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Background: To evaluate clinical outcomes in patients with malignancy who are SARS-CoV-2 (COVID-19) positive and investigate if factors such as age, gender, and race contribute to COVID-19 mortality in patients with malignancy.

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e13540 Background: The identification of pathogenic variants and variants of unknown significance (VUS) in multi-gene cancer predisposition testing raises new questions regarding cancer risk and management. We evaluated the personal and family cancer patterns and variation by race and ethnicity, among individuals positive for pathogenic variants in non-BRCA1/ 2 cancer predisposing genes. Methods: The Karmanos Cancer Institute (KCI) Cancer Genetics database was queried from May 13, 2013 through December 31, 2018. There were 3,544 unrelated individuals evaluated for hereditary cancer predisposition of whom 1,868 had 18-gene panel testing at 6 sites across Michigan. Data was collected on personal and family cancer history including ages at diagnosis utilizing a 3-generation pedigree, self-identified race and ethnicity and results of genetic testing. We describe the prevalence of pathogenic variants by proband cancer diagnosis, family history, race, and ethnicity. Results: The race/ethnic distribution of the tested cohort included 67.5% non-Hispanic White (NHW), 24.4% African American (AA), 2.1% Arab, 1.8% Ashkenazi Jewish (AJ), 1.0% Hispanic, and 3.4% other. The distribution of cancer diagnoses included 40.6% breast, 5.5% ovarian, 4.1% colon, 3.5% endometrial, 2.0% pancreas and 39.7% unaffected. Pathogenic variants were seen in 151 (8.1%) individuals and VUS in 309 (16.5%). The five most common pathogenic variants were CHEK2 (40), MUTYH (22), ATM (20), and PALB2 (18). The most common pathogenic variants by race and ethnicity were CHEK2 (NHW), RAD51C (AA), PALB2 (Arab), CHEK2, MSH6 (AJ), and none in Hispanics. Variants associated with the four most common cancer types were breast ( CHEK2 ), ovarian ( CHEK2, MUTYH, BRIP1), colon ( ATM), and endometrial ( MSH6, PALB2). Of 40 individuals with CHEK2 variants, 92.5% were NHW, and 34 (85%), 31 (78%), 10 (25%), 1 (2.5%) had family history of breast cancer, breast cancer before age 50, ovarian, and colon cancer, respectively. Of 20 with ATM variants, 95% were NHW, 13 had family history data and 10 (76.9%), 8 (61.5%), 2 (15.4%), 1 (7.7%) had family history of breast, breast cancer before age 50, ovarian, and colon cancer, respectively. Conclusions: Pathogenic variants seen using multigene panel testing differ by race, ethnicity and personal/family history of cancer. This data will inform genetic counseling strategies in regards to cancer risk and management. Data on additional genes updated through 2019 will be presented.

e24063 Background: Coronavirus 19 (COVID-19) is a severe global pandemic and a public health challenge. Patients with COVID-19 and cancer are at an increased risk of poor clinical outcomes. Data is lacking in evaluating outcomes in patients with different cancers, races and ages; particularly in Florida with high proportion of elderly and the largest racial/ethnic disparities. We evaluated the in-hospital mortality of COVID-19 positive cancer patients. Methods: We used retrospective data of COVID-19 patients hospitalized at the Memorial Healthcare System between March 1, 2020 and January 18, 2021. Over 4,870 patients with COVID-19 were evaluated, of which 265 (5.4%) had cancer. The primary endpoint was in-hospital mortality in patients with cancer and COVID-19. Mortality was analyzed in COVID-19 patients with/without a cancer history. We used descriptive statistics to synthesize outcomes and characteristics from the study population. Univariate and multivariate logistic analysis were performed to define baseline clinical characteristics potentially associated with mortality in cancer patients with COVID-19. Results: 4,870 patients with COVID-19 were evaluated and 265 had malignancy. The study included all different races including Non-Hispanic Whites (NHW) 816 (16.8%), Hispanics 2,271 (46.6%), African-Americans (AA) 1,534 (31.5%) and other minorities 248 (5.1%). Of cancer patients, 24.1% NHW, 43% Hispanic, 28.7% AA and 4.2% other minorities. Amongst races, NHW with cancer accounted for the highest number of COVID-related deaths representing 37.5%, while Hispanics and AA accounted for 18.4% and 19.7% respectfully. Amid cancer subtypes, 24.6% of hematological cancers resulted in mortality and 23.5% of solid cancers resulted in mortality, but no statistical significance was seen. Additionally, after adjusting for age, gender, and race, cancer was linked to an increased in-hospital mortality. Lastly, older age (> 65), elevated creatinine levels (Cr) and elevated C-reactive protein (CRP) were associated with increased risk of death. Conclusions: Patients with COVID-19 and cancer had worse outcomes. Cancer subtypes included hematological and solid cancers, with similar in-hospital mortalities. Although NHW were the smallest group, they had the highest rate of in-hospital deaths amongst cancer patients with COVID-19, in comparison to Hispanics, the largest group in the study, had the least amount of in-hospital deaths. Additionally, factors such as advanced age, elevated Cr and CRP were associated with increased risk of COVID-related deaths. The findings indicate the need for close surveillance and monitoring of these patients as they are more likely to have complications such as mortality from COVID-19.