Analyses of Risk, Racial Disparity, and Outcomes Among US Patients With Cancer and COVID-19 Infection
JAMA Oncol. 2021;7(2):220-227. doi:10.1001/jamaoncol.2020.6178
QuanQiu Wang, MS1; Nathan A. Berger, MD2,3; Rong Xu, PhD1,3
Probable reasons include:
1) Suppressed immune system due to chemotherapy
2) Lower vitamin D levels due to cancer
3) Lower vitamin D levels due to dark skin
Note: The word vitamin does not occur once in the PDF
COVID-19 more frequent and deadly for those with dark skins (high risk of low vitamin D)
African American Health Disparities are associated with low Vitamin D - Grant Feb 2021 contains the following chart
Low Vitamin D increases health problems - independent of skin color
Items in both categories Cancer and Skin-Dark are listed here:
- Newly diagnosed Children with Cancer have low vitamin D, especially if black - May 2022
- Cancers and Vitamin D Receptors, including change with race – Feb 2021
- 26 health factors increase the risk of COVID-19 – all are proxies for low vitamin D
- Those with recent cancer diagnosis had 7X increased risk of COVID-19 (more if A-A )- Dec 2020
- More US deaths due to cancer than heart if dark skinned – Sept 2012
- Hypothesis: Blacks get more cancer than whites due to lower levels of vitamin D – June 2012
Download the PDF from VitaminDWiki
2X to 5X increased risk if African-American vs White
Death rate vs race from COVID-19
Importance Patients with specific cancers may be at higher risk than those without cancer for coronavirus disease 2019 (COVID-19) and its severe outcomes. At present, limited data are available on the risk, racial disparity, and outcomes for COVID-19 illness in patients with cancer.
Objectives To investigate how patients with specific types of cancer are at risk for COVID-19 infection and its adverse outcomes and whether there are cancer-specific race disparities for COVID-19 infection.
Design, Setting, and Participants This retrospective case-control analysis of patient electronic health records included 73.4 million patients from 360 hospitals and 317 000 clinicians across 50 US states to August 14, 2020. The odds of COVID-19 infections for 13 common cancer types and adverse outcomes were assessed.
Exposures The exposure groups were patients diagnosed with a specific cancer, whereas the unexposed groups were patients without the specific cancer.
Main Outcomes and Measures The adjusted odds ratio (aOR) and 95% CI were estimated using the Cochran-Mantel-Haenszel test for the risk of COVID-19 infection.
Results Among the 73.4 million patients included in the analysis (53.6% female), 2 523 920 had at least 1 of the 13 common cancers diagnosed (all cancer diagnosed within or before the last year), and 273 140 had recent cancer (cancer diagnosed within the last year). Among 16 570 patients diagnosed with COVID-19, 1200 had a cancer diagnosis and 690 had a recent cancer diagnosis of at least 1 of the 13 common cancers.
Those with recent cancer diagnosis were at significantly increased risk for COVID-19 infection (aOR, 7.14 [95% CI, 6.91-7.39]; P < .001), with the strongest association for recently diagnosed
- leukemia (aOR, 12.16 [95% CI, 11.03-13.40]; P < .001),
- non–Hodgkin lymphoma (aOR, 8.54 [95% CI, 7.80-9.36]; P < .001), and
- lung cancer (aOR, 7.66 [95% CI, 7.07-8.29]; P < .001) and
weakest for thyroid cancer (aOR, 3.10 [95% CI, 2.47-3.87]; P < .001).
Among patients with recent cancer diagnosis, African Americans had a significantly higher risk for COVID-19 infection than White patients; this racial disparity was largest for breast cancer (aOR, 5.44 [95% CI, 4.69-6.31]; P < .001), followed by prostate cancer (aOR, 5.10 [95% CI, 4.34-5.98]; P < .001), colorectal cancer (aOR, 3.30 [95% CI, 2.55-4.26]; P < .001), and lung cancer (aOR, 2.53 [95% CI, 2.10-3.06]; P < .001). Patients with cancer and COVID-19 had significantly worse outcomes (hospitalization, 47.46%; death, 14.93%) than patients with COVID-19 without cancer (hospitalization, 24.26%; death, 5.26%) (P < .001) and patients with cancer without COVID-19 (hospitalization, 12.39%; death, 4.03%) (P < .001).
Conclusions and Relevance In this case-control study, patients with cancer were at significantly increased risk for COVID-19 infection and worse outcomes, which was further exacerbated among African Americans. These findings highlight the need to protect and monitor patients with cancer as part of the strategy to control the pandemic.
In addition, it appears that many cancers have learned how to deactivate the vitamin D Receptor, so that even less Vitamin D gets to cells
Vitamin D Receptor and Cancers
81+ Vitamin D Receptor pages with CANCER in the title
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