Black People With Cancer Have Poorer Covid-19 Outcomes

Black people with cancer who contracted Covid-19 had significantly worse outcomes than white people with cancer who got Covid-19, according to a new study of over 3,500 people, published in JAMA Network Open.

“We saw worse Covid-19 illness at presentation, higher rates of hospitalization, higher rates of intensive care unit admission, higher rates of mechanical ventilation and worse death rates in Black patients compared to non-Hispanic white patients,” said Dimpy Shah, MD, PhD, lead author of the study and assistant professor of population health sciences at The University of Texas Health Science Center at San Antonio, TX.

Black patients with cancer already experience a 15% higher cancer death rate than white patients and the study also noted that Black people represent 13% of the U.S. population, but account for 20% of Covid-19 cases and 23% of Covid-19-related deaths.

To do their work, the team statistically processed the data so the two groups were comparable in terms of cancer type and treatment, finding that the disparity in Covid-19 outcomes persisted and was not due to other factors, such as Black patients having more aggressive cancer types or treatment.

“Race in medicine is largely a social construct because the majority of differences in health outcomes between Black patients and white patients are due to systematic racialization,” Dr. Shah said. “Some of the societal root causes of health disparities, including lack of access to health care, social determinants of health, preexisting comorbidities and access to clinical research, are common to both cancer and Covid-19, and together these two diseases create a perfect storm,” added Shah.

The researchers also looked at the difference in Covid-19 treatments prescribed to Black and white patients. Hydroxychloroquine, a malaria drug which has since proven to be ineffective for treating Covid-19 in several studies, was prescribed to Black patients more frequently. White patients were more likely to be prescribed remdesivir, an FDA-approved antiviral agent.

Patients with cancer have experienced worse Covid-19 outcomes throughout the pandemic due to treatments which can often leave them immunocompromised and other comorbidities. Most people with cancer do respond to Covid-19 vaccines, but some may have a reduced, or absent protective effect, putting them at further risk of severe Covid-19 outcomes.

The new study adds further information about risk of Covid-19 in people with cancer that suggests that Black patients are particularly vulnerable to severe Covid-19 outcomes.

“There have been unfounded claims that structural racism does not exist,” said Shah. “Besides adding to the science of Covid-19 and cancer, this study is important because it is a call to action that structural racism still very much exists, and we can see the evidence of how it affects our minority patients with cancer,” added Shah.

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