Background: The coronavirus disease (COVID-19) first identified in Wuhan in December 2019 became a pandemic within a few months of its discovery. The impact of COVID-19 is due to both its rapid spread and its severity, but the determinants of severity have not been fully delineated. Objective: Identify factors associated with hospitalization and disease severity in a racially and ethnically diverse cohort of COVID-19 patients. Methods: We analyzed data from COVID-19 patients diagnosed at the University of Cincinnati health system from March 13, 2020 to May 31, 2020. Severe COVID-19 was defined as admission to intensive care unit or death. Logistic regression modeling adjusted for covariates was used to identify the factors associated with hospitalization and severe COVID-19. Results: Among the 689 COVID-19 patients included in our study, 29.2% were non-Hispanic White, 25.5% were non-Hispanic Black, 32.5% were Hispanic, and 12.8% were of other race/ethnicity. About 31.3% of patients were hospitalized and 13.2% had severe disease. In adjusted analyses, the sociodemographic factors associated with hospitalization and/or disease severity included older age, non-Hispanic Black or Hispanic race/ethnicity (compared to non-Hispanic White), and smoking. The following comorbidities: diabetes, hypercholesterolemia, asthma, COPD, chronic kidney disease, cardiovascular diseases, osteoarthritis, and vitamin D deficiency were associated with hospitalization and/or disease severity. Hematological disorders such as anemia, coagulation disorders, and thrombocytopenia were associated with both hospitalization and disease severity. Conclusion: This study confirms race and ethnicity as predictors of severe COVID-19. It also finds clinical risk factors for hospitalization and severe COVID-19 not previously identified such a vitamin D deficiency, hypercholesterolemia, osteoarthritis, and anemia.

BACKGROUND. Attention to the economic consequences of cancer has grown as the number of cancer survivors is increasing. Although prevalent among low‐income minority survivors, the impact of economic stress on quality of life (QOL) remains largely unexplored. METHODS. Data are reported for 487 predominantly Hispanic low‐income women with a primary diagnosis of breast or gynecological cancer and undergoing active treatment or follow‐up. Cross‐sectional and longitudinal analyses examined the effects of economic concerns on QOL, depression, and anxiety. RESULTS. Rates of unemployment, medical cost and wage concerns, and financial stress were high in this study population, at baseline, respectively, 70%, 68%, 47%, and 49%. The proportions reporting unemployed status and medical cost concerns stayed flat from baseline to 6 months, followed by a pronounced drop at 12 months. Patient reported rates of lost wage worries increased from baseline to 6 months, followed by a moderate decrease. Functional, emotional, physical, and social‐family well‐being and depression and anxiety scores exhibited consistent linear improvement from baseline to 12 months. Over 12 months, patients reporting economic concerns had significantly poorer functional, emotional, and affective well‐being. CONCLUSIONS. Economic stress is negatively associated with QOL, highlighting the importance of addressing economic stress in low‐income women with cancer. Cancer 2008. © 2007 American Cancer Society.

Collaborative care reduced depression symptoms and enhanced quality of life; however, results call for ongoing depression symptom monitoring and treatment for low-income cancer survivors.

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Objective-This paper describes the randomized clinical trial methodology for a population based study of oncology patients receiving cancer care in a public sector medical center. The primary goal is to test the effectiveness of socioculturally tailored collaborative care intervention in improving depression and quality of life outcomes among low-income ethnic minority patients with major depression and cancer.Methods-The PHQ-9 depression scale was used to identify patients meeting criteria for major depression (1 cardinal depression symptom + a PHQ-9 score of ≥ 10). Study eligible patients were ≥90 days from cancer diagnosis who were receiving acute cancer treatment or follow-up care in oncology clinics. Patients with advanced disease limiting life expectancy to <6 months, acutely suicidal or on antipsychotic medication were excluded. Allowing for attrition due to death or loss to follow-up, the study was powered at the 80% level to detect a 20% difference between study arms in the proportion of patients with ≥50% reduction in PHQ-9 symptoms at 12 months.Results-Of 2,330 patients screened, 23.2% met criteria. An 82.4% enrollment rate resulted in 447 primarily women being recruited and randomized to intervention or usual care. Conclusion-The study applies methods used in primary care depression trials with adaptations for oncology care clinics and for low-income minority patients.