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Ma Y, Zhang L, Wei R, Dai W, Zeng R, Luo D, Jiang R, Zhuo Z, Yang Q, Li J, Leung FW, Duan C, Sha W, Chen H. Risks of digestive diseases in long COVID: evidence from a population-based cohort study. BMC Med 2024; 22:14. [PMID: 38195495 PMCID: PMC10777515 DOI: 10.1186/s12916-023-03236-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND In the post-pandemic era, a wide range of COVID-19 sequelae is of growing health concern. However, the risks of digestive diseases in long COVID have not been comprehensively understood. To investigate the long-term risk of digestive diseases among COVID patients. METHODS In this large-scale retrospective cohort study with up to 2.6 years follow-up (median follow-up: 0.7 years), the COVID-19 group (n = 112,311), the contemporary comparison group (n = 359,671) and the historical comparison group (n = 370,979) predated the COVID-19 outbreak were built using UK Biobank database. Each digestive outcome was defined as the diagnosis 30 days or more after the onset of COVID-19 infection or the index date. Hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were computed utilizing the Cox regression models after inverse probability weighting. RESULTS Compared with the contemporary comparison group, patients with previous COVID-19 infection had higher risks of digestive diseases, including gastrointestinal (GI) dysfunction (HR 1.38 (95% CI 1.26 to 1.51)); peptic ulcer disease (HR 1.23 (1.00 to 1.52)); gastroesophageal reflux disease (GERD) (HR 1.41 (1.30 to 1.53)); gallbladder disease (HR 1.21 (1.06 to 1.38)); severe liver disease (HR 1.35 (1.03 to 1.76)); non-alcoholic liver disease (HR 1.27 (1.09 to 1.47)); and pancreatic disease (HR 1.36 (1.11 to 1.66)). The risks of GERD were increased stepwise with the severity of the acute phase of COVID-19 infection. Even after 1-year follow-up, GERD (HR 1.64 (1.30 to 2.07)) and GI dysfunction (HR 1.35 (1.04 to 1.75)) continued to pose risks to COVID-19 patients. Compared to those with one SARS-CoV-2 infection, reinfected patients were at a higher risk of pancreatic diseases (HR 2.57 (1.23 to 5.38)). The results were consistent when the historical cohort was used as the comparison group. CONCLUSIONS Our study provides insights into the association between COVID-19 and the long-term risk of digestive system disorders. COVID-19 patients are at a higher risk of developing digestive diseases. The risks exhibited a stepwise escalation with the severity of COVID-19, were noted in cases of reinfection, and persisted even after 1-year follow-up. This highlights the need to understand the varying risks of digestive outcomes in COVID-19 patients over time, particularly those who experienced reinfection, and develop appropriate follow-up strategies.
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Affiliation(s)
- Yuying Ma
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Lijun Zhang
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Rui Wei
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Weiyu Dai
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Ruijie Zeng
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- Shantou University Medical College, Shantou, 515000, Guangdong, China
| | - Dongling Luo
- Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, 510080, China
| | - Rui Jiang
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Zewei Zhuo
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Qi Yang
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Jingwei Li
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Felix W Leung
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90024, USA.
- Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, CA, 91343, USA.
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
| | - Weihong Sha
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
- School of Medicine, South China University of Technology, Guangzhou, 510006, China.
- Shantou University Medical College, Shantou, 515000, Guangdong, China.
| | - Hao Chen
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
- School of Medicine, South China University of Technology, Guangzhou, 510006, China.
- Shantou University Medical College, Shantou, 515000, Guangdong, China.
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COVID-19 Adverse Outcomes in Immunocompromised Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2023. [DOI: 10.5812/ijcm-131077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a devastating viral pandemic infecting millions of people with a wide range of symptoms from fever to death. It has been suggested that immunocompromised patients are at a higher risk of severe disease, poor clinical outcomes, and mortality. However, these patients’ risk factors and COVID-19-related outcomes are not well characterized. Objectives: We evaluated the COVID-19-related outcomes among immunocompromised patients ranging from solid tumors, hematological malignancies, and HIV to autoimmune disease and transplant recipients who received immunosuppressive agents. We also aimed at finding risk factors related to mortality among immunocompromised patients with COVID-19. Methods: This cross-sectional study was conducted in Khansari Hospital, Iran between March and November 2021. We included immunocompromised patients with nasal swab positive SARS-CoV-2 polymerase chain reaction (PCR) results in the study. Patient outcomes, including hospitalization ward and the mortality rate, were assessed till three months after COVID-19 infection were evaluated in all patients. Moreover, the relation between risk factors and the rate of the mortality rate was analyzed in immunocompromised patients with COVID-19. Results: A total number of 74 immunocompromised patients with solid tumors, hematologic malignancies, autoimmune diseases, acquired immunodeficiencies, and solid-organ transplant recipients were included in the study. Results indicated that the male gender and ICU hospitalization significantly increase the mortality risk. Surprisingly, chemotherapy is associated with a lower risk of mortality. Conclusions: Identifying the risk factors can improve the decision-making on cancer patients’ management during the COVID-19 infection. A further large cohort of patients would be required to identify risk factors relating to poor clinical outcomes and mortality rates in immunocompromised patients with COVID-19.
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COVID and Cancer: A Complete 3D Advanced Radiological CT-Based Analysis to Predict the Outcome. Cancers (Basel) 2023; 15:cancers15030651. [PMID: 36765610 PMCID: PMC9913442 DOI: 10.3390/cancers15030651] [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: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cancer patients infected with COVID-19 were shown in a multitude of studies to have poor outcomes on the basis of older age and weak immune systems from cancer as well as chemotherapy. In this study, the CT examinations of 22 confirmed COVID-19 cancer patients were analyzed. METHODOLOGY A retrospective analysis was conducted on 28 cancer patients, of which 22 patients were COVID positive. The CT scan changes before and after treatment and the extent of structural damage to the lungs after COVID-19 infection was analyzed. Structural damage to a lung was indicated by a change in density measured in Hounsfield units (HUs) and by lung volume reduction. A 3D radiometric analysis was also performed and lung and lesion histograms were compared. RESULTS A total of 22 cancer patients were diagnosed with COVID-19 infection. A repeat CT scan were performed in 15 patients after they recovered from infection. Most of the study patients were diagnosed with leukemia. A secondary clinical analysis was performed to show the associations of COVID treatment on the study subjects, lab data, and outcome on mortality. It was found that post COVID there was a decrease of >50% in lung volume and a higher density in the form of HUs due to scar tissue formation post infection. CONCLUSION It was concluded that COVID-19 infection may have further detrimental effects on the lungs of cancer patients, thereby, decreasing their lung volume and increasing their lung density due to scar formation.
