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Marasović Šušnjara I, Mijaković M, Jurčev Savičević A. The Influence of the COVID-19 Pandemic on Hospitalizations for Ambulatory Care-Sensitive Conditions in Split-Dalmatia County, Croatia. Medicina (Kaunas) 2024; 60:523. [PMID: 38674169 PMCID: PMC11052272 DOI: 10.3390/medicina60040523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: We aimed to explore whether the COVID-19 pandemic influenced hospitalizations for ambulatory care-sensitive conditions (ACSCs) in Split-Dalmatia County, Croatia. Materials and Methods: We performed a cross-sectional comparative study using two different time periods, the pre-pandemic (from March 2019 to February 2020) and the pandemic period (from March 2020 to February 2021), to explore the possible influences that the COVID-19 pandemic had on hospitalizations for ACSCs. The ACSCs were classified into the categories of vaccine-preventable, chronic, and acute disease. The indicators were statistically analyzed. Results: During the pandemic, a decrease in the total number of hospitalizations and ACSC hospitalizations was recorded. The relative risk for having any ACSC hospitalization in the pandemic period compared to the pre-pandemic period was 0.67 (95% CI, 0.64-0.71; p = 0). The risk reduction was seen in all three categories of vaccine-preventable ACSCs, chronic disease, and acute disease. Large reductions were found in the relative risk of hospitalization for COPD and asthma. Considering the mode of discharge, there was a statistically significantly higher risk of ACSCs with fatal outcomes during the pandemic than in the pre-pandemic period (relative risk 1.31; 95% CI, 1.01-1.7; p = 0.0197). Conclusions: The results of this study show that the COVID-19 pandemic influenced the total number of hospitalizations as well as hospitalizations relating to ACSCs. Certainly, one of the reasons for these changes was due to organizational changes in the working of the entire health system due to the COVID-19 pandemic.
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Affiliation(s)
- Ivana Marasović Šušnjara
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
- University Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Marijana Mijaković
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
| | - Anamarija Jurčev Savičević
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
- University Department of Health Studies, University of Split, 21000 Split, Croatia
- School of Medicine, University of Split, 21000 Split, Croatia
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Appanna N, Patel G, Burke E, Burnett A, Clark J, Mew R, Khan S, Little M, Liu J, Panneerselvam H, Patel V, Platt J, Tilby M, Watts I, Harper‐Wynne C, Lee LYW. Safe prescribing in cancer patients during the COVID-19 pandemic: A new initiative from the UK Cancer Coronavirus Project (UKCCP) team. Int J Cancer 2023; 152:1275-1277. [PMID: 36454180 PMCID: PMC9877804 DOI: 10.1002/ijc.34387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 12/05/2022]
Affiliation(s)
| | - Grisma Patel
- Cancer Division, UCL Cancer Institute, University College LondonLondonUK
| | - Emma Burke
- Oxford University Hospitals NHS TrustLondonUK
| | | | - James Clark
- Department of Surgery and Cancer, Imperial College LondonLondonUK
| | - Rosie Mew
- Royal Devon and Exeter NHS Foundation TrustExeterUK
| | - Sam Khan
- Leicester Cancer Research Centre, University of LeicesterLeicesterUK
| | | | - Justin Liu
- Leeds Institute of Medical Research at St James'sUniversity of LeedsLeedsUK
| | | | | | - James Platt
- Leeds Institute of Medical Research at St James's, University of LeedsLeedsUK
| | - Michael Tilby
- Department of Oncology, University Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Isabella Watts
- Department of Academic Oncology, Royal Free HospitalLondonUK
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3
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Perego G, Di Mattei VE, Mazzetti M, Milano F, Gatti C, Rancoita PMV, Taranto P, Rabaiotti E, Cioffi R, Candiani M. The Experience of COVID-19 in a Sample of Gynecological Cancer Patients Undergoing Chemotherapy: A Focus on the Psychological Implications. Int J Environ Res Public Health 2023; 20:3851. [PMID: 36900862 PMCID: PMC10002022 DOI: 10.3390/ijerph20053851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Cancer patients are at an increased risk of developing severe consequences due to the COVID-19 infection. However, psychological outcomes in this population have been overlooked in the literature. The present study aims to identify significant psychological differences between gynecological cancer patients undergoing chemotherapy before and during the pandemic. Additionally, we explore the correlations between COVID-19-related concerns and anxiety, depression, distress, and quality of life levels. Forty-two patients completed the STAI-Y, the EORTC QLQ-C30, the BDI II, the DT, and an ad-hoc questionnaire that investigated COVID-19-related concerns. The analyses did not show significant differences in the psychometric scales between the two groups, highlighting a considerable resilience against mental health and quality of life deterioration during the COVID-19 pandemic in gynecologic cancer patients. However, COVID-19-related concerns were positively associated with anxiety and inversely related to emotional functioning levels. These results emphasize the importance of a comprehensive patient care and the need to implement a multidisciplinary approach that includes psychological support in the treatment plan. Moreover, it is essential to encourage clear communication to convey comprehensive information about the impact of the pandemic on physical and psychological levels, as well as to offer psychoeducational tools to face the pandemic.
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Affiliation(s)
- Gaia Perego
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Martina Mazzetti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Milano
- Department of Psychology, University of Milano-Bicocca, 20132 Milan, Italy
| | - Carola Gatti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Maria Vittoria Rancoita
- University Centre for Statistics in Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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Gonzalez-Cao M, Puertolas T, Martinez-Vila C, Carrera C, Maldonado Seral C, Rodríguez-Jiménez P, Sequero S, Cerezuela-Fuentes P, Feltes Ochoa R, Muñoz E, Antoñanzas Basa M, Martín-Liberal J, Soria A, Francisco Rodriguez Moreno J, Marquez-Rodas I, Lopez Criado P, Luis Manzano J, Lopez-Castro R, Ayala de Miguel P, Villalobos L, Martin Algarra S, Gonzalez-Barrallo I, Boada A, García Castaño A, Puig S, Crespo G, Luna Fra P, Aguayo Zamora C, Feito Rodríguez M, Valles L, Drozdowskyj A, Gardeazabal J, Antonio Fernandez-Morales L, Rodrigo A, Cruz R, Yelamos O, Rubio B, Mujica K, Provencio M, Berrocal A; Spanish Melanoma Group (GEM). SARS-CoV-2 infection in patients with melanoma: results of the Spanish Melanoma Group registry. Clin Transl Oncol 2023; 25:768-75. [PMID: 36566266 DOI: 10.1007/s12094-022-02985-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/12/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The Spanish Melanoma Group (GEM) developed a national registry of patients with melanoma infected by SARS-CoV-2 ("GRAVID"). METHODS The main objective was to describe the COVID-19 fatality rate in patients with melanoma throughout the pandemic, as well as to explore the effect of melanoma treatment and tumor stage on the risk of COVID-19 complications. These are the final data of the register, including cases from February 2020 to September 2021. RESULTS One hundred-fifty cases were registered. Median age was 68 years (range 6-95), 61 (40%) patients were females, and 63 (42%) patients had stage IV. Thirty-nine (26%) were on treatment with immunotherapy, and 17 (11%) with BRAF-MEK inhibitors. COVID-19 was resolved in 119 cases, including 85 (57%) patients cured, 15 (10%) that died due to melanoma, and 20 (13%) that died due to COVID-19. Only age over 60 years, cardiovascular disorders, and diabetes mellitus increased the risk of death due to COVID-19, but not advanced melanoma stage nor melanoma systemic therapies. Three waves have been covered by the register: February-May 2020, August-November 2020, and December 2020-April 2021. The first wave had the highest number of registered cases and COVID-19 mortality. CONCLUSION Tumor stage or melanoma treatments are non-significant prognostic factors for COVID-19 mortality. During the pandemic in Spain there was a downward trend in the number of patients registered across the waves, as well as in the severity of the infection. CLINICALTRIALS GOV IDENTIFIER NCT04344002.
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Zyoud SH, Koni A, Al-Jabi SW, Amer R, Shakhshir M, Al Subu R, Salameh H, Odeh R, Musleh S, Abushamma F, Abu Taha A. Current global research landscape on COVID-19 and cancer: Bibliometric and visualization analysis. World J Clin Oncol 2022; 13:835-847. [PMID: 36337308 PMCID: PMC9630994 DOI: 10.5306/wjco.v13.i10.835] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/26/2022] [Accepted: 10/12/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer is a severe public health issue that seriously jeopardizes global health. In individuals with coronavirus disease 2019 (COVID-19), cancer is considered an independent risk factor for severe illness and increased mortality.
AIM To identify research hotspots and prospects, we used bibliometrics to examine the global production of COVID-19 literature published in the field of oncology.
METHODS Data on publication output were identified based on the Scopus database between January 1, 2020, and June 21, 2022. This study used VOSviewer to analyze collaboration networks among countries and assess the terms most often used in the titles and abstracts of retrieved publications to determine research hotspots linked to cancer and COVID-19. The Impact Index Per Article for the top 10 high-cited papers collected from Reference Citation Analysis (RCA) are presented.
RESULTS A total of 7015 publications were retrieved from the database. The United States published the greatest number of articles (2025; 28.87%), followed by Italy (964; 13.74%), the United Kingdom (839; 11.96%), and China (538; 7.67%). The University of Texas MD Anderson Cancer Center (n = 205, 2.92%) ranked first, followed by the Memorial Sloan-Kettering Cancer Center (n = 176, 2.51%). The European Journal of Cancer (n = 106, 1.51%) ranked first, followed by the Frontiers in Oncology (n = 104, 1.48%), Cancers (n = 102, 1.45%), and Pediatric Blood and Cancer (n = 95; 1.35%). The hot topics were stratified into “cancer care management during the COVID-19 pandemic”; and “COVID-19 vaccines in cancer patients”.
CONCLUSION This is the first bibliometric analysis to determine the present state and upcoming hot themes related to cancer and COVID-19 and vice versa using VOSviewer during the early stages of the pandemic. The emergence of hot themes related to cancer and COVID-19 may aid researchers in identifying new research areas in this field.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Amer Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Riad Amer
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Rand Al Subu
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Husam Salameh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Razan Odeh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Sultan Musleh
- Hematology and Oncology Department, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Adham Abu Taha
- Department of Pathology, An-Najah National University Hospital, Nablus 44839, Palestine
- Department of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Dilip Pandkar P, Raosaheb Deshmukh S, Sachdeva V. COVID-19 patient with B Cell Lymphoma co-morbidity managed with co-administration of Ayurvedic formulation. J Ayurveda Integr Med 2022; 13:100632. [PMID: 35975131 PMCID: PMC9372187 DOI: 10.1016/j.jaim.2022.100632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/16/2022] [Accepted: 08/01/2022] [Indexed: 11/03/2022] Open
Abstract
‘Renaissance took place in Chaos and plague’. It was COVID-19 pandemic, when world realized ayurveda co-interventions are praiseworthy even in acute, infective and fatal conditions like COVID-19. We report perhaps first case of COVID-19 patient with cancer managed with poly-herbal ayurvedic formulation and integrated approach. In the first wave of COVID-19 (June 2020), a 47 year old male with history of Chronic kidney disease and active B Cell Lymphoma complained of fever, malaise, cattarah and ageusia. He was found positive on RT-PCR which was done promptly and was later treated in home quarantine with antipyretics, Vitamin C and Madhav rasayan a polyherbal preparation containing Piper longum, Glycyrrhiza glabra, Eclipta alba, Achyranthes aspera, Embelia ribes and Aloe vera designed to modulate host response. It was challenging to treat a patient with cancer with immunocompromised status as he had recently finished his chemotherapy cycle (R–CHOP regimen). Patient well tolerated the intervention and recovered symptomatically. He did not developed any respiratory complications and oxygen saturation remained maintained. On 7th day RT-PCR was found to be negative. Plethora of literature is available on anti-viral and immunomodulatory efficacies of Ayurveda herbs based on in vitro studies. Such efficacies can be replicated at patient's level if supported with wisdom of Ayurveda epistemology. Early diagnosis on RT-PCR and early inception of ayurveda medicine and diet interventions might be crucial element for better recovery.
