Race, COVID-19 infections, and chronic disease contributed to higher COVID-related hospitalization rates for Black patients compared to white patients, according to new research from scientists at Louisiana State University (LSU) Health, New Orleans, School of Public Health published in the Journal of the National Cancer Institute.
This is the first study to quantify the effect of chronic diseases on racial disparity in COVID-associated hospitalizations.
"Our research findings offer compelling evidence, underscoring that longstanding racial health discrepancies, particularly in chronic disease management, substantially contribute to the significantly higher COVID-19-associated hospitalization rates among non-Hispanic Black cancer patients than their non-Hispanic White counterparts," said first study author Xiao-Cheng Wu, MD, MPH, in an LSU press release.
Researchers cross-referenced surveillance data from Louisiana residents ages 20 and older who were diagnosed as having primary cancer cases from 2015 to 2019 with COVID-19 data to identify cancer patients who tested positive for COVID-19 by RT-PCR or antigen test in 2020.
Cancer patients who also tested positive for COVID-19 were found among hospital inpatient discharge data to identify COVID-associated hospitalizations.
80% higher hospital rate for Black patients
A total of 6,381 cancer patients included in the study tested positive for COVID-19, of which 31.6% were non-Hispanic Black. Of those patients, 79.5% had a chronic disease, including diabetes, high blood pressure, and kidney disease, compared to 66.0% of White cancer patients with COVID-19.
Black patients also had a higher rate of COVID-associated hospitalization compared to White peers (27.2% vs 17.2%).
This work demonstrates that COVID-19 infection exacerbates the health disparities.
Overall, the odds of COVID-19–associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio, 1.80; 95% confidence interval, 1.59 to 2.04).
High blood pressure, diabetes, and chronic renal disease were the top chronic diseases and explained 9.6%, 8.9%, and 7.3% of the racial disparity, respectively, between COVID-associated hospitalization for Black and White patients.
"This work demonstrates that COVID-19 infection exacerbates the health disparities caused by Cancer in the most underserved populations in our state," said lead researcher Augusto Ochoa, MD.
Chronic disease likely contributed substantially to worse COVID-19 outcomes among Black cancer patients, the authors concluded, and targeted interventions are needed to address the disparities.