COVID-19 Disproportionately Affects Black Women With Gynecologic Cancer

Black women with gynecologic cancer constituted a significant portion of patients hospitalized for and who died from COVID-19—despite only making up a third of the patient population, according to a study.

“Mounting evidence suggests disproportionate coronavirus disease 2019 (COVID‐19) hospitalizations and deaths because of racial disparities. The association of race in a cohort of gynecologic oncology patients with severe acute respiratory syndrome‐coronavirus 2 infection is unknown,” the researchers reported.

The study authors collected data from patients from eight New York City area hospital systems who had gynecologic cancer and COVID-19. They implemented a multivariable mixed-effects logistic regression model that took into consideration county clustering. The main outcome was COVID-19 hospitalization and mortality.

A total of 193 patients with gynecologic cancer were identified, of whom a third were Black (n=67 [34.7%]), and two-thirds were non-Black (n=126, 65.3%).

Black patients, compared to non-Black patients, were more likely to require hospitalization (n=48/67 [71.6%] vs. n=58/126 [46%]; P=0.001). Despite only constituting a third of the study population, Black patients accounted for two in five of the 34 patients (17.6%) who died from COVID-19 (n=14 [41.2%]).

• In the hospitalized cohort, Black patients, compared to non-Black patients, had a higher likelihood of the following:
• have ≥3 comorbidities (n=30/37] [81.1%] vs. n=29/49 [59.2%]; P=0.05)
• reside in Brooklyn (n=17/21 [81.0%] vs. n=12/27 [44.4%]; P=0.02)
• live with family (n=25/36 [69.4%] vs. n=37/89 [41.6%]; P=0.009)
• have public insurance (n=39/49 [79.6%] vs. n=39/73 [53.4%]; P=0.006)

Multivariate analysis found that Black patients aged younger than 65 years had a higher risk for hospitalization than non-Black patients aged younger than 65 years (odds ratio, 4.87; 95% confidence interval, 1.82-12.99; P=0.002).

The study was published in Cancer.

“Although Black patients represented only one‐third of patients with gynecologic cancer, they accounted for disproportionate rates of hospitalization (>45%) and death (>40%) because of COVID‐19 infection; younger Black patients had a nearly 5‐fold greater risk of hospitalization. Efforts to understand and improve these disparities in COVID‐19 outcomes among Black patients are critical,” the researchers concluded.