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2038. COVID-19 in an Inner-City Lung Cancer Screening Cohort
Authors * Denotes Presenting Author
  1. Elliot Shulman *; Albert Einstein College of Medicine
  2. Linda Haramati; Montefiore Medical Center
  3. Edward Mardakhaev; Northwell Health
  4. Abraham Kessler; Montefiore Medical Center
  5. Maria Serrano; Montefiore Medical Center
  6. Kapil Wattamwar ; Montefiore Medical Center
Objective:
The COVID-19 pandemic peaked during spring 2020 in New York, with the highest rates of infection and mortality in underserved populations. Our lung cancer screening program in the Bronx, NY primarily serves an ethnic minority and impoverished inner-city population. We evaluated COVID-19 infection in this cohort.

Materials and Methods:
IRB approval was obtained for ongoing retrospective study of institution’s clinical lung cancer screening program with waiver of informed consent. COVID-19 infection was diagnosed in 2.3% (57/2529) of patients who underwent CT for lung cancer screening since the program’s inception, December 2012 through June 2020. Infection was confirmed with a positive SARS-Cov-2 PCR, positive antibody test, or documented infection in EMR. Patients with suspected COVID-19 infection were followed up via phone call for confirmation. COVID-19-related admissions and mortality were recorded along with demographics and comorbidities. Bivariate analysis was performed; p-value <0.05 was considered significant.

Results:
Lung cancer screening patients who were diagnosed with COVID-19 had a mean age of 67 ± 6 years, included 51% (29 of 57) women, and had a mean BMI of 30 ± 7.3 kg/m2. The majority were ethnic minorities, including 28% (16 of 57) Black/African-American and 47% (27 of 57) Hispanic. As compared to the overall lung cancer screening population, patients with COVID-19 were more likely to be Hispanic (47.3% vs 36.6%, p=.096), and less likely to be White (22.4% vs 14%, p=.15). Mortality was 19% (11 of 57), and 14% (8 of 57) were admitted to the hospital. Comorbidities included: hypertension - 77% (44 of 57), diabetes - 42% (24 of 57), chronic obstructive pulmonary disease - 39% (22 of 57), chronic kidney disease - 28% (16 of 57), asthma - 21% (12 of 57), congestive heart failure - 18% (10 of 57), myocardial infarction- 12% (7 of 57). The mean age-adjusted Charlson score was 5.91 ± 2.39 among those who died versus 4.43 ± 2.58 for those who survived (p = .1).

Conclusion:
COVID -19 infection in our inner-city lung cancer screening cohort, an ethnic-minority predominant population with multiple comorbidities, had a mortality rate of 19%. COVID-19 mortality for the 2529-person screening cohort was 0.43%, higher than for the broader population of the Bronx (0.28%), likely reflecting the multiple comorbidities and older age of the lung cancer screening cohort.