Study of cancer patients and COVID-19 highlights health disparities

July 23, 2021

Findings from a study led by researchers at Henry Ford Cancer Institute, in collaboration with Advocate Aurora Health, the Food and Drug Administration and Syapse, show an elevated risk for severe COVID-19 effects or death among patients with cancer, with the highest risk being among low-income and Black patients.

Researchers who led the study, which was recently published in Cancer Reports, analyzed data from 146,702 adults diagnosed with cancer between 2015 and 2020. From this group, 1,267 COVID-19 cases were identified between February 1 and July 30, 2020. The data analyzed was part of the Syapse® Learning Health Network, which is a global precision oncology data sharing network that aims to improve cancer care across communities by using real-world data to support clinical decisions.

As part of the study, researchers analyzed treatments and clinical outcomes for patients with COVID-19. Among hospitalized patients, the most common admission diagnoses were similar for patients with active cancer (first diagnosed or received anticancer treatment within the last 12 months) and those with a history of cancer. Breathing abnormalities were more common for males than females among hospitalized patients (Table S2). Patients in zip codes with median household income below $30,000 were nearly twice as likely as patients in zip codes with median household income above $30,000 to be hospitalized for pneumonia, fluid balance disorders, cough, respiratory failure, or acute renal failure. Additionally, findings from the study show Black patients were more likely than other groups to be admitted for breathing abnormalities, pneumonia, fluid balance disorders, cough, acute renal failure or chronic kidney disease and fever.

“The data analyzed demonstrates health disparities related to both race and income that are multi-factorial and already well-recognized in the U.S.,” said Clara Hwang, M.D., medical oncologist at Henry Ford Cancer Institute and principal investigator of the study at Henry Ford. “Our hope is these findings will help inform the care provided for those who are at a higher risk of complications or death from COVID-19, and lead to continued research that will help us better understand why this disproportionate effect on Black patients exists.”

Black patients with cancer and separately those living in zip codes with median household income less than $30,000 were at the highest risk of severe COVID-19 effects or death.

“The findings from this study show that patients with cancer are more vulnerable to the effects of COVID-19, especially those with comorbidities and cancer that has been diagnosed in the past 12 months,” said Shirish Gadgeel, M.D., division head of Hematology/Oncology at Henry Ford Cancer Institute, and co-author of the study. “We found that people with cancer who were diagnosed with COVID-19 were more likely to have other chronic underlying illnesses compared to patients with cancer without COVID-19, such as chronic conditions affecting the kidneys, heart, lungs and blood vessels. Our findings indicate older people with cancer were more likely to die from COVID-19, which is consistent with what has been observed among those without cancer.”

At Henry Ford, patients with cancer and other high-risk conditions were prioritized to receive the COVID-19 vaccine when it became available for each age group. To protect those at risk of the most severe complications or death from COVID-19, including patients with cancer, Henry Ford implemented enhanced safety measures, which facilitated seamless care of cancer patients during the COVID-19 pandemic.

The enhanced safety measures implemented include patients being prescreened by phone for COVID-19 symptoms the day before their appointment, as well as additional screening at building entrances; maintaining six-foot spacing between chairs in the infusion room; blood work being done in the infusion room to save patients a trip to the lab, and both in-person and virtual visits offered for patients.

A key part of making this study possible is the partnership between Henry Ford and Syapse, which was created in 2016.

Through this partnership, Henry Ford shares deidentified cancer outcomes data with other health systems through the Syapse Learning Health Network, which enables more rapid learning from real-world experiences to improve patient care around the globe. Henry Ford Cancer Institute provides world-class cancer care to nearly 10,000 new patients each year, and comprises more than 1,450 cancer care experts at five hospitals, 11 outpatient facilities and hundreds of aligned doctor’s offices throughout Southeast and Southcentral Michigan.

Although this study characterized the impact of race and socioeconomic status in one of the largest U.S. cohorts of patients with cancer and COVID-19 reported to-date, similar associations have been reported in non-cancer populations. Further research is needed to study the underlying causes of COVID-19’s disproportionate effect among minority populations and patients residing in lower income areas, as well as the long-term effects of COVID-19 on patients with cancer.

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