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Stecca CE, Jiang DM, Veitch Z, Hotte SJ, Alimohamed N, Wood L, Sridhar SS. Evaluation of Trends in Treatment of Metastatic Hormone Sensitive Prostate Cancer (mHSPC) Across Canada During the COVID-19 Pandemic. Clin Genitourin Cancer 2022; 21:273-277. [PMID: 36621461 DOI: 10.1016/j.clgc.2022.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND In metastatic hormone sensitive prostate cancer (mHSPC), treatment intensification with either docetaxel or an androgen-receptor-axis targeted therapy (ARAT), added to androgen deprivation therapy (ADT) is the new standard of care. To better understand patterns of treatment intensification in Canada and specifically how it has been influenced by the COVID-19 pandemic, we conducted a national survey of genitourinary medical oncologists from across Canada. METHODS Using SurveyMonkey, we conducted an online survey of 119 medical oncologists in Canada from January 15 to January 27, 2021. The survey consisted of 16 questions, including demographics, and asked specifically about their approach to managing mHSPC before and during the pandemic. RESULTS Overall there were 50/119 (42%) respondents. Most were male (65%), from Ontario (35%), practicing in academic centers (71%), with 45% reporting their practices focused primarily on genitourinary malignancies and one other tumor site. The majority were in practice 1 to 5 years (34%). Overall 65% indicated their practice patterns had changed since the pandemic, with 51% offering more ARATs and less docetaxel chemotherapy. In low volume mHSPC, the use of ARATs increased from 73% to 79%, while the use of docetaxel remained unaltered at 2%. In high volume disease, the use of ARATs increased from 63% to 84%, while the use of docetaxel decreased from 37% to 14%. Use of granulocyte colony stimulating factor (G-CSF) with docetaxel chemotherapy increased by 35%. Post-pandemic, 45% reported they intend to maintain these changes. Only 18% reported they had prostate cancer patients test positive for COVID-19, and all patients recovered. CONCLUSION Management of patients with mHSPC in Canada has changed during the pandemic, with increased uptake of ARATs and reduced use of docetaxel, a trend expected to continue beyond the pandemic. How this trend will impact uptake of triplet therapy (ADT + ARAT + Docetaxel), downstream treatment choices and overall outcomes remains to be seen.
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Affiliation(s)
- Carlos E Stecca
- Division of Medical Oncology and Hematology, University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Di Maria Jiang
- Division of Medical Oncology and Hematology, University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Zachary Veitch
- Division of Medical Oncology and Hematology, Saint Michael's Hospital, Toronto, ON, Canada
| | - Sebastian J Hotte
- Division of Medical Oncology and Hematology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
| | - Nimira Alimohamed
- Division of Medical Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Nova Scotia Health, Dalhousie University, Halifax, NS, Canada
| | - Srikala S Sridhar
- Division of Medical Oncology and Hematology, University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada.
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Cancer Patients and the COVID-19 Vaccines: Considerations and Challenges. Cancers (Basel) 2022; 14:cancers14225630. [PMID: 36428722 PMCID: PMC9688380 DOI: 10.3390/cancers14225630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Few guidelines exist for COVID-19 vaccination amongst cancer patients, fostering uncertainty regarding the immunogenicity, safety, and effects of cancer therapies on vaccination, which this review aims to address. A literature review was conducted to include the latest articles covering the immunogenicity and safety of COVID-19 vaccination in patients with solid and hematologic cancers receiving various treatments. Lower seropositivity following vaccination was associated with malignancy (compared to the general population), and hematologic malignancy (compared to solid cancers). Patients receiving active cancer therapy (unspecified), chemotherapy, radiotherapy, and immunosuppressants generally demonstrated lower seropositivity compared to healthy controls; though checkpoint inhibition, endocrine therapy, and cyclin dependent kinase inhibition did not appear to affect seropositivity. Vaccination appeared safe and well-tolerated in patients with current or past cancer and those undergoing treatment. Adverse events were comparable to the general population, but inflammatory lymphadenopathy following vaccination was commonly reported and may be mistaken for malignant etiology. Additionally, radiation recall phenomenon was sporadically reported in patients who had received radiotherapy. Overall, while seropositivity rates were decreased, cancer patients showed capacity to generate safe and effective immune responses to COVID-19 vaccination, thus vaccination should be encouraged and hesitancy should be addressed in this population.
