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Sullivan M, Lei X, Giordano SH, Chavez-MacGregor M. Breast cancer (BC) and severe COVID-19 (C-19) outcomes: a matched analysis. Breast Cancer Res Treat 2024:10.1007/s10549-024-07301-1. [PMID: 38580882 DOI: 10.1007/s10549-024-07301-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/21/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE Patients with cancer receiving anticancer treatment have a higher risk of severe COVID-19 (C-19) outcomes. We examine the association between breast cancer (BC), recent treatment (systemic therapy, surgery, radiation), and C-19 outcomes. METHODS Retrospective matched cohort study using the Optum® de-identified C-19 Electronic Health Record dataset (2007-2022). Patients with C-19 were categorized into: no cancer, BC with recent treatment, and BC without recent treatment and matched based on age, C-19 diagnosis date, and comorbidity score. We evaluated 30-day mortality, mechanical ventilation, intensive care unit (ICU) stay, and hospitalization. A composite outcome including all outcomes was analyzed. Multivariable logistic regression models were used. RESULTS 2200 matched triplets (1:1:10) of patients with BC recently treated, BC not recently treated, and no cancer were included. Rates of adverse outcomes improved in 2021 compared to 2020. Compared to patients without cancer, those with BC recently treated had a similar risk of adverse outcomes, while patients with BC not recently treated had a lower risk of ICU stay and hospitalization. Using the composite variable, BC recently treated had similar outcomes (OR = 1.02; 95%CI 0.93-1.11) to patients without cancer, while BC patients not recently treated had better outcomes (OR = 0.66; 95%CI 0.59-0.74). Among patients with BC, chemotherapy within 3 months was associated with a higher risk of hospitalization (OR = 2.30; 95%CI 1.76-2.99) and composite outcome (OR = 2.11; 95%CI 1.64-2.72). CONCLUSION Patients with BC have a similar risk of adverse C-19 outcomes compared to patients without cancer. Among patients with BC, recent chemotherapy was associated with a higher risk of hospitalization.
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Affiliation(s)
- Marija Sullivan
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiudong Lei
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1444, Houston, TX, 77030, USA
| | - Sharon H Giordano
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1444, Houston, TX, 77030, USA
- Division of Cancer Medicine, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mariana Chavez-MacGregor
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1444, Houston, TX, 77030, USA.
- Division of Cancer Medicine, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Xu W, Zhao J, Luan F, Zhang Z, Liu L, Zhao H, Feng B, Fu G. Survival and safety analysis of COVID-19 vaccine in Chinese patients with non-small cell lung cancer. Cancer Med 2024; 13:e7032. [PMID: 38651178 PMCID: PMC11036071 DOI: 10.1002/cam4.7032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 disease (COVID-19) has caused a worldwide challenging and threatening pandemic. We aimed to assess the safety and efficacy of the COVID-19 vaccines in Non-Small Cell Lung Cancer (NSCLC) patients. METHODS Patient self-reported adverse events related to vaccines were recorded by follow-up through a uniform questionnaire. Survival analysis was performed by Kaplan-Meier method. A multivariate analysis was performed by the Cox proportional hazard regression model to determine the effect of each variable on the survival of lung cancer patients. RESULTS A total of 860 patients with NSCLC on treatment were enrolled. Mean age was 57 years in patients with early stage group and 62 years in advanced stage group. The vaccination rate was 71.11% for early-stage patients and 19.48% for advanced-stage patients; most of them (86.5%) received the COVID-19 inactivated virus (Vero cell) vaccine (Coronavac; Sinovac). The most common systemic adverse reaction was weakness. The main reason for vaccine refusal in those unvaccinated patients was concern about the safety of vaccination in the presence of a tumor and undergoing treatment (56.9% and 53.4%). The 1-year disease-free survival (DFS) rate was 100% for vaccinated and 97.4% for unvaccinated early-stage patients. Then we compared the progression-free survival (PFS) of vaccinated (median PFS 9.0 months) and unvaccinated (median PFS 7.0 months) advanced stage patients (p = 0.815). Advanced NSCLC patients continued to be divided into groups receiving radio-chemotherapy, immunotherapy, and targeted therapy, with no statistical difference in PFS between the groups (p > 0.05). The median overall survival (OS) of vaccinated patients was 20.5 months, and that of unvaccinated patients was 19.0 months (p = 0.478) in advanced NSCLC patients. CONCLUSIONS COVID-19 vaccination is safe for Chinese NSCLC patients actively receiving different antitumor treatments without increasing the incidence of adverse reactions, and vaccination does not affect cancer patient survival.
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Affiliation(s)
- Wei Xu
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Department of Medical Oncology, Shandong Provincial HospitalCheeloo College of Medicine, Shandong UniversityJinanShandongChina
| | - Jing Zhao
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Fang Luan
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Zhizhao Zhang
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Lei Liu
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Hui Zhao
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Bin Feng
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
| | - Guobin Fu
- Department of Medical OncologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Department of Medical Oncology, Shandong Provincial HospitalCheeloo College of Medicine, Shandong UniversityJinanShandongChina
- Department of Medical OncologyThe Third Affiliated Hospital of Shandong First Medical UniversityJinanShandongChina
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Llanos AAM, Fong AJ, Ghosh N, Devine KA, O'Malley D, Paddock LE, Bandera EV, Hudson SV, Evens AM, Manne SL. COVID-19 perceptions, impacts, and experiences: a cross-sectional analysis among New Jersey cancer survivors. J Cancer Surviv 2024; 18:439-449. [PMID: 35904727 PMCID: PMC9336177 DOI: 10.1007/s11764-022-01236-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cancer survivors are particularly vulnerable to adverse COVID-19-related outcomes, but limited data exist on perceptions about the pandemic and related experiences in this group. METHODS In a cross-sectional analysis of 494 survivors of genitourinary, breast, gynecologic, colorectal, lung, melanoma, or thyroid cancer, from a larger study of cancer survivors in New Jersey, we assessed perceptions about COVID-19 threat, impacts, and experiences using three validated instruments. Responses were coded on a 7-point Likert scale, and subscales were averaged across included items, with higher scores indicating greater perceptions of COVID-19 threat and greater impacts and experiences because of the pandemic. Multivariable linear regression models were used to determine factors associated with higher scores, with Bonferroni correction for multiple comparisons. RESULTS In general, cancer survivors reported moderate perceived COVID-19 threat (3 items, mean score = 3.71 ± 1.97), minimal COVID-19-related impacts (6 items, mean score = 2.23 ± 1.34), and COVID-19-related experiences (7 items, mean score = 2.17 ± 1.00). COVID-19 impact subscale scores varied little (mean subscale score range = 2.09 to 2.29), while COVID-19 experiences subscale scores were quite variable (mean subscale score range = 1.52 to 3.39). Asian American/Pacific Islander race, Black race, female sex, and having more cardiovascular and metabolic and other comorbidities were associated with higher scores on the perceived coronavirus threat questionnaire. Having completed the COVID-19 questionnaires earlier in the pandemic, younger age, American/Pacific Islander race, Hispanic ethnicity, and having more comorbidities were associated with higher scores on the COVID-19 impact questionnaire. Younger age, racial minority status, and having more cardiovascular and metabolic comorbidities were associated with higher scores on the COVID-19 experience questionnaire. CONCLUSION Among cancer survivors in New Jersey-a state that experienced high rates of COVID-19 infection-sociodemographic and health-related factors (e.g., race and ethnicity, sex, and multimorbidity) correlate with greater perceptions of COVID-19 threat, impacts, and experiences. IMPLICATIONS FOR CANCER SURVIVORS Studies are needed to examine the influence of vaccination status on COVID-19 perceptions and identify inequities in clinical outcomes due to pandemic-related disruptions to cancer care.
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Affiliation(s)
- Adana A M Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Angela J Fong
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Nabarun Ghosh
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Denalee O'Malley
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Lisa E Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA
| | - Elisa V Bandera
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Andrew M Evens
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Sharon L Manne
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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4
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Hasseli R, Hanses F, Stecher M, Specker C, Weise T, Borgmann S, Hasselberger M, Hertenstein B, Hower M, Hoyer BF, Koll C, Krause A, von Lilienfeld-Toal M, Lorenz HM, Merle U, Nunes de Miranda SM, Pletz MW, Regierer AC, Richter JG, Rieg S, Roemmele C, Ruethrich MM, Schmeiser T, Schulze-Koops H, Strangfeld A, Vehreschild MJ, Voit F, Voll RE, Vehreschild JJ, Müller-Ladner U, Pfeil A. The protective effect of tumor necrosis factor-alpha inhibitors in COVID-19 in patients with inflammatory rheumatic diseases compared to the general population-A comparison of two German registries. Front Med (Lausanne) 2024; 11:1332716. [PMID: 38510457 PMCID: PMC10953502 DOI: 10.3389/fmed.2024.1332716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Objectives To investigate, whether inflammatory rheumatic diseases (IRD) inpatients are at higher risk to develop a severe course of SARS-CoV-2 infections compared to the general population, data from the German COVID-19 registry for IRD patients and data from the Lean European Survey on SARS-CoV-2 (LEOSS) infected patients covering inpatients from the general population with SARS-CoV-2 infections were compared. Methods 4310 (LEOSS registry) and 1139 cases (IRD registry) were collected in general. Data were matched for age and gender. From both registries, 732 matched inpatients (LEOSS registry: n = 366 and IRD registry: n = 366) were included for analyses in total. Results Regarding the COVID-19 associated lethality, no significant difference between both registries was observed. Age > 65°years, chronic obstructive pulmonary disease, diabetes mellitus, rheumatoid arthritis, spondyloarthritis and the use of rituximab were associated with more severe courses of COVID-19. Female gender and the use of tumor necrosis factor-alpha inhibitors (TNF-I) were associated with a better outcome of COVID-19. Conclusion Inflammatory rheumatic diseases (IRD) patients have the same risk factors for severe COVID-19 regarding comorbidities compared to the general population without any immune-mediated disease or immunomodulation. The use of rituximab was associated with an increased risk for severe COVID-19. On the other hand, the use of TNF-I was associated with less severe COVID-19 compared to the general population, which might indicate a protective effect of TNF-I against severe COVID-19 disease.
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Affiliation(s)
- Rebecca Hasseli
- Section of Rheumatology and Clinical Immunology, Department of Internal Medicine D, University Hospital Münster, Münster, Germany
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Giessen, Germany
| | - Frank Hanses
- Emergency Department and Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christof Specker
- Department of Rheumatology and Clinical Immunology, KEM Kliniken Essen-Mitte, Essen, Germany
| | | | - Stefan Borgmann
- Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
| | | | | | - Martin Hower
- Department of Pneumology, Infectious Diseases, Internal Medicine and Intensive Care, Klinikum Dortmund GmbH, Dortmund, Germany
| | - Bimba F. Hoyer
- Department for Rheumatology and Clinical Immunology, University of Schleswig-Holstein, Kiel, Germany
| | - Carolin Koll
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Andreas Krause
- Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin, Berlin, Germany
| | | | - Hanns-Martin Lorenz
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Uta Merle
- Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Mathias W. Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Anne C. Regierer
- Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany
| | - Jutta G. Richter
- Department of Rheumatology, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine-University, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine-University, Düsseldorf, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, University of Freiburg, Freiburg, Germany
| | - Christoph Roemmele
- Department of Gastroenterology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Maria M. Ruethrich
- Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany
| | | | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, University of Munich, Munich, Germany
| | - Anja Strangfeld
- Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany
| | - Maria J.G.T. Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Florian Voit
- Department of Internal Medicine II, School of Medicine, University Hospital Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Reinhard E. Voll
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Giessen, Germany
| | - Alexander Pfeil
- Department of Internal Medicine III, University Hospital Jena, Jena, Germany
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Li P, Huang L, Han R, Tang M, Fei G, Zeng D, Wang R. Safety and efficacy of Paxlovid in the treatment of adults with mild to moderate COVID-19 during the omicron epidemic: a multicentre study from China. Expert Rev Anti Infect Ther 2024:1-9. [PMID: 38300126 DOI: 10.1080/14787210.2024.2309998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/30/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Since December 2022, the Omicron variant has led to a widespread pandemic in China. The study was to explore the safety and effectiveness of Paxlovid for the treatment of coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS We included patients at risk of developing severe COVID-19, all of whom exhibited mild to moderate symptoms and were admitted to three hospital centers. Patients were divided into two groups: one received Paxlovid alongside standard care, while the other was given only standard care. We compared clinical characteristics, hospital stay duration, and clinical outcomes between two groups. Multi-factor analysis determined the independent risk factors influencing the duration of hospitalization and disease progression. RESULTS In the study, those treated with Paxlovid shorter hospital stays than those in the control group (p < 0.001). Multivariate analysis indicated that the absence of Paxlovid treatment was a distinct risk factor for hospitalizations lasting over 7 days (OR: 4.983, 95% CI: 3.828-6.486, p < 0.001) and 14 days (OR: 2.940, 95% CI: 2.402-3.597, p < 0.001). CONCLUSION Amid the Omicron outbreak, Paxlovid has proven to be a safe and effective treatment for reducing hospitalization durations for patients with mild to moderate COVID-19.
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Affiliation(s)
- Pulin Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ling Huang
- Department of Infectious Disease, Hefei Second People's Hospital, Hefei, China
| | - Rui Han
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Min Tang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guanghe Fei
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Daxiong Zeng
- Department of Pulmonary and Critical Care Medicine, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou, China
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ran Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
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Chen YSE, Gawel SH, Desai P, Rojas J, Barbian HJ, Tippireddy N, Gopinath R, Schneider S, Orzechowski A, Cloherty G, Landay A. COVID-19 waves in an urban setting 2020-2022: an electronic medical record analysis. Front Public Health 2024; 12:1323481. [PMID: 38347927 PMCID: PMC10859858 DOI: 10.3389/fpubh.2024.1323481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
Background Global and national surveillance efforts have tracked COVID-19 incidence and clinical outcomes, but few studies have compared comorbid conditions and clinical outcomes across each wave of the pandemic. We analyzed data from the COVID-19 registry of a large urban healthcare system to determine the associations between presenting comorbidities and clinical outcomes during the pandemic. Methods We analyzed registry data for all inpatients and outpatients with COVID-19 from March 2020 through September 2022 (N = 44,499). Clinical outcomes were death, hospitalization, and intensive care unit (ICU) admission. Demographic and clinical outcomes data were analyzed overall and for each wave. Unadjusted and multivariable logistic regressions were performed to explore the associations between age, sex, race, ethnicity, comorbidities, and mortality. Results Waves 2 and 3 (Alpha and Delta variants) were associated with greater hospitalizations, ICU admissions, and mortality than other variants. Chronic pulmonary disease was the most common comorbid condition across all age groups and waves. Mortality rates were higher in older patients but decreased across all age groups in later waves. In every wave, mortality was associated with renal disease, congestive heart failure, cerebrovascular disease, diabetes, and chronic pulmonary disease. Multivariable analysis found that liver disease and renal disease were significantly associated with mortality, hospitalization, and ICU admission, and diabetes was significantly associated with hospitalization and ICU admission. Conclusion The COVID-19 registry is a valuable resource to identify risk factors for clinical outcomes. Our findings may inform risk stratification and care planning for patients with COVID-19 based on age and comorbid conditions.