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Affiliation(s)
- Prasad Dilip Pandkar
- Department of Kriya sharir (Ayurveda Physiology), Bharati Vidyapeeth Deemed University, College of Ayurveda, Pune 411043
| | - Santosh Raosaheb Deshmukh
- Department of Kriya sharir (Ayurveda Physiology), Bharati Vidyapeeth Deemed University, College of Ayurveda, Pune 411043
| | - Vinay Sachdeva
- Department of Kriya sharir (Ayurveda Physiology), Bharati Vidyapeeth Deemed University, College of Ayurveda, Pune 411043
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Ghosh A, Mukerjee N, Sharma B, Pant A, Kishore Mohanta Y, Jawarkar RD, Bakal RL, Terefe EM, Batiha GES, Mostafa-Hedeab G, Aref Albezrah NK, Dey A, Baishya D. Target Specific Inhibition of Protein Tyrosine Kinase in Conjunction With Cancer and SARS-COV-2 by Olive Nutraceuticals. Front Pharmacol 2022; 12:812565. [PMID: 35356629 PMCID: PMC8959131 DOI: 10.3389/fphar.2021.812565] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/24/2021] [Indexed: 12/18/2022] Open
Abstract
The fact that viruses cause human cancer dates back to the early 1980s. By reprogramming cellular signaling pathways, viruses encoded protein that can regulate altered control of cell cycle events. Viruses can interact with a superfamily of membrane bound protein, receptor tyrosine kinase to modulate their activity in order to increase virus entrance into cells and promotion of viral replication within the host. Therefore, our study aimed at screening of inhibitors of tyrosine kinase using natural compounds from olive. Protein tyrosine kinase (PTK) is an important factor for cancer progression and can be linked to coronavirus. It is evident that over expression of Protein tyrosine kinase (PTK) enhance viral endocytosis and proliferation and the use of tyrosine kinase inhibitors reduced the period of infection period. Functional network studies were carried out using two major PTKs viz. Anaplastic lymphoma kinase (ALK) and B-lymphocytic kinase (BTK). They are associated with coronavirus in regulation of cell signaling proteins for cellular processes. We virtually screened for 161 library of natural compounds from olive found overexpressed in ALK and BTK in metastatic as well as virus host cells. We have employed both ligand and target-based approach for drug designing by high throughput screening using Multilinear regression model based QSAR and docking. The QSAR based virtual screening of 161 olive nutraceutical compounds has successfully identified certain new hit; Wedelosin, in which, the descriptor rsa (ratio of molecular surface area to the solvent accessible surface area) plays crucial role in deciding Wedelosin’s inhibitory potency. The best-docked olive nutraceuticals further investigated for the stability and effectivity of the BTK and ALK during in 150 ns molecular dynamics and simulation. Post simulation analysis and binding energy estimation in MMGBSA further revealed the intensive potential of the olive nutraceuticals in PTK inhibition. This study is therefore expected to widen the use of nutraceuticals from olive in cancer as well as SARS-CoV2 alternative therapy.
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Affiliation(s)
- Arabinda Ghosh
- Microbiology Division, Department of Botany, Gauhati University, Guwahati, India
| | - Nobendu Mukerjee
- Department of Microbiology, Ramakrishna Mission Vivekananda Centenary College, Kolkata, India
| | - Bhavdeep Sharma
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, India
| | - Anushree Pant
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, India
| | - Yugal Kishore Mohanta
- Department of Applied Biology, University of Science and Technology Meghalaya, Ri Bhoi, India
| | - Rahul D Jawarkar
- Department of Medicinal Chemistry, Dr. Rajendra Gode Institute of Pharmacy, Amravati, India
| | - Ravindrakumar L Bakal
- Department of Medicinal Chemistry, Dr. Rajendra Gode Institute of Pharmacy, Amravati, India
| | - Ermias Mergia Terefe
- Department of Pharmacology and Pharmacognosy, School of Pharmacy and Health Sciences, United states International University-Africa, Nairobi, Kenya
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Gomaa Mostafa-Hedeab
- Pharmacology Department & Health Research Unit-Medical College-Jouf University, Sakakah, Saudi Arabia.,Pharmacology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Debabrat Baishya
- Department of Bioengineering, Gauhati University, Guwahati, India
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Moreno-Sanchez F, Gomez-Gomez B. Antibiotic Management of Patients with Hematologic Malignancies: From Prophylaxis to Unusual Infections. Curr Oncol Rep 2022. [PMID: 35316843 DOI: 10.1007/s11912-022-01226-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/22/2022]
Abstract
Purpose of Review Patients with hematological malignancies are recognized for their high susceptibility and increased risk of developing infections associated with immunosuppression that can be caused by the infection itself or by the treatments that condition a decrease in the humoral and T lymphocyte response, so this review attempts to gather the main bacterial, viral, parasitic, and fungal agents that affect them and give recommendations for their approach and diagnosis. Recent Findings In recent years, with the discovery and use of new therapies including immunological and targeted treatments, it has been possible to improve the survival and response of patients with hematological malignancies; however, antimicrobial resistance has also increased; we have faced new and unknown microorganisms, such as the SARS-CoV-2 that caused the COVID-19 pandemic in the past year, and therefore, new risks and more severe infections are presented. Summary We present a review of the different circumstances where hematological malignancies increased the risk of infections and which microorganisms affect these patients, their characteristics, and the suggested prophylaxis.
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Nowikiewicz T, Szymankiewicz M, Drzewiecka M, Głowacka-Mrotek I, Tarkowska M, Nowikiewicz M, Zegarski W. Did the COVID-19 Pandemic Truly Adversely Affect Disease Progress and Therapeutic Options in Breast Cancer Patients? A Single-Centre Analysis. J Clin Med 2022; 11:jcm11041014. [PMID: 35207286 PMCID: PMC8879378 DOI: 10.3390/jcm11041014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/03/2022] [Accepted: 02/11/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: The uncontrolled spread and transmission of SARS-CoV-2 infections has disrupted most areas of social and economic life all over the world. The most important changes concern problems related to the functioning of healthcare systems. The aim of this study was to evaluate clinical consequences associated with the COVID-19 pandemic for patients with newly diagnosed breast cancer, treated at our centre. Methods: The study participants were patients first time diagnosed with breast cancer, treated between January 2019 and March 2021, who were provided any type of cancer treatment at our centre. The study determined the grade of clinical and pathological progress of the disease and types of cancer treatment applied in patients. Results: In total, 2863 patients were included in the analysis. The number of hospitalized patients was 1228 (1123 treated surgically, 105 receiving conservative treatment) in 2019, 1318 (1206 and 112 patients, respectively) in 2020, and 317 (288 and 29 patients, respectively) in 2021. Conclusions: Despite many hazards associated with the new epidemiological situation, we were able to maintain the continuous operation of our centre. We have achieved a measurable success, and even managed to increase the number of treated breast cancer patients.
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Affiliation(s)
- Tomasz Nowikiewicz
- Department of Surgical Oncology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-067 Bydgoszcz, Poland;
- Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland;
- Correspondence: ; Tel.: +48-60-2534912; Fax: +48-52-3743301
| | - Maria Szymankiewicz
- Department of Microbiology, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland;
| | - Marta Drzewiecka
- Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland;
| | - Iwona Głowacka-Mrotek
- Department of Rehabilitation, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
| | - Magdalena Tarkowska
- Department of Urology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
| | - Magdalena Nowikiewicz
- Department of Hepatobiliary and General Surgery, A. Jurasz University Hospital, 85-094 Bydgoszcz, Poland;
| | - Wojciech Zegarski
- Department of Surgical Oncology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-067 Bydgoszcz, Poland;
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10
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Ernst M, Beutel ME, Brähler E. Cancer as a risk factor for distress and its interactions with sociodemographic variables in the context of the first wave of the COVID-19 pandemic in Germany. Sci Rep 2022; 12:2021. [PMID: 35132127 PMCID: PMC8821553 DOI: 10.1038/s41598-022-06016-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/21/2022] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic poses a psychological challenge, especially for individuals with chronic illnesses. The aim of this study was to investigate associations of cancer with distress, including its interplay with further risk and protective factors. We conducted a representative survey of the German population (N = 2503, including N = 144 with a cancer diagnosis) during the first wave of the pandemic. In multiple linear and logistic regression analyses, we tested associations of cancer with depression and anxiety symptoms and suicidal ideation. We also investigated moderating effects of age, gender, income, living situation, marital status, and loneliness. Individuals with cancer were more likely to report anxiety symptoms (φ = .061), suicidal ideation (φ = .050), and loneliness (φ = .044) than other participants. In regression analyses that controlled for sociodemographic differences, cancer was still associated with anxiety symptoms. We also observed interaction effects, indicating that this relation was especially strong in men with cancer and that cancer survivors with a low income were particularly likely to report anxiety symptoms. The findings demonstrate that cancer survivors are a vulnerable group and that factors of different life domains interact in shaping well-being in the population, necessitating comprehensive risk assessment and support offers during the pandemic and beyond.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany.
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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11
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Savabi-esfahani M, Zangeneh S, Sharbafchi MR. Cancer Patients’ Challenges During COVID-19 Pandemic: An Approach to Decision-Making in Management and Policy-Making. Arch Clin Infect Dis 2022; 16. [DOI: 10.5812/archcid.104590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Context: Cancer patients are more susceptible to novel coronavirus infection due to their immune system deficiency and anticancer treatments. During the COVID-19 outbreak, cancer patients have faced many challenges. The present study aimed to review the literature on cancer patients’ challenges during the COVID-19 pandemic to offer an approach to decision-making in management and policy-making. Evidence Acquisition: In this review study, national and international databases were searched. Inclusion Criteria were the risk of COVID-19 in cancer patients, medical services, surgery, and cancer screening during the COVID-19 pandemic, cancer patients’ challenges during the COVID-19 pandemic, and management and policy-making in this pandemic. Results: Cancer patients’ challenges during the COVID 19 pandemic were classified as follows: (1) risk of COVID-19 for cancer patients; (2) access to medical services and screening during the COVID-19 pandemic; and (3) psychological disorders during the COVID-19 pandemic. Studies have revealed that individuals with cancer experience a higher risk of the COVID-19 infection and mortality compared to healthy individuals. Most oncology clinics postpone unnecessary appointments; however, patients with invasive cancer are treated with no delay. Proper management, disease control, and attention to mental health care can prevent psychological disorders. Conclusions: Managing cancer patients’ challenges during the SARS-CoV-2 is of paramount importance. Cancer clinics need to develop new care and follow-up protocols. Moreover, policy-makers should provide appropriate policies to address the challenges of this disease in the future.
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12
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Blaise D, Berger P, Mokart D, Camerlo J, Fougereau E, Giovannini M, Houvenaeghel G, Turrini O, Chabannon C, Piana G, Brenot-Rossi I, Tallet A, Gonçalves A, Charbonnier A, Vey N, Grossi S, Viens P. The Management of a Comprehensive Cancer Center during the First Six Months of the COVID-19 Pandemic in the South of France: Lessons from the Paoli-Calmettes Institute's Experience. Clin Hematol Int 2021; 3:119-129. [PMID: 34938984 PMCID: PMC8690701 DOI: 10.2991/chi.k.210919.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/05/2021] [Indexed: 12/15/2022] Open
Abstract
During the COVID-19 pandemic, it was rapidly established that cancer patients have an increased risk of developing severe forms of the 2019 coronavirus disease (COVID-19) due to a backlog of cancer diagnostics and immunosuppressive treatments. Cancer centers had to quickly adapt to continue cancer therapies despite the high infection risks and major disruptions in the French healthcare system. We described and analyzed the impact of the pandemic in our institution: management adjustments, COVID-19 infection rates in patients and staff, and impacts on clinical activities and finances during the first wave of the pandemic from March to September 2020. We also compared the results to the clinical activity data from preceding periods. A crisis unit was rapidly created that met 27 times over 66 days, generating numerous changes in hospital protocol. While our area was devastated by the pandemic, the infection rate of our staff and patients remained low (less than 1.5% of all employees). However, the lockdown period was accompanied with a reduction of most clinical activities, leading to decreases of 43%, 36%, 36%, 1%, and 10% in surgery, endoscopy, radiotherapy, and in- and out-patient chemotherapy sessions, respectively, with substantial financial loss. Our report highlights the need for the rapid creation, implementation, and adaptation of new protocols during a pandemic’s evolution to prevent disease transmission. Lessons from this situation should provide motivation to better prepare for/limit the dismantling of cancer therapies that can dramatically impact patient care and have deleterious consequences on an institution’s financial situation.
