{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:50:50Z","timestamp":1785433850294,"version":"3.56.0"},"reference-count":41,"publisher":"eLife Sciences Publications, Ltd","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"},{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"},{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"National Cancer Institute","award":["P30 CA068485"],"award-info":[{"award-number":["P30 CA068485"]}]},{"name":"National Cancer Institute","award":["P30-CA046592"],"award-info":[{"award-number":["P30-CA046592"]}]},{"name":"National Cancer Institute","award":["P30 CA023100"],"award-info":[{"award-number":["P30 CA023100"]}]},{"name":"National Cancer Institute","award":["P30-CA054174"],"award-info":[{"award-number":["P30-CA054174"]}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"crossref","award":["MRSG-16-152-01 -CCE"],"award-info":[{"award-number":["MRSG-16-152-01 -CCE"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Center for AdvancingTranslational Sciences, National Institute of Health,","award":["KL2 TR002646"],"award-info":[{"award-number":["KL2 TR002646"]}]}],"content-domain":{"domain":["elifesciences.org"],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,9,18]]},"abstract":"<jats:sec id=\"abs1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial\/ethnic populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32\u20131.67]); Black patients (aOR 1.74; 95 CI 1.24\u20132.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70\u20136.79) and Other (aOR 2.97; 95 CI 1.71\u20135.17) racial\/ethnic groups; worse ECOG performance status (ECOG PS \u22652: aOR, 7.78 [95% CI, 4.83\u201312.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63\u20133.15])\/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20\u20132.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66\u20133.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89\u201322.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial\/ethnic patients experienced worse outcomes compared to non-Hispanic White patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs5\">\n                    <jats:title>Funding:<\/jats:title>\n                    <jats:p>This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS\/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs6\">\n                    <jats:title>Clinical trial number:<\/jats:title>\n                    <jats:p>\n                      CCC19 registry is registered on ClinicalTrials.gov,\n                      <jats:related-object document-id=\"NCT04354701\" document-id-type=\"clinical-trial-number\" id=\"RO1\" source-id=\"ClinicalTrials.gov\" source-id-type=\"registry-name\" source-type=\"clinical-trials-registry\" xlink:href=\"https:\/\/clinicaltrials.gov\/show\/NCT04354701\">NCT04354701<\/jats:related-object>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7554\/elife.82618","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T06:30:13Z","timestamp":1697524213000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.82618","source":"Crossref","is-referenced-by-count":2,"title":["Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study"],"prefix":"10.7554","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04354701","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7586-6920","authenticated-orcid":true,"given":"Gayathri","family":"Nagaraj","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04bj28v14","id-type":"ROR","asserted-by":"publisher"}],"name":"Loma Linda University Cancer Center","place":["Loma Linda, United 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