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Affiliation(s)
- Yi-shuan Elaine Chen
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Susan H. Gawel
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Pankaja Desai
- Rush University Medical Center, Chicago, IL, United States
| | - Juan Rojas
- Rush University Medical Center, Chicago, IL, United States
| | | | | | - Rajkamal Gopinath
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Sharon Schneider
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Anthony Orzechowski
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Gavin Cloherty
- Abbott Diagnostics Division, Abbott Laboratories, Abbott Park, IL, United States
- Abbott Pandemic Defense Coalition, Abbott Park, IL, United States
| | - Alan Landay
- Rush University Medical Center, Chicago, IL, United States
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7
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Mohan M, Kothari A, Verhagen N, Shreenivas A, Radhakrishnan SV, Dhakal B, Figueroa-Castro C, Chhabra S, Janz S, Pasquini M, Hamadani M, Szabo A, D'Souza A. Blood and marrow transplant within 4 weeks of SARS-CoV-2 infection is associated with increased risk of mortality: a National COVID Cohort Collaborative (N3C) Study. Bone Marrow Transplant 2024; 59:121-124. [PMID: 37803198 DOI: 10.1038/s41409-023-02096-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Meera Mohan
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Anai Kothari
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Aditya Shreenivas
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Binod Dhakal
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Carlos Figueroa-Castro
- Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Siegfried Janz
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marcello Pasquini
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mehdi Hamadani
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aniko Szabo
- Division of Biostatistics, Institute of Health and Safety, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anita D'Souza
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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8
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Sullivan M, Lei X, Giordano SH, Chavez-MacGregor M. Breast Cancer (BC) and Severe COVID-19 (C-19) Outcomes: A Matched Analysis. RESEARCH SQUARE 2023:rs.3.rs-3485880. [PMID: 38168222 PMCID: PMC10760205 DOI: 10.21203/rs.3.rs-3485880/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Purpose Patients with cancer receiving anticancer treatment have a higher risk of severe COVID-19 (C-19) outcomes. We examine the association between breast cancer (BC), recent treatment (systemic therapy, surgery, radiation), and C-19 outcomes. Methods Retrospective matched cohort study using the Optum® de-identified COVID-19 Electronic Health Record dataset (2007-2022). Patients with C-19 were categorized into: No cancer, BC with recent treatment, and BC without recent treatment and matched based on age, C-19 diagnosis date, and comorbidity score. We evaluated 30-day mortality, mechanical ventilation, intensive care unit (ICU) stay, and hospitalization. A composite outcome including all outcomes was analyzed. Multivariable logistic regression models were used. Results 2200 matched triplets (1:1:10) of patients with BC recently treated, BC not recently treated, and no cancer were included. Rates of adverse outcomes improved in 2021 compared to 2020. Compared to patients without cancer, those with BC recently treated had a similar risk of adverse outcomes, while patients with BC not recently treated had a lower risk of ICU stay and hospitalization. Using the composite variable, BC recently treated had similar outcomes (OR = 1.02; 95%CI 0.93-1.11) to patients without cancer, while BC patients not recently treated had better outcomes (OR = 0.66; 95%CI 0.59-0.74). Among patients with BC, chemotherapy within 3-months was associated with a higher risk of hospitalization (OR = 2.30; 95%CI 1.76-2.99) and composite outcome (OR = 2.11; 95%CI 1.64-2.72). Conclusion Patients with BC have a similar risk of adverse C-19 outcomes compared to patients without cancer. Among patients with BC, recent chemotherapy was associated with a higher risk of hospitalization.
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Affiliation(s)
| | - Xiudong Lei
- The University of Texas MD Anderson Cancer Center
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9
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Al-Rabi K, Al-Qadi F, Al-Ibraheem A, Halahleh K, Salah S, Ababneh H, Akkawi M, Sughayer M, Tafesh L, Abu Abed L, Ma'koseh M. The Impact COVID-19 Infection on Cancer Patients: A Tertiary Cancer Center Experience in Jordan. Cureus 2023; 15:e51310. [PMID: 38288187 PMCID: PMC10823193 DOI: 10.7759/cureus.51310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Cancer patients are at higher risk of serious complications of COVID-19. Few studies evaluated the impact of COVID-19 on cancer patients in low- and middle-income countries. Our study aims to evaluate the outcomes of COVID-19 infection in cancer patients treated at our institution. Methods: Medical records of patients with a positive COVID-19 polymerase chain reaction (PCR) between April 2020 and October 2020 were reviewed. Fisher's exact test and logistic regression analysis were employed to correlate various variables with mortality. Survival estimates were generated using the Kaplan-Meier method. RESULTS A total of 317 patients were included, with a median age was 55 years (range: 19-88). 82 (25.9%) had hematological neoplasms while the remainder had solid cancers. At the time of infection, 220 (69.4%) had active cancer, and 99 (31.2%) had received systemic anticancer treatment (SACT) within four weeks. Hospitalization was required for 101 (31.8%), 17 (5.3%) were admitted to the ICU and 50 (15.8%) died. Among patients with active cancer, SACT was delayed or discontinued in 140 (63.6%) patients. In the entire patient cohort, low albumin (p=<0.001) and leucocytosis (p=<0.001) correlated with mortality within six months of COVID-19 infection. The six-month mortality rate in patients with active cancer was significantly higher in patients with hypertension (p=0.024), no recent SACT (0.017), hematological cancer (p=0.029), low albumin (p=<0.001), leucocytosis (p=0.002) and lymphocyte count of less than 500/µL (p=0.004). Recent chemotherapy was associated with better 6-month survival rates (78.8% vs 89.9%, p=0.012) in patients with active cancer, patients with solid cancers (95.9% vs 82.2%, p=0.006) and was non-inferior in patient with hematological neoplasms (72% vs 65.4%, p=0.519). Conclusion: COVID-19 infection in our cancer patients was associated with significant morbidity and mortality and adversely affected their treatment. The decision to delay or discontinue SACT should be individualized, considering other risk factors for mortality.
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Affiliation(s)
- Kamal Al-Rabi
- Medical Oncology, King Hussein Cancer Center, Amman, JOR
- Internal Medicine, School of Medicine, University of Jordan, Amman, JOR
| | - Fadwa Al-Qadi
- Internal Medicine, King Hussein Cancer Center, Amman, JOR
| | | | | | - Samer Salah
- Medical Oncology, King Hussein Cancer Center, Amman, JOR
| | - Hazim Ababneh
- Internal Medicine, King Hussein Cancer Center, Amman, JOR
| | | | - Maher Sughayer
- Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, JOR
| | - Lana Tafesh
- Internal Medicine, School of Medicine, University of Jordan, Amman, JOR
| | - Layan Abu Abed
- Internal Medicine, King Hussein Cancer Center, Amman, JOR
| | - Mohammad Ma'koseh
- Medical Oncology, King Hussein Cancer Center, Amman, JOR
- Internal Medicine, School of Medicine, University of Jordan, Amman, JOR
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10
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Khawaja F, Angelidakis G, Feldman A, Ravi V, Woodman E, Bhatti M, Ariza‐Heredia E, Elhajj P, Spallone A, Jiang Y, Chemaly RF. COVID-19 in cancer patients: The impact of vaccination on outcomes early in the pandemic. Cancer Med 2023; 12:22006-22022. [PMID: 38063366 PMCID: PMC10757141 DOI: 10.1002/cam4.6781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND With the rapid evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the development of effective and safe vaccines was of utmost importance to protect vulnerable individuals, including cancer patients. Studies comparing the clinical outcomes of cancer patients with or without vaccination against coronavirus disease 2019 (COVID-19) have not demonstrated clear benefit. We aimed to determine the protective effects of COVID-19 vaccination by comparing vaccinated and unvaccinated cancer patients after the initial phase of vaccine roll-out and to identify risk factors associated with hospitalization, severe COVID-19, and 30-day COVID-19 attributable mortality. METHODS We performed a retrospective cohort study of cancer patients with COVID-19 diagnosed by polymerase chain reaction on nasal swabs between January 1, 2021 and July 30, 2021. Outcomes of interest included hospitalization, severe COVID-19, and 30-day COVID-19 attributable mortality. Univariate and multivariate analyses were performed to identify factors associated with clinical outcomes, using vaccination status as a variable of interest in all models. RESULTS Key risk factors, such as age ≥ 60 years; comorbidities including diabetes mellitus, heart failure, and lung diseases; and specific cancer types (leukemia and lymphoma) were independently associated with hospital admission for COVID-19, severe COVID-19, and 30-day COVID-19 attributable mortality in cancer patients regardless of their vaccination status. Vaccinated patients were protected against severe COVID-19 but with no impact on hospitalization or mortality due to COVID-19. CONCLUSION Our study highlights a significant benefit of COVID-19 vaccination for cancer patients-specifically its protection against severe COVID-19.
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Affiliation(s)
- Fareed Khawaja
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Georgios Angelidakis
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Adina Feldman
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Vinod Ravi
- Data‐Driven Determinants for COVID‐19 Oncology Discovery Effort (D3CODE) TeamThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of Sarcoma Medical Oncology, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Eric Woodman
- Data‐Driven Determinants for COVID‐19 Oncology Discovery Effort (D3CODE) TeamThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of Genomic Medicine, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Micah Bhatti
- Department of Laboratory MedicineThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Ella Ariza‐Heredia
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Peter Elhajj
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Amy Spallone
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Ying Jiang
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Roy F. Chemaly
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
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11
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Muthu M, Dalal S, George M, Clavijo CS, Lenz C, Nortje N. The importance of facilitating goal-concordant care (GCC) in a pandemic: the MD Anderson Experience with hospitalized COVID-19-positive patients. Support Care Cancer 2023; 31:661. [PMID: 37906311 DOI: 10.1007/s00520-023-08135-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Provider-patient communication (PPC) about goals of care (GOC) facilitates goal-concordant care (GCC) delivery. Hospital resource limitations imposed during the pandemic made it vital to deliver GCC to a patient cohort with COVID-19 and cancer. We aimed to evaluate the implementation of a real-time goals of care intervention and to make recommendations for future pandemics with similar clinical scenarios. METHODS This is a retrospective cohort study, of all COVID-19 positive patients admitted to The University of Texas MD Anderson Cancer Center between March of 2020 and January of 2021. The cohort included the following: (1) patients 18 years of age or older; (2) positive COVID-19 infection; (3) requiring hospitalization. Medical records were reviewed and all patient data including demographics, comorbidities, and outcomes were collected and analyzed in the Syntropy platform, Palantir Foundry, as part of the institutional Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) protocol. A multidisciplinary GOC task force developed processes for ease of conducting GOC-PPC and implemented structured documentation. We looked at ACP documentation pre- and post-implementation alongside demographics, length of stay (LOS), 30-day readmission rate and mortality. RESULTS There were 494 unique patients identified, 53% male, 61.5% Caucasian, 16.8% African American, and 3.2% Asian. Active cancer was identified in 84.6% patients, of which 65.6% were solid tumors and 34.4% hematologic malignancies. LOS was 9 days with a 30-day readmission rate of 15% and inpatient mortality of 14%. Inpatient ACP note documentation was significantly higher post-implementation as compared to pre-implementation (90% vs 8%, P<0.05). We saw sustained ACP documentation throughout the pandemic suggesting effective processes. CONCLUSIONS The implementation of institutional structured processes for GOC-PPC resulted in rapid sustainable adoption of ACP documentation for COVID-19-positive cancer patients. This was highly beneficial for this population during the pandemic, as it demonstrated the role of agile processes in care delivery models, which will be beneficial in the future when rapid implementation is needed.
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Affiliation(s)
- Mayoora Muthu
- Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Shalini Dalal
- Department of Palliative & Supportive Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marina George
- Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cesar Simbaqueba Clavijo
- Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Caitlin Lenz
- Department of Clinical Informatics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nico Nortje
- Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Nutrition and Dietetics, University of the Western Cape, Cape Town, South Africa
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12
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Forster M, Wuerstlein R, Koenig A, Stefan A, Wiegershausen E, Batz F, Trillsch F, Mahner S, Harbeck N, Chelariu-Raicu A. Health-related quality of life and patient-centred outcomes with COVID-19 vaccination in patients with breast cancer and gynaecological malignancies. Front Oncol 2023; 13:1217805. [PMID: 37901314 PMCID: PMC10602875 DOI: 10.3389/fonc.2023.1217805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Safety and tolerability of COVID-19 vaccines were demonstrated by several clinical trials which led to the first FDA/EMA approvals in 2021. Because of mass immunizations, most social restrictions were waived with effects on quality of life. Therefore, our a-priori hypothesis was that COVID-19 vaccination impacted the health-related quality of life (HR-QoL) in patients with breast and gynecological cancer. Methods From March 15th until August 11th, 2022, fully vaccinated patients with breast and gynecological cancer treated in the oncological outpatient clinics of the Department of Obstetrics and Gynecology, LMU University Hospital, Munich, Germany filled out a vaccine related QoL survey. Patients were asked about demographics (age, comorbidities), clinical parameters related to previous COVID-19 infections, and HR-QoL related parameters (living situation, responsibilities in everyday life). Subsequently, a questionnaire with 12 items was designed using a 5-point Likert scale (0 - strongly disagree/4 - strongly agree), covering the aspects health and therapy, social environment, participation in everyday life and overall assessment. Results By August 11th, 2022, 108 out of 114 (94.7%) patients had received at least three doses of COVID-19 vaccine and six patients at least two doses. More than half of the surveyed patients were >55y (52.6%; mean: 55.1y, range 29-86y). Patients with breast cancer (n= 83) had early (59.0%) or metastatic cancer (41.0%); gynecological cancers (n=31) also included metastatic (54.8%) and non-metastatic cancer (45.2%). 83.3% of the patients stated that COVID-19 vaccination had a positive impact on their HR-QoL. Furthermore, 29 patients (25.4%) had undergone a COVID-19 infection. These patients reported self-limiting symptoms for a median duration of 5.9 days and no hospital admissions were registered. Conclusions Our study demonstrates that vaccination against COVID-19 was positively associated with HR-QoL in patients with breast and gynecological cancer. Furthermore, vaccinated patients who underwent COVID-19 disease experienced only self-limiting symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Oncology Center and CCC Munich, University Hospital, LMU Munich, Munich, Germany
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13
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Overheu O, Lendowski S, Quast DR, Kühn D, Vidal Blanco E, Kraeft AL, Steinmann E, Kourti E, Lugnier C, Steinmann J, Reinacher-Schick A, Pfaender S. Longitudinal data on humoral response and neutralizing antibodies against SARS-CoV-2 Omicron BA.1 and subvariants BA.4/5 and BQ.1.1 after COVID-19 vaccination in cancer patients. J Cancer Res Clin Oncol 2023; 149:10633-10644. [PMID: 37300723 PMCID: PMC10257184 DOI: 10.1007/s00432-023-04961-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE The SARS-CoV-2 Omicron variant of concern (VOC) and subvariants like BQ.1.1 demonstrate immune evasive potential. Little is known about the efficacy of booster vaccinations regarding this VOC and subvariants in cancer patients. This study is among the first to provide data on neutralizing antibodies (nAb) against BQ.1.1. METHODS Cancer patients at our center were prospectively enrolled between 01/2021 and 02/2022. Medical data and blood samples were collected at enrollment and before and after every SARS-CoV-2 vaccination, at 3 and 6 months. RESULTS We analyzed 408 samples from 148 patients (41% female), mainly with solid tumors (85%) on active therapy (92%; 80% chemotherapy). SARS-CoV-2 IgG and nAb titers decreased over time, however, significantly increased following third vaccination (p < 0.0001). NAb (ND50) against Omicron BA.1 was minimal prior and increased significantly after the third vaccination (p < 0.0001). ND50 titers against BQ.1.1 after the third vaccination were significantly lower than against BA.1 and BA.4/5 (p < 0.0001) and undetectable in half of the patients (48%). Factors associated with impaired immune response were hematologic malignancies, B cell depleting therapy and higher age. Choice of vaccine, sex and treatment with chemo-/immunotherapy did not influence antibody response. Patients with breakthrough infections had significantly lower nAb titers after both 6 months (p < 0.001) and the third vaccination (p = 0.018). CONCLUSION We present the first data on nAb against BQ.1.1 following the third vaccination in cancer patients. Our results highlight the threat that new emerging SARS-CoV-2 variants pose to cancer patients and support efforts to apply repeated vaccines. Since a considerable number of patients did not display an adequate immune response, continuing to exhibit caution remains reasonable.
