After adjusting the potential confounders and covariates, the odds of undergoing tumor resection/biopsy (aOR-0.37, p< 0.001), radiation (aOR-0.36, p< 0.001), and chemotherapy (aOR-0.31, p< 0.001) for COVID-19 positive patients were significantly lower than COVID-19 negative patients (NCDB). Similar results were detected in primary brain tumor patients using N3C. The odds of undergoing surgical procedures in patients resided in the higher density of COVID-19 prevalence (four zip code-level, per 1000 population) (aOR-0.63, 0.69, 0.59, all p< 0.001) and with COVID-19 positivity (aOR-0.54, p< 0.001) were significantly lower comparing to the related reference groups (N3C). CONCLUSIONS Our findings suggest that healthcare delivery for GBM and primary brain tumors has been remarkably affected by COVID-19 positivity and high-level COVID-19 prevalence during the pandemic.