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Zuo X, Ren S, Zhang H, Tian J, Tian R, Han B, Liu H, Dong Q, Wang Z, Cui Y, Niu R, Zhang F. Chemotherapy induces ACE2 expression in breast cancer via the ROS-AKT-HIF-1α signaling pathway: a potential prognostic marker for breast cancer patients receiving chemotherapy. J Transl Med 2022; 20:509. [PMID: 36335375 PMCID: PMC9636712 DOI: 10.1186/s12967-022-03716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Angiotensin-converting enzyme 2 (ACE2) is a key enzyme of the renin-angiotensin system and a well-known functional receptor for the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into host cells. The COVID-19 pandemic has brought ACE2 into the spotlight, and ACE2 expression in tumors and its relationship with SARS-COV-2 infection and prognosis of cancer patients have received extensive attention. However, the association between ACE2 expression and tumor therapy and prognosis, especially in breast cancer, remains ambiguous and requires further investigation. We have previously reported that ACE2 is elevated in drug-resistant breast cancer cells, but the exact function of ACE2 in drug resistance and progression of this malignant disease has not been explored. Methods The expression of ACE2 and HIF-1α in parental and drug-resistant breast cancer cells under normoxic and hypoxic conditions was analyzed by Western blot and qRT-PCR methods. The protein levels of ACE2 in plasma samples from breast cancer patients were examined by ELISA. The relationship between ACE2 expression and breast cancer treatment and prognosis was analyzed using clinical specimens and public databases. The reactive oxygen species (ROS) levels in breast cancer cells were measured by using a fluorescent probe. Small interfering RNAs (siRNAs) or lentivirus-mediated shRNA was used to silence ACE2 and HIF-1α expression in cellular models. The effect of ACE2 knockdown on drug resistance in breast cancer was determined by Cell Counting Kit 8 (CCK-8)-based assay, colony formation assay, apoptosis and EdU assay. Results ACE2 expression is relatively low in breast cancer cells, but increases rapidly and specifically after exposure to anticancer drugs, and remains high after resistance is acquired. Mechanistically, chemotherapeutic agents increase ACE2 expression in breast cancer cells by inducing intracellular ROS production, and increased ROS levels enhance AKT phosphorylation and subsequently increase HIF-1α expression, which in turn upregulates ACE2 expression. Although ACE2 levels in plasma and cancer tissues are lower in breast cancer patients compared with healthy controls, elevated ACE2 in patients after chemotherapy is a predictor of poor treatment response and an unfavorable prognostic factor for survival in breast cancer patients. Conclusion ACE2 is a gene in breast cancer cells that responds rapidly to chemotherapeutic agents through the ROS-AKT-HIF-1α axis. Elevated ACE2 modulates the sensitivity of breast cancer cells to anticancer drugs by optimizing the balance of intracellular ROS. Moreover, increased ACE2 is not only a predictor of poor response to chemotherapy, but is also associated with a worse prognosis in breast cancer patients. Thus, our findings provide novel insights into the spatiotemporal differences in the function of ACE2 in the initiation and progression of breast cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03716-w.
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Chen J, Song J, Dai L, Post SR, Qin Z. SARS-CoV-2 infection and lytic reactivation of herpesviruses: A potential threat in the postpandemic era? J Med Virol 2022; 94:5103-5111. [PMID: 35819034 PMCID: PMC9350099 DOI: 10.1002/jmv.27994] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 02/06/2023]
Abstract
The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative pathogen for the coronavirus disease 2019 (COVID-19) pandemic, has greatly stressed our healthcare system. In addition to severe respiratory and systematic symptoms, several comorbidities increase the risk of fatal disease outcomes, including chronic viral infections. Increasing cases of lytic reactivation of human herpesviruses in COVID-19 patients and vaccinated people have been reported recently. SARS-CoV2 coinfection, COVID-19 treatments, and vaccination may aggravate those herpesvirus-associated diseases by reactivating the viruses in latently infected host cells. In this review, we summarize recent clinical findings and limited mechanistic studies regarding the relationship between SARS-CoV-2 and different human herpesviruses that suggest an ongoing potential threat to human health in the postpandemic era.