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Affiliation(s)
- Oliver Overheu
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany.
| | - Simon Lendowski
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Daniel R Quast
- Department of Internal Medicine, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Daniel Kühn
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Elena Vidal Blanco
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Anna-Lena Kraeft
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Eleni Kourti
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Celine Lugnier
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Anke Reinacher-Schick
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
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14
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Valencia-Espinoza E, Cabezas MDC, Plaza A, García K, Calle C, Fornasini M, Luna J, Miño C. COVID-19 mortality and risk factors in patients with cancer in Ecuador: A retrospective, non-randomized, controlled study. Medicine (Baltimore) 2023; 102:e34082. [PMID: 37352022 PMCID: PMC10289611 DOI: 10.1097/md.0000000000034082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/14/2023] [Accepted: 06/02/2023] [Indexed: 06/25/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) pandemic has affected different human populations since March 2020 and challenged healthcare systems, especially in chronic non-communicable diseases such as cancer. The present study aimed to evaluate the mortality, risk factors, and symptoms of cancer patients and control subjects, diagnosed with COVID-19 and admitted to intensive care unit (ICU). This retrospective, observational, non-randomized, controlled study of patients admitted to ICU was conducted between March and August 2020 in an Ecuadorian oncology center. Patient information collected from electronic medical records included sociodemographic information, clinical history, symptoms, laboratory test results, COVID-19 treatment, and discharge status. For patients with neoplasia, diagnosis, type, and status of cancer, as well as antineoplastic treatment received over the past month was also recorded. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed with SPSS (version 22.0) and R (version 4.1.3). In total, 79 adult COVID-19 patients were studied (40 with cancer and 39 controls). The total mean time until COVID-19 symptoms onset was 6.2 ± 3.5 days (5.3 ± 3.2 days in the cancer group vs 7.2 ± 3.6 days in the control group; P = .016) but no difference was observed in reported symptoms. All patients received an antibiotic treatment, but only 70% of the cancer group had antivirals (P < .001). Cancer patients had lower hemoglobin levels than controls (10.7 ± 2.8 vs 13.3 ± 1.7 g/dL; P < .001). In terms of mortality, not statistically significance difference was reported between groups. The study showed that high ferritin (Absolute Odds Ratio of 3.9; 95% CI 1.1-14.6) and mechanical ventilation (Absolute Odds Ratio of 4.9; 95% CI 1.3-18.6) were independent COVID-19 mortality risk factors. COVID-19 infection did not represent an increased risk of mortality in cancer patients, but elevated ferritin levels and the need for mechanical ventilation were identified as mortality risk factors.
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Affiliation(s)
| | | | - Andrea Plaza
- Internal Medicine Service, Hospital SOLCA Guayaquil, Guayaquil, Ecuador
| | - Katherine García
- Onco-hemathology Service, Hospital SOLCA Guayaquil, Guayaquil, Ecuador
| | - Carlos Calle
- Emergency Service, Hospital SOLCA Guayaquil, Guayaquil, Ecuador
- School of Medicine, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
| | - Marco Fornasini
- School of Medicine, Universidad Internacional del Ecuador (UIDE), Quito, Ecuador
| | - José Luna
- Health Science Faculty, Universidad Internacional SEK, Quito, Ecuador
| | - Camila Miño
- School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Public Health, London School of Hygiene & Tropical Medicine, London, UK
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15
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Muthu M, Dalal S, George M, Clavijo CS, Lenz C, Nortje N. The Importance of Facilitating Goal-Concordant Care (GCC) in a Pandemic: The MD Anderson Experience with hospitalized COVID-19 positive patients. RESEARCH SQUARE 2023:rs.3.rs-2968661. [PMID: 37398052 PMCID: PMC10312944 DOI: 10.21203/rs.3.rs-2968661/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Purpose Provider-patient communication (PPC) about goals of care (GOC) facilitates goal-concordant care (GCC) delivery. Hospital resource limitations imposed during the pandemic made it vital to deliver GCC to a patient cohort with COVID-19 and cancer. Our aim was to understand the population and adoption of GOC-PPC along with structured documentation in the form of an Advance Care Planning (ACP) note. Methods A multidisciplinary GOC task force developed processes for ease of conducting GOC-PPC and implemented structured documentation. Data were obtained from multiple electronic medical record elements, with each source identified, data integrated and analyzed. We looked at PPC and ACP documentation pre and post implementation alongside demographics, length of stay (LOS), 30-day readmission rate and mortality. Results 494 unique patients were identified, 52% male, 63% Caucasian, 28% Hispanic, 16% African American and 3% Asian. Active cancer was identified in 81% patients, of which 64% were solid tumors and 36% hematologic malignancies. LOS was 9 days with a 30-day readmission rate of 15% and inpatient mortality of 14%. Inpatient ACP note documentation was significantly higher post-implementation as compared to pre-implementation (90% vs 8%, P < 0.05). We saw sustained ACP documentation throughout the pandemic suggesting effective processes. Conclusions The implementation of institutional structured processes for GOC-PPC resulted in rapid sustainable adoption of ACP documentation for COVID-19 positive cancer patients. This was highly beneficial for this population during the pandemic, as it demonstrated the role of agile processes in care delivery models, which will be beneficial in the future when rapid implementation is needed.
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Affiliation(s)
| | | | | | | | - Caitlin Lenz
- The University of Texas MD Anderson Cancer Center
| | - Nico Nortje
- The University of Texas MD Anderson Cancer Center
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16
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Zhang Z, Ishak NDB, Que FVF, Chua ZY, Chan SH, Chiang J, Yie JNY. COVID-19 vaccination uptake and safety profile among germline BRCA1 and BRCA2 pathogenic variant carriers in Singapore. Hered Cancer Clin Pract 2023; 21:5. [PMID: 37046302 PMCID: PMC10091319 DOI: 10.1186/s13053-023-00248-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 03/01/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Although Singapore is one of the highest vaccinated countries in the world, vaccine hesitancy remains in a subpopulation, including individuals with cancer predisposition syndromes. At the Cancer Genetics Service National Cancer Centre Singapore, we see patients with germline genetic alterations, most being BRCA1/2 pathogenic/likely pathogenic variant (PV/LPV) carriers. While reported safe for cancer patients, there are limited studies addressing the safety profile and outcomes of COVID-19 vaccination among individuals with germline PV/LPV in cancer predisposition genes such as BRCA1/2. This study aims to evaluate the outcomes of COVID-19 vaccination among germline PV/LPV carriers in BRCA1/2. METHODS We conducted a phone call survey of COVID-19 vaccination uptake and toxicity in a prospective cohort of 189 participants with germline BRCA1/2 PV/LPV between 1st Sept 2021 and 30th Sept 2021. We collected demographics data including gender, race, age, history of cancer, types of cancer, and number of cancers. Statistical difference in baseline demographics between responders with history of cancer and those without were assessed using Chi-square, Fisher's exact and independent t-test analysis. Logistic regression was used to evaluate effect of demographics on the occurrence of post-vaccination side effects. RESULTS Among 189 BRCA1/2 PV/LPV carriers responded, 97 carried PV/LPV in BRCA1 and 92 in BRCA2. Majority were vaccinated (89.5%) and had completed the two-dose vaccine schedule, with 7 (4.1%) received only one dose. The most common post-vaccination side effects was myalgia (56.5%) followed by fever (40.2%), headache (16.3%) and fatigue (11.2%). There were no major severe side events. Evaluation by logistic regression showed that the occurrence of side effects was not affected by PV/LPV gene (BRCA1 or BRCA2), gender, race, age or history of cancer. CONCLUSION The post-vaccination side effects profile among individuals with germline PV/LPV in BRCA1/2 is consistent with the Singaporean general population, hence recommendations for COVID-19 vaccination for these individuals should not differ from non-carriers and should be encouraged by their healthcare providers.
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Affiliation(s)
- Zewen Zhang
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Nur Diana Binte Ishak
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Frances Victoria Fajardo Que
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Zi Yang Chua
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Sock Hoai Chan
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Jianbang Chiang
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Joanne Ngeow Yuen Yie
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore.
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17
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Balakumar N, Catueno S, Nadiger M, Keshavamurthy PRS, Totapally BR, Sherani F, Mba N, Gist KM, Tripathi S, Gajic O, Deo N, Kumar V, Walkey A, Kashyap R, Bhalala US. Coronavirus Disease 2019 in Pediatric Oncology Patients: A Matched-Cohort Analysis of the SCCM Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. J Pediatr Hematol Oncol 2023; 45:e309-e314. [PMID: 36729758 PMCID: PMC10038816 DOI: 10.1097/mph.0000000000002588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/10/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is a paucity of multicenter data describing the impact of coronavirus disease 2019 (COVID-19) on hospitalized pediatric oncology patients. Using a large, multicenter, Society of Critical Care Medicine (SCCM) Discovery Viral Infection and Respiratory Illness University Study (VIRUS) database, we aimed at assessing outcomes of COVID-19 infection in this population. METHOD This is a matched-cohort study involving children below 18 years of age hospitalized with COVID-19 between March 2020 and January 2021. Using the VIRUS; COVID-19 Registry database, children with oncologic diseases were compared with propensity score matched (age groups, sex, race, and ethnicity) cohort of children without oncologic diseases for the prevalence of Multisystem Inflammatory Syndrome in Children (MIS-C), intensive care unit (ICU) admission, interventions, hospital, and ICU length of stay. RESULTS The number of children in the case and control groups was 45 and 180, respectively. ICU admission rate was similar in both groups ([47.7 vs 51.7%], P =0.63). The proportion of children requiring noninvasive and invasive mechanical ventilation, and its duration were similar between groups, same as hospital mortality. Interestingly, MIS-C was significantly lower in the oncology group compared with the control (2.4 vs 24.6%; P =0.0002). CONCLUSIONS In this study using a multicenter VIRUS database, ICU admission rate, interventions, and outcomes of COVID-19 were similar in children with the oncologic disease compared with control patients. The incidence of MIS-C is lower in oncologic patients.
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Affiliation(s)
- Niveditha Balakumar
- Division of Critical Care Medicine, Department of Pediatrics, Children’s Hospital of San Antonio and Baylor College of Medicine, Houston
| | - Samanta Catueno
- Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi, TX and Texas A&M University, College Station, TX
| | - Meghana Nadiger
- Division of Critical Care Medicine, Department of Pediatrics, Children’s Hospital of Illinois and University of Illinois College of Medicine
| | - Prithvi Raj Sendi Keshavamurthy
- Division of Critical Care Medicine, Department of Pediatrics, Nicklaus Children’s Hospital and Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Balagangadhar R Totapally
- Division of Critical Care Medicine, Department of Pediatrics, Nicklaus Children’s Hospital and Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Farha Sherani
- Division of Hematology-Oncology, Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi and Texas A and M University, College Station
| | - Nkechi Mba
- Division of Hematology-Oncology, Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi and Texas A and M University, College Station
| | | | | | | | | | | | | | | | - Utpal S. Bhalala
- Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi, TX and Texas A&M University, College Station, TX
- Department of Anesthesiology and Critical Care, University of Texas Medical Branch, Galveston, TX
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18
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Identification of Clinical Features Associated with Mortality in COVID-19 Patients. OPERATIONS RESEARCH FORUM 2023. [PMCID: PMC9984757 DOI: 10.1007/s43069-022-00191-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractUnderstanding clinical features and risk factors associated with COVID-19 mortality is needed to early identify critically ill patients, initiate treatments and prevent mortality. A retrospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020 was conducted. COVID-19-related mortality and its association with clinical features including headache, chest pain, symptoms on computerized tomography (CT), hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia were investigated. Based on the investigation outcome, decision tree and dimension reduction algorithms were used to identify the aforementioned risk factors. Of the 3008 patients (mean age 59.3 ± 18.7 years, 44% women) with COVID-19, 373 died. There was a significant association between COVID-19 mortality and old age, headache, chest pain, low respiratory rate, oxygen saturation < 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Our results might help identify early symptoms related to COVID-19 and better manage patients according to the extracted decision tree. The proposed ML models identified a number of clinical features and risk factors associated with mortality in COVID-19 patients. These models if implemented in a clinical setting might help to early identify patients needing medical attention and care. However, more studies are needed to confirm these findings.
