Vaidya Leah, Rizvi Nubaira, Wu Xiao-Cheng, Maniscalco Lauren S, Yi Yong, Ochoa Augusto, Yu Qingzhao
Biostatistics and Data Science, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Louisiana Tumor Registry, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Sci Rep. 2025 Mar 26;15(1):10407. doi: 10.1038/s41598-025-95037-3.
Previous research demonstrated Non-Hispanic Black populations experience higher COVID-19 mortality rates than Non-Hispanic White individuals. Additionally, cancer status is a known risk factor for COVID-19 death. While prior studies investigated comorbidities as exploratory variables in differences in COVID-19 hospitalization, none have explored their role in COVID-19-related deaths. This study aimed to evaluate whether Charlson Comorbidity Index (CCI) and subsequently, individual diseases are potential explanatory variables for this relationship. The analysis focused on Non-Hispanic Black and Non-Hispanic White cancer patients aged 20 or older, diagnosed between 2011 and 2019, who tested positive for COVID-19 from the start of pandemic through June 30, 2021 from Louisiana Tumor Registry. Two separate mediation analyses were conducted. First checked whether overall comorbidity, measured by CCI, could explain the difference in COVID-19 mortality. If so, further checked which individual comorbidities contributed to this difference. The hazard rate for Non-Hispanic Black cancer patients dying from COVID-19 was 6.46 times than that of Non-Hispanic White patients. The CCI accounted for 12.7% of the differences observed in COVID-19 mortality, with renal disease as the top contributor, explaining 4.9%. These findings could help develop interventions to reduce COVID-19 mortality and address the disproportionate impact, especially by managing chronic conditions like renal disease.
先前的研究表明，非西班牙裔黑人人群的新冠病毒病（COVID-19）死亡率高于非西班牙裔白人。此外，癌症状态是已知的COVID-19死亡风险因素。虽然先前的研究将合并症作为COVID-19住院差异的探索性变量进行了调查，但尚无研究探讨它们在COVID-19相关死亡中的作用。本研究旨在评估查尔森合并症指数（CCI）以及随后的个体疾病是否是这种关系的潜在解释变量。分析聚焦于2011年至2019年期间诊断出、年龄在20岁及以上、从大流行开始至2021年6月30日期间COVID-19检测呈阳性的非西班牙裔黑人和非西班牙裔白人癌症患者，数据来自路易斯安那肿瘤登记处。进行了两项独立的中介分析。首先检查以CCI衡量的总体合并症是否可以解释COVID-19死亡率的差异。如果是这样，进一步检查哪些个体合并症导致了这种差异。非西班牙裔黑人癌症患者死于COVID-19的风险率是非西班牙裔白人患者的6.46倍。CCI占观察到的COVID-19死亡率差异的12.7%，其中肾病是最大的促成因素，解释了4.9%。这些发现有助于制定干预措施以降低COVID-19死亡率，并解决这种不成比例的影响，特别是通过管理肾病等慢性病。
