Abstract
The goal of this work is to investigate the sociodemographic characteristics and health status of women with breast cancer (BC) in association with COVID-19 by menopausal status. In a Swedish register-based cross-sectional study, we compared women with BC and with or without a positive COVID-19 test, stratified by menopausal status (age ≥ 51 years). Socioeconomic characteristics and health status (represented by diagnoses registered in 5 years- and prescription dispensed in 2 years preceding Jan 2020) were considered in association with COVID-19 diagnosis. The study population included 38,523 women with BC. Median age at BC diagnosis was 45 years (IQR = 40-48) for premenopausal- and 67 (IQR = 60-73) for postmenopausal BC. A logistic regression model was used and found the significant covariate effects (adjusted odds ratios, ORs) for a positive COVID-19 test among women with premenopausal BC to be being born outside of Europe: 1.29, (1.13-1.46), being married: 1.23, (1.12-1.36), being unemployed 1.92 (1.59-2.30), having upper secondary school education 1.25 (1.01-1.54), having > 15 outpatient visits: 1.31, (1.07-1.61), and a history of being admitted to hospital 1-5 times: 1.12 (1.01-1.25). Corresponding significant covariate effects among women with postmenopausal BC were being born outside of Europe: 1.61 (1.41-1.83), being married: 1.12 (1.04-1.21), and being unemployed 1.54 (1.40-1.69). Postmenopausal women furthermore had more outpatient visits or hospital admissions before the pandemic in COVID-19 positive patients compared to patients without a COVID-19 positive test, e.g. 1.47 (1.26-1.71) for > 15 outpatient visits compared with no visit and 6.35 (3.33-12.11) for > 15 hospital admissions compared with no admission. Varied socioeconomical and clinical conditions were more frequent among patients with a positive COVID-19 test compared to patients without a positive test among women with BC in pre- or post-menopausal status. We conclude that some characteristics of women such as unemployment, country of birth or health status measured by number of prescribed drugs were more prevalent among women who developed COVID-19 compared to women without COVID-19 diagnosis and either of menopausal status of breast cancer.