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19
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Risk factors of SARS-CoV-2 infection and complications from COVID-19 in lung cancer patients. Int J Clin Oncol 2023; 28:531-542. [PMID: 36859565 PMCID: PMC9977088 DOI: 10.1007/s10147-023-02311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Identifying lung cancer patients at an increased risk of getting SARS-CoV-2-related complications will facilitate tailored therapy to maximize the benefit of anti-cancer therapy, while decreasing the likelihood of COVID-19 complications. This analysis aimed to identify the characteristics of lung cancer patients that predict for increased risk of death or serious SARS-CoV-2 infection. PATIENTS AND METHODS This was a retrospective cohort study of patients with lung cancer diagnosed October 1, 2015, and December 1, 2020, and a diagnosis of COVID-19 between February 2, 2020, and December 1, 2020, within the Veterans Health Administration. Serious SARS-CoV-2 infection was defined as hospitalization, ICU admission, or mechanical ventilation or intubation within 2 weeks of COVID-19 diagnosis. For categorical variables, differences were assessed using Χ2 tests, while Kruskal-Wallis rank-sum test was used for continuous variables. Multivariable logistic regression models were fit relative to onset of serious SARS-CoV-2 infection and death from SARS-CoV-2 infection. RESULTS COVID-19 infection was diagnosed in 352 lung cancer patients. Of these, 61 patients (17.3%) died within four weeks of diagnosis with COVID-19, and 42 others (11.9%) experienced a severe infection. Patients who had fatal or severe infection were older and had lower hemoglobin levels than those with mild or moderate infection. Factors associated with death from SARS-CoV-2 infection included increasing age, immune checkpoint inhibitor therapy and low hemoglobin level. CONCLUSIONS The mortality of lung cancer patients from COVID-19 disease in the present cohort was less than previously reported in the literature. The identification of risk factors associated with severe or fatal outcomes informs management of patients with lung cancer who develop COVID-19 disease.
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20
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Giesen N, Busch E, Schalk E, Beutel G, Rüthrich MM, Hentrich M, Hertenstein B, Hirsch HH, Karthaus M, Khodamoradi Y, Koehler P, Krüger W, Koldehoff M, Krause R, Mellinghoff SC, Penack O, Sandherr M, Seggewiss-Bernhardt R, Spiekermann K, Sprute R, Stemler J, Weissinger F, Wörmann B, Wolf HH, Cornely OA, Rieger CT, von Lilienfeld-Toal M. AGIHO guideline on evidence-based management of COVID-19 in cancer patients: 2022 update on vaccination, pharmacological prophylaxis and therapy in light of the omicron variants. Eur J Cancer 2023; 181:102-118. [PMID: 36652889 PMCID: PMC9737523 DOI: 10.1016/j.ejca.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Abstract
The novel coronavirus SARS-CoV-2 and the associated infectious disease COVID-19 pose a significant challenge to healthcare systems worldwide. Patients with cancer have been identified as a high-risk population for severe infections, rendering prophylaxis and treatment strategies for these patients particularly important. Rapidly evolving clinical research, resulting in the recent advent of various vaccines and therapeutic agents against COVID-19, offers new options to improve care and protection of cancer patients. However, ongoing epidemiological changes and rise of new virus variants require repeated revisions and adaptations of prophylaxis and treatment strategies to meet these new challenges. Therefore, this guideline provides an update on evidence-based recommendations with regard to vaccination, pharmacological prophylaxis and treatment of COVID-19 in cancer patients in light of the currently dominant omicron variants. It was developed by an expert panel of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) based on a critical review of the most recent available data.
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Affiliation(s)
- Nicola Giesen
- Department of Hematology, Oncology and Palliative Care, Robert Bosch Hospital, Stuttgart, Germany.
| | - Elena Busch
- Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Enrico Schalk
- Department of Hematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Gernot Beutel
- Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO), Germany
| | - Maria M Rüthrich
- Department of Interdisciplinary Intensive Care Medicine, Vivantes Humboldt-Klinikum, Berlin, Germany
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital Munich, Munich, Germany
| | | | - Hans H Hirsch
- Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Meinolf Karthaus
- Department of Hematology, Oncology and Palliative Care, Klinikum Neuperlach/Klinikum Harlaching, Munich, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - William Krüger
- Department of Hematology and Oncology, Stem Cell Transplantation, Palliative Care, University Hospital Greifswald, Greifswald, Germany
| | - Michael Koldehoff
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Hygiene and Environmental Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Robert Krause
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Sibylle C Mellinghoff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Olaf Penack
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Tumorimmunology, Berlin, Germany
| | - Michael Sandherr
- MVZ Penzberg, Department of Hematology and Oncology, Weilheim, Germany
| | - Ruth Seggewiss-Bernhardt
- Medizinische Klinik V, Sozialstiftung Bamberg, Bamberg, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Karsten Spiekermann
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Florian Weissinger
- Department of Internal Medicine, Hematology, Oncology, Stem Cell Transplantation and Palliative Care, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Bernhard Wörmann
- Division of Haematology, Oncology and Tumor Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Heinrich Wolf
- Department of Hematology, Oncology and Hemostaseology, Südharzklinikum Nordhausen, Nordhausen, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Christina T Rieger
- Hemato-Oncology Germering & Interdisciplinary Tumorcenter, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marie von Lilienfeld-Toal
- Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
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21
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Effectiveness and Safety of COVID-19 Vaccination in Patients with Malignant Disease. Vaccines (Basel) 2023; 11:vaccines11020486. [PMID: 36851363 PMCID: PMC9962104 DOI: 10.3390/vaccines11020486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/25/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
A novel virus named SARS-CoV-2 has caused a worldwide pandemic, resulting in a disastrous impact to the public health since 2019. The disease is much more lethal among patients with malignant disease. Vaccination plays an important role in the prevention of infection and subsequent severe COVID-19. However, the efficacy and safety of vaccines for cancer patients needs further investigation. Encouragingly, there have been important findings deduced from research so far. In this review, an overview of the immunogenicity, effectiveness, and safeness of COVID-19 vaccines in patients with cancer to date is to be shown. We also highlight important questions to consider and directions that could be followed in future research.
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22
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Rugge M, Zorzi M, Guzzinati S, Stocco C, Avossa F, Del Zotto S, Clagnan E, Bricca L, Dal Maso L, Serraino D. Outcomes of SARS-CoV-2 infection in cancer versus non-cancer-patients: a population-based study in northeastern Italy. TUMORI JOURNAL 2023; 109:38-46. [PMID: 35130777 PMCID: PMC9895302 DOI: 10.1177/03008916211073771] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study assesses the risk of infection and clinical outcomes in a large consecutive population of cancer and non-cancer patients tested for SARS-CoV-2 status. METHODS Study patients underwent SARS-CoV-2 molecular-testing between 22 February 2020 and 31 July 2020, and were found infected (CoV2+ve) or uninfected. History of malignancy was obtained from regional population-based cancer registries. Cancer-patients were distinguished by time between cancer diagnosis and SARS-CoV-2 testing (<12/⩾12 months). Comorbidities, hospitalization, and death at 15 September 2020 were retrieved from regional population-based databases. The impact of cancer history on SARS-CoV-2 infection and clinical outcomes was calculated by fitting a multivariable logistic regression model, adjusting for sex, age, and comorbidities. RESULTS Among 552,362 individuals tested for SARS-CoV-2, 55,206 (10.0%) were cancer-patients and 22,564 (4.1%) tested CoV2+ve. Irrespective of time since cancer diagnosis, SARS-CoV-2 infection was significantly lower among cancer patients (1,787; 3.2%) than non-cancer individuals (20,777; 4.2% - Odds Ratio (OR)=0.60; 0.57-0.63). CoV2+ve cancer-patients were older than non-cancer individuals (median age: 77 versus 57 years; p<0.0001), were more frequently men and with comorbidities. Hospitalizations (39.9% versus 22.5%; OR=1.61; 1.44-1.80) and deaths (24.3% versus 9.7%; OR=1.51; 1.32-1.72) were more frequent in cancer-patients. CoV2+ve cancer-patients were at higher risk of death (lung OR=2.90; 1.58-5.24, blood OR=2.73; 1.88-3.93, breast OR=1.77; 1.32-2.35). CONCLUSIONS The risks of hospitalization and death are significantly higher in CoV2+ve individuals with past or present cancer (particularly malignancies of the lung, hematologic or breast) than in those with no history of cancer.
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Affiliation(s)
- Massimo Rugge
- Department of Medicine - DIMED,
Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, Padova,
Italy,Veneto Tumour Registry, Azienda Zero,
Padova, Italy
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero,
Padova, Italy
| | | | | | - Francesco Avossa
- Regional Epidemiological Service Unit,
Azienda Zero, Padova, Italy
| | | | - Elena Clagnan
- Friuli Venezia Giulia Regional Health
Coordination Agency, Udine, Italy
| | - Ludovica Bricca
- Department of Medicine - DIMED,
Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, Padova,
Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di
Riferimento Oncologico, IRCCS, Aviano, Italy,Luigino Dal Maso, Cancer Epidemiology,
Centro di Riferimento Oncologico (CRO) Aviano, via Gallini, 2, Aviano (PN),
33081, Italy.
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di
Riferimento Oncologico, IRCCS, Aviano, Italy
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23
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Raad II, Hachem R, Masayuki N, Datoguia T, Dagher H, Jiang Y, Subbiah V, Siddiqui B, Bayle A, Somer R, Fernández Cruz A, Gorak E, Bhinder A, Mori N, Hamerschlak N, Shelanski S, Dragovich T, Vong Kiat YE, Fakhreddine S, Pierre AH, Chemaly RF, Mulanovich V, Adachi J, Borjan J, Khawaja F, Granwehr B, John T, Yepez EY, Torres HA, Ammakkanavar NR, Yibirin M, Reyes-Gibby CC, Pande M, Ali N, Rojo RD, Ali SM, Deeba RE, Chaftari P, Matsuo T, Ishikawa K, Hasegawa R, Aguado-Noya R, García AG, Puchol CT, Lee DG, Slavin M, Teh B, Arias CA, Kontoyiannis DP, Malek AE, Chaftari AM. International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship. eLife 2023; 12:81127. [PMID: 36715684 PMCID: PMC9981148 DOI: 10.7554/elife.81127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
Background In this international multicenter study, we aimed to determine the independent risk factors associated with increased 30 day mortality and the impact of cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries. Methods We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers. Results We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin, and procalcitonin) but were less likely to present with clinical symptoms (p≤0.01). By country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (≥65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30 day mortality rate than those who did not (5.9 vs 17.6%; p=0.03). Conclusions Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality. Funding National Cancer Institute and National Institutes of Health.
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Affiliation(s)
- Issam I Raad
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Ray Hachem
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Nigo Masayuki
- https://ror.org/03gds6c39Division of Infectious Diseases, McGovern Medical School, The University of Texas Health Science Center at HoustonHoustonUnited States
| | - Tarcila Datoguia
- Médica Hematologista Hospital Israelita Albert EinsteinSão PauloBrazil
| | - Hiba Dagher
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Ying Jiang
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Vivek Subbiah
- https://ror.org/0509zzg37MD Anderson Cancer Network, UT MD Anderson Cancer CenterHoustonUnited States
- https://ror.org/04twxam07Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Bilal Siddiqui
- https://ror.org/040cn9093Department of Hematology Oncology, Community Health NetworkIndianapolisUnited States
| | - Arnaud Bayle
- https://ror.org/03xjwb503Department of Medical Oncology, Gustave Roussy, Université Paris-SaclayVillejuifFrance
| | - Robert Somer
- https://ror.org/056nm0533Cooper Medical School of Rowan University, Cooper University Health CareCamdenUnited States
| | - Ana Fernández Cruz
- https://ror.org/01e57nb43Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Puerta de HierroMadridSpain
| | - Edward Gorak
- https://ror.org/00v47pv90Department of Hematology Oncology, Baptist HealthJacksonvilleUnited States
| | - Arvinder Bhinder
- https://ror.org/04gqr8882Department of Hematology/Oncology, Ohio Health MarionMarionUnited States
| | - Nobuyoshi Mori
- https://ror.org/002wydw38Department of Infectious Diseases, St. Luke's International HospitalTokyoJapan
| | | | - Samuel Shelanski
- https://ror.org/04cqn7d42Banner MD Anderson Cancer Center – North ColoradoGreelyUnited States
| | - Tomislav Dragovich
- Division of Cancer Medicine, Banner MD Anderson Cancer CenterGilbertUnited States
| | - Yee Elise Vong Kiat
- https://ror.org/032d59j24Department of Medical Oncology, Tan Tock Seng HospitalSingaporeSingapore
| | - Suha Fakhreddine
- https://ror.org/000tqtb97Department of Infectious Diseases, Rafik Hariri University HospitalBeirutLebanon
| | - Abi Hanna Pierre
- https://ror.org/000tqtb97Department of Infectious Diseases, Rafik Hariri University HospitalBeirutLebanon
| | - Roy F Chemaly
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Victor Mulanovich
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Javier Adachi
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Jovan Borjan
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Fareed Khawaja
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Bruno Granwehr
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Teny John
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Eduardo Yepez Yepez
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Harrys A Torres
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Natraj Reddy Ammakkanavar
- https://ror.org/04twxam07Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Marcel Yibirin
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Cielito C Reyes-Gibby
- https://ror.org/04twxam07Department of Emergency Medicine, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Mala Pande
- https://ror.org/04twxam07Department of Gastroenterology, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Noman Ali
- https://ror.org/04twxam07Department of Hospital Medicine, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Raniv Dawey Rojo
- https://ror.org/04twxam07Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Shahnoor M Ali
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Rita E Deeba
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Patrick Chaftari
- https://ror.org/04twxam07Department of Emergency Medicine, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Takahiro Matsuo
- https://ror.org/002wydw38Department of Infectious Diseases, St. Luke's International HospitalTokyoJapan
| | - Kazuhiro Ishikawa
- https://ror.org/002wydw38Department of Infectious Diseases, St. Luke's International HospitalTokyoJapan
| | - Ryo Hasegawa
- https://ror.org/002wydw38Department of Infectious Diseases, St. Luke's International HospitalTokyoJapan
| | - Ramón Aguado-Noya
- https://ror.org/01e57nb43Oncology Department, Hospital Universitario Puerta de Hierro-MajadahondaMadridSpain
| | - Alvaro Garcia García
- https://ror.org/01e57nb43Hematology Department, Hospital Universitario Puerta de Hierro-MajadahondaMadridSpain
| | - Cristina Traseira Puchol
- https://ror.org/01e57nb43Oncology Department, Hospital Universitario Puerta de Hierro-MajadahondaMadridSpain
| | - Dong Gun Lee
- https://ror.org/01fpnj063Division of Infectious Diseases, Department of Internal Medicine, Vaccine Bio Research Institute, The Catholic University of KoreaSeoulRepublic of Korea
| | - Monica Slavin
- https://ror.org/02a8bt934Department of Infectious Diseases and National Centre for Infections in Cancer, Peter MacCallum Cancer CentreMelbourneAustralia
| | - Benjamin Teh
- https://ror.org/02a8bt934Department of Infectious Diseases and National Centre for Infections in Cancer, Peter MacCallum Cancer CentreMelbourneAustralia
| | - Cesar A Arias
- https://ror.org/03gds6c39Division of Infectious Diseases, McGovern Medical School, The University of Texas Health Science Center at HoustonHoustonUnited States
| | | | - Dimitrios P Kontoyiannis
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Alexandre E Malek
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
| | - Anne-Marie Chaftari
- https://ror.org/04twxam07Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer CenterHoustonUnited States
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24
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The Immune, Inflammatory and Hematological Response in COVID-19 Patients, According to the Severity of the Disease. Microorganisms 2023; 11:microorganisms11020319. [PMID: 36838284 PMCID: PMC9967162 DOI: 10.3390/microorganisms11020319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the immune and inflammatory responses in COVID-19 patients by dosing specific IgM and IgG total antibodies and interleukin 6, correlating them with the hematological and biochemical blood parameters and comparing them by the form of the disease. MATERIALS AND METHODS One hundred twenty-five patients with polymerase chain reaction-confirmed COVID-19, hospitalized between 15.03.2020 and 1.07.2020 in the Clinical Hospital of Infectious Diseases "Sf. Parascheva" Iaşi, were tested by chemiluminescence for the presence of anti-SARS-CoV-2 IgM and IgG and IL-6 in the serum. The results were correlated with the results of the CBC count and serum biochemical parameters detected on the admission day. The patients presented different forms of the disease (asymptomatic, mild, moderate, severe, and critical) according to World Health Organization (WHO) criteria for the clinical management of COVID-19. RESULTS The amplitude of the immune response was directly correlated with the form of the disease. In the asymptomatic/mild form patients, the IL-6 and CRP concentrations were significantly higher and eosinophil count was significantly lower compared with the reference interval. In the moderate form, the concentrations of IL-6, CRP, and IgG were significantly higher, compared with the reference interval, while eosinophil count and eGFR were significantly lower. In severe/critical COVID-19 patients, IL-6, CRP, NLR, PLR, glucose, AST, urea, creatinine, and eGFR were significantly higher compared with the reference interval, while eosinophil count was significantly lower. IL-6 boosted in all forms of COVID-19, with a major increase in severe and critical patients. IL-6, neutrophil count, % neutrophils, NLR, PLR, CRP, AST, and urea increased with the severity of the SARS-CoV-2 infection, and the lymphocyte count, % lymphocytes, eosinophil count, % eosinophils, and hemoglobin decreased with the increased severity of COVID-19. CONCLUSIONS The amplitude and the moment of appearance of the immune response depended on the form of the disease. IgM generally occurred in the first 14 days of illness, and IgG appeared beginning with the second week of disease. IgG titer increased rapidly until the fourth week of disease and decreased slowly after 4 weeks. The amplitudes of all the tested inflammatory and serological markers depended on the COVID-19 form, increasing somewhat in the moderate forms and even more in the critical ones. The lymphocyte and eosinophil count are able to predict the risk of severe COVID-19.