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Nolan MB, Piasecki TM, Smith SS, Baker TB, Fiore MC, Adsit RT, Bolt DM, Conner KL, Bernstein SL, Eng OD, Lazuk D, Gonzalez A, Hayes-Birchler T, Jorenby DE, D'Angelo H, Kirsch JA, Williams BS, Kent S, Kim H, Lubanski SA, Yu M, Suk Y, Cai Y, Kashyap N, Mathew J, McMahan G, Rolland B, Tindle HA, Warren GW, Abu-el-rub N, An LC, Boyd AD, Brunzell DH, Carrillo VA, Chen LS, Davis JM, Deshmukh VG, Dilip D, Goldstein AO, Ha PK, Iturrate E, Jose T, Khanna N, King A, Klass E, Lui M, Mermelstein RJ, Poon C, Tong E, Wilson KM, Theobald WE, Slutske WS. Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin. Cancer Epidemiol Biomarkers Prev 2023; 32:12-21. [PMID: 35965473 PMCID: PMC9827105 DOI: 10.1158/1055-9965.epi-22-0500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/29/2022] [Accepted: 08/08/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is mixed evidence about the relations of current versus past cancer with severe COVID-19 outcomes and how they vary by patient and cancer characteristics. METHODS Electronic health record data of 104,590 adult hospitalized patients with COVID-19 were obtained from 21 United States health systems from February 2020 through September 2021. In-hospital mortality and ICU admission were predicted from current and past cancer diagnoses. Moderation by patient characteristics, vaccination status, cancer type, and year of the pandemic was examined. RESULTS 6.8% of the patients had current (n = 7,141) and 6.5% had past (n = 6,749) cancer diagnoses. Current cancer predicted both severe outcomes but past cancer did not; adjusted odds ratios (aOR) for mortality were 1.58 [95% confidence interval (CI), 1.46-1.70] and 1.04 (95% CI, 0.96-1.13), respectively. Mortality rates decreased over the pandemic but the incremental risk of current cancer persisted, with the increment being larger among younger vs. older patients. Prior COVID-19 vaccination reduced mortality generally and among those with current cancer (aOR, 0.69; 95% CI, 0.53-0.90). CONCLUSIONS Current cancer, especially among younger patients, posed a substantially increased risk for death and ICU admission among patients with COVID-19; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types. IMPACT This study clarifies the characteristics that modify the risk associated with cancer on severe COVID-19 outcomes across the first 20 months of the COVID-19 pandemic. See related commentary by Egan et al., p. 3.
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Affiliation(s)
- Margaret B. Nolan
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Thomas M. Piasecki
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stevens S. Smith
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael C. Fiore
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Robert T. Adsit
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daniel M. Bolt
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Karen L. Conner
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Steven L. Bernstein
- Department of Emergency Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Oliver D. Eng
- Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - David Lazuk
- Yale-New Haven Health System, New Haven, Connecticut
| | - Alec Gonzalez
- BlueTree Network, a Tegria Company, Madison, Wisconsin
| | - Todd Hayes-Birchler
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Douglas E. Jorenby
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Heather D'Angelo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Julie A. Kirsch
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Brian S. Williams
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Sean Kent
- Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Hanna Kim
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Youmi Suk
- School of Data Science, University of Virginia, Charlottesville, Virginia
| | - Yuxin Cai
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nitu Kashyap
- Yale-New Haven Health System, New Haven, Connecticut
- Yale School of Medicine, New Haven, Connecticut
| | - Jomol Mathew
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Gabriel McMahan
- Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Betsy Rolland
- Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Hilary A. Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Graham W. Warren
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina
| | - Noor Abu-el-rub
- Center for Medical Informatics and Enterprise Analytics, University of Kansas Medical Center, Kansas City, Kansas
| | - Lawrence C. An
- Division of General Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Andrew D. Boyd
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | | | - Victor A. Carrillo
- Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, New Jersey
| | - Li-Shiun Chen
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - James M. Davis
- Duke Cancer Institute and Duke University Department of Medicine, Durham, North Carolina
| | | | - Deepika Dilip
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Adam O. Goldstein
- Department of Family Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Patrick K. Ha
- Division of Head and Neck Surgical Oncology, University of California San Francisco, San Francisco, California
| | | | - Thulasee Jose
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Niharika Khanna
- University of Maryland School of Medicine, Baltimore, Maryland
| | - Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Comprehensive Cancer Center, Chicago, Illinois
| | - Elizabeth Klass
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michelle Lui
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robin J. Mermelstein
- Department of Psychology and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Chester Poon
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elisa Tong
- Department of Internal Medicine, University of California Davis, Davis, California
| | - Karen M. Wilson
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Wendy E. Theobald
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Corresponding Author: Wendy S. Slutske, UW Center for Tobacco Research and Intervention, 1930 Monroe Street #200, Madison, WI 53711. Phone: 608-262-8673; E-mail:
| | - Wendy S. Slutske
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Corresponding Author: Wendy S. Slutske, UW Center for Tobacco Research and Intervention, 1930 Monroe Street #200, Madison, WI 53711. Phone: 608-262-8673; E-mail:
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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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Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue. Int J Mol Sci 2022; 23:ijms232213683. [PMID: 36430175 PMCID: PMC9690863 DOI: 10.3390/ijms232213683] [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: 09/27/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/10/2022] Open
Abstract
Post-COVID-19 syndrome (PCS) is characterized by persisting sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PCS can affect patients with all COVID-19 disease severities. As previous studies have revealed impaired blood flow as a provoking factor triggering PCS, it was the aim of the present study to investigate the potential association between self-reported chronic fatigue and retinal microcirculation in patients with PCS, potentially indicating an objective biomarker. A prospective study was performed, including 201 subjects: 173 patients with PCS and 28 controls. Retinal microcirculation was visualized by OCT angiography (OCT-A) and quantified using the Erlangen-Angio-Tool as macula and peripapillary vessel density (VD). Chronic fatigue (CF) was assessed according to the variables of Bell’s score, age and gender. VDs in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were analyzed, considering the repetitions (12 times). Seropositivity for autoantibodies targeting G protein-coupled receptors (GPCR-AAbs) was determined by an established cardiomyocyte bioassay. Taking account of the repetitions, a mixed model was performed to detect possible differences in the least square means between the different groups included in the analysis. An age effect in relation to VD was observed between patients and controls (p < 0.0001). Gender analysis showed that women with PCS showed lower VD levels in the SVP compared to male patients (p = 0.0015). The PCS patients showed significantly lower VDs in the ICP as compared to the controls (p = 0.0001 (CI: 0.32; 1)). Moreover, considering PCS patients, the mixed model revealed a significant difference between those with chronic fatigue (CF) and those without CF with respect to VDs in the SVP (p = 0.0033 (CI: −4.5; −0.92)). The model included variables of age, gender and Bell’s score, representing a subjective marker for CF. Consequently, retinal microcirculation might serve as an objective biomarker in subjectively reported chronic fatigue in patients with PCS.
