COVID-19 and Cancer May Disproportionally Affect Black Patients Compared With Others

The results, according to the study authors, may highlight a bigger issue related to structural racism in health care.

Black patients with cancer were more likely to have worse outcomes from COVID-19 compared with White patients, according to a recent study.

“Understanding and addressing the cumulative and synergistic association of racial inequities (eg, preexisting comorbidities, [social determinants of health] and inadequate access to quality health care and cutting-edge research) on clinical outcomes is pivotal,” Dr. Julie Fu, of the Department of Internal Medicine, Hematology-Oncology at Tufts Medical Center Cancer Center in Stoneham, Massachusetts, and colleagues wrote. “This is a call for action to eradicate root causes of racial inequities, within the causal framework of structural racism, to reduce the disproportionate burden of diseases, such as COVID-19 and cancer, among Black patients and, possibly, other minority racial and ethnic groups.”

Throughout the COVID-19 pandemic, it has been demonstrated that racial and ethnic minority groups, specifically non-Hispanic Black patients, often have a disproportionate burden of the virus compared with non-Hispanic White patients. This has been indicated by higher rates of hospitalization, infection and death, according to the study’s introduction. Particularly, Black patients represent 13% of the population in the United States, yet they account for 20% of patients with COVID-19 and 23% of deaths related to the virus.

In addition, Black patients with cancer have higher rates of death compared with other racial and ethnic groups even before the COVID-19 pandemic. This may be related to factors such as preexisting comorbid conditions (having two or more diseases at the same time), socioeconomic status and access to care. Based on this information, researchers hypothesized that Black patients with cancer and COVID-19 may have more severe cases of COVID-19, worse clinical characteristics before they were diagnosed with cancer and COVID-19, outcomes and complications compared with White patients.

Researchers assessed data from 3,506 patients (median age, 67 years; 50% women) with confirmed diagnoses of cancer and COVID-19. Of these patients, 30% were Black and 70% were White. The main focus of this study was to assess COVID-19 severity, which was based on a scale of five factors: no complications, hospital admission, intensive care unit admission, mechanical ventilation use and all-cause death.

Compared with White patients, Black patients were more likely to have preexisting comorbidities including diabetes (38% versus 24%), obesity (45% versus 38%) and kidney disease (23% versus 16%).

Black patients presented with significantly worse COVID-19 severity and worse illness despite similar cancer status, cancer type and the type of anticancer therapy when they were diagnosed with COVID-19.

“Structural racism refers to the ways in which societies reinforce systems of health care, law enforcement, education, employment, benefits, media and housing that perpetuate discriminatory distribution of resources and attitudes,” the study authors wrote. “The COVID-19 pandemic highlighted the health burden on racial and ethnic minority groups and the complexity of structural racism, which has led to disproportionately worse clinical outcomes among Black patients.”

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