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Spiliopoulou P, Janse van Rensburg HJ, Avery L, Kulasingam V, Razak A, Bedard P, Hansen A, Chruscinski A, Wang B, Kulikova M, Chen R, Speers V, Nguyen A, Lee J, Coburn B, Spreafico A, Siu LL. Longitudinal efficacy and toxicity of SARS-CoV-2 vaccination in cancer patients treated with immunotherapy. Cell Death Dis 2023; 14:49. [PMID: 36670100 PMCID: PMC9853486 DOI: 10.1038/s41419-022-05548-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/17/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023]
Abstract
Despite more than 2 years having elapsed since the onset of SARS-CoV-2 pandemic, a level of hesitation around increased SARS-CoV-2 vaccine toxicity in cancer patients receiving immunotherapy (IO) remains. This hesitation stems from the idea that IO agents could elicit an overwhelming immune stimulation post vaccination and therefore increase the risk of vaccine-related toxicity. The aim of our study was to explore serological responses to SARS-CoV-2 vaccination in patients treated with IO and describe the level of immune stimulation using parameters such as blood cytokines, autoantibody levels and immune related adverse events (irAEs) post vaccination. Fifty-one evaluable patients were enrolled in this longitudinal study. Absolute levels and neutralization potential of anti-SARS-CoV-2 antibodies were not significantly different in the IO group compared to non-IO. Chemotherapy adversely affected seroconversion when compared to IO and/or targeted treatment. Following vaccination, the prevalence of grade ≥2 irAEs in patients treated with IO was not higher than the usual reported IO toxicity. We report, for the first time, that anti-SARS-CoV-2 vaccination, elicited the generation of five autoantibodies. The significantly increased autoantibodies were IgM autoantibodies against beta-2 glycoprotein (p = 0.02), myeloperoxidase (p = 0.03), nucleosome (p = 0.041), SPLUNC2 (p < 0.001) and IgG autoantibody against Myosin Heavy Chain 6 (MYH6) (p < 0.001). Overall, comprehensive analysis of a small cohort showed that co-administration of SARS-CoV-2 vaccine and IO is not associated with increased irAEs. Nevertheless, the detection of autoantibodies post anti-SARS-CoV-2 vaccination warrants further investigation (NCT03702309).
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Affiliation(s)
| | | | - Lisa Avery
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Vathany Kulasingam
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Albiruni Razak
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Philippe Bedard
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Aaron Hansen
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Andrzej Chruscinski
- Mutli-Organ Transplant Program, University Health Network, Toronto, ON, Canada
| | - Ben Wang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Maria Kulikova
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Rachel Chen
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Vanessa Speers
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Alisa Nguyen
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jasmine Lee
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Bryan Coburn
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Anna Spreafico
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Lillian L Siu
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
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Llanos AAM, Ashrafi A, Ghosh N, Tsui J, Lin Y, Fong AJ, Ganesan S, Heckman CJ. Evaluation of Inequities in Cancer Treatment Delay or Discontinuation Following SARS-CoV-2 Infection. JAMA Netw Open 2023; 6:e2251165. [PMID: 36637818 PMCID: PMC9856904 DOI: 10.1001/jamanetworkopen.2022.51165] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE There is a disproportionately greater burden of COVID-19 among Hispanic and non-Hispanic Black individuals, who also experience poorer cancer outcomes. Understanding individual-level and area-level factors contributing to inequities at the intersection of COVID-19 and cancer is critical. OBJECTIVE To evaluate associations of individual-level and area-level social determinants of health (SDOH) with delayed or discontinued cancer treatment following SARS-CoV-2 infection. DESIGN, SETTING, AND PARTICIPANTS This retrospective, registry-based cohort study used data from 4768 patients receiving cancer care who had positive test results for SARS-CoV-2 and were enrolled in the American Society for Clinical Oncology COVID-19 Registry. Data were collected from April 1, 2020, to September 26, 2022. EXPOSURES Race and ethnicity, sex, age, and area-level SDOH based on zip codes of residence at the time of cancer diagnosis. MAIN OUTCOMES AND MEASURES Delayed (≥14 days) or discontinued cancer treatment (any cancer treatment, surgery, pharmacotherapy, or radiotherapy) and time (in days) to restart pharmacotherapy. RESULTS A total of 4768 patients (2756 women [57.8%]; 1558 [32.7%] aged ≥70 years at diagnosis) were included in the analysis. There were 630 Hispanic (13.2%), 196 non-Hispanic Asian American or Pacific Islander (4.1%), 568 non-Hispanic Black (11.9%), and 3173 non-Hispanic White individuals (66.5%). Compared with non-Hispanic White individuals, Hispanic and non-Hispanic Black individuals were more likely to experience a delay of at least 14 days or discontinuation of any treatment and drug-based treatment; only estimates for non-Hispanic Black individuals were statistically significant, with correction for multiple comparisons (risk ratios [RRs], 1.35 [95% CI, 1.22-1.49] and 1.37 [95% CI, 1.23-1.52], respectively). Area-level SDOH (eg, geography, proportion of residents without health insurance or with only a high school education, lower median household income) were associated with delayed or discontinued treatment. In multivariable Cox proportinal hazards regression models, estimates suggested that Hispanic (hazard ratio [HR], 0.87 [95% CI, 0.71-1.05]), non-Hispanic Asian American or Pacific Islander (HR, 0.79 [95% CI, 0.46-1.35]), and non-Hispanic Black individuals (HR, 0.81 [95% CI, 0.67-0.97]) experienced longer delays to restarting pharmacotherapy compared with non-Hispanic White individuals. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that race and ethnicity and area-level SDOH were associated with delayed or discontinued cancer treatment and longer delays to the restart of drug-based therapies following SARS-CoV-2 infection. Such treatment delays could exacerbate persistent cancer survival inequities in the United States.
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Affiliation(s)
- Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Adiba Ashrafi
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Nabarun Ghosh
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Jennifer Tsui
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Yong Lin
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Angela J. Fong
- Rutgers Cancer Institute of New Jersey, New Brunswick
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Shridar Ganesan
- Rutgers Cancer Institute of New Jersey, New Brunswick
- Department of Medicine and Pharmacology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Carolyn J. Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Kodde C, Bonsignore M, Schöndube D, Bauer T, Hohenstein S, Bollmann A, Meier-Hellmann A, Kuhlen R, Nachtigall I. Mortality in cancer patients with SARS-CoV-2 or seasonal influenza: an observational cohort study from a German-wide hospital network. Infection 2023; 51:119-127. [PMID: 35657531 PMCID: PMC9163872 DOI: 10.1007/s15010-022-01852-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/07/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE At the beginning of the COVID-19 pandemic, SARS-CoV-2 was often compared to seasonal influenza. We aimed to compare the outcome of hospitalized patients with cancer infected by SARS-CoV-2 or seasonal influenza including intensive care unit admission, mechanical ventilation and in-hospital mortality. METHODS We analyzed claims data of patients with a lab-confirmed SARS-CoV-2 or seasonal influenza infection admitted to one of 85 hospitals of a German-wide hospital network between January 2016 and August 2021. RESULTS 29,284 patients with COVID-19 and 7442 patients with seasonal influenza were included. Of these, 360 patients with seasonal influenza and 1625 patients with COVID-19 had any kind of cancer. Cancer patients with COVID-19 were more likely to be admitted to the intensive care unit than cancer patients with seasonal influenza (29.4% vs 24.7%; OR 1.31, 95% CI 1.00-1.73 p < .05). No statistical significance was observed in the mechanical ventilation rate for cancer patients with COVID-19 compared to those with seasonal influenza (17.2% vs 13.6% OR 1.34, 95% CI 0.96-1.86 p = .09). 34.9% of cancer patients with COVID-19 and 17.9% with seasonal influenza died (OR 2.45, 95% CI 1.81-3.32 p < .01). Risk factors among cancer patients with COVID-19 or seasonal influenza for in-hospital mortality included the male gender, age, a higher Elixhauser comorbidity index and metastatic cancer. CONCLUSION Among cancer patients, SARS-CoV-2 was associated with a higher risk for in-hospital mortality than seasonal influenza. These findings underline the need of protective measurements to prevent an infection with either COVID-19 or seasonal influenza, especially in this high-risk population.
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Affiliation(s)
- Cathrin Kodde
- Department of Respiratory Diseases “Heckeshorn”, Helios Clinic Emil-Von-Behring, Berlin, Germany
| | - Marzia Bonsignore
- Division of Infectious Diseases and Prevention, Helios Hospitals Duisburg, Duisburg, Germany
| | - Daniel Schöndube
- grid.491878.b0000 0004 0542 382XDepartment of Oncology and Hematology, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - Torsten Bauer
- Department of Respiratory Diseases “Heckeshorn”, Helios Clinic Emil-Von-Behring, Berlin, Germany
| | - Sven Hohenstein
- grid.9647.c0000 0004 7669 9786Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Andreas Bollmann
- grid.9647.c0000 0004 7669 9786Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Irit Nachtigall
- Division of Infectious Diseases and Infection Prevention, Helios Hospital Emil-Von-Behring, Berlin, Germany ,grid.6363.00000 0001 2218 4662Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Onder AH, Keskin AS, Onder KD, Kizilates F, Heybeli C. Factors associated with development of an acute ischemic event during hospitalization for COVID-19 in cancer and non-cancer patients. Ann Saudi Med 2023; 43:1-9. [PMID: 36739498 PMCID: PMC9899339 DOI: 10.5144/0256-4947.2023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND COVID-19 and solid cancer are both associated with an increased risk of thromboembolism. OBJECTIVES Assess whether solid cancer is a risk factor for acute ischemic event development among patients with COVID-19. DESIGN Retrospective cohort SETTING: A tertiary training and research hospital PATIENTS AND METHODS: Patients who were hospitalized for COVID-19 for ≥3 days between 15 March 2020 and 30 March 2021 at Antalya Training and Research Hospital, Antalya, Turkiye. were included in the study. Independent predictors of the development of acute ischemic events during hospitalization were determined using multivariable logistic regression analysis. MAIN OUTCOME MEASURES Risk factors for acute ischemic event development. SAMPLE SIZE 538 patients. RESULTS Patients diagnosed with solid cancer comprised 11.3% of the cohort (n=61). Forty-one (7.6%) developed an acute ischemic event at a median of 3 (range, 1-15) days after hospitalization. The presence of a solid cancer (OR 3.80, 95% CI 1.20-12.03, P=.023) along with length of hospital stay (OR 1.05 per day, 95% CI 1.01-1.09, P=.025) were independent predictors of acute ischemic event development during the course of COVID-19. Mortality was reported in 200 (37%) patients at a median of 5 (range, 3-10) days after hospitalization. The presence of solid tumor increased mortality 5.83 times (95% CI 3.19-10.63, P<.001) while this ratio was 4.59 (95% CI 2.29-9.23, P<.001) for patients who experienced an acute ischemic event. CONCLUSION Patients with active cancer carry a significant risk for acute ischemic event development during the course of COVID-19 and such patients may require particular attention in terms of anticoagulation therapy. LIMITATIONS Retrospective design and small sample size. CONFLICT OF INTEREST None.
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Affiliation(s)
- Arif Hakan Onder
- From the Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkiye
| | - Aysegul Seremet Keskin
- From the Department of Infectious Disease and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkiye
| | - Kubra Demir Onder
- From the Department of Infectious Disease and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkiye
| | - Filiz Kizilates
- From the Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkiye
| | - Cihan Heybeli
- From the Division of Nephrology, Mus State Hospital, Mus, Turkiye
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In-Hospital Mortality and Morbidity in Cancer Patients with COVID-19: A Nationwide Analysis from the United States. Cancers (Basel) 2022; 15:cancers15010222. [PMID: 36612218 PMCID: PMC9818639 DOI: 10.3390/cancers15010222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused significant mortality and mortality worldwide. There is limited information describing the outcomes of COVID-19 in cancer patients. Methods: We utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) 2020 database to collect information on cancer patients hospitalized for COVID-19 in the United States. Using the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) coding system, adult (≥18 years) patients with COVID-19 were identified. Adjusted analyses were performed to assess for mortality, morbidity, and resource utilization among cancer patients. Results: A total of 1,050,045 patients were included. Of them, 27,760 had underlying cancer. Cancer patients were older and had more comorbidities. The all-cause in-hospital mortality rate in cancer patients was 17.58% vs. 11% in non-cancer. After adjusted logistic regression, cancer patients had a 21% increase in the odds of all-cause in-hospital mortality compared with those without cancer (adjusted odds ratio (aOR) 1.21, 95%CI 1.12−1.31, p-value < 0.001). Additionally, an increased odds in acute respiratory failure rate was found (aOR 1.14, 95%CI 1.06−1.22, p-value < 0.001). However, no significant differences were found in the odds of septic shock, acute respiratory distress syndrome, and mechanical ventilation between the two groups. Additionally, no significant differences in the mean length of hospital stay and the total hospitalization charges between cancer and non-cancer patients. Conclusion: Cancer patients hospitalized for COVID-19 had increased odds of all-cause in hospital mortality and acute respiratory failure compared with non-cancer patients.
