COVID-19 severity is higher in male cancer patients compared to females

Reviewed by Emily Henderson, B.Sc.Nov 23 2020

Men with cancer and COVID-19 may be at significantly higher risk for severe symptoms and even death as compared to females fighting both, a University of Kansas Cancer Center research team has found.

Anup Kasi, M.D., MPH, assistant professor of oncology at the University of Kansas Medical Center and The University of Kansas Cancer Center, and his team analyzed information from multiple studies involving patients with both cancer and COVID-19.

The odds of male cancer patients suffering severe illness or death from COVID-19 are 60 percent higher compared to female patients, their research showed.

Knowing this propensity for poorer outcomes in males with COVID-19 and cancer will help physicians make better decisions in caring for them in clinical settings."

Anup Kasi, M.D, MPH, Assistant Professor, Oncology, University of Kansas Medical Center

About the study

The news was initially published in EClinical Medicine, a clinical journal published online by The Lancet. The Lancet, a prestigious international weekly medical journal, then carried an updated version of the study in its "Gender Equality and Health" article collection.

Clinicians also learned of the study findings through medical news sites such as ESMO, Medwire and Medicine Matters.

"We were especially happy that ESMO highlighted our study to raise awareness among the cancer community," Kasi said. "Both ESMO and The Lancet are selective in what they choose to share."

The research team collected 17 different studies about COVID-19 and cancer from when COVID-19 first appeared to June 2020. They scoured medical-publication databases and proceedings from online conferences to study a total of 3,968 patients who battled both COVID-19 and cancer.

In addition to Kasi, the research team from The University of Kansas Cancer Center included:

• Kathan Mehta, M.D., MPH, assistant professor of oncology
• Weijing Sun, M.D., FACP, professor and division director of oncology
• Elizabeth Wulff-Burchfield, M.D., assistant professor of oncology

Building on prior research

In studies prior to this, other researchers had noted a higher death rate for men who contracted COVID-19. In fact, China, Italy and Ireland reported that men accounted for 70 percent of all COVID-19 deaths.

Would such gender differences also apply to cancer patients? "We didn't know if the same gender differences in severity risk would still apply or not," Kasi said.

That's because cancer and the impact of cancer treatment, such as chemotherapy, immunotherapy or targeted therapy, could have drastically changed that "gender factor." Instead, they found that the rates of severe symptoms and death in male patients with cancer were comparable with the general population.

Local cohort

Within days of the EClinical Medicine publication, Kasi and Mehta presented related information at a meeting of the American Association for Cancer Research.

Instead of searching far and wide for a patient pool to study, the two looked closer to home. They analyzed factors that might contribute to the severity of COVID-19 symptoms in cancer patients using only patients from the University of Kansas Cancer Center.

Those patients were asked to join a list of cancer patients across the United States who contracted COVID-19. These lists, called registries, were set up to help researchers identify trends and treatments for this unique population fighting a very new virus.

At KU Cancer Center, patients could register for three different registries, including:

• COVID-19 and Cancer Consortium (CCC19)
• American Society of Clinical Oncology (ASCO) Registry
• National Cancer Institute COVID-19 in Cancer Patients Study (NCCAPS)

Larger cohort

The University of Kansas Cancer patients who opted into the CCC-19 registry were also included in a larger-scale study of COVID-19's effects on cancer patients published three months earlier.

That study encompassed 928 patients from the United States, Canada and Spain and included Kasi and Wulff-Burchfield as authors.

It also showed a higher mortality rate for males fighting cancer and COVID-19 as compared to females, though its focus was broader than the KU Cancer Center's EClinical Medicine study and included sex difference as only one of many factors studied.

"The data behind risk factors for COVID-19 in the general population as well as in the cancer patient population is still evolving," Kasi said. "But the takeaway message is that the male sex may be a potential risk factor in the cancer patient population for poor outcomes with COVID-19 infections."