Factors Associated With Hospitalization Among Breast Cancer Patients With COVID-19: A Diverse Multi-Center Los Angeles Cohort Study

Kathuria‐Prakash, Nikhita; Antrim, Lauren; Hornstein, Nicholas; Sun, Alexander W.; Kang, Irene; Baclig, Nikita V.; Angell, Trevor E.; Lechner, Melissa G.; Wald-Dickler, Noah; In, Gino K

doi:10.1016/j.clbc.2021.12.005

Cited by 4 publications

(5 citation statements)

References 40 publications

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“… COVID-19 imposes an increased risk of mortality in breast cancer patients. Kathuria-Prakash et al, USA 115 Observational study 1 Jan 2020–31 Dec 2020 132 (60 years) Hospitalization of breast cancer patients with COVID-19 Older age*, comorbidities**, lobular subtype*, and Hispanic/Latinx ethnicity* were significantly associated with hospitalization. Endocrine therapy might protect from worse conditions.…”

Section: Resultsmentioning

confidence: 99%

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Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Prodhan

Islam

Khandker

et al. 2023

BCTT

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During the COVID-19 pandemic, several priority diseases were not getting sufficient attention. Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients’ conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient’s mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.

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Section: Resultsmentioning

confidence: 99%

“…Older age, the presence of comorbidities, lobular subtype, and Hispanic/Latinx ethnicity were significantly associated with hospitalization due to COVID-19. 115 …”

Section: Resultsmentioning

confidence: 99%

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Prodhan

Islam

Khandker

et al. 2023

BCTT

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“…A COVID-19 and Cancer Consortium (CCC19) registry-based study showed that Black cancer patients suffered from significantly more severe cases of COVID-19 than White patients, measured by a 5-level ordinal scale including hospitalization, mechanical ventilation, and all-cause mortality [6]. Kathuria-Prakash et al reported that Hispanic/Latinx ethnicity had a higher hospitalization rate among breast cancer patients with COVID-19 [7], and our results on GI cancer reflect a similar pattern. Also, based on the UC CORDS dataset, Kwon et al identified Hispanic ethnicity as a risk factor for hospitalization but no racial/ethnical disparities in mechanical ventilation and death within 30 days following COVID-19 among cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…A few epidemiological studies have investigated the racial disparities in clinical prognosis among cancer patients with COVID-19. A significantly increased risk of hospitalization and mortality for patients with cancer in general [3][4][5][6] or specific cancer (e.g., breast [7], gynecological [8], hematological [9], and prostate cancer [10]) was reported among racial minorities including African Americans (AA) or Blacks, American Indians and Alaska Natives (AI/AN), Asians and Pacific Islanders (API), and Hispanics.…”

Section: Introductionmentioning

confidence: 99%

Racial Disparities in the Clinical Prognosis of Gastrointestinal Cancer Patients with COVID-19: a Retrospective Study in UC CORDS

2023

J. Racial and Ethnic Health Disparities

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Background Cancer patients are highly vulnerable to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Few studies have examined racial disparities of clinical prognosis among gastrointestinal (GI) cancer patients with COVID-19, especially after the approval of COVID-19 vaccines. Methods We conducted a retrospective study based on the University of California COVID Research Data Set (UC CORDS). Patients aged ≥ 18 with GI cancer as well as SARS-CoV-2 infection between March 10, 2020, and May 8, 2022, were included. We examined racial disparities using multivariable logistic regression. Results Among the 1054 GI cancer cases included, 117 (11.1%) patients were Asian and Pacific Islander, 51 (4.8%) were Black patients, 377 (35.8%) were Hispanic patients, 403 (38.2%) were White patients, and 106 (10.1%) belonged to other or unknown races. Fully adjusted logistic models revealed a significantly increased risk of COVID-19-related hospitalization or emergency room visits among the Black (OR = 2.26, 95% CI = 1.08–4.70), the Hispanic (OR = 2.24, 95% CI = 1.48–3.39), and the patients of other or unknown races (OR = 1.80, 95% CI = 1.00–3.26) compared with the White patients. No significant racial disparities in 30-day all-cause mortality and mechanical ventilation rate were found. Vaccination, age, cancer type, recent cancer diagnoses in UC CORDS, metastatic cancer or secondary malignant neoplasm, and Charlson comorbidity index score were associated with the prognosis of GI cancer patients with COVID-19. Conclusions GI cancer patients belonging to racial minorities experience worse COVID-19 outcomes. Vaccination status is a crucial factor associated with GI cancer patients’ prognosis among different race/ethnicity groups. Targeted communication in the context of cancer is needed to encourage vaccination uptake in this vulnerable population.

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“…In our study, the patients with antitumor treatment did not experience severe COVID-19, and no exacerbation of symptoms was observed even in patients who were still symptomatic at the time of antitumor therapy. Previous studies showed that advanced age and comorbidities were significantly associated with hospitalization ( 20 ). In our study, the average age of patients is less than 60 years old, so there were fewer comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Comparison of adverse effects of anti-tumor therapy for breast cancer shortly after COVID-19 diagnosis vs. the control period

Ding,

Xiang,

et al. 2023

Front. Oncol.

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BackgroundCOVID-19 is an acute infectious disease caused by SARS-CoV-2. The best time to restart antitumor therapy in breast cancer patients after SARS-CoV-2 infection is unknown. This study aimed to evaluate treatment-related adverse events in breast cancer patients who received antitumor therapies within a short time after SARS-CoV-2 infection (observation) as well as before (control) and to provide safety data.MethodsWe conducted a self-controlled cohort study using the data from the Breast Disease Center of Peking University First Hospital. We identified patients who received antitumor therapy within 28 days after COVID-19 infection between December 20, 2022, and January 20, 2023. The primary outcome was treatment-related adverse events. McNemar’s test was used to compare the incidence rate of adverse reactions between periods.ResultsWe identified 183 patients with breast cancer, of whom 109 were infected with SARS-CoV-2 within 28 days before antitumor treatment and were included. In total, 28 patients (25.7%) received neoadjuvant therapy, 60 (55.0%) received adjuvant therapy, and 21 (19.3%) received advanced rescue therapy. None of patients required hospitalization for severe or critical COVID-19, but 15 patients (13.8%) still had sequelae of COVID-19 while receiving antitumor treatment. The most common adverse events were peripheral neuropathy (n = 32 [29.4%]), pain (n = 29 [26.6%]), fatigue (n = 28 [25.7%]), nausea (n = 23 [21.1%]), and neutropenia (n = 19 [17.4%]). There was no increased risk of overall treatment-related adverse events (n = 87 [79.8%] vs. n = 91 [83.5%]; p = 0.42) or serious adverse events (n = 13 [11.9%] vs. n = 12 [11.0%]; p = 1.00) from receiving antitumor therapy shortly after the diagnosis of COVID-19. We also found no increased risk in subgroup analyses, and no patients discontinued antitumor therapy due to adverse events.ConclusionRestarting antitumor therapy 2-4 weeks after having mild or moderate COVID-19 is a relatively safe strategy for breast cancer patients that does not increase the risk of treatment-related adverse events.

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Factors Associated With Hospitalization Among Breast Cancer Patients With COVID-19: A Diverse Multi-Center Los Angeles Cohort Study

Cited by 4 publications

References 40 publications

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Racial Disparities in the Clinical Prognosis of Gastrointestinal Cancer Patients with COVID-19: a Retrospective Study in UC CORDS

Comparison of adverse effects of anti-tumor therapy for breast cancer shortly after COVID-19 diagnosis vs. the control period

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