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Single Center Experience Using Monoclonal COVID-19 Antibodies in the Management of Immunocompromised Patients with COVID-19. Microorganisms 2022; 10:microorganisms10122490. [PMID: 36557743 PMCID: PMC9786569 DOI: 10.3390/microorganisms10122490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The medical care of immunocompromised patients with COVID-19 infection causes major hurdles in the management of these patients in clinical practice. However, poor responses to vaccinations in patients with oncological or autoimmune diseases require rapid action and effective care in this fragile patient population. Monoclonal antibodies (mAb) offer an effective therapeutic option with a favorable toxicity profile. We have retrospectively reviewed the first 100 patients treated with mAb in our clinic and assessed the individual vaccine response, side effects of mAb, hospitalization rate and mortality. None of the outpatients treated with mAb had to be hospitalized. In particular, the third SARS-CoV-2 vaccination had a significant effect on the seroconversion (37.5% vs. 77.8% positive patients) in the entire group of patients studied. No side effects of 3°/4° were observed following mAb administration; the mortality in the entire cohort was 7%. Our data and experience show good effectiveness and a favorable tolerability profile of mAb, supporting the feasibility of this therapy in everyday clinical practice. Of note, in immunocompromised patients, both the vaccination status and success need to be recorded in a systematic manner and taken into account in terms of therapeutic intervention using mAb in case of a SARS-CoV-2 infection.
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Seknazi L, Jamelot M, Canouï-Poitrine F, Gligorov J, Benderra MA. COVID-19 mortality: are comorbidities, socio-economic status and ethnicity more important than cancer? ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1302. [PMID: 36660679 PMCID: PMC9843393 DOI: 10.21037/atm-22-5592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Lauren Seknazi
- Department of Medical Oncology, Institut Universitaire de Cancérologie, Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | - Mathieu Jamelot
- Department of Medical Oncology, Institut Universitaire de Cancérologie, Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | - Florence Canouï-Poitrine
- Université Paris-Est Créteil, INSERM, IMRB, Créteil, France;,AP-HP, Henri-Mondor Hospital, Public Health Department & Clinical Research Unit (URC Mondor), Créteil, France
| | - Joseph Gligorov
- Department of Medical Oncology, Institut Universitaire de Cancérologie, Sorbonne University, AP-HP, Tenon Hospital, Paris, France;,INSERM U938, CRSA, Institut Universitaire de Cancérologie, AP-HP Sorbonne Université, Paris, France
| | - Marc-Antoine Benderra
- Department of Medical Oncology, Institut Universitaire de Cancérologie, Sorbonne University, AP-HP, Tenon Hospital, Paris, France;,Université Paris-Est Créteil, INSERM, IMRB, Créteil, France;,AP-HP, Henri-Mondor Hospital, Public Health Department & Clinical Research Unit (URC Mondor), Créteil, France
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Refaat L, Abdellateif MS, Bayoumi A, Khafagy M, Kandeel EZ, Nooh HA. Detection of abnormal lymphocytes in the peripheral blood of COVID-19 cancer patients: diagnostic and prognostic possibility. Hematology 2022; 27:745-756. [PMID: 35724413 DOI: 10.1080/16078454.2022.2089830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Peripheral morphological abnormalities play important roles in the early diagnosis and prognosis of the COVID-19 infection. The aim of the present study was to assess the morphological alterations in the peripheral blood (PB) cells in patients with COVID-19 infection, with special attention to a different group of atypical lymphocytes that had been observed in the PB of COVID-19 cancer and non-cancer patients. METHODS The PB cells were examined in 84 COVID-19 positive cancer patients, and 20 COVID-19 positive non-cancer patients, compared to 30 healthy normal controls. The data were correlated to the disease severity, patients' clinicopathological features, and outcomes. RESULTS There was an increased incidence of giant platelets, neutrophils shifting left, and abnormal monocytes in the COVID-19 positive cancer and non-cancer patients compared to the control group (P < .001, P < .001 and P = .014; respectively). Neutrophils with abnormal toxic granulations, Pseudo Pelger-Heut abnormality, and reactive lymphocytes were significantly increased in COVID-19 cancer patients compared to COVID-19 non-cancer patients and the control group (P = .001, P < .001, and P < .001; respectively). An abnormal form of lymphocytes' morphological changes (Covicytes) was significantly detected in COVID-19 cancer patients [60.7% (51/84)], and in COVID-19 non-cancer patients [55% (11/20)], while it was absent in the normal controls [0.0% (0/30), P < 0.001]. The presence of the Covicytes is associated significantly with a better prognosis in cancer and non-cancer COVID-19 patients. CONCLUSION Covicytes could be a useful marker supporting the diagnosis of SARS-COV-2 infection, and it is associated with a favorable prognosis.
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Affiliation(s)
- Lobna Refaat
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mona S Abdellateif
- Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmed Bayoumi
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Medhat Khafagy
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Eman Z Kandeel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hend A Nooh
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
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Khosravifar M, Koolaji S, Rezaei N, Ghanbari A, Hashemi SM, Ghasemi E, Bitaraf A, Tabatabaei‐Malazy O, Rezaei N, Fateh SM, Dilmaghani‐Marand A, Haghshenas R, Kazemi A, Pakatchian E, Kompani F, Djalalinia S. A year of experience with COVID-19 in patients with cancer: A nationwide study. Cancer Rep (Hoboken) 2022; 6:e1678. [PMID: 36437484 PMCID: PMC9875662 DOI: 10.1002/cnr2.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cancer is a major public health problem and comorbidity associated with COVID-19 infection. According to previous studies, a higher mortality rate of COVID-19 in cancer patients has been reported. AIMS This study was undertaken to determine associated risk factors and epidemiological characteristics of hospitalized COVID-19 patients with cancer using a nationwide COVID-19 hospital data registry in Iran for the first time. METHODS In this retrospective study, we used a national data registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) symptoms and patients with confirmed positive COVID-19 PCR between 18 February 2020 and 18 November 2020. The patients were classified into two groups patients with/without malignancy. Logistic regression model was utilized to analyze demographic factors, clinical features, comorbidities, and their associations with the disease outcomes. RESULTS In this study, 11 068 and 645 186 in-patients with SARS symptoms with and without malignancy were included, respectively. About 1.11% of our RT-PCR-positive patients had cancer. In patients with malignancy and COVID-19, older ages than 60 (OR: 1.88, 95% CI: 1.29-2.74, p-value: .001), male gender (OR: 1.43, 95% CI: 1.16-1.77, p-value: .001), concomitant chronic pulmonary diseases (CPD) (OR: 1.75, 95% CI: 1.14-2.68, p-value: .009), and presence of dyspnea (OR; 2.00, 95% CI: 1.60-2.48, p-value: <.001) were associated with increased mortality rate. CONCLUSION Given the immunocompromised state of patients with malignancy and their vulnerability to Covid-19 complications, collecting data on the comorbidities and their effects on the disease outcome can build on a better clinical view and help clinicians make decisions to manage these cases better; for example, determining special clinical care, especially in the shortage of health services.
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Affiliation(s)
- Mina Khosravifar
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sogol Koolaji
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Negar Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Ghanbari
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Seyedeh Melika Hashemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Ghasemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Bitaraf
- School of MedicineKermanshah University of Medical sciencesKermanshahIran
| | - Ozra Tabatabaei‐Malazy
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nazila Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sahar Mohammadi Fateh
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Arezou Dilmaghani‐Marand
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Rosa Haghshenas
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ameneh Kazemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Pakatchian
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farzad Kompani
- Division of Hematology and OncologyChildren's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical SciencesTehranIran
| | - Shirin Djalalinia
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Deputy of Research and TechnologyMinistry of Health and Medical EducationTehranIran
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Waghmare A. SARS-CoV-2 infection and COVID-19 in children. Clin Chest Med 2022; 44:359-371. [PMID: 37085225 PMCID: PMC9678836 DOI: 10.1016/j.ccm.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is common in children, and clinical manifestations can vary depending on age, underlying disease, and vaccination status. Most children will have asymptomatic or mild infection, but certain baseline characteristics can increase the risk of moderate to severe disease. The following article will provide an overview of the clinical manifestations of coronavirus disease 2019 in children, including the post-infectious phenomenon called multisystem inflammatory syndrome in children. Currently available treatment and prophylaxis strategies will be outlined, with the caveat that new therapeutics and clinical efficacy data are constantly on the horizon.
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Al-qaim ZH, Owadh HKH, Ali SA, Hussein AS, Ameen TR, Kolemen A, Washi GA, Jalil AT. COVID-19 vaccination in patients with cancer: Opportunities and challenges. Front Oncol 2022; 12:1029325. [PMID: 36425557 PMCID: PMC9679654 DOI: 10.3389/fonc.2022.1029325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/17/2022] [Indexed: 09/26/2023] Open
Abstract
The rapid spread of the SARS-Cov-2 virus, the increase in the number of patients with severe COVID-19, and the high mortality rate created the basis for the production of safe and effective vaccines. Studies have confirmed the increased risk of severe Covid-19 disease and mortality in cancer patients. It is logical that cancer patients should be the first to receive the primary vaccination and the booster vaccine for Covid-19. Since studies related to cancer patients and the effectiveness of existing Covid-19 vaccines have not been widely conducted, there are significant uncertainties about the effectiveness of the vaccine and the level of humoral and cellular immune responses in these patients. As a result, the possible risks and side effects of existing vaccines are not clear for patients with different cancers who are undergoing special treatments. In this study, we will discuss the effectiveness and safety of existing vaccines on cancer patients. In addition, we highlight factors that could affect the effectiveness of vaccines in these patients and finally discuss opportunities and challenges related to vaccination in cancer patients.
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Affiliation(s)
- Zahraa Haleem Al-qaim
- Anesthesia Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | | | - Sarah A. Ali
- Department of Medical Laboratory Techniques, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Alaa S. Hussein
- Radiological Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | | | - Ayshan Kolemen
- Department of Dentistry, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Ghassan A. Washi
- Department of Nursing, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Abduladheem Turki Jalil
- Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, Iraq
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de Brito BB, Marques HS, Silva FAFD, Cordeiro Santos ML, Araújo GRL, Valente LDA, Freire de Melo F. Influence of the COVID-19 pandemic in the gastrointestinal oncology setting: An overview. World J Gastrointest Pathophysiol 2022; 13:157-169. [PMID: 36187602 PMCID: PMC9516457 DOI: 10.4291/wjgp.v13.i5.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/27/2022] [Accepted: 08/18/2022] [Indexed: 02/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been impacting healthcare in various ways worldwide and cancer patients are greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. The reorganization of the health facilities in order to supply the high demand resulting from the aforementioned infection as well as the social isolation measures led to impairments for the diagnosis and follow-up of patients with gastrointestinal cancers, which has had an impact on the prognosis of the oncologic patients. In that context, health authorities and organizations have elaborated new guidelines with specific recommendations for the management of individuals with gastrointestinal neoplasms during the pandemic. Of note, oncologic populations seem to be more susceptible to unfavorable outcomes when exposed to SARS-CoV-2 infection and some interactions involving virus, tumor, host immune system and anticancer therapies are probably related to the poorer prognosis observed in those COVID-19 patients. Moreover, vaccination stands out as the main prevention method against severe SARS-CoV-2 infection and some particularities have been observed regarding the seroconversion of vaccinated oncologic patients including those with gastrointestinal malignancies. In this minireview, we gather updated information regarding the influence of the pandemic in the diagnosis of gastrointestinal neoplasms, new recommendations for the management of gastrointestinal cancer patients, the occurrence of SARS-CoV-2 infection in those individuals and the scenario of the vaccination against the virus in that population.
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Affiliation(s)
- Breno Bittencourt de Brito
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Hanna Santos Marques
- Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45055-380, Bahia, Brazil
| | | | - Maria Luísa Cordeiro Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Glauber Rocha Lima Araújo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Lara de Araujo Valente
- Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45055-380, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Brazil
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Preface of the Special Issue "COVID-19 Infection and Hematological Malignancies". Cancers (Basel) 2022; 14:cancers14184497. [PMID: 36139657 PMCID: PMC9496995 DOI: 10.3390/cancers14184497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 01/08/2023] Open
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Martín M, Vallejo C, López-Campos F, Quereda C, Muñoz T, Sánchez-Conde M, Dominguez JA, Soriano C, Martín M, Suárez-Carantoña C, Muriel A, Garrido P, Acero J, Alvarez-Diaz A, de la Pinta C, Martínez-García L, Hernánz R, Fernández E, Alarza M, Hervás A, Sancho S. SARS-CoV-2 Virus in Cancer Patients: A New Unknown in an Unsolved Equation. Oncology 2022; 101:1-11. [PMID: 36063800 PMCID: PMC9747739 DOI: 10.1159/000525802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/07/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Cancer patients are more susceptible to infections, and infection can be more severe than in patients without cancer diagnosis. We conducted this retrospective study in patients admitted for SARS-CoV-2 infection in order to find differences in inflammatory markers and mortality in cancer patients compared to others. METHODS We reviewed the electronic records of patients admitted for SARS-CoV-2 infection confirmed by PCR from March to September 2020. Data on socio-demographics, comorbidities, inflammatory makers, and cancer-related features were analyzed. RESULTS 2,772 patients were admitted for SARS-CoV-2, to the Hospital Universitario Ramón y Cajal in Madrid during this period. Of these, 2,527 (91%) had no history of neoplastic disease, 164 (5.9%) patients had a prior history of cancer but were not undergoing oncological treatment at the time of infection, and 81 (2.9%) were in active treatment. Mortality in patients without a history of cancer was 19.5%, 28.6% for patients with a prior history of cancer, and 34% in patients with active cancer treatment. Patients in active oncology treatment with the highest mortality rate were those diagnosed with lung cancer (OR 5.6 95% CI: 2.2-14.1). In the multivariate study, active oncological treatment (OR 2.259 95% CI: 1.35-3.77) and chemotherapy treatment (OR 3.624 95% CI: 1.17-11.17), were statistically significant factors for the risk of death for the whole group and for the group with active oncological treatment, respectively. CONCLUSION Cancer patients on active systemic treatment have an increased risk of mortality after SARS-CoV-2 infection, especially with lung cancer or chemotherapy treatment.
