Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using electronic medical records

Abstract: Assessment of Vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using Electronic Medical Records Aaron Galaznik, MD MBA1 | Emelly Rusli, MPH1 | Vicki Wing, MS1 | Rahul Jain, PhD1 | Sheila Diamond, MS CGC1 | David Fajgenbaum, MD MBA MSc FCPP2 1 Medidata Acorn AI, a Dassault Systèmes company, New York, NY, 10014 | 2 Castleman Disease Collaborative Network and the University of Pennsylvania, Philadelphia, PA, 19104 RESULTS BACKGROUND BACKGROUND • • While patients with cancer are known to be at increased risk of infection in part due to the immunocompromising nature of cancer treatments, recent data indicate a particularly high risk for COVID-19 infection and poor outcomes. 1 • Our study suggests potentially vulnerable populations, such as breast and prostate cancer patients, may have an elevated risk of COVID-19 infection if vitamin D deficient. Vitamin D deficiency has been previously reported in two leading causes of cancer deaths: breast and prostate. 4 • In this study, we performed a retrospective cohort analysis on nationally representative electronic medical records (EMR) to assess whether vitamin D deficiency affects risk of COVID19 among these patients. Vitamin D may play an important role in COVID-19. A recent study demonstrated vitamin D deficiency may increase risk of COVID-19 infection, and a small randomized controlled trial in Spain reported significant improvement in mortality among hospitalized patients treated with calcifediol. 2,3 METHODS Figure 1. Study Timeline • A total of 16,287 breast cancer and 14,919 prostate cancer patients were included in the study. (Figure 2) Table 1. Patient Demographic and Clinical Characteristics Breast Cancer TOTAL (N = 16,287) Patient Characteristics N/Mean %/SD N/Mean %/SD 68.9 11.3 73.6 8.5 <70 years (n, %) 7,962 48.9% 4,625 31.0% 70-79 years (n, %) 5,368 33.0% 6,499 43.6% 80+ years (n, %) 2,957 18.2% 3,795 25.4% 16,287 100.0% 0 0.0% 0 13,805 2,102 305 16 49 10 0.0% 84.8% 12.9% 1.9% 0.1% 0.3% 0.1% 14,919 12,390 2,405 89 12 22 1 100.0% 83.1% 16.1% 0.6% 0.1% 0.1% 0.0% 2,384 14.6% 1,318 8.8% 1.1 1.5 1.4 1.7 Congestive heart failure (n, %) 1,075 6.60% 1,483 9.94% Obesity (n, %) 5,036 30.9% 4,627 31.0% Diabetes mellitus (n, %) 3,327 20.4% 3,897 26.1% 356 2.2% 303 2.0% 1,730 10.6% 2,371 15.9% Age (Mean, SD) Sex (n, %) Female Male White Race (n, %) Black Asian Native Hawaiian/Pacific Islander American Indian or Alaska Native Missing Vitamin D deficient (n, %) Comorbid Conditions Quan Charlson Comorbidity Index (Mean, SD) Liver disease (n, %) Figure 2. Patient Attrition Patient with ≥ 1 encounter between 3/1/2018 and 3/1/2019, and after 3/1/2020 (index date) Age ≥ 18 and non-missing sex and race n = 1,630,384 (52.8%) • • • Patients with breast (female) or prostate (male) cancer were identified between 3/1/2018 and 3/1/2020 from Healthjump EMR data provided pro-bono by the COVID-19 Research Database.5 Logistic regressions, adjusted for baseline demographic and clinical characteristics assessed in the 12 months prior to 3/1/2020, were conducted to estimate the effect of • • The average age was 68.9 years in the breast cancer cohort and 73.6 years in the prostate cancer cohort. (Table 1) • Approximately 15% of the breast cancer cohort and 9% of the prostate cancer cohort had vitamin D deficiency. • The most common comorbid conditions were obesity (approximately a third..