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Assessing Unique Risk Factors for COVID-19 Complications Among Cancer Patients: A Multi-ethnic Cohort Study. J Immigr Minor Health 2022; 25:624-633. [PMID: 36344859 PMCID: PMC9640901 DOI: 10.1007/s10903-022-01413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
Abstract
A myriad of organ-specific complications have been observed with COVID-19. While racial/ethnic minorities have been disproportionately burdened by this disease, our understanding of the unique risk factors for complications among a diverse population of cancer patients remains limited. This is a multi-institutional, multi-ethnic cohort study evaluating COVID-19 complications among cancer patients. Patients with an invasive cancer diagnosis and confirmed SARS-CoV-2 infection were identified from March to November 2020. Demographic and clinical data were obtained and a multivariate logistic regression was employed to evaluate the impact of demographic and clinical factors on COVID-19 complications. The study endpoints were evaluated independently and included any complication, sepsis, pulmonary complications and cardiac complications. A total of 303 patients were evaluated, of whom 48% were male, 79% had solid tumors, and 42% were Hispanic/Latinx (Hispanic). Malignant hematologic cancers were associated with a higher risk of sepsis (OR 3.93 (95% CI 1.58–9.81)). Male patients had a higher risk of sepsis (OR 4.42 (95% CI 1.63–11.96)) and cardiac complications (OR 2.02 (95% CI 1.05–3.89)). Hispanic patients had a higher odds of any complication (OR 2.31 (95% CI 1.18–4.51)) and other race was associated with a higher odds of cardiac complications (OR 2.41 (95% CI 1.01–5.73)). Clinically, fever, cough, and ≥2 co-morbidities were independently significantly associated with any complication. This analysis evaluated covariates that can significantly predict a myriad of complications among a multi-ethnic cohort of cancer patients. The conclusions drawn from this analysis elucidate a mechanistic understanding of differential illness severity from COVID-19.
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Health influence of SARS-CoV-2 (COVID-19) on cancer: a review. Acta Biochim Biophys Sin (Shanghai) 2022; 54:1395-1405. [PMID: 36269132 PMCID: PMC9828497 DOI: 10.3724/abbs.2022147] [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] [Indexed: 12/29/2022] Open
Abstract
The novel coronavirus, namely, SARS-CoV-2 (COVID-19), broke out two years ago and has caused major global health issues. Adequate treatment options are still lacking for the management of COVID-19 viral infections. Many patients afflicted with COVID-19 may range from asymptomatic to severe symptomatic, triggering poor clinical outcomes, morbidity, and mortality. Cancer is one of the leading causes of death worldwide. It is pertinent to re-examine cancer prevalence during the COVID-19 pandemic to prevent mortality and complications. Understanding the impact of SARS-CoV-2 on cancer is key to appropriate healthcare measures for the treatment and prevention of this vulnerable population. Data was acquired from PubMed using key search terms. Additional databases were utilized, such as the Centers for Disease Prevention and Control, American Cancer Society (ACS), and National Cancer Institute (NCI). Cancer patients are more prone to SARS-CoV-2 infection and exhibit poor health outcomes, possibly due to a chronic immunosuppressive state and anticancer therapies. Male sex, older age, and active cancer disease or previous cancer are risk factors for COVID-19 infection, leading to possible severe complications, including morbidity or mortality. The speculated mechanism for potentially higher mortality or COVID-19 complications is through reduced immune system function and inflammatory processes through cancer disease, anticancer therapy, and active COVID-19 infection. This review includes prostate, breast, ovarian, hematologic, lung, colorectal, esophageal, bladder, pancreatic, cervical, and head and neck cancers. This review should help better maintain the health of cancer patients and direct clinicians for COVID-19 prevention to improve the overall health outcomes.
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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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10
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Li J, Ming Z, Yang L, Wang T, Liu G, Ma Q. Long noncoding RNA XIST: Mechanisms for X chromosome inactivation, roles in sex-biased diseases, and therapeutic opportunities. Genes Dis 2022; 9:1478-1492. [PMID: 36157489 PMCID: PMC9485286 DOI: 10.1016/j.gendis.2022.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 11/30/2022] Open
Abstract
Sexual dimorphism has been reported in various human diseases including autoimmune diseases, neurological diseases, pulmonary arterial hypertension, and some types of cancers, although the underlying mechanisms remain poorly understood. The long noncoding RNA (lncRNA) X-inactive specific transcript (XIST) is involved in X chromosome inactivation (XCI) in female placental mammals, a process that ensures the balanced expression dosage of X-linked genes between sexes. XIST is abnormally expressed in many sex-biased diseases. In addition, escape from XIST-mediated XCI and skewed XCI also contribute to sex-biased diseases. Therefore, its expression or modification can be regarded as a biomarker for the diagnosis and prognosis of many sex-biased diseases. Genetic manipulation of XIST expression can inhibit the progression of some of these diseases in animal models, and therefore XIST has been proposed as a potential therapeutic target. In this manuscript, we summarize the current knowledge about the mechanisms for XIST-mediated XCI and the roles of XIST in sex-biased diseases, and discuss potential therapeutic strategies targeting XIST.
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11
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Liu D, Zheng Y, Kang J, Wang D, Bai L, Mao Y, Zha G, Tang H, Zhang R. Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients With COVID-19. Front Med (Lausanne) 2022; 8:736109. [PMID: 35071254 PMCID: PMC8782432 DOI: 10.3389/fmed.2021.736109] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 12/02/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Some patients with comorbidities and rapid disease progression have a poor prognosis. Aim: We aimed to investigate the characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients. Methods: A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed. Results: Approximately 91.23% (655/718) of COVID-19 patients were younger than 60 years old. Approximately 64.76% (465/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia, and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included age, the number of comorbidities and hyperlipidaemia for disease severity, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities and age played a predictive role in disease progression and outcomes. Conclusion: Not only high number and specific comorbidities but also age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on not only the number and specific comorbidities but also age in COVID-19 patients to predict disease progression and prognosis. Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563.