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Affiliation(s)
- Didier Blaise
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France.,Centre de Recherche en Cancerologie de Marseille (CRCM), Inserm, CNRS, Marseille, France.,Aix-Marseille University (AMU), Marseille, France
| | - Pierre Berger
- Infectious Diseases Committee, Institut Paoli-Calmettes, Marseille, France
| | - Djamel Mokart
- Department of Anesthesiology and Critical Care, Institut Paoli-Calmettes, Marseille, France
| | - Jacques Camerlo
- Department of Cancer Ambulatory Care, Institut Paoli-Calmettes, Marseille, France
| | | | - Marc Giovannini
- Medical and Surgical Endoscopy Cancer Unit, Institut Paoli-Calmettes, Marseille, France
| | - Gilles Houvenaeghel
- Aix-Marseille University (AMU), Marseille, France.,Department of Cancer Surgery 2, Institut Paoli-Calmettes, Marseille, France
| | - Olivier Turrini
- Aix-Marseille University (AMU), Marseille, France.,Department of Cancer Surgery 1, Institut Paoli-Calmettes, Marseille, France
| | - Christian Chabannon
- Centre de Recherche en Cancerologie de Marseille (CRCM), Inserm, CNRS, Marseille, France.,Aix-Marseille University (AMU), Marseille, France.,Cellular Therapy Platform, Institut Paoli-Calmettes, Marseille, France
| | - Gilles Piana
- Department of Cancer Imagery, Institut Paoli-Calmettes, Marseille, France
| | | | - Agnès Tallet
- Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France
| | - Anthony Gonçalves
- Centre de Recherche en Cancerologie de Marseille (CRCM), Inserm, CNRS, Marseille, France.,Aix-Marseille University (AMU), Marseille, France.,Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Aude Charbonnier
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France
| | - Norbert Vey
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France.,Centre de Recherche en Cancerologie de Marseille (CRCM), Inserm, CNRS, Marseille, France.,Aix-Marseille University (AMU), Marseille, France
| | - Sabrina Grossi
- General Direction, Institut Paoli-Calmettes, Marseille, France
| | - Patrice Viens
- Aix-Marseille University (AMU), Marseille, France.,Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.,General Direction, Institut Paoli-Calmettes, Marseille, France.,Sport Cancer Laboratory EA4670, Luminy Campus, Aix-Marseille University, Marseille
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13
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Akingboye A, Mahmood F, Amiruddin N, Reay M, Nightingale P, Ogunwobi OO. Increased risk of COVID-19-related admissions in patients with active solid organ cancer in the West Midlands region of the UK: a retrospective cohort study. BMJ Open 2021; 11:e053352. [PMID: 34903546 PMCID: PMC8671845 DOI: 10.1136/bmjopen-2021-053352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Susceptibility of patients with cancer to COVID-19 pneumonitis has been variable. We aim to quantify the risk of hospitalisation in patients with active cancer and use a machine learning algorithm (MLA) and traditional statistics to predict clinical outcomes and mortality. DESIGN Retrospective cohort study. SETTING A single UK district general hospital. PARTICIPANTS Data on total hospital admissions between March 2018 and June 2020, all active cancer diagnoses between March 2019 and June 2020 and clinical parameters of COVID-19-positive admissions between March 2020 and June 2020 were collected. 526 COVID-19 admissions without an active cancer diagnosis were compared with 87 COVID-19 admissions with an active cancer diagnosis. PRIMARY AND SECONDARY OUTCOME MEASURES 30-day and 90-day post-COVID-19 survival. RESULTS In total, 613 patients were enrolled with male to female ratio of 1:6 and median age of 77 years. The estimated infection rate of COVID-19 was 87 of 22 729 (0.4%) in the patients with cancer and 526 of 404 379 (0.1%) in the population without cancer (OR of being hospitalised with COVID-19 if having cancer is 2.942671 (95% CI: 2.344522 to 3.693425); p<0.001). Survival was reduced in patients with cancer with COVID-19 at 90 days. R-Studio software determined the association between cancer status, COVID-19 and 90-day survival against variables using MLA. Multivariate analysis showed increases in age (OR 1.039 (95% CI: 1.020 to 1.057), p<0.001), urea (OR 1.005 (95% CI: 1.002 to 1.007), p<0.001) and C reactive protein (CRP) (OR 1.065 (95% CI: 1.016 to 1.116), p<0.008) are associated with greater 30-day and 90-day mortality. The MLA model examined the contribution of predictive variables for 90-day survival (area under the curve: 0.749); with transplant patients, age, male gender and diabetes mellitus being predictors of greater mortality. CONCLUSIONS Active cancer diagnosis has a threefold increase in risk of hospitalisation with COVID-19. Increased age, urea and CRP predict mortality in patients with cancer. MLA complements traditional statistical analysis in identifying prognostic variables for outcomes of COVID-19 infection in patients with cancer. This study provides proof of concept for MLA in risk prediction for COVID-19 in patients with cancer and should inform a redesign of cancer services to ensure safe delivery of cancer care.
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Affiliation(s)
| | | | | | | | - Peter Nightingale
- Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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14
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Kamal M, Baudo M, Shmushkevich S, Geng Y, Rahouma M. Early mortality following COVID-19 infection among cancer patients who received radiotherapy: A meta-analysis. J Radiother Pract. [DOI: 10.1017/s1460396921000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Identifying the patients at higher risk for poor outcomes after radiotherapy (RT) during coronavirus disease 19 (COVID-19) era is an unmet clinical need. Methods: The Ovid MEDLINE, Ovid Embase, Clarivate Analytics Web of Science, PubMed and Wiley-Blackwell Cochrane Library databases were searched. Eligible studies were required to address the outcomes of cancer patients who underwent RT during the COVID-19 era. The primary outcome was early mortality, while secondary outcomes included length of hospital stay, hospital admission, intensive care unit (ICU) admission and use of mechanical ventilation. Pooled event rates were calculated, and meta-regression and ‘leave-one-out’ sensitivity analyses were performed. Results: Twelve eligible studies were included out of 928. The prevalence of early mortality after COVID-19 infection was 21·0%. The prevalence of hospital admission, ICU admission and mechanical ventilation was 78·1, 15·4 and 20·0%, respectively. Meta-regression showed that older age was significantly and positively associated with early mortality (β = 0·0765 ± 0·0349, p = 0·0284), while breast cancer was negatively associated with early mortality (β = −1·2754 ± 0·6373, p = 0·0454). Conclusions: Older age adversely impacts the early mortality rate in cancer patients during COVID-19 era. The risks of interruption/delay of cancer treatment should be weighed against the risk of increased morbidity and mortality from the infection. A global registry is needed to establish international oncologic guidelines during the COVID-19 era.
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15
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Ullah S, Ullah F, Rahman W, Karras DA, Ullah A, Ahmad G, Ijaz M, Gao T. CRDB: A Centralized Cancer Research DataBase and an example use case mining correlation statistics of cancer and covid-19 (Preprint). JMIR Cancer 2021; 8:e35020. [PMID: 35430561 PMCID: PMC9191331 DOI: 10.2196/35020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/07/2022] [Accepted: 04/10/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - Dimitrios A Karras
- Department General, Faculty of Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Anees Ullah
- Kyrgyz State Medical University, Bishkek, Kyrgyzstan
| | | | | | - Tianshun Gao
- Research Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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16
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Hammad M, Shalaby L, Sidhom I, Sherief N, Abdo I, Soliman S, Madeny Y, Hassan R, Elmeniawy S, Khamis N, Zaki I, Mansour T, El-Ansary MG, Al-Halfawy A, Abouelnaga S, Elhaddad A. Management and Outcome of Coronavirus Disease 2019 (COVID-19) in Pediatric Cancer Patients: A Single Centre Experience from a Developing Country. Clin Lymphoma Myeloma Leuk 2021; 21:e853-e864. [PMID: 34420893 PMCID: PMC8312090 DOI: 10.1016/j.clml.2021.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Sufficient data pertaining to the impact of the Coronavirus disease 2019 (COVID-19) on pediatric cancer patients is still lacking. The aim of this prospective study was to describe clinical management and outcomes of COVID-19 in pediatric oncology patients. PATIENTS AND METHODS Conducted between May 1, 2020 and November 30, 2020, this study included 76 pediatric oncology patients with confirmed COVID-19. Remdesivir (RDV) was the antiviral therapy used. RESULTS The median age of patients was 9 years. Sixty patients were on first line treatment. Hematological malignancies constituted 86.8% of patients. Severe to critical infections were 35.4% of patients. The commonest symptom was fever (93.4%). Chemotherapy was delayed in 59.2% of patients and doses were modified in 30.2%. The 60-day overall survival (OS) stood at 86.8%, with mortalities occurring only among critical patients. Of sixteen acute leukemia patients in the first induction therapy, 13 survived and 10 achieved complete remission. A negative RT-PCR within 2 weeks and improvement of radiological findings were statistically related to disease severity (P = .008 and .002, respectively). Better OS was associated with regression of radiological findings after 30 days from infection (P = .002). Forty-five patients received RDV, 42.1% had severe and critical forms of infection compared to 25.7% in the No-RDV group and yet OS was comparable in both groups. CONCLUSION Most pediatric cancer patients with COVID-19 should have good clinical outcomes except for patients with critical infections. Cancer patients can tolerate chemotherapy including induction phase, alongside COVID-19 treatment. In severe and critical COVID-19, RDV might have a potential benefit.
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Affiliation(s)
- Mahmoud Hammad
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt,Address for correspondence: Mahmoud Hammad, Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Lobna Shalaby
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Iman Sidhom
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Nancy Sherief
- Clinical Research Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Ibrahim Abdo
- Clinical Pharmacy Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Sonia Soliman
- Clinical Pathology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Youssef Madeny
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Reem Hassan
- Clinical and Chemical Pathology Department Faculty of Medicine, Cairo University and Clinical Pathology Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Shaimaa Elmeniawy
- Continuous Performance Improvement Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Nagwa Khamis
- Clinical Pathology Department Ain Shams University and Infection Control Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Iman Zaki
- Radio-diagnosis Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Tarek Mansour
- Virology and Immunology Department, National Cancer Institute, Cairo University and Clinical Pathology Department Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | | | - Ahmed Al-Halfawy
- Pulmonology Medicine Department, Kasr Al-Ainy Cairo University, Cairo, Egypt
| | - Sherif Abouelnaga
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
| | - Alaa Elhaddad
- Pediatric Oncology Department National Cancer Institute, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357). Cairo, Egypt
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17
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Ballatore Z, Merloni F, Ranallo N, Bastianelli L, Vitarelli F, Cantini L, Ricci G, Ferretti B, Alessandroni P, Del Prete M, Chiorrini S, Safi M, Ficarelli R, Benedetti G, Faloppi L, Marcellini M, Stoico R, Berardi R. Cancer patient perspective in the arena of COVID-19 pandemic. Psychooncology 2021; 31:39-45. [PMID: 34315188 PMCID: PMC8420223 DOI: 10.1002/pon.5774] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) outbreak has been declared a global pandemic of unprecedented proportions. Italy is a country which has been heavily affected. Cancer patients are at a higher risk owing to their intrinsic fragility related to their underlying disease and oncologic treatment. Against this backdrop, we conducted a survey to investigate how patients perceived their condition, clinical management and availability of information during the pandemic. METHODS Between 15 April and 1 May 2020 a survey was submitted to cancer patients at oncology departments in the Marche region. Questions regarding the perception of personal safety, continuity of cancer care, information quality and psychological distress. RESULTS Seven hundred patients participated in the survey; 59% were female and 40% were aged between 46 and 65. The majority of the participants perceived compliance with appropriate safety standards by cancer care providers and 80% were reassured about their concerns during the medical interview. 40% were worried of being at a higher risk of infection and 71% felt they were at a greater risk because of chemotherapy. 55% felt that postponing cancer treatment could reduce its efficacy, however 76% declared they did not feel abandoned at the time of treatment postponement. Patients between 46 and 65 years declared a significant reduction in sleep (p < 0.01) and in concentration (p = 0.03). CONCLUSIONS The emergency care offered to cancer patients has been deemed satisfactory in terms of both safety standards and care management. However, the majority of participants perceived the mutual negative influence between their oncologic disease and the risk of infection highlighting the need for special measures to ensure safe continuity of care.
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Affiliation(s)
- Zelmira Ballatore
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Filippo Merloni
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Nicoletta Ranallo
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Lucia Bastianelli
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Francesca Vitarelli
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Luca Cantini
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Giulia Ricci
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | | | - Paolo Alessandroni
- U.O. OncologiaAzienda Ospedaliera Ospedali Riuniti Marche NordPesaroItaly
| | | | | | - Mobin Safi
- U.O. OncologiaOspedale C. UrbaniJesiItaly
| | - Rita Ficarelli
- U.O. OncologiaPresidio Ospedaliero Unico “Santa Maria della Misericordia”UrbinoItaly
| | | | | | | | - Rosa Stoico
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Rossana Berardi
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
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18
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Navaeian A, Mahmoudi S, Pourakbari B, Bakhtiari M, Khodabandeh M, Abdolsalehi MR, Sharari AS, Mamishi S. COVID-19 infection in children with underlying malignancies in Iran. J Basic Clin Physiol Pharmacol 2021; 33:79-84. [PMID: 34192829 DOI: 10.1515/jbcpp-2021-0057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Although coronavirus disease 2019 (COVID-19) prognosis is mostly good in pediatric patients with no underlying diseases, there are a few reports on children with oncological underlying malignancies. This study aimed to describe the clinical and laboratory features of 20 children with COVID-19 who had underlying malignancies in an Iranian referral pediatrics hospital. METHODS All children under 15-year-old of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and presence of an underlying malignancy were included in the study. RESULTS In this study, among 20 patients, 11 were male (55%). The mean age of the patients was 6.0 ± 4.1 years. Twelve patients (60%) had acute lymphocytic leukemia, two had acute myeloid leukemia (10%), and six had solid organ tumors (30%). The most common symptoms were fever (65%) and cough (65%). We reported severe pneumonia in seven hospitalized patients (35%) and three patients (20%) required intensive care unit admission and mechanical ventilation. Procalcitonin was normal in 73% of the cases (11 out of 15), but it was highly elevated in four cases (27%). Five patients (25%) had positive blood cultures and a mortality of 20% was reported. CONCLUSIONS This is the largest study on SARS-CoV-2 infected pediatric patients with underlying malignancies in Iran. Since the risk of exposure to SARS-CoV-2 and even death in children with malignancy, either in the hospital or community setting during the pandemic is high, special precautions to reduce the risk of transmission are highly suggested.
