The severity of COVID-19 is greater in male cancer patients than in females

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

Men with cancer and COVID-19 may have a significantly higher risk of severe symptoms and even death than women who fight both, a research team from the University of Kansas Cancer Center has found.

Anup Kasi, MD, 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 cancer and COVID-19.

The odds of male cancer patients suffering from serious illness or death from COVID-19 are 60 percent higher than female patients, their research has shown.

Knowing this propensity for worse outcomes in males with COVID-19 and cancer will help doctors make better decisions about caring for them in the clinical setting. “

Anup Kasi, MD, 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 published an updated version of the study in its collection of articles “Gender Equality and Health”.

Doctors also learned of the study results through medical news sites like ESMO, Medwire, and Medicine Matters.

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

The research team collected 17 different studies on COVID-19 and cancer since COVID-19 first appeared in June 2020. It sifted through databases of medical publications and online conference proceedings to study a total of 3,968 patients who have fought both COVID-19 and cancer.

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

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

Building on previous research

In studies prior to this, other researchers had noted a higher death rate for men who had contracted COVID-19. In fact, China, Italy, and Ireland reported that men accounted for 70% 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 hold true,” Kasi said.

This is because cancer and the impact of cancer treatment, such as chemotherapy, immunotherapy, or targeted therapy, may have drastically changed that “gender factor”. Instead, they found that the rates of severe symptoms and death in male cancer patients were comparable to those in the general population.

Local cohort

A few days after the publication of EClinical Medicine, Kasi and Mehta presented the relevant information at a meeting of the American Association for Cancer Research.

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

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

At the 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

University of Kansas cancer patients who opted for the CCC-19 registry were also included in a large-scale study on the effects of COVID-19 on cancer patients published three months earlier.

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

It also showed a higher death rate for males battling cancer and COVID-19 than females, although its focus was broader than the KU Cancer Center clinical medicine study and included sex difference as only one of the many factors studied.

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