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Affiliation(s)
- Dafeng Liu
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Yongli Zheng
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Jun Kang
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Dongmei Wang
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Lang Bai
- Center of Infectious Diseases, Sichuan University West China Hospital, Chengdu, China
| | - Yi Mao
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Guifang Zha
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
| | - Hong Tang
- Center of Infectious Diseases, Sichuan University West China Hospital, Chengdu, China
| | - Renqing Zhang
- Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China.,The Public and Health Clinic Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China
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12
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Westerman KE, Lin J, Sevilla-Gonzalez MDR, Tadess B, Marchek C, Manning AK. Gene-Environment Interaction Analysis Incorporating Sex, Cardiometabolic Diseases, and Multiple Deprivation Index Reveals Novel Genetic Associations With COVID-19 Severity. Front Genet 2022; 12:782172. [PMID: 35096005 PMCID: PMC8790169 DOI: 10.3389/fgene.2021.782172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/07/2021] [Indexed: 01/20/2023] Open
Abstract
Increasing evidence indicates that specific genetic variants influence the severity of outcomes after infection with COVID-19. However, it is not clear whether the effect of these genetic factors is independent of the risk due to more established non-genetic demographic and metabolic risk factors such as male sex, poor cardiometabolic health, and low socioeconomic status. We sought to identify interactions between genetic variants and non-genetic risk factors influencing COVID-19 severity via a genome-wide interaction study in the UK Biobank. Of 378,051 unrelated individuals of European ancestry, 2,402 were classified as having experienced severe COVID-19, defined as hospitalization or death due to COVID-19. Exposures included sex, cardiometabolic risk factors [obesity and type 2 diabetes (T2D), tested jointly], and multiple deprivation index. Multiplicative interaction was tested using a logistic regression model, conducting both an interaction test and a joint test of genetic main and interaction effects. Five independent variants reached genome-wide significance in the joint test, one of which also reached significance in the interaction test. One of these, rs2268616 in the placental growth factor (PGF) gene, showed stronger effects in males and in individuals with T2D. None of the five variants showed effects on a similarly-defined phenotype in a lookup in the COVID-19 Host Genetics Initiative. These results reveal potential additional genetic loci contributing to COVID-19 severity and demonstrate the value of including non-genetic risk factors in an interaction testing approach for genetic discovery.
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Affiliation(s)
- Kenneth E. Westerman
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Joanna Lin
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
| | - Magdalena del Rocio Sevilla-Gonzalez
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Beza Tadess
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, United States
| | - Casey Marchek
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, United States
| | - Alisa K. Manning
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
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13
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de Feijter M, Kocevska D, Blanken TF, van der Velpen IF, Ikram MA, Luik AI. The network of psychosocial health in middle-aged and older adults during the first COVID-19 lockdown. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2469-2479. [PMID: 35674801 PMCID: PMC9174915 DOI: 10.1007/s00127-022-02308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Psychosocial health problems, such as social isolation, loneliness, depression and anxiety, have gained attention during the COVID-19 pandemic and are commonly co-occurring. We investigated the network of psychosocial health constructs during the COVID-19 pandemic. METHODS This study included 4553 participants (mean age: 68.6 ± 11.2 years, 56% women) from the prospective Rotterdam Study, who filled out a questionnaire between April and July 2020, the time of the first COVID-19 wave in the Netherlands. Psychosocial health constructs included were depressive symptoms (Center for Epidemiological Studies Depression scale), anxiety symptoms (Hospital Anxiety and Depression scale), loneliness (University of California, Los Angeles loneliness scale), social connectedness (five items) and pandemic-related worry (five items). We estimated mixed graphical models to assess the network of items of these constructs and whether age and sex affected the network structure. RESULTS Within the network of psychosocial constructs, a higher depressive symptoms score was particularly associated with items of loneliness and social connectedness, whereas overall anxiety was particularly associated with items of pandemic-related worry. Between people from different sex and age, the network structure significantly altered. CONCLUSION This study demonstrates that within the same network of psychosocial health constructs, depressive symptom score is particularly associated with loneliness and social connectedness, whereas anxiety symptom score is associated with pandemic-related worry during the first COVID-19 lockdown. Our results support that psychosocial constructs should be considered in conjunction with one another in prevention and treatment efforts in clinical care, and that these efforts need to be tailored to specific demographic groups.
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Affiliation(s)
- Maud de Feijter
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Desana Kocevska
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Tessa F. Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Isabelle F. van der Velpen
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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14
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Seshachalam A, Saju SV, Raju H, Rathnam K, Janarthinakani M, Prasad K, Patil C, Anoop P, Reddy N, Anumula S, Golamari K, Bodepudi S, Danthala M, Malipatil B, Senthilkumar G, Niraimathi K, Raman SG. Outcome of COVID-19 in Indian patients with cancer: A multicenter, retrospective study. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_212_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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15
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Ullgren H, Camuto A, Rosas S, Pahnke S, Ginman B, Enblad G, Glimelius I, Fransson P, Friesland S, Liu LL. Clinical characteristics and factors associated with COVID-19-related death and morbidity among hospitalized patients with cancer: a Swedish cohort study. Acta Oncol 2021; 60:1459-1465. [PMID: 34334081 DOI: 10.1080/0284186x.2021.1958005] [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: 10/20/2022]
Abstract
INTRODUCTION Cancer patients are considered to have a higher risk of dying and developing severe Coronavirus Disease 2019 (COVID-19). To date, there are few studies including co-morbidities and sociodemographic factors when investigating the outcome of COVID-19 in a cohort of cancer patients. In this study, we analyzed cancer patients that have been hospitalized due to COVID-19 during the first wave of the pandemic in Sweden to investigate the impact of COVID-19 on mortality and morbidity. PATIENTS AND METHODS We retrospectively collected data on all patients with cancer that were hospitalized due to COVID-19-related symptoms at Uppsala University Hospital and Karolinska University Hospital between 1 March and 31 August 2020. The primary endpoint was COVID-19-related death and the secondary endpoint was to describe COVID-19 severity, defined as symptom severity (grades 0-4) and length of stay (LOS) at the university hospitals. RESULTS In total, 193 patients were included among which 31% died due to COVID-19 and 8% died of other causes. In a multivariable analysis, older age >70 (OR 3.6; 95% CI [1.8-7.3], p < 0.001) and male gender (OR 2.8 [1.4-5.8], p = 0.005) were factors associated with higher likelihood of COVID-19-related death. Several comorbidities ≥2 (OR 5.4 [2.0-14.3], p = 0.001) was independently associated with COVID-19 severity. Treatment with chemotherapy within 90 days prior to COVID-19 diagnosis were not associated with COVID-19-related death or severity. CONCLUSION Factors associated with higher likelihood of COVID-19-related death were older age and male gender. More severe COVID-19 symptoms were seen in patients with multiple comorbidities. We did not see any associations between COVID-19-related death or severity and recent treatment including chemotherapy. In summary, this supports a thorough assessment regarding potential risks with COVID-19 infection in patients with cancer, with a combination of individual risk factors in addition to cancer treatments.
