LAUSR

Background: The COVID-19 pandemic and response underscore the urgent need for real-time population-level data, especially for vulnerable populations (e.g., cancer patients, racial and ethnic minorities). Smartphone applications (“apps”) facilitate the collection of self-reported data at scale, the results of which can then be rapidly redeployed to inform the public health response. The COVID Symptom Study is an app that was launched March 24, 2020, and is now used by nearly 4 million people in the U.S., U.K., and Sweden. Methods: COVID Symptom Study app users self-report health status (e.g., symptoms, COVID-19 testing, health care utilization), comorbidities, demographics, and key risk factors for infection on a daily basis. Multivariable adjusted logistic regression models were used to determine the association of cancer and race with COVID-19 prevalence, adjusting for age, sex, comorbidities, and risk factors for infection, from app launch through May 25, 2020. Results: Among 23,266 individuals with cancer and 1,784,293 without cancer, we documented 155 and 10,249 self-reports of COVID-19, respectively. Compared to individuals without cancer, those with cancer had an increased risk of COVID-19 (adjusted odds ratio (aOR): 1.60; 95% confidence interval (CI): 1.36-1.88). The association was stronger among older participants >65 compared to younger participants (Pinteraction Conclusion: Our results demonstrate an increase in COVID-19 risk among ethnic minorities and individuals with cancer, particularly those on treatment with chemotherapy/immunotherapy. The association with minorities was not completely explained by other known risk factors for COVID-19 or sociodemographic characteristics. These findings highlight the utility of app-based syndromic surveillance for quantifying the impact of the COVID-19 pandemic on at-risk populations. Citation Format: David A. Drew, Long H. Nguyen, Wenjie Ma, Chun-Han Lo, Amit D. Joshi, Daniel Sikavi, Christina M. Astley, Karla Lee, Mary Ni Lochlainn, Maria Gomez, Sebastien Ourselin, Andrew T. Chan. Cancer and race: Two important risk factors for COVID-19 incidence as captured by the COVID Symptom Study real-time epidemiology tool [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S09-01.