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Affiliation(s)
- Margarita Martín
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain,*Margarita Martín,
| | - Carmen Vallejo
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Fernando López-Campos
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Carmen Quereda
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Teresa Muñoz
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Matilde Sánchez-Conde
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Cruz Soriano
- Intensive Medicine Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Mercedes Martín
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Alfonso Muriel
- Biostatistics Clinic Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Pilar Garrido
- Médical Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Julio Acero
- Oral and Maxillofacial Surgery Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Ana Alvarez-Diaz
- Pharmacy Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Carolina de la Pinta
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Raúl Hernánz
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Eva Fernández
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Marina Alarza
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Asunción Hervás
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sonsoles Sancho
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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Raad I, Hachem R, Masayuki N, Datoguia T, Dagher H, Jiang Y, Subbiah V, Siddiqui B, Bayle A, Somer R, Cruz AF, Gorak E, Bhinder A, Mori N, Hamerschlak N, Shelanski S, Dragivich T, Kiat YEV, Fakhreddine S, Hanna PA, Chemaly RF, Mulanovich V, Adachi J, Borjan J, Khawaja F, Granwehr B, John T, Guevara EY, Torres H, Ammakkanavar NR, Yibirin M, Reyes-Gibby CC, Pande M, Ali N, Rojo RD, Ali SM, Deeba RE, Chaftari P, Matsuo T, Ishikawa K, Hasegawa R, Aguado-Noya R, García-García Á, Puchol CT, Lee DG, Slavin M, Teh B, Arias CA, Kontoyiannis DP, Malek AE, Chaftari AM. International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.08.25.22279181. [PMID: 36097568 PMCID: PMC9465833 DOI: 10.1101/2022.08.25.22279181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background In this international multicenter study we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries. Methods We retrospectively collected de-identified data on a cohort of cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, from 16 international centers. Results We analyzed 3966 COVID-19 confirmed patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were more likely to be pancytopenic, and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding two weeks (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms (p≤0.01). By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46; 95% CI 1.03 to 2.07; p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55; 95% CI 3.34 to6.20; p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58; CI 0.39-0.88; p=0.009). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who did not (5.9% vs 17.6%; p=0.03). Conclusions Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality. Condensed Abstract In this large multicenter worldwide study of 4015 patients with COVID-19 that included 1115 patients with cancer, we found that cancer is an independent risk factor for increased 30-day all-cause mortality. Remdesivir is a promising treatment modality to reduce 30-day all-cause mortality.
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Milch V, Nelson AE, Austen M, Hector D, Turnbull S, Sathiaraj R, Der Vartanian C, Wang R, Anderiesz C, Keefe D. Conceptual Framework for Cancer Care During a Pandemic Incorporating Evidence From the COVID-19 Pandemic. JCO Glob Oncol 2022; 8:e2200043. [PMID: 35917484 PMCID: PMC9470141 DOI: 10.1200/go.22.00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE With successive infection waves and the spread of more infectious variants, the COVID-19 pandemic continues to have major impacts on health care. To achieve best outcomes for patients with cancer during a pandemic, efforts to minimize the increased risk of severe pandemic infection must be carefully balanced against unintended adverse impacts of the pandemic on cancer care, with consideration to available health system capacity. Cancer Australia's conceptual framework for cancer care during a pandemic provides a planning resource for health services and policy-makers that can be broadly applied globally and to similar pandemics. METHODS Evidence on the impact of the COVID-19 pandemic on cancer care and health system capacity to June 2021 was reviewed, and the conceptual framework was developed and updated. RESULTS Components of health system capacity vary during a pandemic, and capacity relative to pandemic numbers and severity affects resources available for cancer care delivery. The challenges of successive pandemic waves and high numbers of pandemic cases necessitate consideration of changing health system capacity in decision making about cancer care. Cancer Australia’s conceptual framework provides guidance on continuation of care across the cancer pathway, in the face of challenges to health systems, while minimizing infection risk for patients with cancer and unintended consequences of delays in screening, diagnosis, and cancer treatment and backlogs because of service interruption. CONCLUSION Evidence from the COVID-19 pandemic supports continuation of cancer care wherever possible during similar pandemics. Cancer Australia's conceptual framework, underpinned by principles for optimal cancer care, informs decision making across the cancer care continuum. It incorporates consideration of changes in health system capacity and capacity for cancer care, in relation to pandemic progression, enabling broad applicability to different global settings.
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Affiliation(s)
- Vivienne Milch
- Cancer Australia, Sydney, New South Wales, Australia
- The University of Notre Dame, Sydney, New South Wales, Australia
| | - Anne E. Nelson
- Evidence Review Contractor, Sydney, New South Wales, Australia
| | | | - Debra Hector
- Cancer Australia, Sydney, New South Wales, Australia
| | | | | | | | - Rhona Wang
- Cancer Australia, Sydney, New South Wales, Australia
| | - Cleola Anderiesz
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- National Breast Cancer Foundation, Sydney, New South Wales, Australia
| | - Dorothy Keefe
- Cancer Australia, Sydney, New South Wales, Australia
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Feasibility and Application of Cluster Nursing to the Care of Patients with Acute Oncology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8973449. [PMID: 35958913 PMCID: PMC9357692 DOI: 10.1155/2022/8973449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
Objective To probe the utility of cluster nursing for the care of acute oncology clients. Methods One hundred fourteen cases of acute oncology pioneers undergoing therapy in our clinic from April 2019 to February 2021 were randomly assigned into two consecutive arms, conventional care and cluster care, in accordance with the nursing modality. Complications, satisfaction, quality of survival, and negative emotions were compared across the two parties. Results The comorbidity incidence rate of the subject matter in the research cohort was 7.02%, which was below the comorbidity rate of 17.54% in the reaction cohort (P < 0.05); the percentage of satisfaction in the research cohort was 96.49%, which was higher than the satisfaction rate of 78.95% in the reaction cohort (P < 0.05); aftercare, the quality of survival was significantly higher in both groups, and the SAS and SDS scores were significantly lower, with a more pronounced trend of change in the research cohort than in the reaction cohort (P < 0.05). Conclusion Bundled care for casualty oncology is of major value, with a marked reduction in the incidence of postoperative complications, high quality of survival, an excellent prognosis and negative mood, high patient morale and satisfaction and compliance with curative treatment, and good support for subsequent care.
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Shumilov E, Aperdannier L, Schmidt N, Szuszies C, Neesse A, Hoffknecht P, Khandanpour C, Mikesch JH, Stelljes M, Boeckel GR, Tepasse PR, Reitnauer L, Koch R, Hasenkamp J, Bacher U, Scheithauer S, Trümper L, Schmitz N, Wulf G, Kerkhoff A, Lenz G, Krekeler C, Bleckmann A. Clinical Post-SARS-CoV-2 Infection Scenarios in Vaccinated and Non-Vaccinated Cancer Patients in Three German Cancer Centers: A Retrospective Analysis. Cancers (Basel) 2022; 14:cancers14153746. [PMID: 35954410 PMCID: PMC9367483 DOI: 10.3390/cancers14153746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary This study investigated SARS-CoV-2 infections and their impact on cancer in COVID-19 vaccinated (n = 49) and non-vaccinated (n = 84) cancer patients. A mild course of COVID-19 was documented more frequently in vaccinated cancer patients (49% vs. 29%), while the incidence of severe and critical courses occurred in approximately one-half of the non-vaccinated patients (22% vs. 42%). In comparison to non-vaccinated patients, admissions to intermediate and intensive care units and the need for non-invasive and invasive respiratory support were reduced by 71% and 50% among vaccinated patients. The median length of hospital stay was 11 days for non-vaccinated and 5 days for vaccinated patients. COVID-19 mortality was reduced by 83% in vaccinated patients. Finally, the median time from SARS-CoV-2 infection to restarting cancer therapy was 12 and 26 days among vaccinated and non-vaccinated groups, respectively. Our results provide evidence for the significant benefits of COVID-19 vaccines for cancer patients. Abstract COVID-19 vaccines have become an integral element in the protection of cancer patients against SARS-CoV-2. To date, there are no direct comparisons of the course of COVID-19 infection in cancer patients between the pre- and post-vaccine era. We analyzed SARS-CoV-2 infections and their impact on cancer in COVID-19 vaccinated and non-vaccinated patients from three German cancer centers. Overall, 133 patients with SARS-CoV-2 were enrolled in pre- and post-vaccine eras: 84 non-vaccinated and 49 vaccinated, respectively. A mild course of COVID-19 was documented more frequently in vaccinated patients (49% vs. 29%), while the frequency of severe and critical courses occurred in approximately one-half of the non-vaccinated patients (22% vs. 42%, p = 0.023). Particularly, patients with hematologic neoplasms benefited from vaccination in this context (p = 0.031). Admissions to intermediate- and intensive-care units and the necessity of non-invasive and invasive respiratory support were reduced by 71% and 50% among vaccinated patients, respectively. The median length of admission was 11 days for non-vaccinated and 5 days for vaccinated patients (p = 0.002). COVID-19 mortality was reduced by 83% in vaccinated patients (p = 0.046). Finally, the median time from SARS-CoV-2 infection to restarting cancer therapy was 12 and 26 days among vaccinated and non-vaccinated groups, respectively (p = 0.002). Although this study does not have enough power to perform multivariate analyses to account for confounders, it provides data on COVID-19 in non-vaccinated and vaccinated cancer patients and illustrates the potential benefits of COVID-19 vaccines for these patients.
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Affiliation(s)
- Evgenii Shumilov
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Correspondence: or (E.S.); (A.B.)
| | - Lena Aperdannier
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Nicole Schmidt
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Christoph Szuszies
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Albrecht Neesse
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany;
| | - Petra Hoffknecht
- Department of Thorax Oncology, Franziskus-Hospital Harderberg, Niels-Stensen-Kliniken, 49124 Georgsmarienhütte, Germany;
| | - Cyrus Khandanpour
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Department of Hematology and Medical Oncology, University of Lübeck and University of Schleswig-Holstein, 23564 Lübeck, Germany
| | - Jan-Henrik Mikesch
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Matthias Stelljes
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Göran Ramin Boeckel
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Münster, Germany; (G.R.B.); (P.-R.T.)
- Department of Medicine D for Nephrology and Rheumatology, University Hospital Münster, 48149 Münster, Germany
| | - Phil-Robin Tepasse
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Münster, Germany; (G.R.B.); (P.-R.T.)
| | - Lea Reitnauer
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Raphael Koch
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Justin Hasenkamp
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Ulrike Bacher
- Central Hematology Laboratory, Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Medicine Göttingen (UMG), 37077 Göttingen, Germany;
| | - Lorenz Trümper
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Norbert Schmitz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Gerald Wulf
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Andrea Kerkhoff
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Carolin Krekeler
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Annalen Bleckmann
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Correspondence: or (E.S.); (A.B.)
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COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress. Cancers (Basel) 2022; 14:cancers14153711. [PMID: 35954374 PMCID: PMC9367547 DOI: 10.3390/cancers14153711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary We herein report a review of the current literature on adult patients with acute leukemia (AL) infected with SARS-CoV-2. SARS-CoV-2-associated mortality ranges from 20–52% in adult patients with AL, and patients with acute myeloid leukemia have a particularly high COVID-19-related mortality. Of note, most of the available data relate to the pre-vaccination era and to variants before Omicron. Based on expert opinions, the current recommendations suggest delaying systemic AL treatment in SARS-CoV-2-positive patients until SARS-CoV-2 negativity, if immediate AL treatment is not required. It is recommended to offer vaccination to all AL patients, and seronegative patients should additionally receive prophylactic administration of anti-SARS-CoV-2 monoclonal antibodies. Patients with AL infected with SARS-CoV-2 should be treated early with antiviral therapy to prevent disease progression and to enable the rapid elimination of the virus. Abstract The majority of publications regarding SARS-CoV-2 infections in adult patients with acute leukemia (AL) refer to hematological patients in general and are not focused on acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). We herein report a review of the current literature on adult AL patients infected with SARS-CoV-2. Overall, SARS-CoV-2-associated mortality ranges from 20–52% in patients with adult AL. AML patients have a particularly high COVID-19-related mortality. Of note, most of the available data relate to the pre-vaccination era and to variants before Omicron. The impact of COVID-19 infections on AL treatment is rarely reported. Based on the few studies available, treatment delay does not appear to be associated with an increased risk of relapse, whereas therapy discontinuation was associated with worse outcomes in AML patients. Therefore, the current recommendations suggest delaying systemic AL treatment in SARS-CoV-2-positive patients until SARS-CoV-2 negativity, if immediate AL treatment is not required. It is recommended to offer vaccination to all AL patients; the reported antibody responses are around 80–96%. Seronegative patients should additionally receive prophylactic administration of anti-SARS-CoV-2 monoclonal antibodies. Patients with AL infected with SARS-CoV-2 should be treated early with antiviral therapy to prevent disease progression and enable the rapid elimination of the virus.
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Raichle C, Borgmann S, Bausewein C, Rieg S, Jakob CEM, Simon ST, Tometten L, Vehreschild JJ, Leisse C, Erber J, Stecher M, Pauli B, Rüthrich MM, Pilgram L, Hanses F, Isberner N, Hower M, Degenhardt C, Hertenstein B, Vehreschild MJGT, Römmele C, Jung N. Hospitalized patients dying with SARS-CoV-2 infection—An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry. PLoS One 2022; 17:e0271822. [PMID: 35905129 PMCID: PMC9337665 DOI: 10.1371/journal.pone.0271822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background
COVID-19 is a severe disease with a high need for intensive care treatment and a high mortality rate in hospitalized patients. The objective of this study was to describe and compare the clinical characteristics and the management of patients dying with SARS-CoV-2 infection in the acute medical and intensive care setting.
Methods
Descriptive analysis of dying patients enrolled in the Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS), a non-interventional cohort study, between March 18 and November 18, 2020. Symptoms, comorbidities and management of patients, including palliative care involvement, were compared between general ward and intensive care unit (ICU) by univariate analysis.
Results
580/4310 (13%) SARS-CoV-2 infected patients died. Among 580 patients 67% were treated on ICU and 33% on a general ward. The spectrum of comorbidities and symptoms was broad with more comorbidities (≥ four comorbidities: 52% versus 25%) and a higher age distribution (>65 years: 98% versus 70%) in patients on the general ward. 69% of patients were in an at least complicated phase at diagnosis of the SARS-CoV-2 infection with a higher proportion of patients in a critical phase or dying the day of diagnosis treated on ICU (36% versus 11%). While most patients admitted to ICU came from home (71%), patients treated on the general ward came likewise from home and nursing home (44% respectively) and were more frequently on palliative care before admission (29% versus 7%). A palliative care team was involved in dying patients in 15%. Personal contacts were limited but more often documented in patients treated on ICU (68% versus 47%).
Conclusion
Patients dying with SARS-CoV-2 infection suffer from high symptom burden and often deteriorate early with a demand for ICU treatment. Therefor a demand for palliative care expertise with early involvement seems to exist.