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Affiliation(s)
- Helena Ullgren
- Department of Nursing, Umeå University, Umeå, Sweden
- Regional Cancer Center, Stockholm-Gotland, Sweden
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Angela Camuto
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Sumy Rosas
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Simon Pahnke
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Beatrice Ginman
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Gunilla Enblad
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Ingrid Glimelius
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Signe Friesland
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lisa L. Liu
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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Treskova-Schwarzbach M, Haas L, Reda S, Pilic A, Borodova A, Karimi K, Koch J, Nygren T, Scholz S, Schönfeld V, Vygen-Bonnet S, Wichmann O, Harder T. Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence. BMC Med 2021; 19:212. [PMID: 34446016 PMCID: PMC8390115 DOI: 10.1186/s12916-021-02058-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/08/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions. METHODS Systematic reviews (SRs) were identified in PubMed, Embase/Medline and seven pre-print servers until December 11, 2020. Due to the absence of age-adjusted risk effects stratified by geographical regions, a re-analysis of the evidence was conducted. Primary studies were extracted from SRs and evaluated for inclusion in the re-analysis. Studies were included if they reported risk estimates (odds ratio (OR), hazard ratio (HR), relative risk (RR)) for hospitalisation, intensive care unit admission, intubation or death. Estimated associations were extracted from the primary studies for reported pre-existing conditions. Meta-analyses were performed stratified for each outcome by regions of the World Health Organization. The evidence certainty was assessed using GRADE. Registration number CRD42020215846. RESULTS In total, 160 primary studies from 120 SRs contributed 464 estimates for 42 pre-existing conditions. Most studies were conducted in North America, European, and Western Pacific regions. Evidence from Africa, South/Latin America, and the Eastern Mediterranean region was scarce. No evidence was available from the South-East Asia region. Diabetes (HR range 1.2-2.0 (CI range 1.1-2.8)), obesity (OR range 1.5-1.75 (CI range 1.1-2.3)), heart failure (HR range 1.3-3.3 (CI range 0.9-8.2)), COPD (HR range 1.12-2.2 (CI range 1.1-3.2)) and dementia (HR range 1.4-7.7 (CI range 1.2-39.6)) were associated with fatal COVID-19 in different regions, although the estimates varied. Evidence from Europe and North America showed that liver cirrhosis (OR range 3.2-5.9 (CI range 0.9-27.7)) and active cancer (OR range 1.6-4.7 (CI range 0.5-14.9)) were also associated with increased risk of death. Association between HIV and undesirable COVID-19 outcomes showed regional heterogeneity, with an increased risk of death in Africa (HR 1.7 (CI 1.3-2.2)). GRADE certainty was moderate to high for most associations. CONCLUSION Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others. The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.
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Affiliation(s)
| | - Laura Haas
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sarah Reda
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Antonia Pilic
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Anna Borodova
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Kasra Karimi
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Judith Koch
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Teresa Nygren
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Stefan Scholz
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Viktoria Schönfeld
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sabine Vygen-Bonnet
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Ole Wichmann
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Thomas Harder
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
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17
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Westerman KE, Lin J, Sevilla-Gonzalez M, Tadess B, Marchek C, Manning AK. Gene-environment interaction analysis incorporating sex, cardiometabolic diseases, and multiple deprivation index reveals novel genetic associations with COVID-19 severity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.08.13.21261910. [PMID: 34462758 PMCID: PMC8404897 DOI: 10.1101/2021.08.13.21261910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Increasing evidence indicates that specific genetic variants influence the severity of outcomes after infection with COVID-19. However, it is not clear whether the effect of these genetic factors is independent of the risk due to more established non-genetic demographic and metabolic risk factors such as male sex, poor cardiometabolic health, and low socioeconomic status. We sought to identify interactions between genetic variants and non-genetic risk factors influencing COVID-19 severity via a genome-wide interaction study in the UK Biobank. Of 378,051 unrelated individuals of European ancestry, 2,402 were classified as having experienced severe COVID-19, defined as hospitalization or death due to COVID-19. Exposures included sex, cardiometabolic risk factors (obesity and type 2 diabetes [T2D], tested jointly), and multiple deprivation index. Multiplicative interaction was tested using a logistic regression model, conducting both an interaction test and a joint test of genetic main and interaction effects. Five independent variants reached genome-wide significance in the joint test, one of which also reached significance in the interaction test. One of these, rs2268616 in the PGF gene, showed stronger effects in males and in individuals with T2D. None of the five variants showed effects on a similarly-defined phenotype in a lookup in the COVID-19 Host Genetics Initiative. These results reveal potential additional genetic loci contributing to COVID-19 severity and demonstrate the value of including non-genetic risk factors in an interaction testing approach for genetic discovery.
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Affiliation(s)
- Kenneth E. Westerman
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Joanna Lin
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Magdalena Sevilla-Gonzalez
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Beza Tadess
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
| | - Casey Marchek
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
| | - Alisa K. Manning
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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18
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Costa GJ, de Azevedo CRAS, Júnior JIC, Bergmann A, Thuler LCS. Higher severity and risk of in-hospital mortality for COVID-19 patients with cancer during the year 2020 in Brazil: A countrywide analysis of secondary data. Cancer 2021; 127:4240-4248. [PMID: 34343344 PMCID: PMC8426714 DOI: 10.1002/cncr.33832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) and cancer are serious public health problems worldwide. However, little is known about the risk factors of in-hospital mortality among COVID-19 patients with and without cancer in Brazil. The objective of this study was to evaluate the risk factors of in-hospital mortality among COVID-19 patients with and without cancer and to compare mortality according to gender and topography during the year 2020 in Brazil. METHODS This was a secondary data study of hospitalized adult patients with a diagnosis of COVID-19 by real-time polymerase chain reaction testing in Brazil. The data were collected from the Influenza Epidemiological Surveillance Information System. RESULTS This study analyzed data from 322,817 patients. The prevalence of cancer in patients with COVID-19 was 2.3%. COVID-19 patients with neurological diseases and cancer had the most lethal comorbidities in both sexes. COVID-19 patients with cancer were more likely to be older (median age, 67 vs 62 years; P < .001), to have a longer hospital stay (13.1 vs 11.5 days; P < .001), to be admitted to the intensive care unit (45.3% vs 39.6%; P < .001), to receive more invasive mechanical ventilation (27.1% vs 21.9%), and to have a higher risk of death (adjusted odds ratio [aOR], 1.94; 95% confidence interval [CI], 1.83-2.06; P < .001) than those without cancer. Patients with hematological neoplasia (aOR, 2.85; 95% CI, 2.41-3.38; P < .001) had a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72-1.95; P < .001) in both sexes. CONCLUSIONS Brazilian COVID-19 patients with cancer have higher disease severity and a higher risk of mortality than those without cancer.
