SARS-CoV-2 Testing, Positivity Rates, and Healthcare Outcomes in a Cohort of 22,481 Breast Cancer Survivors.
JCO Clin Cancer Inform
; 5: 168-175, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-1063206
ABSTRACT
PURPOSE:
As health inequities during the pandemic have been magnified, we evaluated how use of SARS-CoV-2 testing differed by race or ethnicity in a large cohort of breast cancer survivors and examined the correlates of testing positive.METHODS:
We conducted a retrospective cohort study of 22,481 adult breast cancer survivors who were active members of a large California integrated healthcare plan in 2020. We collected data on their breast cancer diagnosis, comorbidity, and demographic characteristics. We examined SARS-CoV-2 testing utilization between March 2020 and September 2020 by race or ethnicity, comorbidity, and other patient characteristics. We also examined the correlates of a having a positive SARS-CoV-2 test result. We conducted bivariable and multivariable logistic regression to identify correlates of testing utilization and test positivity.RESULTS:
Of these 22,481 women, 3,288 (14.6%) underwent SARS-CoV-2 testing. The cohort included 51.8% women of color. Of the 3,288 tested, 264 (8.0%) women had a positive test result. In multivariable analyses, Latinx survivors were more likely (adjusted odds ratio [OR], 1.23; 95% CI, 1.12 to 1.34) to undergo testing than White survivors; however, Asian or Pacific Islander survivors were 16% less likely to get tested (adjusted OR, 0.84; 95% CI, 0.75 to 0.94). Compared to White survivors, Latinx survivors were 3.5 times (adjusted OR, 3.47; 95% CI, 2.52 to 4.77) and Asian or Pacific Islander or Other survivors were 2.2-fold (adjusted OR, 2.23; 95% CI, 1.49 to 3.34) more likely to test positive. Being overweight (adjusted OR, 1.83; 95% CI, 1.24 to 2.72) or obese (adjusted OR, 2.04; 95% CI, 1.39 to 2.98) were also strongly associated with SARS-CoV-2 positivity.CONCLUSION:
Even in an integrated healthcare system, Asian or Pacific Islander patients were less likely to undergo SARS-CoV-2 testing than White survivors, but more likely to test positive. Additionally, Latinx ethnicity and high body mass index were strongly correlated with a greater odds of SARS-CoV-2 test positivity.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Breast Neoplasms
/
Healthcare Disparities
/
Cancer Survivors
/
COVID-19 Testing
/
SARS-CoV-2
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
JCO Clin Cancer Inform
Year:
2021
Document Type:
Article
Affiliation country:
Cci.20.00158
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