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Affiliation(s)
- Amene Navaeian
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Bakhtiari
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodabandeh
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Abdolsalehi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alieh Safari Sharari
- Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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19
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Bodilsen J, Nielsen PB, Søgaard M, Dalager-Pedersen M, Speiser LOZ, Yndigegn T, Nielsen H, Larsen TB, Skjøth F. Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study. BMJ 2021; 373:n1135. [PMID: 34035000 PMCID: PMC8142604 DOI: 10.1136/bmj.n1135] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the incidence of hospital admissions and associated mortality rates for non-covid medical conditions during the covid-19 pandemic. DESIGN Nationwide, population based cohort study. SETTING Denmark from 13 March 2019 to 27 January 2021. PARTICIPANTS All Danish residents >1 year of age. MAIN OUTCOMES MEASURES Population based healthcare registries that encompass the entire Danish population were used to compare hospital admission and mortality rates during the covid-19 pandemic (from 11 March 2020 to 27 January 2021) with the prepandemic baseline data (from 13 March 2019 to 10 March 2020). Hospital admissions were categorised as covid-19 when patients were assigned a diagnosis code for covid-19 within five days of admission. All patients were followed until migration, death, or end of follow-up, whichever came first. Rate ratios for hospital admissions were computed using Poisson regression and were directly standardised using the Danish population on 1 January 2019 as reference. 30 day mortality rate ratios were examined by Cox regression, adjusted for age and sex, and covid-19 diagnosis was used as a competing risk. RESULTS 5 753 179 residents were identified during 567.8 million person weeks of observation, with 1 113 705 hospital admissions among 675 447 people. Compared with the prepandemic baseline period (mean hospital admission rate 204.1 per 100 000/week), the overall hospital admission rate for non-covid-19 conditions decreased to 142.8 per 100 000/week (rate ratio 0.70, 95% confidence interval 0.66 to 0.74) after the first national lockdown, followed by a gradual return to baseline levels until the second national lockdown when it decreased to 158.3 per 100 000/week (0.78, 0.73 to 0.82). This pattern was mirrored for most major diagnosis groups except for non-covid-19 respiratory diseases, nervous system diseases, cancer, heart failure, sepsis, and non-covid-19 respiratory infections, which remained lower throughout the study period. Overall 30 day mortality rates were higher during the first national lockdown (mortality rate ratio 1.28, 95% confidence interval 1.23 to 1.32) and the second national lockdown (1.20, 1.16 to 1.24), and these results were similar across most major diagnosis groups. For non-covid-19 respiratory diseases, cancer, pneumonia, and sepsis, the 30 day mortality rate ratios were also higher between lockdown periods. CONCLUSIONS Hospital admissions for all major non-covid-19 disease groups decreased during national lockdowns compared with the prepandemic baseline period. Additionally, mortality rates were higher overall and for patients admitted to hospital with conditions such as respiratory diseases, cancer, pneumonia, and sepsis. Increased attention towards management of serious non-covid-19 medical conditions is warranted.
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Affiliation(s)
- Jacob Bodilsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Brønnum Nielsen
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Søgaard
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Troels Yndigegn
- Department of Cardiology, Lund University Hospital, Lund, Sweden
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Torben Bjerregaard Larsen
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Flemming Skjøth
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
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Purcaru OS, Artene SA, Barcan E, Silosi CA, Stanciu I, Danoiu S, Tudorache S, Tataranu LG, Dricu A. The Interference between SARS-CoV-2 and Tyrosine Kinase Receptor Signaling in Cancer. Int J Mol Sci 2021; 22:4830. [PMID: 34063231 PMCID: PMC8124491 DOI: 10.3390/ijms22094830] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 01/08/2023] Open
Abstract
Cancer and viruses have a long history that has evolved over many decades. Much information about the interplay between viruses and cell proliferation and metabolism has come from the history of clinical cases of patients infected with virus-induced cancer. In addition, information from viruses used to treat some types of cancer is valuable. Now, since the global coronavirus pandemic erupted almost a year ago, the scientific community has invested countless time and resources to slow down the infection rate and diminish the number of casualties produced by this highly infectious pathogen. A large percentage of cancer cases diagnosed are strongly related to dysregulations of the tyrosine kinase receptor (TKR) family and its downstream signaling pathways. As such, many therapeutic agents have been developed to strategically target these structures in order to hinder certain mechanisms pertaining to the phenotypic characteristics of cancer cells such as division, invasion or metastatic potential. Interestingly, several authors have pointed out that a correlation between coronaviruses such as the SARS-CoV-1 and -2 or MERS viruses and dysregulations of signaling pathways activated by TKRs can be established. This information may help to accelerate the repurposing of clinically developed anti-TKR cancer drugs in COVID-19 management. Because the need for treatment is critical, drug repurposing may be an advantageous choice in the search for new and efficient therapeutic compounds. This approach would be advantageous from a financial point of view as well, given that the resources used for research and development would no longer be required and can be potentially redirected towards other key projects. This review aims to provide an overview of how SARS-CoV-2 interacts with different TKRs and their respective downstream signaling pathway and how several therapeutic agents targeted against these receptors can interfere with the viral infection. Additionally, this review aims to identify if SARS-CoV-2 can be repurposed to be a potential viral vector against different cancer types.
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Affiliation(s)
- Oana-Stefana Purcaru
- Department of Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania; (O.-S.P.); (S.-A.A.); (E.B.); (A.D.)
| | - Stefan-Alexandru Artene
- Department of Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania; (O.-S.P.); (S.-A.A.); (E.B.); (A.D.)
| | - Edmond Barcan
- Department of Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania; (O.-S.P.); (S.-A.A.); (E.B.); (A.D.)
| | - Cristian Adrian Silosi
- Department of Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania;
| | - Ilona Stanciu
- “Victor Babeş” Clinical Hospital of Infectious Diseases and Pneumophtisiology, Craiova, Str. Calea Bucuresti, nr. 126, 200525 Craiova, Romania;
| | - Suzana Danoiu
- Department of Physiopathology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania;
| | - Stefania Tudorache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova, 710204 Craiova, Romania;
| | - Ligia Gabriela Tataranu
- Department of Neurosurgery, “Bagdasar-Arseni” Emergency Hospital, Soseaua Berceni 12, 041915 Bucharest, Romania
| | - Anica Dricu
- Department of Biochemistry, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Str. Petru Rares nr. 2-4, 710204 Craiova, Romania; (O.-S.P.); (S.-A.A.); (E.B.); (A.D.)
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21
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Venkatesulu BP, Chandrasekar VT, Girdhar P, Advani P, Sharma A, Elumalai T, Hsieh CE, Elghazawy HI, Verma V, Krishnan S. A Systematic Review and Meta-Analysis of Cancer Patients Affected by a Novel Coronavirus. JNCI Cancer Spectr 2021; 5:pkaa102. [PMID: 33875976 PMCID: PMC7928783 DOI: 10.1093/jncics/pkaa102] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/17/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cancer patients with coronavirus disease 2019 (COVID-19) have been reported to have double the case fatality rate of the general population. METHODS A systematic search of PubMed, Embase, and Cochrane Central was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio (OR) and forest plots (random-effects model) were constructed for both primary and secondary outcomes. RESULTS This systematic review of 38 studies and meta-analysis of 181 323 patients from 26 studies included 23 736 cancer patients. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (n = 165 980, OR = 2.54, 95% confidence interval [CI] = 1.47 to 4.42), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated. Among cancer subtypes, the mortality was highest in hematological malignancies (n = 878, OR = 2.39, 95% CI = 1.17 to 4.87) followed by lung cancer (n = 646, OR = 1.83, 95% CI = 1.00 to 3.37). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of comorbidities. There was insufficient data to assess the association of COVID-19-directed therapy and survival outcomes in cancer patients. CONCLUSION Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.
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Affiliation(s)
- Bhanu Prasad Venkatesulu
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
- Department of Radiation Oncology, Loyola University, Maywood, IL
| | | | - Prashanth Girdhar
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Pragati Advani
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Amrish Sharma
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Thiraviyam Elumalai
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Cheng En Hsieh
- Department of Radiation Oncology, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan City, Taiwan
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston and The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hagar I Elghazawy
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Abbaseya, Cairo, Egypt
| | - Vivek Verma
- Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Sunil Krishnan
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL, USA
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22
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Dettorre GM, Dolly S, Loizidou A, Chester J, Jackson A, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Sng CCT, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Seguí E, Biello F, Generali D, Grisanti S, Seeva P, Rizzo G, Libertini M, Maconi A, Moss C, Russell B, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Liñan R, Marrari A, Carmona-García MC, Chopra N, Tondini CA, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, Roqué A, Lee AJX, Newsom-Davis T, García-Illescas D, Reyes R, Wong YNS, Ferrante D, Scotti L, Marco-Hernández J, Ruiz-Camps I, Patriarca A, Rimassa L, Chiudinelli L, Franchi M, Santoro A, Prat A, Gennari A, Van Hemelrijck M, Tabernero J, Diamantis N, Pinato DJ. Systemic pro-inflammatory response identifies patients with cancer with adverse outcomes from SARS-CoV-2 infection: the OnCovid Inflammatory Score. J Immunother Cancer 2021; 9:e002277. [PMID: 33753569 PMCID: PMC7985977 DOI: 10.1136/jitc-2020-002277] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. METHODS In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. RESULTS We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p<0.01), recovering in survivors to pre-COVID-19 levels. Patients in poorer risk categories for each index except the PLR exhibited higher mortality rates (p<0.001) and shorter median overall survival in the training and validation sets (p<0.01). Multivariable analyses revealed the OIS to be most independently predictive of survival (validation set HR 2.48, 95% CI 1.47 to 4.20, p=0.001; adjusted concordance index score 0.611). CONCLUSIONS Systemic inflammation is a validated prognostic domain in SARS-CoV-2-infected patients with cancer and can be used as a bedside predictor of adverse outcome. Lymphocytopenia and hypoalbuminemia as computed by the OIS are independently predictive of severe COVID-19, supporting their use for risk stratification. Reversal of the COVID-19-induced proinflammatory state is a putative therapeutic strategy in patients with cancer.
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Affiliation(s)
- Gino M Dettorre
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Angela Loizidou
- Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - John Chester
- Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | | | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | | | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Pavetha Seeva
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Antonio Maconi
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Bruno Vincenzi
- Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rossella Bertulli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Andrea Marrari
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Neha Chopra
- Cancer Division, University College London Hospitals, London, UK
| | | | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ariadna Roqué
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Tom Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - David García-Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | | | - Daniela Ferrante
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
| | | | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | | | | | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Aleix Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | | | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
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23
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Madhusoodhan PP, Pierro J, Musante J, Kothari P, Gampel B, Appel B, Levy A, Tal A, Hogan L, Sharma A, Feinberg S, Kahn A, Pinchinat A, Bhatla T, Glasser CL, Satwani P, Raetz EA, Onel K, Carroll WL. Characterization of COVID-19 disease in pediatric oncology patients: The New York-New Jersey regional experience. Pediatr Blood Cancer 2021; 68:e28843. [PMID: 33338306 PMCID: PMC7883045 DOI: 10.1002/pbc.28843] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Pediatric oncology patients undergoing active chemotherapy are suspected to be at a high risk for severe disease secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection; however, data to support this are lacking. We aim to describe the characteristics of coronavirus disease 2019 (COVID-19) in this population and also its impact on pediatric cancer care in the New York region during the peak of the pandemic. PATIENTS AND METHODS This multicenter, retrospective study included 13 institutions. Clinical and laboratory information on 98 patients ≤21 years of age receiving active anticancer therapy, who tested positive for SARS-CoV-2 by nasopharyngeal swab polymerase chain reaction (PCR), was collected. RESULTS Of the 578 pediatric oncology patients tested for COVID-19, 98 were positive, of whom 73 were symptomatic. Most experienced mild disease, 28 required inpatient management, 25 needed oxygen support, and seven required mechanical ventilation. There is a slightly higher risk of severe disease in males and obese patients, though not statistically significant. Persistent lymphopenia was noted in severe cases. Delays in cancer therapy occurred in 67% of SARS-CoV-2-positive patients. Of four deaths, none were solely attributable to COVID-19. The impact of the pandemic on pediatric oncology care was significant, with 54% of institutions reporting delays in chemotherapy, 46% delays in surgery, and 30% delays in transplant. CONCLUSION In this large multi-institutional cohort, we observed that mortality and morbidity from COVID-19 amongst pediatric oncology patients were low overall, but higher than reported in general pediatrics. Certain subgroups might be at higher risk of severe disease. Delays in cancer care due to SARS-CoV-2 remain a concern.