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Affiliation(s)
- Guilherme Jorge Costa
- Department of Teaching and Research, Pernambuco Cancer Hospital, Recife, Brazil.,Department of Pneumology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | | | - José Iran Costa Júnior
- Department of Oncology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.,Oncologia D'Or, Recife, Brazil
| | - Anke Bergmann
- Clinical Epidemiology Program, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
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Aveyard P, Gao M, Lindson N, Hartmann-Boyce J, Watkinson P, Young D, Coupland CAC, Tan PS, Clift AK, Harrison D, Gould DW, Pavord ID, Hippisley-Cox J. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. THE LANCET. RESPIRATORY MEDICINE 2021; 9:909-923. [PMID: 33812494 PMCID: PMC8016404 DOI: 10.1016/s2213-2600(21)00095-3] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous studies suggested that the prevalence of chronic respiratory disease in patients hospitalised with COVID-19 was lower than its prevalence in the general population. The aim of this study was to assess whether chronic lung disease or use of inhaled corticosteroids (ICS) affects the risk of contracting severe COVID-19. METHODS In this population cohort study, records from 1205 general practices in England that contribute to the QResearch database were linked to Public Health England's database of SARS-CoV-2 testing and English hospital admissions, intensive care unit (ICU) admissions, and deaths for COVID-19. All patients aged 20 years and older who were registered with one of the 1205 general practices on Jan 24, 2020, were included in this study. With Cox regression, we examined the risks of COVID-19-related hospitalisation, admission to ICU, and death in relation to respiratory disease and use of ICS, adjusting for demographic and socioeconomic status and comorbidities associated with severe COVID-19. FINDINGS Between Jan 24 and April 30, 2020, 8 256 161 people were included in the cohort and observed, of whom 14 479 (0·2%) were admitted to hospital with COVID-19, 1542 (<0·1%) were admitted to ICU, and 5956 (0·1%) died. People with some respiratory diseases were at an increased risk of hospitalisation (chronic obstructive pulmonary disease [COPD] hazard ratio [HR] 1·54 [95% CI 1·45-1·63], asthma 1·18 [1·13-1·24], severe asthma 1·29 [1·22-1·37; people on three or more current asthma medications], bronchiectasis 1·34 [1·20-1·50], sarcoidosis 1·36 [1·10-1·68], extrinsic allergic alveolitis 1·35 [0·82-2·21], idiopathic pulmonary fibrosis 1·59 [1·30-1·95], other interstitial lung disease 1·66 [1·30-2·12], and lung cancer 2·24 [1·89-2·65]) and death (COPD 1·54 [1·42-1·67], asthma 0·99 [0·91-1·07], severe asthma 1·08 [0·98-1·19], bronchiectasis 1·12 [0·94-1·33], sarcoidosis 1·41 [0·99-1·99), extrinsic allergic alveolitis 1·56 [0·78-3·13], idiopathic pulmonary fibrosis 1·47 [1·12-1·92], other interstitial lung disease 2·05 [1·49-2·81], and lung cancer 1·77 [1·37-2·29]) due to COVID-19 compared with those without these diseases. Admission to ICU was rare, but the HR for people with asthma was 1·08 (0·93-1·25) and severe asthma was 1·30 (1·08-1·58). In a post-hoc analysis, relative risks of severe COVID-19 in people with respiratory disease were similar before and after shielding was introduced on March 23, 2020. In another post-hoc analysis, people with two or more prescriptions for ICS in the 150 days before study start were at a slightly higher risk of severe COVID-19 compared with all other individuals (ie, no or one ICS prescription): HR 1·13 (1·03-1·23) for hospitalisation, 1·63 (1·18-2·24) for ICU admission, and 1·15 (1·01-1·31) for death. INTERPRETATION The risk of severe COVID-19 in people with asthma is relatively small. People with COPD and interstitial lung disease appear to have a modestly increased risk of severe disease, but their risk of death from COVID-19 at the height of the epidemic was mostly far lower than the ordinary risk of death from any cause. Use of inhaled steroids might be associated with a modestly increased risk of severe COVID-19. FUNDING National Institute for Health Research Oxford Biomedical Research Centre and the Wellcome Trust.
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Affiliation(s)
- Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK.
| | - Min Gao
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK; School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK
| | - Peter Watkinson
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK
| | - Duncan Young
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Carol A C Coupland
- University of Nottingham, Division of Primary Care, Faculty of Medicine & Health Sciences, University Park, Nottingham, UK
| | - Pui San Tan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ashley K Clift
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David Harrison
- Intensive Care National Audit & Research Centre, London, UK
| | - Doug W Gould
- Intensive Care National Audit & Research Centre, London, UK
| | - Ian D Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Vanichkachorn G, Newcomb R, Cowl CT, Murad MH, Breeher L, Miller S, Trenary M, Neveau D, Higgins S. Post-COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at Mayo Clinic and Characteristics of the Initial Patient Cohort. Mayo Clin Proc 2021; 96:1782-1791. [PMID: 34218857 PMCID: PMC8112396 DOI: 10.1016/j.mayocp.2021.04.024] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To describe characteristics of a series of patients reporting prolonged symptoms after an infection with coronavirus disease 2019 (COVID-19). PATIENTS AND METHODS This study describes the multidisciplinary COVID-19 Activity Rehabilitation Program, established at Mayo Clinic to evaluate and treat patients with post-COVID syndrome, and reports the clinical characteristics of the first 100 patients receiving evaluation and management during the timeframe of June 1, 2020, and December 31, 2020. RESULTS The cohort consisted of 100 patients (mean age, 45.4±14.2 years; 68% women; mean body mass index, 30.2 kg/m2; presenting a mean of 93 days after infection). Common preexisting conditions were respiratory (23%) and mental health, including depression and/or anxiety (34%). Most (75%) had not been hospitalized for COVID-19. Common presenting symptoms ware fatigue (80%), respiratory complaints (59%), and neurological complaints (59%) followed by subjective cognitive impairment, sleep disturbance, and mental health symptoms. More than one-third of patients (34%) reported difficulties in performing basic activities of daily living. Only 1 in 3 patients had returned to unrestricted work duty at the time of the analysis. For most patients, laboratory and imaging tests showed no abnormalities or were nondiagnostic despite debilitating symptoms. Most patients required physical therapy, occupational therapy, or brain rehabilitation. Face-to-face and virtual care delivery modalities were feasible. CONCLUSION Most of the patients did not have COVID-19-related symptoms that were severe enough to require hospitalization, were younger than 65 years, and were more likely to be female, and most had no preexisting comorbidities before severe acute respiratory syndrome coronavirus 2 infection. Symptoms including mood disorders, fatigue, and perceived cognitive impairment resulted in severe negative impacts on resumption of functional and occupational activities in patients experiencing prolonged effects.
