Study Finds Higher Risk for COVID-19 Infection Among Minorities and Patients With Cancer

Especially Among Individuals Treated With Chemotherapy or Immunotherapy

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According to the latest data from the Centers for Disease Control and Prevention, Native American or Alaska Native and non-Hispanic Black people have the highest rates of hospitalization or death from COVID-19, followed by Hispanics and Latinos.

A large population-based study using a smartphone app to capture self-reported health data has found that racial and ethnic minorities and patients with cancer had an increased risk of being infected with the coronavirus. For patients undergoing treatment with chemotherapy or immunotherapy, there was a particularly increased risk of being infected with the virus and COVID-19–related hospitalization. The study by Drew et al was presented during the American Association for Cancer Research Virtual Meeting: COVID-19 and Cancer (Abstract S09-01).

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Study Methodology

The study researchers used a mobile symptom tracker in the COVID Symptom Study to learn how the coronavirus spreads through a population. The COVID Symptom Study app was launched on March 24, 2020, and is now used by nearly 4 million people in the United States, the United Kingdom, and Sweden.

Participants in the study were asked about their health status, including symptoms, COVID-19 testing, health-care utilization, comorbidities, demographics, and key risk factors for infection on a daily basis. Multivariable adjusted logistic regression models were used to determine the association of cancer and race with prevalence of COVID-19, adjusting for age, sex, comorbidities, and risk factors for infection, from launch of the app through May 25, 2020.

Study Results

Among 23,266 individuals with cancer and 1,784,293 without cancer, the researchers documented 155 and 10,249 self-reports of COVID-19 infection, respectively.

Compared to individuals without cancer, those with cancer had an increased risk of COVID-19 infection (adjusted odds ratio [aOR] = 1.60, 95% confidence interval [CI] = 1.36–1.88). The association was stronger among participants older than 65 compared to younger participants (P < .001), and among males (aOR = 1.71, 95% CI = 1.36–2.15) compared to females (aOR = 1.43, 95% CI = 1.14–1.79, P = .02). Treatment with chemotherapy or immunotherapy was associated with a twofold increased risk of COVID-19 infection (aOR = 2.22, 95% CI = 1.68–2.94) and risk of COVID-related hospitalization (aOR = 2.47, 95% CI = 2.22–2.76).

In a separate analysis, the researchers documented 8,990 self-reported cases of positive COVID-19 testing among 2,304,472 non-Hispanic White participants (93.6% of the cohort); 93 among 19,498 Hispanic participants; 204 among 19,498 Black participants; 608 among 64,429 Asian participants; and 352 among 65,046 mixed race/other racial minority participants. Compared with non-Hispanic White participants, the odds ratios for reporting a positive COVID-19 test for racial minorities ranged from 1.44 (mixed race/other races) to 2.59 (Black).

After accounting for risk factors for infection, comorbidities, and sociodemographic characteristics, the adjusted odds ratios were 1.37 (95% CI = 1.09­–1.72) for Hispanic participants, 1.42 (95% CI = 1.23–1.64) for Black participants, 1.44 (95% CI = 1.33–1.57) for Asian participants, and 1.18 (95% CI = 1.06–1.32) for mixed race/other minority participants.

Clinical Significance

“Our results demonstrate an increase in COVID-19 risk among ethnic minorities and individuals with cancer, particularly those on treatment with chemotherapy/immunotherapy. The association with minorities was not completely explained by other known risk factors for COVID-19 or sociodemographic characteristics. These findings highlight the utility of app-based syndromic surveillance for quantifying the impact of the COVID-19 pandemic on at-risk populations,” concluded the study authors.

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The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.