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Affiliation(s)
- P. Pallavi Madhusoodhan
- Department of PediatricsDivision of Pediatric Hematology‐OncologyMount Sinai Kravis Children's HospitalIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - Joanna Pierro
- Department of PediatricsDivision of Pediatric Hematology‐OncologyHassenfeld Children's Hospital at NYU Langone HealthPerlmutter Cancer CenterNYU Grossman School of MedicineNew YorkNew York
| | - Jordan Musante
- Department of PediatricsDivision of Pediatric Hematology‐OncologyMount Sinai Kravis Children's HospitalIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - Prachi Kothari
- Department of PediatricsMemorial Sloan Kettering Cancer CenterNew YorkNew York
| | - Bradley Gampel
- Department of PediatricsDivision of Pediatric HematologyOncology, and Stem Cell TransplantationNew York‐Presbyterian Morgan Stanley Children's HospitalColumbia University Medical CenterNew YorkNew York
| | - Burton Appel
- Children's Cancer InstituteJoseph M. Sanzari Children's HospitalHackensack University Medical CenterHackensackNew Jersey
| | - Adam Levy
- Department of PediatricsDivision of Pediatric Hematology/Oncology and Cellular TherapyChildren's Hospital at MontefioreAlbert Einstein College of MedicineBronxNew York
| | - Adit Tal
- Department of PediatricsDivision of Pediatric Hematology/Oncology and Cellular TherapyChildren's Hospital at MontefioreAlbert Einstein College of MedicineBronxNew York
| | - Laura Hogan
- Department of PediatricsStony Brook Children's HospitalStony BrookNew York
| | - Archana Sharma
- Rutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | - Shari Feinberg
- Department of PediatricsDivision of Pediatric Hematology‐Oncology at Maimonides Cancer CenterMaimonides Medical CenterBrooklynNew York
| | - Alissa Kahn
- The Valerie Fund Center at St. Joseph's Children's HospitalPatersonNew Jersey
| | - Ashley Pinchinat
- Department of PediatricsDivision of HematologyOncologyand Stem Cell TransplantationMaria Fareri Children's Hospital at Westchester Medical CenterNew York Medical CollegeValhallaNew York
| | - Teena Bhatla
- Department of PediatricsDivision of Pediatric Hematology‐OncologyChildren's Hospital of New Jersey at Newark Beth Israel Medical CenterNewarkNew Jersey
| | - Chana L. Glasser
- Department of PediatricsDivision of Pediatric Hematology‐OncologyNYU Winthrop HospitalNYU Long Island School of MedicineMineolaNew York
| | - Prakash Satwani
- Department of PediatricsDivision of Pediatric HematologyOncology, and Stem Cell TransplantationNew York‐Presbyterian Morgan Stanley Children's HospitalColumbia University Medical CenterNew YorkNew York
| | - Elizabeth A. Raetz
- Department of PediatricsDivision of Pediatric Hematology‐OncologyHassenfeld Children's Hospital at NYU Langone HealthPerlmutter Cancer CenterNYU Grossman School of MedicineNew YorkNew York
| | - Kenan Onel
- Departments of Genetics and Genomic SciencesMedicinePathologyand PediatricsTisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - William L. Carroll
- Department of PediatricsDivision of Pediatric Hematology‐OncologyHassenfeld Children's Hospital at NYU Langone HealthPerlmutter Cancer CenterNYU Grossman School of MedicineNew YorkNew York
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24
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Zarifkar P, Kamath A, Robinson C, Morgulchik N, Shah SFH, Cheng TKM, Dominic C, Fehintola AO, Bhalla G, Ahillan T, Mourgue d'Algue L, Lee J, Pareek A, Carey M, Hughes DJ, Miller M, Woodcock VK, Shrotri M. Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis. Clin Oncol (R Coll Radiol) 2021; 33:e180-e191. [PMID: 33261978 PMCID: PMC7674130 DOI: 10.1016/j.clon.2020.11.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/25/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023]
Abstract
Much of routine cancer care has been disrupted due to the perceived susceptibility to SARS-CoV-2 infection in cancer patients. Here, we systematically review the current evidence base pertaining to the prevalence, presentation and outcome of COVID-19 in cancer patients, in order to inform policy and practice going forwards. A keyword-structured systematic search was conducted on Pubmed, Cochrane, Embase and MedRxiv databases for studies reporting primary data on COVID-19 in cancer patients. Studies were critically appraised using the NIH National Heart, Lung and Blood Institute's quality assessment tool set. The pooled prevalence of cancer as a co-morbidity in patients with COVID-19 and pooled in-hospital mortality risk of COVID-19 in cancer patients were derived by random-effects meta-analyses. In total, 110 studies from 10 countries were included. The pooled prevalence of cancer as a co-morbidity in hospitalised patients with COVID-19 was 2.6% (95% confidence interval 1.8%, 3.5%, I2: 92.0%). Specifically, 1.7% (95% confidence interval 1.3%, 2.3%, I2: 57.6.%) in China and 5.6% (95% confidence interval 4.5%, 6.7%, I2: 82.3%) in Western countries. Patients most commonly presented with non-specific symptoms of fever, dyspnoea and chest tightness in addition to decreased arterial oxygen saturation, ground glass opacities on computer tomography and non-specific changes in inflammatory markers. The pooled in-hospital mortality risk among patients with COVID-19 and cancer was 14.1% (95% confidence interval 9.1%, 19.8%, I2: 52.3%). We identified impeding questions that need to be answered to provide the foundation for an iterative review of the developing evidence base, and inform policy and practice going forwards. Analyses of the available data corroborate an unfavourable outcome of hospitalised patients with COVID-19 and cancer. Our findings encourage future studies to report detailed social, demographic and clinical characteristics of cancer patients, including performance status, primary cancer type and stage, as well as a history of anti-cancer therapeutic interventions.
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Affiliation(s)
- P Zarifkar
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.
| | - A Kamath
- Faculty of Medicine, University of Oxford, Medical Sciences Divisional Office, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - C Robinson
- Faculty of Medicine, University of Oxford, Medical Sciences Divisional Office, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - N Morgulchik
- Imperial College London, Department of Chemistry, Molecular Sciences Research Hub, London, UK
| | - S F H Shah
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - T K M Cheng
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - C Dominic
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - A O Fehintola
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - G Bhalla
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - T Ahillan
- University College London Medical School, London, UK
| | | | - J Lee
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - A Pareek
- Department of Radiology Stanford University School of Medicine, Stanford, California, USA
| | - M Carey
- Department of Palliative Care Oxford University Hospitals NHS Foundation Trust, Sobell House Hospice, Churchill Hospital, Oxford, UK
| | - D J Hughes
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - M Miller
- Department of Palliative Care Oxford University Hospitals NHS Foundation Trust, Sobell House Hospice, Churchill Hospital, Oxford, UK
| | - V K Woodcock
- Department of Oncology, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - M Shrotri
- London School of Hygiene & Tropical Medicine, London, UK
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25
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Baxter MA, Murphy J, Cameron D, Jordan J, Crearie C, Lilley C, Sadozye A, Maclean M, Hall P, Phillips A, Greger A, Madeleine J, Petty RD. The impact of COVID-19 on systemic anticancer treatment delivery in Scotland. Br J Cancer 2021; 124:1353-1356. [PMID: 33526866 PMCID: PMC8039028 DOI: 10.1038/s41416-021-01262-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022] Open
Abstract
Understanding the impact of the COVID-19 pandemic on systemic anticancer therapy delivery (SACT) is crucial to appreciate the short- and long-term consequences for cancer patients and plan future care. Here, we report real-time national SACT delivery data from NHS Scotland. We demonstrate an initial rapid reduction in patient attendance of 28.7% with subsequent rapid recovery following service redesign. The smallest decrease was seen in breast cancer (19.7%), which also had the most rapid recovery and the largest decrease seen in colorectal cancer (43.4%). Regional variation in the magnitude of impact on SACT delivery was observed, but nadirs occurred at the same time and the rate of recovery was similar across all regions. This recovery reflected a coordinated national approach and associated patient and clinician support structures, which facilitated the creation of COVID-19-protected areas for SACT delivery in Scottish cancer centres enabling rapid sharing of successful and innovative strategies. The data show that these actions have limited the disadvantage to cancer patients.
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Affiliation(s)
- Mark A Baxter
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.,Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK
| | | | - David Cameron
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.,Edinburgh Cancer Centre, NHS Lothian, Edinburgh, UK
| | | | | | | | | | | | - Peter Hall
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK.,Edinburgh Cancer Centre, NHS Lothian, Edinburgh, UK
| | - Angela Phillips
- Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK
| | | | | | - Russell D Petty
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. .,Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK.
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Millen GC, Arnold R, Cazier JB, Curley H, Feltbower RG, Gamble A, Glaser AW, Grundy RG, Lee LYW, McCabe MG, Phillips RS, Stiller CA, Várnai C, Kearns PR. Severity of COVID-19 in children with cancer: Report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. Br J Cancer 2021; 124:754-759. [PMID: 33299130 PMCID: PMC7884399 DOI: 10.1038/s41416-020-01181-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/31/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Children with cancer are frequently immunocompromised. While children are generally thought to be at less risk of severe SARS-CoV-2 infection than adults, comprehensive population-based evidence for the risk in children with cancer is unavailable. We aimed to produce evidence of the incidence and outcomes from SARS-CoV-2 in children with cancer attending all hospitals treating this population across the UK. METHODS Retrospective and prospective observational study of all children in the UK under 16 diagnosed with cancer through data collection from all hospitals providing cancer care to this population. Eligible patients tested positive for SARS-CoV-2 on reverse transcription polymerase chain reaction (RT-PCR). The primary end-point was death, discharge or end of active care for COVID-19 for those remaining in hospital. RESULTS Between 12 March 2020 and 31 July 2020, 54 cases were identified: 15 (28%) were asymptomatic, 34 (63%) had mild infections and 5 (10%) moderate, severe or critical infections. No patients died and only three patients required intensive care support due to COVID-19. Estimated incidence of hospital identified SARS-CoV-2 infection in children with cancer under 16 was 3%. CONCLUSIONS Children with cancer with SARS-CoV-2 infection do not appear at increased risk of severe infection compared to the general paediatric population. This is reassuring and supports the continued delivery of standard treatment.
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Affiliation(s)
- Gerard C Millen
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Department of Paediatric Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Roland Arnold
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jean-Baptiste Cazier
- Centre for Computational Biology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Helen Curley
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Richard G Feltbower
- Leeds Institute for Data Analytics (LIDA), School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Ashley Gamble
- Children's Cancer and Leukaemia Group (CCLG), Leicester, LE1 7GB, UK
| | - Adam W Glaser
- Leeds Institute for Data Analytics (LIDA), School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
- Professor of Paediatric Oncology and Late Effects Medicine, Leeds Institute of Medical Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Richard G Grundy
- Children's Cancer and Leukaemia Group (CCLG), Leicester, LE1 7GB, UK
- Children's Brain Tumour Research Centre, School of Medicine, The University of Nottingham, Nottingham, NG7 2UH, UK
| | - Lennard Y W Lee
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- National Cancer Registration and Analysis Service, Public Health England, London, SE1 8UG, UK
| | - Robert S Phillips
- Centre for Reviews and Dissemination, University of York, York, UK
- Department of Paediatric Oncology, Leeds Children's Hospital, Leeds, UK
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, SE1 8UG, UK
| | - Csilla Várnai
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Centre for Computational Biology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Pamela R Kearns
- Department of Paediatric Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
- Cancer Research UK Clinical Trials Unit, NIHR Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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Fernandes GA, Feriani D, França E Silva ILA, Mendonça E Silva DR, Arantes PE, Canteras JDS, da Silva RR, Curado MP. Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center. Semin Oncol 2021; 48:171-180. [PMID: 33573780 PMCID: PMC7849494 DOI: 10.1053/j.seminoncol.2021.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil. METHODS Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable. RESULTS Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33-12.34) and hematological (OR 2.17, 95% CI 0.96-4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25-6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19. CONCLUSIONS Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.
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Affiliation(s)
| | - Diego Feriani
- Department of Infection Prevention and Control, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Paola Engelmann Arantes
- Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Maria Paula Curado
- Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil.
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Piciu A, Manole S, Piciu D, Dreve T, Roman A. Asymptomatic COVID-19 cancer patients incidentally discovered during F18-FDG PET/CT monitoring. Med Pharm Rep 2021; 94:58-64. [PMID: 33629050 PMCID: PMC7880066 DOI: 10.15386/mpr-1776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/25/2022] Open
Abstract
Background The aim of the study was to present the PET/CT imaging features in a small series of asymptomatic patients with known cancer pathologies, infected with the SARS-CoV-2 virus, which were incidentally discovered during their monitoring scan of F18-FDG PET/CT. Methods We included in our study a number of five cases (3 female and 2 male) out of 478 patients examined by F18-FDG PET/CT between March - April 2020, with confirmed diagnostic of cancer. Four patients had lung damages suggestive for the mentioned viral infection and 1 patient had multiple lung metastases from thyroid cancer. All patients were asymptomatic for acute respiratory disease at the time of examination, being subsequently confirmed for the viral infection by specific PCR analysis. Results The asymptomatic positive SARS-CoV-2 cancer patients discovered incidentally in PET/CT F18-FDG represent 0.83% and their imaging characteristics were suggestive for high FDG activity in the lung despite the lack of respiratory symptoms. Conclusion The SARS CoV-2 viral infection in asymptomatic cancer patients is a very rare possibility, but represents a challenging scenario both for the differential diagnosis in cancer and also for the epidemiologic context.