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Affiliation(s)
- Greg Vanichkachorn
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN.
| | - Richard Newcomb
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - Clayton T Cowl
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - M Hassan Murad
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - Laura Breeher
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - Sara Miller
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN
| | - Michael Trenary
- Division of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Daniel Neveau
- Division of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Steven Higgins
- Division of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
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21
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Russell B, Moss CL, Palmer K, Sylva R, D’Souza A, Wylie H, Haire A, Cahill F, Steel R, Hoyes A, Wilson I, Macneil A, Shifa B, Monroy-Iglesias MJ, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Zaki K, Sita-Lumsden A, Josephs D, Enting D, Swampillai A, Sawyer E, Fields P, Wrench D, Rigg A, Sullivan R, Van Hemelrijck M, Dolly S. COVID-19 Risk Factors for Cancer Patients: A First Report with Comparator Data from COVID-19 Negative Cancer Patients. Cancers (Basel) 2021; 13:2479. [PMID: 34069565 PMCID: PMC8161328 DOI: 10.3390/cancers13102479] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 01/11/2023] Open
Abstract
Very few studies investigating COVID-19 in cancer patients have included cancer patients as controls. We aimed to identify factors associated with the risk of testing positive for SARS CoV2 infection in a cohort of cancer patients. We analyzed data from all cancer patients swabbed for COVID-19 between 1st March and 31st July 2020 at Guy's Cancer Centre. We conducted logistic regression analyses to identify which factors were associated with a positive COVID-19 test. Results: Of the 2152 patients tested for COVID-19, 190 (9%) tested positive. Male sex, black ethnicity, and hematological cancer type were positively associated with risk of COVID-19 (OR = 1.85, 95%CI:1.37-2.51; OR = 1.93, 95%CI:1.31-2.84; OR = 2.29, 95%CI:1.45-3.62, respectively) as compared to females, white ethnicity, or solid cancer type, respectively. Male, Asian ethnicity, and hematological cancer type were associated with an increased risk of severe COVID-19 (OR = 3.12, 95%CI:1.58-6.14; OR = 2.97, 95%CI:1.00-8.93; OR = 2.43, 95%CI:1.00-5.90, respectively). This study is one of the first to compare the risk of COVID-19 incidence and severity in cancer patients when including cancer patients as controls. Results from this study have echoed those of previous reports, that patients who are male, of black or Asian ethnicity, or with a hematological malignancy are at an increased risk of COVID-19.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Charlotte L. Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Kieran Palmer
- King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Rushan Sylva
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Andrea D’Souza
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Fidelma Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Renee Steel
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
| | - Angela Hoyes
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - Isabelle Wilson
- Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK;
| | - Alyson Macneil
- Breast Surgery, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.S.)
| | - Belul Shifa
- Breast Surgery, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.S.)
| | - Maria J Monroy-Iglesias
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Sophie Papa
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Sheeba Irshad
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Paul Ross
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - James Spicer
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Shahram Kordasti
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Danielle Crawley
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Kamarul Zaki
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Debra Josephs
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Deborah Enting
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Angela Swampillai
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
| | - Elinor Sawyer
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Paul Fields
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - David Wrench
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - Anne Rigg
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Saoirse Dolly
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
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22
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Lin Z, Chen J, Han S. Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis. Expert Rev Anticancer Ther 2021; 21:1055-1066. [PMID: 33970745 DOI: 10.1080/14737140.2021.1927721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Cancer patients are more vulnerable to Coronavirus disease-2019 (COVID-19) and have a higher risk of adverse outcomes than the general population. Therefore, it is necessary to evaluate whether anti-cancer therapies such as surgery, chemotherapy, immunotherapy, and targeted therapy will increase the severity and mortality of cancer patients with COVID-19.Methods: Relevant articles were retrieved from PubMed, Embase, Web of Science, Cochrane Library and China National Knowledge Infrastructure (CNKI). The search time was from December 1, 2019 to January 23, 2021. Meta-analysis was conducted using Revman 5.3 statistical software.Results: A total of 26 studies were included in this meta-analysis, involving 5571 cancer patients infected with SARS-CoV-2. Meta-analysis showed that surgery, chemotherapy, immunotherapy and targeted therapy were not associated with disease severity or mortality (107/688, OR =1.30, 95% CI[0.79, 2.13], P =0.30; 1956/2674, OR =1.27, 95% CI [0.95, 1.69], P =0.10; 342/1455, OR =1.20, 95% CI [0.90, 1.61], P =0.21; 503/1378, OR =0.92, 95% CI [0.72, 1.19], P =0.54, respectively).Conclusion: In cancer patients with COVID-19, anti-cancer therapy had no adverse effect on disease severity or mortality. Further research is necessary to determine the complex interrelationship between anti-cancer therapy, particularly chemotherapy, and COVID-19.
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Affiliation(s)
- Zhixian Lin
- Department of Oncology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - Jiangfeng Chen
- Department of Integrated Traditional Chinese and Western Medicine Oncology Ward 1, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, China
| | - Sunya Han
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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23
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Hamlish T, Papautsky EL. Differences in Emotional Distress Among Black and White Breast Cancer Survivors During the Covid-19 Pandemic: a National Survey. J Racial Ethn Health Disparities 2021; 9:576-580. [PMID: 33620715 PMCID: PMC7901509 DOI: 10.1007/s40615-021-00990-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/12/2022]
Abstract
The Covid-19 pandemic is straining US healthcare resources, causing significant disruptions in cancer care. Prior to the pandemic, Black cancer survivors experienced a disproportionate burden of delays in cancer treatment compared to White cancer survivors. As a result of the pandemic, disruptions in care are widespread and affect cancer survivors regardless of race. This shift presented an opportunity to investigate differences in how Black and White cancer survivors experience disruptions in cancer care due to the pandemic. We conducted a national survey of adult breast cancer survivors, distributed online from 4/2/20 to 4/27/20. We used t-tests to compare cancer and non-cancer-related worry during the Covid-19 pandemic between Black and White breast cancer survivors. Analysis of data from 570 respondents (106 Black and 464 White) indicated significantly higher levels of distress among White respondents compared to Black respondents. Our results point to the importance of assessing race differences in emotional response to disruptions in cancer care during the pandemic. We suggest that differences in emotional distress may reflect differences in previous experience of treatment delays and coping strategies between Black and White breast cancer survivors.
