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de Azambuja E, Brandão M, Wildiers H, Laenen A, Aspeslagh S, Fontaine C, Collignon J, Lybaert W, Verheezen J, Rutten A, Vuylsteke P, Goeminne JC, Demey W, Van Beckhoven D, Deblonde J, Rottey S, Geukens T, Punie K, Bafort K, Belkhir L, Bossuyt N, Colombie V, Daubresse C, Dauby N, De Munter P, Delmarcelle D, Delvallee M, Demeester R, Delefortrie Q, Dugernier T, Holemans X, Louviaux I, Machurot P, Minette P, Mokrane S, Nachtergal C, Noirhomme S, Piérard D, Rossi C, Schirvel C, Sermijn E, Staelens F, Triest F, Van Beckhoven D, Van Goethem N, Van Praet J, Vanhoenacker A, Verstraete R, Willems E, Wyndham-Thomas C. Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis. ESMO Open 2020; 5:e000947. [PMID: 32978251 PMCID: PMC7520811 DOI: 10.1136/esmoopen-2020-000947] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [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] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer seems to have an independent adverse prognostic effect on COVID-19-related mortality, but uncertainty exists regarding its effect across different patient subgroups. We report a population-based analysis of patients hospitalised with COVID-19 with prior or current solid cancer versus those without cancer. METHODS We analysed data of adult patients registered until 24 May 2020 in the Belgian nationwide database of Sciensano. The primary objective was in-hospital mortality within 30 days of COVID-19 diagnosis among patients with solid cancer versus patients without cancer. Severe event occurrence, a composite of intensive care unit admission, invasive ventilation and/or death, was a secondary objective. These endpoints were analysed across different patient subgroups. Multivariable logistic regression models were used to analyse the association between cancer and clinical characteristics (baseline analysis) and the effect of cancer on in-hospital mortality and on severe event occurrence, adjusting for clinical characteristics (in-hospital analysis). RESULTS A total of 13 594 patients (of whom 1187 with solid cancer (8.7%)) were evaluable for the baseline analysis and 10 486 (892 with solid cancer (8.5%)) for the in-hospital analysis. Patients with cancer were older and presented with less symptoms/signs and lung imaging alterations. The 30-day in-hospital mortality was higher in patients with solid cancer compared with patients without cancer (31.7% vs 20.0%, respectively; adjusted OR (aOR) 1.34; 95% CI 1.13 to 1.58). The aOR was 3.84 (95% CI 1.94 to 7.59) among younger patients (<60 years) and 2.27 (95% CI 1.41 to 3.64) among patients without other comorbidities. Severe event occurrence was similar in both groups (36.7% vs 28.8%; aOR 1.10; 95% CI 0.95 to 1.29). CONCLUSIONS This population-based analysis demonstrates that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. This adverse effect was more pronounced among younger patients and those without other comorbidities. Patients with solid cancer should be prioritised in vaccination campaigns and in tailored containment measurements.
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Affiliation(s)
- Evandro de Azambuja
- Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium.
| | - Mariana Brandão
- EPI Unit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Hans Wildiers
- Department of General Medical Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Annouschka Laenen
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium
| | | | | | | | - Willem Lybaert
- Department of Medical Oncology, AZ Nikolaas, Sint-Niklaas, Belgium
| | - Jolanda Verheezen
- Department of Medical Oncology, St. Trudo Hospital, Sint-Truiden, Belgium
| | - Annemie Rutten
- Department of Medical Oncology, GZA Ziekenhuizen, Campus Sint-Augustinus, Wilrijk, Belgium
| | - Peter Vuylsteke
- Department of Medical Oncology, UCLouvain, CHU-UCL Namur, Namur, Belgium; Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | | | - Wim Demey
- Department of Medical Oncology, AZ Klina, Brasschaat, Belgium
| | | | | | - Sylvie Rottey
- Department of Medical Oncology, Gent University Hospital, Gent, Belgium
| | - Tatjana Geukens
- Laboratory for Translational Breast Cancer Research, KU Leuven, Leuven, Belgium
| | - Kevin Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
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Daubresse C, Daubresse JC. [Hospital in-patients with diabetes]. Rev Med Liege 2005; 60:594-8. [PMID: 16035334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
As the diabetic population is becoming older, hospitalization is more frequent and of longer duration with increased costs. Hospital stay could be a good opportunity to improve diabetes care. All observational studies demonstrate that improving metabolic control reduces mortality, morbidity and hospitalisation costs. For critically ill patients and those referred for myocardial infarction or submitted to cardiac surgery, randomised controlled studies have proven the efficacy of strict metabolic control and defined the targets to be reached. Unfortunately, for many reasons, it is difficult to treat the patients to the targets and in non specialized departments, diabetes control may even be worse during hospitalisation. We urgently need to find innovating solutions to mitigate the consequences of the reduced number of competent nurses and doctors in the field of diabetes.
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Affiliation(s)
- C Daubresse
- Service de Diabétologie, CHC Clinique Saint Joseph, 4000 Liège
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Abstract
A chemically modified form of dextran was prepared, having a polymerizable moiety (acrylamide) and a reactive functional group (primary amine). Dextran was activated with 4-nitrophenyl-chloroformate (24 mol per polysaccharide, 9.8 mol per 100 glucose residues); 9.8% glucose residues were converted to aliphatic carbonates and 5.2% were converted to cyclic carbonates. The activated dextran was coupled with trityldiaminoethane (8 mol per 100 glucose residues), reactivated with 4-nitrophenylchloroformate, then coupled with acryloamidodiaminohexane (6.8 mol per 100 glucose residues). The trityl group was removed by hydrolysis with trifluoroacetic acid to yield the required aminated acryloamidodextran. The modified dextran was shown to be polymerizable by inverse emulsion polymerization. Submicron particles were successfully prepared, containing functional amine groups suitable for preparing drug conjugates or for modifying the surface properties of this biomaterial.
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Affiliation(s)
- C Daubresse
- Centre d'Etudes et de Recherches sur les Macromolécules, University of Liège, Sart-Tilman, Belgium
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