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Affiliation(s)
- Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Manole
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,CT Clinic, Cluj-Napoca, Romania
| | - Doina Piciu
- CT Clinic, Cluj-Napoca, Romania.,Department of Endocrine Tumors and Nuclear Medicine, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | | | - Andrei Roman
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,CT Clinic, Cluj-Napoca, Romania
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29
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Bakouny Z, Hawley JE, Choueiri TK, Peters S, Rini BI, Warner JL, Painter CA. COVID-19 and Cancer: Current Challenges and Perspectives. Cancer Cell 2020; 38:629-646. [PMID: 33049215 PMCID: PMC7528740 DOI: 10.1016/j.ccell.2020.09.018] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
Patients with cancer have been disproportionately affected by the COVID-19 pandemic. This effect has included the adverse outcomes in patients with cancer who develop COVID-19, the impact of the COVID-19 pandemic on the delivery of cancer care, and the severe disruption to cancer research. However, patients with cancer are a heterogeneous population, and recent studies have now documented factors that allow risk stratification of patients with cancer in order to optimize care. In this review, we highlight data at the intersection of COVID-19 and cancer, including the biological interplay between the two diseases and practical recommendations for the treatment of patients with cancer during the pandemic. We additionally discuss the potential long-lasting impact of the pandemic on cancer care due to its deleterious effect on cancer research, as well as biological insights from the cancer research community that could help develop novel therapies for all patients with COVID-19.
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Affiliation(s)
- Ziad Bakouny
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jessica E Hawley
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Brian I Rini
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremy L Warner
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Corrie A Painter
- Cancer Program, Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA 02142, USA.
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30
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Lou E, Teoh D, Brown K, Blaes A, Holtan SG, Jewett P, Parsons H, Mburu EW, Thomaier L, Hui JYC, Nelson HH, Vogel RI. Perspectives of cancer patients and their health during the COVID-19 pandemic. PLoS One 2020; 15:e0241741. [PMID: 33125442 PMCID: PMC7598454 DOI: 10.1371/journal.pone.0241741] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction The immunosuppressive nature of some cancers and many cancer-directed treatments may increase the risk of infection with and severe sequelae from Coronavirus Disease 2019 (COVID-19). The objective of this study was to compare concerns about COVID-19 among individuals undergoing cancer treatment to those with a history of cancer not currently receiving therapy and to those without a cancer history. Methods We conducted a cross-sectional anonymous online survey study of adults currently residing in the United States. Participants were recruited over a one-week period (April 3–11, 2020) using promoted advertisements on Facebook and Twitter. Groups were compared using chi-squared tests, Fisher’s exact tests, and t-tests. Results 543 respondents from 47 states provided information on their cancer history and were included in analyses. Participants receiving active treatment reported greater concern about infection from the SARS-CoV-2 coronavirus (p<0.001), higher levels of family distress caused by the COVID-19 pandemic (p = 0.004), and greater concern that the general public does not adequately understand the seriousness of COVID-19 (p = 0.04). Those with metastatic disease were more likely to indicate that COVID-19 had negatively affected their cancer care compared to patients with non-metastatic cancer (50.8% vs. 31.0%; p = 0.02). The most commonly reported treatment modifications included chemotherapy delays. Conclusions Patients undergoing active treatment for cancer were most concerned about the short-term effects of the COVID-19 pandemic on the logistics as well as potential efficacy of ongoing cancer treatment, longer term effects, and overarching societal concerns that the population at large is not as concerned about the public health implications of SARS-CoV-2 infection.
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Affiliation(s)
- Emil Lou
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Deanna Teoh
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Katherine Brown
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Anne Blaes
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Shernan G. Holtan
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Patricia Jewett
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Helen Parsons
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - E. Waruiru Mburu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Lauren Thomaier
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Jane Yuet Ching Hui
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Heather H. Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rachel I. Vogel
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, Minnesota, United States of America
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31
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Borregón Rivilla M, Martínez Barroso KA. Coronavirus infection in cancer patients, last update. Medicina Clínica (English Edition) 2020; 155:299-301. [PMID: 32953991 PMCID: PMC7486851 DOI: 10.1016/j.medcle.2020.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Lee LYW, Cazier JB, Starkey T, Briggs SEW, Arnold R, Bisht V, Booth S, Campton NA, Cheng VWT, Collins G, Curley HM, Earwaker P, Fittall MW, Gennatas S, Goel A, Hartley S, Hughes DJ, Kerr D, Lee AJX, Lee RJ, Lee SM, Mckenzie H, Middleton CP, Murugaesu N, Newsom-Davis T, Olsson-Brown AC, Palles C, Powles T, Protheroe EA, Purshouse K, Sharma-Oates A, Sivakumar S, Smith AJ, Topping O, Turnbull CD, Várnai C, Briggs ADM, Middleton G, Kerr R. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol 2020; 21:1309-1316. [PMID: 32853557 PMCID: PMC7444972 DOI: 10.1016/s1470-2045(20)30442-3] [Citation(s) in RCA: 399] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK. METHODS We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models. FINDINGS 319 (30·6%) of 1044 patients in the UKCCMP cohort died, 295 (92·5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0·10 in patients aged 40-49 years to 0·48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15-2·15; p<0·0043). Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case-fatality rate (2·25, 1·13-4·57; p=0·023). After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09-4·08; p=0·028). INTERPRETATION Patients with cancer with different tumour types have differing susceptibility to SARS-CoV-2 infection and COVID-19 phenotypes. We generated individualised risk tables for patients with cancer, considering age, sex, and tumour subtype. Our results could be useful to assist physicians in informed risk-benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies. FUNDING University of Birmingham and University of Oxford.
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Affiliation(s)
- Lennard Y W Lee
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Department of Oncology, University of Oxford, Oxford, UK; University Hospitals Birmingham, Birmingham, UK
| | - Jean-Baptiste Cazier
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Thomas Starkey
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Sarah E W Briggs
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Roland Arnold
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Vartika Bisht
- Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Stephen Booth
- Department of Haematology, University of Oxford, Oxford, UK
| | - Naomi A Campton
- Institute of Translational Medicine, Birmingham Health Partners, Birmingham, UK
| | - Vinton W T Cheng
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Graham Collins
- Department of Haematology, University of Oxford, Oxford, UK
| | - Helen M Curley
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | | | | | - Anshita Goel
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Simon Hartley
- Centre for Computational Biology, University of Birmingham, Birmingham, UK; Advanced Research Computing, University of Birmingham, Birmingham, UK
| | - Daniel J Hughes
- Department of Cancer Imaging, King's College London, London, UK
| | - David Kerr
- Nuffield Division of Clinical and Laboratory Services, University of Oxford, Oxford, UK
| | - Alvin J X Lee
- UCL Cancer Institute, University College London, London, UK
| | - Rebecca J Lee
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - Chris P Middleton
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Nirupa Murugaesu
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Tom Newsom-Davis
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Claire Palles
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Emily A Protheroe
- University of Birmingham Medical School, University of Birmingham, Birmingham, UK
| | - Karin Purshouse
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK
| | | | | | | | | | - Chris D Turnbull
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Csilla Várnai
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | | | - Gary Middleton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK.
| | - Rachel Kerr
- Department of Oncology, University of Oxford, Oxford, UK
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33
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Borregón Rivilla M, Martínez Barroso KA. Infección por coronavirus en pacientes oncológicos, evidencias a fecha de hoy. Med Clin (Barc) 2020; 155:299-301. [PMID: 32861432 PMCID: PMC7362806 DOI: 10.1016/j.medcli.2020.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022]
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34
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Curigliano G, Banerjee S, Cervantes A, Garassino MC, Garrido P, Girard N, Haanen J, Jordan K, Lordick F, Machiels JP, Michielin O, Peters S, Tabernero J, Douillard JY, Pentheroudakis G. Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus. Ann Oncol 2020; 31:1320-1335. [PMID: 32745693 PMCID: PMC7836806 DOI: 10.1016/j.annonc.2020.07.010] [Citation(s) in RCA: 194] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
We established an international consortium to review and discuss relevant clinical evidence in order to develop expert consensus statements related to cancer management during the severe acute respiratory syndrome coronavirus 2-related disease (COVID-19) pandemic. The steering committee prepared 10 working packages addressing significant clinical questions from diagnosis to surgery. During a virtual consensus meeting of 62 global experts and one patient advocate, led by the European Society for Medical Oncology, statements were discussed, amended and voted upon. When consensus could not be reached, the panel revised statements until a consensus was reached. Overall, the expert panel agreed on 28 consensus statements that can be used to overcome many of the clinical and technical areas of uncertainty ranging from diagnosis to therapeutic planning and treatment during the COVID-19 pandemic.
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Affiliation(s)
- G Curigliano
- Department of Oncology and Hemato-Oncology, Division of Early Drug Development, European Institute of Oncology, IRCCS and University of Milano, Milan, Italy.
| | - S Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, UK
| | - A Cervantes
- Department of Medical Oncology, Biomedical Research Institute, INCLIVA, University of Valencia, Valencia, Spain; Hematology and Medical Oncology, CIBERONC Instituto de Salud Carlos III, Madrid, Spain
| | - M C Garassino
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Garrido
- Medical Oncology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - N Girard
- Thoracic Oncology, Université de Lyon, Université Claude Bernard Lyon, Lyon, France; Thoracic Surgery, Département Oncologie Médicale, Institut Curie, Paris, France
| | - J Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - F Lordick
- Department of Institut Roi Albert II, University Cancer Center Leipzig, Leipzig University Medical Center, Leipzig, Germany
| | - J P Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
| | - O Michielin
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - S Peters
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Y Douillard
- Department of Medical Oncology, Centre René Gauducheau, Nantes, France
| | - G Pentheroudakis
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Epirus, Greece
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Lee LYW, Hill T, Topping O, Tilby M, Baker M, Greig J, Isherwood L, Miller R, Petrenko Y, Desai R, Field A, Kennedy B, Khan S, Kountourou A, Ndlovu S, Starkey T, Storey F, Turner L, Vaughan-Williams W, Moyler S, Preston H, Latty B, Walker S, Henderson DR, Thompson J, Jones N, Ghafoor Q, Pascoe J, Williams S, Middleton G. Utility of COVID-19 Screening in Cancer Patients. Cancer Cell 2020; 38:306-307. [PMID: 32730750 PMCID: PMC7380207 DOI: 10.1016/j.ccell.2020.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Lennard Y W Lee
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, UK.
| | - Thomas Hill
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Oliver Topping
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael Tilby
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Mark Baker
- University of Birmingham Medical School, University of Birmingham, UK
| | - Julian Greig
- University of Birmingham Medical School, University of Birmingham, UK
| | | | - Robert Miller
- University of Birmingham Medical School, University of Birmingham, UK
| | - Yuriy Petrenko
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ruchi Desai
- University of Birmingham Medical School, University of Birmingham, UK
| | - Alice Field
- University of Birmingham Medical School, University of Birmingham, UK
| | - Bethany Kennedy
- University of Birmingham Medical School, University of Birmingham, UK
| | - Shahbano Khan
- University of Birmingham Medical School, University of Birmingham, UK
| | | | - Sandisile Ndlovu
- University of Birmingham Medical School, University of Birmingham, UK
| | - Thomas Starkey
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, UK
| | - Francesca Storey
- University of Birmingham Medical School, University of Birmingham, UK
| | - Lucy Turner
- University of Birmingham Medical School, University of Birmingham, UK
| | | | - Surrinder Moyler
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Helen Preston
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Beverley Latty
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sharon Walker
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Daniel R Henderson
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Joyce Thompson
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Nicola Jones
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Qamar Ghafoor
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jenny Pascoe
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sarah Williams
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gary Middleton
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, UK.