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Affiliation(s)
- Tamara Hamlish
- University of Illinois Cancer Center, 818 S. Wolcott, Chicago, IL, 60612, USA.
| | - Elizabeth Lerner Papautsky
- Department of Biomedical & Health Information Science, University of Illinois at Chicago, 1919 W. Taylor St., Chicago, IL, 60612, USA
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Lamberghini F, Trifan G, Testai FD. Severe acute respiratory syndrome coronavirus 2 infection in asymptomatic pediatric dental patients. J Am Dent Assoc 2021; 152:277-283. [PMID: 33641860 PMCID: PMC7816946 DOI: 10.1016/j.adaj.2021.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/17/2020] [Accepted: 01/07/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are typically asymptomatic but contagious. The authors investigated the positivity rate of asymptomatic SARS-CoV-2 infection in pediatric dental patients. METHODS The authors reviewed consecutive charts of children younger than 18 years scheduled for elective dental procedures from April 1, 2020, through August 1, 2020. All patients were screened for signs and symptoms of SARS-CoV-2 infection. Asymptomatic patients scheduled for dental procedures underwent polymerase chain reaction (PCR) testing for SARS-CoV-2. Sociodemographic characteristics were abstracted, and positivity rates were calculated. Variables for patients who were SARS-CoV-2 positive and SARS-CoV-2 negative were compared using Fisher exact and Mann-Whitney U tests. RESULTS The sample size was 921. The median age was 6 years, and 50.9% were boys. The overall SARS-CoV-2 positivity rate was 2.3%. Age, insurance status, medical history, and dental diagnosis were comparable in patients who were SARS-CoV-2 positive and SARS-CoV-2 negative. Positivity rates were statistically higher for Hispanic or Latinx patients than other groups (P = .038). CONCLUSIONS Although the yield of testing was low, the systematic evaluation of asymptomatic pediatric dental cases via PCR resulted in the identification of SARS-CoV-2 carriers who could have been infectious. In this study, Hispanics or Latinx had a higher positivity rate than other demographic groups. PRACTICAL IMPLICATIONS PCR testing for SARS-CoV-2 of asymptomatic patients in pediatric dentistry adds value to the use of screening questionnaires for the identification of infected people who could be contagious.
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Cavanna L, Citterio C, Toscani I, Franco C, Magnacavallo A, Caprioli S, Cattadori E, Nunzio CD, Pane R, Schiavo R, Biasini C, Ambroggi M. Cancer patients with COVID-19: a retrospective study of 51 patients in the district of Piacenza, Northern Italy. Future Sci OA 2020; 7:FSO645. [PMID: 33432270 PMCID: PMC7687531 DOI: 10.2144/fsoa-2020-0157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Cancer patients are considered a highly fragile group in the current coronavirus disease 2019 (COVID-19) pandemic. Material & methods: In this study, patients with COVID-19 and cancer, hospitalized in Piacenza, Italy, from 4 April to 4 May 2020 were included. Risk factors for death were analyzed. Results: Fifty-one COVID-19 cancer patients were included, of which the median age was 71.02 years (range: 51–86) and 70.59% were male. Cancer types included gastrointestinal (25.49%), genitourinary (25.49%) and lung (23.53%). Forty-five (88.24%) patients received hydroxychloroquine-based therapy. In addition, 25 of 51 patients died (49%): 12 of 51 (23.53%) owing to cancer and 13 of 51 (25.49%) owing to COVID-19. Conclusion: The risks for death were related to later onset of treatment for COVID-19, severe/critical COVID-19, age, elevated basal CRP and elevated lactate dehydrogenase. The effect of COVID-19 on cancer patients is of high concern during the COVID-19 outbreak. Here we expand on our initial analysis of 25 patients, presenting 51 patients with COVID-19 and cancer and examining their risk factors for mortality considering indicators such as age and treatment history. We confirm that risk of mortality is greater for cancer patients, and also confirm well-known risk factors for mortality in this group.
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Affiliation(s)
- Luigi Cavanna
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Chiara Citterio
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Ilaria Toscani
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Cosimo Franco
- Respiratory Intensive Care Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Andrea Magnacavallo
- Emergency Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Serena Caprioli
- Administration Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Evelina Cattadori
- Research & Innovation Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Camilla Di Nunzio
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Roberto Pane
- Pharmacy Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Roberta Schiavo
- Pathology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Claudia Biasini
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Massimo Ambroggi
- Oncology & Haematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
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26
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Rüthrich MM, Giessen-Jung C, Borgmann S, Classen AY, Dolff S, Grüner B, Hanses F, Isberner N, Köhler P, Lanznaster J, Merle U, Nadalin S, Piepel C, Schneider J, Schons M, Strauss R, Tometten L, Vehreschild JJ, von Lilienfeld-Toal M, Beutel G, Wille K. COVID-19 in cancer patients: clinical characteristics and outcome-an analysis of the LEOSS registry. Ann Hematol 2020; 100:383-393. [PMID: 33159569 PMCID: PMC7648543 DOI: 10.1007/s00277-020-04328-4] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Introduction Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Patients and methods We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. Results In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. Conclusion Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions. Supplementary Information The online version contains supplementary material available at 10.1007/s00277-020-04328-4.
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Affiliation(s)
- Maria Madeleine Rüthrich
- Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany. .,Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institute, Jena, Germany.
| | - C Giessen-Jung
- Department of Internal Medicine III, Ludwig Maximilian University, Munich, Germany
| | - S Borgmann
- Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
| | - A Y Classen
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany
| | - S Dolff
- Department of Infectious Diseases, University Hospital Essen, University Duisburg Essen, Essen, Germany
| | - B Grüner
- Section Clinical Infectiology, University Hospital Ulm, Ulm, Germany
| | - F Hanses
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
| | - N Isberner
- Department of Internal Medicine II, Division of Infectious Diseases, University Hospital Würzburg, Würzburg, Germany
| | - P Köhler
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - J Lanznaster
- Department of Internal Medicine II, Passau Hospital, Passau, Germany
| | - U Merle
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - C Piepel
- Hospital Bremen-Center, Bremen, Germany
| | - J Schneider
- Department of Internal Medicine II, Technical University of Munich, School of Medicine, University hospital rechts der Isar, Munich, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - M Schons
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - R Strauss
- Medical Clinic I, University Hospital Erlangen, Erlangen, Germany
| | - L Tometten
- Department of Gastroenterology and Infectiology, Hospital Ernst-von-Bergmann, Potsdam, Germany
| | - J J Vehreschild
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany.,Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - M von Lilienfeld-Toal
- Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.,Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institute, Jena, Germany
| | - G Beutel
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - K Wille
- University of Bochum, University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Minden, Germany
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Wijeratne DT, Hammad N, Gyawali B. Gender differences in outcomes of cancer patients with COVID: Signal or noise? EClinicalMedicine 2020; 26:100535. [PMID: 32923994 PMCID: PMC7480671 DOI: 10.1016/j.eclinm.2020.100535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Bishal Gyawali
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, 10 Stuart Street, Kingston, Ontario K7L 3N6 Kingston, Canada
- Corresponding author at: Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, 10 Stuart Street, Kingston, Ontario K7L 3N6, Canada.
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