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Affiliation(s)
- Claudia Raichle
- Department of Geriatric and Palliative Medicine, Tropenklinik Paul-Lechler-Krankenhaus, Tübingen, Germany
- * E-mail: (NJ); (CR)
| | - Stefan Borgmann
- Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
| | | | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Centre–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carolin E. M. Jakob
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Steffen T. Simon
- Department of Palliative Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Lukas Tometten
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- Center for Internal Medicine, Medical Department 2, Hematology/Oncology and Infectious Diseases, University Hospital of Frankfurt, Frankfurt, Germany
- German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - Charlotte Leisse
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Johanna Erber
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - Berenike Pauli
- Department of Palliative Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Maria Madeleine Rüthrich
- Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Jena, Germany
| | - Lisa Pilgram
- Center for Internal Medicine, Medical Department 2, Hematology/Oncology and Infectious Diseases, University Hospital of Frankfurt, Frankfurt, Germany
| | - Frank Hanses
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Nora Isberner
- Department of Internal Medicine II, Division of Infectious Diseases, University Hospital Würzburg, Würzburg, Germany
| | - Martin Hower
- Department of Internal Medicine, Klinikum Dortmund, Dortmund, Germany
| | | | | | - Maria J. G. T. Vehreschild
- Department of Internal Medicine 2, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Christoph Römmele
- Department of Internal Medicine III–Gastroenterology and Infectious Diseases, University Hospital Augsburg, Augsburg, Germany
| | - Norma Jung
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- * E-mail: (NJ); (CR)
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The Effects of the COVID-19 Pandemic in Oncology Patient Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159041. [PMID: 35897414 PMCID: PMC9330710 DOI: 10.3390/ijerph19159041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic has changed the way cancer patients should be managed. Using published literature on best practices on oncology patient management, we developed checklists to establish which recommendations were followed and differences between healthcare staff and institutions in a local health unit (overseeing two regional hospitals and 14 primary Healthcare Centers) in an interior region in Portugal. Checklists were delivered and completed by 15 physicians, 18 nurses and 5 pharmacists working at the Hospitals, and 29 physicians and 46 nurses from primary healthcare centers. Hospital staff do not show statistically significant differences regarding most proposed recommendations for the oncology clinical pathway, human resources, treatments, patient management and service management. Primary healthcare centers seem to follow a similar trend. As a local health unit, general recommendations for Oncology Patient Management show statistically significantly different values on education of suspected cases, identification, isolation procedures and samples collection; extension of work schedules; and education on cancer patient and COVID-19 positive referral procedures. All the checklists indicated good-to-high internal consistency. Our analysis showed cohesive work between groups regarding control and prevention of sources of infection; therefore, it is considered the highest priority to ensure that all other services, including oncology, continue functioning. Patient management measures such as adjustments in treatments, analysis, patient care, referrals and emergencies were not ranked higher by responders.
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Liu D, Yuan X, Gao F, Zhao B, Ding L, Huan M, Liu C, Jiang L. High Number and Specific Comorbidities Could Impact the Immune Response in COVID-19 Patients. Front Immunol 2022; 13:899930. [PMID: 35865540 PMCID: PMC9295452 DOI: 10.3389/fimmu.2022.899930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/30/2022] [Indexed: 01/08/2023] Open
Abstract
Background Cellular immunodeficiency and comorbidities are common in COVID-19 patients. Aim The purpose of this study was to investigate comorbidities impacting on the cellular immunity in COVID-19 patients. Methods The research objects included 55 healthy controls and 718 COVID-19 patients who divided into the control group and the COVID-19 group, respectively. Those in the COVID-19 group were divided into subgroups on the basis of the number and types of comorbidities present. Lymphocyte itself and its subsets were compared between the control group and the COVID-19 group, the groups with comorbidities based on the different number and types of comorbidities, and the relationship between the lymphocyte counts and subsets with the number and types of comorbidities was investigated. Results Compared with the control group, the lymphocyte counts and T cell subsets were significantly increased in the groups with comorbidities, but both B and NK cell subsets were significantly decreased in the no comorbidity group and in most of the groups with comorbidities (all P<0.05). In the three comorbidities group, the lymphocyte counts and T cell subsets were all significantly decreased, but the CD56+ percentage was obviously increased (all P<0.05). The number of comorbidities was negatively correlated with the lymphocyte counts and the T and NK cell subsets. A negative correlation also existed between cancer and both the lymphocyte counts and the T cell subsets, between chronic hepatitis B and the lymphocyte counts, and between chronic kidney disease and the CD3+ counts. A positive correlation existed between nonalcoholic fatty liver disease (NAFLD) disease and both lymphocyte and CD3+ counts. The risk factors were number of comorbidities for the lymphocyte count, CD3+CD4+ and CD3+CD8+ percentages, NAFLD for the lymphocyte and CD3+ counts, cardiovascular diseases for CD3+CD4+ and CD3+CD8+ percentages, diabetes mellitus for the CD3+CD8+ percentage, and cancer for the CD3+ percentage, respectively. Conclusions High numbers of comorbidities and specific comorbidities could impact the immune response of COVID-19 patients. This study provides a reference for clinicians in the identification of suitable and timely immunotherapy for COVID-19 patients. Clinical Trial Registry https://www.chictr.org.cn/enindex.aspx, identifier ChiCTR2000034563.
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Affiliation(s)
- Dafeng Liu
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Public Health and Clinical Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Xiaoyan Yuan
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Public Health and Clinical Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Fengjiao Gao
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Public Health and Clinical Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Bennan Zhao
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Public Health and Clinical Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Ling Ding
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Department of Pediatrics, Public Health and Clinical Centre of Chengdu, Chengdu, China
| | - Mingchang Huan
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Department of Surgery, Public Health and Clinical Centre of Chengdu, Chengdu, China
| | - Chao Liu
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Department of Surgery, Public Health and Clinical Centre of Chengdu, Chengdu, China
| | - Liangshuang Jiang
- Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China
- Vice President’s Office, Public Health and Clinical Centre of Chengdu, Chengdu, China
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A O, A C, L V, F C, C B, F CD, G M, F G, S DB, P R, O T, Cm M, M V. Clinical course of Coronavirus Disease-19 in patients with haematological malignancies is characterized by a longer time to respiratory deterioration compared to non-haematological ones: results from a case-control study. Infection 2022; 50:1373-1382. [PMID: 35781785 PMCID: PMC9251021 DOI: 10.1007/s15010-022-01869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/02/2022] [Indexed: 11/06/2022]
Abstract
Background We evaluated clinical features and risk factors for mortality in patients with haematological malignancies and COVID-19. Methods Retrospective, case–control (1:3) study in hospitalized patients with COVID-19. Cases were patients with haematological malignancies and COVID-19, controls had COVID-19 without haematological malignancies. Patients were matched for sex, age and time of hospitalization. Results Overall, 66 cases and 198 controls were included in the study. Cases had higher prior corticosteroid use, infection rates, thrombocytopenia and neutropenia and more likely received corticosteroids and antibiotics than controls. Cases had higher respiratory deterioration than controls (78.7% vs 65.5%, p = 0.04). Notably, 29% of cases developed respiratory worsening > 10 days after hospital admission, compared to only 5% in controls. Intensive Care Unit admission and mortality were higher in cases than in controls (27% vs 8%, p = 0.002, and 35% vs 10%, p < 0.001). At multivariable analysis, having haematological malignancy [OR4.76, p < 0.001], chronic corticosteroid therapy [OR3.65, p = 0.004], prior infections [OR57.7, p = 0.006], thrombocytopenia [OR3.03, p < 0.001] and neutropenia [OR31.1, p = 0.001], low albumin levels [OR3.1, p = 0.001] and ≥ 10 days from hospital admission to respiratory worsening [OR3.3, p = 0.002] were independently associated with mortality. In cases, neutropenia [OR3.1, p < 0.001], prior infections [OR7.7, p < 0.001], ≥ 10 days to respiratory worsening [OR4.1, p < 0.001], multiple myeloma [OR1.5, p = 0.044], the variation of the CT lung score during hospitalization [OR2.6, p = 0.006] and active treatment [OR 4.4, p < 0.001] all were associated with a worse outcome. Conclusion An underlying haematological malignancy was associated with a worse clinical outcome in COVID-19 patients. A prolonged clinical monitoring is needed, since respiratory worsening may occur later during hospitalization. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-022-01869-w.
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Affiliation(s)
- Oliva A
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy.
| | - Curtolo A
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Volpicelli L
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Cancelli F
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Borrazzo C
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Cogliati Dezza F
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Marcelli G
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Gavaruzzi F
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Di Bari S
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Ricci P
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Turriziani O
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Mastroianni Cm
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - Venditti M
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
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Overheu O, Lendowski S, Quast DR, Marheinecke CS, Kourti E, Lugnier C, Andreica I, Kiltz U, Pfaender S, Reinacher-Schick A. Attitude towards and perception of individual safety after SARS-CoV-2 vaccination among German cancer patients. J Cancer Res Clin Oncol 2022; 149:1985-1992. [PMID: 35731276 PMCID: PMC9215322 DOI: 10.1007/s00432-022-04099-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 11/25/2022]
Abstract
Purpose Refusal to receive SARS-CoV-2 vaccination poses a threat to fighting the COVID-19 pandemic. Little is known about German cancer patients’ attitude towards and experience with SARS-CoV-2 vaccination. Methods Patients were enrolled between 04–11/2021. They completed a baseline questionnaire (BLQ) containing multiple choice questions and Likert items ranging from 1 (“totally disagree”) to 11 (“totally agree”) regarding their attitude towards vaccination and COVID-19. A follow-up questionnaire (FUQ) was completed after vaccination. Results 218 patients (43% female) completed BLQ (110 FUQ; 48% female). Most patients agreed to “definitely get vaccinated” (82%) and disagreed with “SARS-CoV-2 vaccination is dispensable due to COVID-19 being no serious threat” (82%; more dissent among men, p = 0.05). Self-assessment as a member of a risk group (p = 0.03) and fear of COVID-19 (p = 0.002) were more common among women. Fear of side effects was more common among women (p = 0.002) and patients with solid or GI tumors (p = 0.03; p < 0.0001). At FUQ, almost all (91%) reported their vaccination to be well tolerated, especially men (p = 0.001). High tolerability correlated with confidence in the vaccine being safe (r = 0.305, p = 0.003). Most patients would agree to get it yearly (78%). After vaccination, patients felt safe meeting friends/family (91%) or shopping (62%). Vacation (32%) or work (22%) were among others considered less safe (less frequent among men, p < 0.05). Conclusion Acceptance of SARS-CoV-2 vaccination is high and it is well tolerated in this sensitive cohort. However, concerns about vaccine safety remain. Those and gender differences need to be addressed. Our results help identify patients that benefit from pre-vaccination consultation.
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Affiliation(s)
- Oliver Overheu
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany.
| | - Simon Lendowski
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Daniel R Quast
- Department of Internal Medicine, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Corinna S Marheinecke
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Eleni Kourti
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Celine Lugnier
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
| | - Ioana Andreica
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Anke Reinacher-Schick
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Gudrunstr 56, 44791, Bochum, Germany
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Kathuria-Prakash N, Antrim L, Hornstein N, Sun AW, Kang IM, Baclig NV, Angell TE, Lechner MG, Wald-Dickler N, In GK. Factors Associated With Hospitalization Among Breast Cancer Patients With COVID-19: A Diverse Multi-Center Los Angeles Cohort Study. Clin Breast Cancer 2022; 22:e558-e566. [PMID: 35027318 PMCID: PMC8677421 DOI: 10.1016/j.clbc.2021.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/22/2021] [Accepted: 12/12/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The SARS-CoV-2 virus has infected and killed millions of people worldwide. Breast cancer is the most prevalent cancer in women and few studies have investigated the outcomes of patients with a history of breast cancer and COVID-19. We report the clinical outcomes of patients with invasive breast cancer who tested positive for SARS-CoV-2, including hospitalization and death, and evaluate demographic and cancer-related factors associated with these outcomes. PATIENTS Patients with a history of invasive breast cancer and positive SARS-CoV-2 test from January 1 to December 31, 2020 at two large, academic Los Angeles health systems were included. METHODS Retrospective chart review of the electronic medical record was performed. Data for demographic and cancer-related factors were manually abstracted. Relationships between outcomes and clinical variables were evaluated using Fisher's exact test and linear regression analysis. RESULTS Among a total of 132 patients, 40 (30.3%) were hospitalized, while 11 (8.3%) required intensive care support, and 8 patients (6.1%) died. Older age and presence of one or more additional comorbidities were associated with hospitalization and death (P = .010, P = .003, P = .034, P < .001). Hispanic/Latinx ethnicity was associated with hospitalization (P = .047). Cancer treatment was not associated with hospitalization or death. CONCLUSION In our diverse, multi-center, breast cancer cohort, Hispanic/Latinx ethnicity, older age and presence of other comorbidities were associated with worse outcomes from COVID-19. Breast cancer treatment, including surgery, radiation, systemic therapy, and endocrine therapy, was not associated with hospitalization in our cohort. Further studies are needed to explore the relationship between breast cancer and COVID-19 outcomes.
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Affiliation(s)
| | - Lauren Antrim
- Department of Medicine, USC Keck School of Medicine, Los Angeles, CA 90033
| | - Nicholas Hornstein
- Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095
| | | | - Irene M. Kang
- Division of Oncology, USC Keck School of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA 90033
| | - Nikita V. Baclig
- Division of Hematology and Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA 90095
| | - Trevor E. Angell
- Division of Endocrinology and Diabetes, USC Keck School of Medicine, Los Angeles, CA 90033
| | - Melissa G. Lechner
- Division of Endocrinology, Diabetes, and Metabolism, UCLA David Geffen School of Medicine, Los Angeles, CA 90095
| | - Noah Wald-Dickler
- Department of Medicine, USC Keck School of Medicine, Los Angeles, CA 90033,Division of Infectious Diseases, USC Keck School of Medicine, Los Angeles, CA 90033
| | - Gino K. In
- Division of Oncology, USC Keck School of Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA 90033,Address for correspondence: Gino K. In, MD, MPH, University of Southern California, Norris Comprehensive Cancer Center, Division of Medical Oncology, 1441 Eastlake Ave, NTT 3449, Los Angeles, CA 90033
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50
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Fendler A, de Vries EGE, GeurtsvanKessel CH, Haanen JB, Wörmann B, Turajlic S, von Lilienfeld-Toal M. COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety. Nat Rev Clin Oncol 2022; 19:385-401. [PMID: 35277694 PMCID: PMC8916486 DOI: 10.1038/s41571-022-00610-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/11/2022]
Abstract
Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future.
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Affiliation(s)
- Annika Fendler
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | | | - John B Haanen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Bernhard Wörmann
- Division of Hematology, Oncology and Tumour Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Samra Turajlic
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
- Skin and Renal Units, The Royal Marsden NHS Foundation Trust, London, UK
| | - Marie von Lilienfeld-Toal
- Department of Haematology and Medical Oncology, University Hospital Jena, Jena, Germany.
- Research Group Infections in Haematology/Oncology, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany.
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