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36
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Angelis V, Tippu Z, Joshi K, Reis S, Gronthoud F, Fribbens C, Okines A, Stanway S, Cottier E, McGrath S, Watkins D, Noble J, Bhosle J, Gerlinger M, Hamid I, Soliman H, Nenclares P, Jones R, Harrington K, Gennatas S. Defining the true impact of coronavirus disease 2019 in the at-risk population of patients with cancer. Eur J Cancer 2020; 136:99-106. [PMID: 32659475 PMCID: PMC7340059 DOI: 10.1016/j.ejca.2020.06.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND In light of the coronavirus disease 2019 (COVID-19) pandemic, cancer centres in the United Kingdom and Europe re-organised their services at an unprecedented pace, and many patients with cancer have had their treatments severely disrupted. Patients with cancer were considered at high risk on sparse evidence, and despite a small number of emerging observational studies, the true incidence and impact of COVID-19 in the 'at-risk' population of patients with cancer is yet to be defined. METHODS Epidemiological and clinical data were collected prospectively for patients attending the Royal Marsden Hospital and three network hospitals between March 1st and April 30th 2020 that were confirmed to have Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Significance of clinical and pathological characteristics was assessed using the Fisher's exact test and Wilcoxon rank sum test, whilst univariate and multivariate logistic regression models were used to further assess risk. The number of patients attending in March/April 2020 for face-to-face attendances was also extracted. FINDINGS During the 2-month study period, 867 of 13,489 (6.4%) patients met the criteria leading to swab testing. Of the total at-risk population, only 113 of 13,489 (0.84%) were swab positive, 101 of 13,489 (0.75%) required hospital admission and 29 of 13,489 (0.21%) died of COVID-19. Of the patients that attended the hospital to receive cytotoxic chemotherapy alone or in combination with other therapy, 59 of 2001 (2.9%) were admitted to the hospital for COVID-19-related issues and 20 of 2001 (1%) died. Of the patients that collected targeted treatments, 16 of 1126 (1.4%) were admitted and 1 of 1126 (0.1%) died. Of the 11 patients that had received radiotherapy, 6 of 1042 (0.6%) required inpatient admission and 2 of 1042 (0.2%) died. INTERPRETATIONS Administration of systemic anticancer therapy appears to be associated with a modest risk of severe COVID-19 infection. Based on this snapshot taken as the first wave of COVID-19 hit our practice, we conclude that continuation of active cancer treatment, even in the palliative setting, is appropriate.
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Affiliation(s)
| | - Zayd Tippu
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | - Kroopa Joshi
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK
| | - Sara Reis
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | - Firza Gronthoud
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | | | - Alicia Okines
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK; The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK
| | - Susannah Stanway
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK; Croydon University Hospital, 530 London Rd, Thornton Heath CR7 7YE, UK
| | - Emma Cottier
- Croydon University Hospital, 530 London Rd, Thornton Heath CR7 7YE, UK
| | - Sophie McGrath
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK
| | - David Watkins
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK
| | - Jillian Noble
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK; Croydon University Hospital, 530 London Rd, Thornton Heath CR7 7YE, UK
| | - Jaishree Bhosle
- Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK
| | - Marco Gerlinger
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK; Royal Marsden Hospital NHS Trust, Downs Rd, Sutton SM2 5PT, UK
| | - Intan Hamid
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | - Heba Soliman
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | - Pablo Nenclares
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK
| | - Robin Jones
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK; The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK
| | - Kevin Harrington
- Royal Marsden Hospital NHS Trust, Fulham Road, London, SW3 6JJ, UK; The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK
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37
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Greenberg A, Anand G, Sinclair G. Lung Cancer Treatment in COVID-19–Positive Patients: Guidelines and Gestalt. JCO Oncol Pract 2020; 16:615-617. [DOI: 10.1200/op.20.00511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aryeh Greenberg
- Aryeh Greenberg, BSc, MBBS, MRCP, PGCert; Girija Anand, MBBS, MRCP, FRCR; and Georges Sinclair, MD, FRCR, Department of Oncology, North Middlesex University Hospital NHS Trust, London, United Kingdom
| | - Girija Anand
- Aryeh Greenberg, BSc, MBBS, MRCP, PGCert; Girija Anand, MBBS, MRCP, FRCR; and Georges Sinclair, MD, FRCR, Department of Oncology, North Middlesex University Hospital NHS Trust, London, United Kingdom
| | - Georges Sinclair
- Aryeh Greenberg, BSc, MBBS, MRCP, PGCert; Girija Anand, MBBS, MRCP, FRCR; and Georges Sinclair, MD, FRCR, Department of Oncology, North Middlesex University Hospital NHS Trust, London, United Kingdom
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38
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Pickles OJ, Lee LYW, Starkey T, Freeman-Mills L, Olsson-Brown A, Cheng V, Hughes DJ, Lee A, Purshouse K, Middleton G. Immune checkpoint blockade: releasing the breaks or a protective barrier to COVID-19 severe acute respiratory syndrome? Br J Cancer 2020; 123:691-693. [PMID: 32546835 PMCID: PMC7296191 DOI: 10.1038/s41416-020-0930-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/12/2020] [Accepted: 05/21/2020] [Indexed: 01/04/2023] Open
Abstract
The rapid emergence of COVID-19 has sent shockwaves through healthcare systems globally, with cancer patients at increased risk. The interplay of the virus and host immune system has been implicated in the development of ARDS. Immunotherapy agents have the potential to adversely potentiate this phenomenon, requiring careful real-world observation.
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Affiliation(s)
- Oliver J Pickles
- Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Lennard Y W Lee
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Thomas Starkey
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Luke Freeman-Mills
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK
| | - Anna Olsson-Brown
- Clatterbridge Cancer Centre, Bebington, Wirral, CH63 4JY, UK
- Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GL, UK
| | - Vinton Cheng
- Leeds Cancer Centre, St James's University Hospital, Leeds, LS9 7TF, UK
| | - Daniel J Hughes
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Alvin Lee
- UCL Cancer Institute, University College London, London, WC1E 6BT, UK
| | - Karin Purshouse
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, EH4 2XR, UK
| | - Gary Middleton
- Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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39
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van Dam PA, Huizing M, Mestach G, Dierckxsens S, Tjalma W, Trinh XB, Papadimitriou K, Altintas S, Vermorken J, Vulsteke C, Janssens A, Berneman Z, Prenen H, Meuris L, Vanden Berghe W, Smits E, Peeters M. SARS-CoV-2 and cancer: Are they really partners in crime? Cancer Treat Rev 2020; 89:102068. [PMID: 32731090 DOI: 10.1016/j.ctrv.2020.102068] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022]
Abstract
The outbreak of the SARS-CoV-2 pandemic has overwhelmed health care systems in many countries. The clinical presentation of the SARS-CoV-2 varies between a subclinical or flu-like syndrome to that of severe pneumonia with multi-organ failure and death. Initial reports have suggested that cancer patients may have a higher susceptibility to get infected by the SARS-CoV-2 virus but current evidence remains poor as it is biased by important confounders. Patients with ongoing or recent cancer treatment for advanced active disease, metastatic solid tumors and hematological malignancies are at higher risk of developing severe COVID-19 respiratory disease that requires hospitalization and have a poorer disease outcome compared to individuals without cancer. However it is not clear whether these are independent risk factors, or mainly driven by male gender, age, obesity, performance status, uncontrolled diabetes, cardiovascular disease and various other medical conditions. These often have a greater influence on the probability to die due to SARS-CoV-2 then cancer. Delayed diagnosis and suboptimal cancer management due to the pandemic results in disease upstaging and has considerable impact cancer on specific death rates. Surgery during the peak of the pandemic seems to increase mortality, but there is no convincing evidence that adjuvant systemic cancer therapy and radiotherapy are contraindicated, implicating that cancer treatment can be provided safely after individual risk/benefit assessment and some adaptive measures. Underlying immunosuppression, elevated cytokine levels, altered expression of the angiotensin converting enzyme (ACE-2) and TMPRSS2, and a prothrombotic status may fuel the effects of a SARS-CoV-2 in some cancer patients, but have the potential to be used as biomarkers for severe disease and therapeutic targets. The rapidly expanding literature on COVID-19 should be interpreted with care as it is often hampered by methodological and statistical flaws.
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40
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Vivarelli S, Falzone L, Grillo CM, Scandurra G, Torino F, Libra M. Cancer Management during COVID-19 Pandemic: Is Immune Checkpoint Inhibitors-Based Immunotherapy Harmful or Beneficial? Cancers (Basel) 2020; 12:E2237. [PMID: 32785162 PMCID: PMC7465907 DOI: 10.3390/cancers12082237] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is currently representing a global health threat especially for fragile individuals, such as cancer patients. It was demonstrated that cancer patients have an increased risk of developing a worse symptomatology upon severe acute respiratory syndrome associated coronavirus-2 (SARS-CoV-2) infection, often leading to hospitalization and intensive care. The consequences of this pandemic for oncology are really heavy, as the entire healthcare system got reorganized. Both oncologists and cancer patients are experiencing rescheduling of treatments and disruptions of appointments with a concurrent surge of fear and stress. In this review all the up-to-date findings, concerning the association between COVID-19 and cancer, are reported. A remaining very debated question regards the use of an innovative class of anti-cancer molecules, the immune checkpoint inhibitors (ICIs), given their modulating effects on the immune system. For that reason, administration of ICIs to cancer patients represents a question mark during this pandemic, as its correlation with COVID-19-associated risks is still under investigation. Based on the mechanisms of action of ICIs and the current evidence, we suggest that ICIs not only can be safely administered to cancer patients, but they might even be beneficial in COVID-19-positive cancer patients, by exerting an immune-stimulating action.
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Affiliation(s)
- Silvia Vivarelli
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Caterina Maria Grillo
- Otolaryngology Unit, Department of Medical Sciences, Surgical and Advanced Technologies, University of Catania, 95123 Catania, Italy;
| | - Giuseppa Scandurra
- Medical Oncology Unit, Azienda Ospedaliera Cannizzaro, 95126 Catania, Italy;
| | - Francesco Torino
- Department of Systems Medicine, Medical Oncology, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Massimo Libra
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
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Abstract
Two recent Lancet and Lancet Oncology papers report that cancer patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have higher mortality rates. Common independent factors associated with increased risk of death were older age, history of smoking status, number of comorbidities, more advanced performance status, and active cancer.
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Affiliation(s)
- Giuseppe Curigliano
- Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS and University of Milano, Milano, Italy.
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42
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Abstract
Since the beginning of the COVID-19 global pandemic, there has been insufficient evidence and experience to help oncologists understand how to deal with infected and non-infected cancer patients. Many hospitals worldwide have shared their experiences of managing such patients by using the internet to reach non-infected cancer patients. However, for infected or suspected infected cancer patients, their experiences in terms COVID-19 diagnosis, anticancer treatment and prognosis are largely unknown and controversial. Here, we summarize the incidence, severe illness rate and mortality according to the published clinical data of COVID-19 in cancer patients and discuss the diagnostic difficulties, anticancer treatment and prognosis of COVID-19-infected cancer patients.
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Affiliation(s)
- Lina Qi
- School of Medicine, Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Kailai Wang
- School of Medicine, Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Chenyang Ye
- School of Medicine, Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Shu Zheng
- School of Medicine, Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University, Hangzhou, China.,Research Center for Air Pollution and Health, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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43
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Edison MA, Connor MJ, Miah S, El-Husseiny T, Winkler M, Dasgupta R, Ahmed HU, Hrouda D. Understanding virtual urology clinics: a systematic review. BJU Int 2020; 126:536-546. [PMID: 32463991 DOI: 10.1111/bju.15125] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic (VC) strategies, and to highlight research gaps in this rapidly evolving field. METHODS Our PROSPERO-registered (CRD42019151946) systematic search of Embase, Medline and the Cochrane Review Database was performed to identify original research articles pertaining to adult urology telehealth or VC strategies. Risk-of-bias (RoB) assessment was performed according to the Cochrane 2.0 RoB tool or the Joanna Briggs Institute Checklist for non-randomized studies. RESULTS A total of 5813 participants were included from 18 original articles (two randomized controlled trials [RCTs], 10 prospective studies, six retrospective studies). Urology sub-specialities comprised: uro-oncology (n = 6); general urology (n = 8); endo-urology (n = 2); and lower urinary tract symptoms and/or incontinence (n = 2). Across all sub-specialties, prospective studies using VCs reported a primary median (interquartile range [IQR]) VC discharge rate of 16.6 (14.7-29.8)% and a primary median (IQR) face-to-face (FTF) clinic referral rate of 32.4 (15.5-53.3)%. Direct cost analysis demonstrated median (IQR) annual cost savings of £56 232 (£46 260-£61 116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with rates of 0.20% (3/1534) and 0.13% (2/1534), respectively. The annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO2 emissions, depending on the mode of transport used. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires. CONCLUSION Urology VCs are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological sub-specialties to confirm equivalency and safety against traditional FTF assessment.
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Affiliation(s)
- Marie Alexandra Edison
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Martin John Connor
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Saiful Miah
- Department of Urology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Tamer El-Husseiny
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Mathias Winkler
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ranan Dasgupta
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Hashim Uddin Ahmed
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - David Hrouda
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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44
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Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, Campton NA, Chackathayil J, Cheng VW, Curley HM, Fittall MW, Freeman-Mills L, Gennatas S, Goel A, Hartley S, Hughes DJ, Kerr D, Lee AJ, Lee RJ, McGrath SE, Middleton CP, Murugaesu N, Newsom-Davis T, Okines AF, Olsson-Brown AC, Palles C, Pan Y, Pettengell R, Powles T, Protheroe EA, Purshouse K, Sharma-Oates A, Sivakumar S, Smith AJ, Starkey T, Turnbull CD, Várnai C, Yousaf N, Kerr R, Middleton G. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet 2020; 395:1919-1926. [PMID: 32473682 PMCID: PMC7255715 DOI: 10.1016/s0140-6736(20)31173-9] [Citation(s) in RCA: 781] [Impact Index Per Article: 195.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer. METHODS In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission. FINDINGS From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56-10·02]; p<0·0001), being male (1·67 [1·19-2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36-2·80]; p<0·001) and cardiovascular disease (2·32 [1·47-3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81-1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks. INTERPRETATION Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment. FUNDING University of Birmingham, University of Oxford.
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Affiliation(s)
- Lennard Yw Lee
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK.
| | - Jean-Baptiste Cazier
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK
| | | | - Roland Arnold
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Vartika Bisht
- Centre for Computational Biology, University of Birmingham, Birmingham, UK; University of Birmingham, Birmingham, UK
| | - Naomi A Campton
- Institute of Translational Medicine, Birmingham Health Partners, Birmingham, UK
| | - Julia Chackathayil
- Cancer Research Clinical Research Facility, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Vinton Wt Cheng
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Helen M Curley
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | | | | | - Anshita Goel
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Simon Hartley
- Centre for Computational Biology, University of Birmingham, Birmingham, UK; Advanced Research Computing, University of Birmingham, Birmingham, UK
| | - Daniel J Hughes
- Department of Cancer Imaging, King's College London, London, UK
| | - David Kerr
- Nuffield Division of Clinical and Laboratory Services, Oxford University, Oxford, UK
| | - Alvin Jx Lee
- UCL Cancer Institute, University College London, London, UK
| | - Rebecca J Lee
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | | | - Christopher P Middleton
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Nirupa Murugaesu
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | | | - Claire Palles
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Yi Pan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | | | | | - Emily A Protheroe
- University of Birmingham Medical School, University of Birmingham, Birmingham, UK
| | - Karin Purshouse
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Thomas Starkey
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Csilla Várnai
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Nadia Yousaf
- The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Rachel Kerr
- Department of Oncology, Oxford University, Oxford, UK
| | - Gary Middleton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; University Hospitals Birmingham, Birmingham, UK
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Allegra A, Pioggia G, Tonacci A, Musolino C, Gangemi S. Cancer and SARS-CoV-2 Infection: Diagnostic and Therapeutic Challenges. Cancers (Basel) 2020; 12:cancers12061581. [PMID: 32549297 PMCID: PMC7352319 DOI: 10.3390/cancers12061581] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
In late December 2019, a new infectious viral disease appeared. A new betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has been recognized as the pathogen responsible for this infection. Patients affected by tumors are more vulnerable to infection owing to poor health status, concomitant chronic diseases, and immunosuppressive conditions provoked by both the cancer and antitumor therapies. In this review, we have analyzed some lesser known aspects of the relationship between neoplasms and SARS-CoV-2 infection, starting from the different expression of the ACE2 receptor of the virus in the various neoplastic pathologies, and the roles that different cytokine patterns could have in vulnerability to infection and the appearance of complications. This review also reports the rationale for a possible use of drugs commonly employed in neoplastic therapy, such as bevacizumab, ibrutinib, selinexor, thalidomide, carfilzomib, and PD-1 inhibitors, for the treatment of SARS-CoV-2 infection. Finally, we have highlighted some diagnostic challenges in the recognition of SARS-CoV-2 infection in cancer-infected patients. The combination of these two health problems-tumors and a pandemic virus-could become a catastrophe if not correctly handled. Careful and judicious management of cancer patients with SARS-Cov-2 could support a better outcome for these patients during the current pandemic.
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Affiliation(s)
- Alessandro Allegra
- Division of Haematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, 98125 Messina, Italy;
- COVID Centre AOU Policlinic G. Martino Messina, 98125 Messina, Italy
- Correspondence: ; Tel.: +390902212364
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy;
| | - Alessandro Tonacci
- Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), 56124 Pisa, Italy;
| | - Caterina Musolino
- Division of Haematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, 98125 Messina, Italy;
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
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Harrington KJ, Bhide SA, Forster MD, Good JS, Gunn L, Kong A, Melcher AA, Metcalf R, Nenclares P, Newbold KL, Nutting CM, Prestwich R, Sacco JJ, Soliman H, Wong KH. Looking a Gift Horse in the Mouth: Observations on NHS England's Interim Guidance on Pembrolizumab in Head and Neck Squamous Cell Cancer. Clin Oncol (R Coll Radiol) 2020; 32:490-2. [PMID: 32513517 DOI: 10.1016/j.clon.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 12/19/2022]
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Venkatesulu BP, Chandrasekar VT, Girdhar P, Advani P, Sharma A, Elumalai T, Hsieh C, Elghazawy HI, Verma V, Krishnan S. A systematic review and meta-analysis of cancer patients affected by a novel coronavirus. medRxiv 2020:2020.05.27.20115303. [PMID: 32511470 PMCID: PMC7265691 DOI: 10.1101/2020.05.27.20115303] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. MATERIALS AND METHODS A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies. RESULTS This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic. CONCLUSION Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.
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Affiliation(s)
- B P Venkatesulu
- Transitional year residency, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, United States
| | - V T Chandrasekar
- Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - P Girdhar
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - P Advani
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Bethesda, MD 20892, United States
| | - A Sharma
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - T Elumalai
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - C Hsieh
- Department of Radiation Oncology, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan City, Taiwan
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston and The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - H I Elghazawy
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Abbaseya, Cairo, Egypt
| | - V Verma
- Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - S Krishnan
- Department of Radiation Oncology, Mayo Clinic Florida, 4500 San Pablo Road S, Mayo 1N, Jacksonville, FL 32224, USA
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Desideri I, Pilleron S, Battisti NML, Gomes F, de Glas N, Neuendorff NR, Liposits G, Paredero-Pérez I, Lok WCW, Loh KP, DuMontier C, Mian H, Soto-Perez-de-Celis E. Caring for older patients with cancer during the COVID-19 pandemic: A Young International Society of Geriatric Oncology (SIOG) global perspective. J Geriatr Oncol 2020; 11:1175-1181. [PMID: 32402764 PMCID: PMC7252080 DOI: 10.1016/j.jgo.2020.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/01/2020] [Indexed: 12/20/2022]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected millions of people in over 180 territories, causing a significant impact on healthcare systems globally. Older adults, as well as people living with cancer, appear to be particularly vulnerable to COVID-19 related morbidity and mortality, which means that older adults with cancer are an especially high-risk population. This has led to significant changes in the way geriatric oncologists provide care to older patients, including the implementation of novel methods for clinical visits, interruptions or delays in procedures, and modification of therapeutic strategies, both in the curative and palliative settings. In this manuscript, we provide a global overview of the perspectives of geriatric oncology providers from countries across Europe, America, and Asia, regarding the adaptive strategies utilized to continue providing high quality care for older patients with cancer during the COVID-19 pandemic. Through these perspectives, we attempt to show that, although each country and setting has specific issues, we all face similar challenges when providing care for our older patients with cancer during these difficult times.
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Affiliation(s)
- Isacco Desideri
- Radiation Oncology Unit, Department of Experimental Biomedical and Clinical Medicine, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Sophie Pilleron
- Department of Public Health, School of medicine, University of Otago, Wellington, New Zealand
| | - Nicolò Matteo Luca Battisti
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London SM2 5PT, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, 15 Cotswold Road, Sutton, London SM2 5NG, United Kingdom
| | - Fabio Gomes
- Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom
| | - Nienke de Glas
- Department of Medical Oncology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, the Netherlands
| | - Nina Rosa Neuendorff
- Medical Department V - Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany
| | - Gabor Liposits
- Department of Oncology, Regional Hospital West Jutland, Gl. Landevej 61, 7400 Herning, West Jutland Hospital Trust, Denmark
| | - Irene Paredero-Pérez
- Medical Oncology Department, Consorcio Hospitalario Provincial de Castellón, Av. Del Dr. Clarà, 19, 12002, Castellón de la Plana, Castellón, Spain
| | - Wendy Chan Wing Lok
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Road, Queen Mary Hospital, Hong Kong
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, 14642 New York, USA
| | - Clark DuMontier
- Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120, USA
| | - Hira Mian
- Division of Hematology, Department of Oncology, McMaster University, 699 Concession St. Suite 4-204, Hamilton, ON, Canada
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Seccion XVI, 14080, Tlalpan, Mexico City, Mexico.
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49
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Ravaioli S, Tebaldi M, Fonzi E, Angeli D, Mazza M, Nicolini F, Lucchesi A, Fanini F, Pirini F, Tumedei MM, Cerchione C, Viale P, Sambri V, Martinelli G, Bravaccini S. ACE2 and TMPRSS2 Potential Involvement in Genetic Susceptibility to SARS-COV-2 in Cancer Patients. Cell Transplant 2020; 29:963689720968749. [PMID: 33108902 PMCID: PMC7593730 DOI: 10.1177/0963689720968749] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 01/11/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. One open question is whether genetics could influence the severity of symptoms. Considering the limited data on cancer patients, we analyzed public data repositories limited to investigate angiotensin-converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2) expressions and genetic variants to identify the basis of individual susceptibility to SARS-CoV-2.Gene expression and variant data were retrieved from Tissue Cancer Genome Atlas, Genotype-Tissue Expression, and gnomAD. Differences in gene expression were tested with Mann-Whitney U-test. Allele frequencies of germline variants were explored in different ethnicities, with a special focus on ACE2 variants located in the binding site to SARS-CoV-2 spike protein.The analysis of ACE2 and TMPRSS2 expressions in healthy tissues showed a higher expression in the age class 20 to 59 years (false discovery rate [FDR] < 0.0001) regardless of gender. ACE2 and TMPRSS2 were more expressed in tumors from males than females (both FDR < 0.0001) and, opposite to the regulation in tissues from healthy individuals, more expressed in elderly patients (FDR = 0.005; FDR < 0.0001, respectively). ACE2 and TMPRSS2 expressions were higher in cancers of elderly patients compared with healthy individuals (FDR < 0.0001). Variants were present at low frequency (range 0% to 3%) and among those with the highest frequency, the variant S19P belongs to the SARS-CoV-2 spike protein binding site and it was exclusively present in Africans with a frequency of 0.2%.The mechanisms of ACE2 and TMPRSS2 regulation could be targeted for preventive and therapeutic purposes in the whole population and especially in cancer patients.Further studies are needed to show a direct correlation of ACE2 and TMPRSS2 expressions in cancer patients and the incidence of COVID-19.
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Affiliation(s)
- Sara Ravaioli
- Department of Clinical and Experimental oncology and hematology,
Biosciences Laboratory, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Michela Tebaldi
- Department of Research and Innovation, Unit of Biostatistics and
Clinical Trials, Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS,
Meldola, FC, Italy
| | - Eugenio Fonzi
- Department of Research and Innovation, Unit of Biostatistics and
Clinical Trials, Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS,
Meldola, FC, Italy
| | - Davide Angeli
- Department of Research and Innovation, Unit of Biostatistics and
Clinical Trials, Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS,
Meldola, FC, Italy
| | - Massimiliano Mazza
- Department of Clinical and Experimental oncology and hematology,
Immunotherapy, Cell Therapy and Biobank (ITCB), Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Fabio Nicolini
- Department of Clinical and Experimental oncology and hematology,
Immunotherapy, Cell Therapy and Biobank (ITCB), Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Alessandro Lucchesi
- Department of Clinical and Experimental oncology and hematology,
Hematology Unit, Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS,
Meldola, FC, Italy
| | - Francesca Fanini
- Department of Clinical and Experimental oncology and hematology,
Biosciences Laboratory, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Francesca Pirini
- Department of Clinical and Experimental oncology and hematology,
Biosciences Laboratory, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Maria Maddalena Tumedei
- Department of Clinical and Experimental oncology and hematology,
Biosciences Laboratory, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Claudio Cerchione
- Department of Clinical and Experimental oncology and hematology,
Hematology Unit, Istituto Scientifico Romagnolo per lo
Studio e la Cura dei Tumori (IRST) IRCCS,
Meldola, FC, Italy
| | - Pierluigi Viale
- Infectious Diseases Unit, Department of Medical and Surgical
Sciences, Alma Mater
Studiorum University of Bologna, Bologna,
Italy
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory,
Pievesestina, Cesena, Italy
- Department of Experimental, Diagnostic and Specialty Medicine
(DIMES), University of Bologna, Bologna, Italy
| | - Giovanni Martinelli
- Scientific Directorate, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Sara Bravaccini
- Department of Clinical and Experimental oncology and hematology,
Biosciences Laboratory, Istituto
Scientifico Romagnolo per lo Studio e la Cura dei
Tumori (IRST) IRCCS, Meldola, FC, Italy
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