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Affiliation(s)
- Jungang Chen
- Department of Pathology, Winthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Jiao Song
- Department of Pathology, Winthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Lu Dai
- Department of Pathology, Winthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Steven R. Post
- Department of Pathology, Winthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Zhiqiang Qin
- Department of Pathology, Winthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
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Evaluating Risk: Benefit Ratio of Fat-Soluble Vitamin Supplementation to SARS-CoV-2-Infected Autoimmune and Cancer Patients: Do Vitamin–Drug Interactions Exist? Life (Basel) 2022; 12:life12101654. [PMID: 36295089 PMCID: PMC9604733 DOI: 10.3390/life12101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This review brings attention to a crucial yet under-investigated subject which is vitamin–drug interactions. Fat-soluble vitamins such as vitamins A, D, E, and K have been proven to possess many beneficial effects in the treatment and prevention of COVID-19. Moreover, it has been reported that deficiencies of fat-soluble vitamins have been directly linked to COVID-19 infection-related morbidity and mortality, especially in high-risk populations such as cancer and autoimmune patients. However, many vitamin–drug interactions exist between most of the newly COVID-19 FDA-approved medications and fat-soluble vitamins. Hence, this mandates personalizing the COVID-19 treatment protocols, especially for patients who have any deficiency in any of these vital vitamins. Weighing the risk-to-benefit ratio of supplementing any of these fat-soluble vitamins with COVID-19 medications is considered crucial to maximize the therapeutic benefit and decrease the side effects of these drugs. Abstract COVID-19 is a recent pandemic that mandated the scientific society to provide effective evidence-based therapeutic approaches for the prevention and treatment for such a global threat, especially to those patients who hold a higher risk of infection and complications, such as patients with autoimmune diseases and cancer. Recent research has examined the role of various fat-soluble vitamins (vitamins A, D, E, and K) in reducing the severity of COVID-19 infection. Studies showed that deficiency in fat-soluble vitamins abrogates the immune system, thus rendering individuals more susceptible to COVID-19 infection. Moreover, another line of evidence showed that supplementation of fat-soluble vitamins during the course of infection enhances the viral clearance episode by promoting an adequate immune response. However, more thorough research is needed to define the adequate use of vitamin supplements in cancer and autoimmune patients infected with COVID-19. Moreover, it is crucial to highlight the vitamin–drug interactions of the COVID-19 therapeutic modalities and fat-soluble vitamins. With an emphasis on cancer and autoimmune patients, the current review aims to clarify the role of fat-soluble vitamins in SARS-CoV-2 infection and to estimate the risk-to-benefit ratio of a fat-soluble supplement administered to patients taking FDA-approved COVID-19 medications such as antivirals, anti-inflammatory, receptor blockers, and monoclonal antibodies.
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Huang Y, Wang Y, Xu D, Xiao L, Qin W, Liu B, Yuan X. Characterization of the SARS-CoV-2 co-receptor NRP1 expression profiles in healthy people and cancer patients: Implication for susceptibility to COVID-19 disease and potential therapeutic strategy. Front Genet 2022; 13:995736. [PMID: 36338984 PMCID: PMC9627153 DOI: 10.3389/fgene.2022.995736] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 08/03/2023] Open
Abstract
Neuropilin-1 (NRP1) is a transmembrane protein involved in many physiological and pathological processes, and it functions as a co-receptor to facilitate the entry of SARS-CoV-2 into host cells. Therefore, it is critical to predict the susceptibility to SARS-CoV-2 and prognosis after infection among healthy people and cancer patients based on expression of NRP1. In the current study, we analyzed the conservation and isoform of NRP1 using public databases. NRP1 expression landscape in healthy people, COVID-19 patients, and cancer patients at both bulk and single-cell RNA-seq level was also depicted. We also analyzed the relationship between tissue-specific NRP1 expression and overall survival (OS), as well as tumor immune environment at a pan-cancer level, providing a comprehensive insight into the relationship between the vulnerability to SARS-CoV-2 infection and tumorigenesis. In conclusion, we identified NRP1 as a potential biomarker in predicting susceptibility to SARS-CoV-2 infection among healthy people and cancer patients.
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Affiliation(s)
| | | | | | | | - Wan Qin
- *Correspondence: Wan Qin, ; Bo Liu, ; Xianglin Yuan,
| | - Bo Liu
- *Correspondence: Wan Qin, ; Bo Liu, ; Xianglin Yuan,
| | - Xianglin Yuan
- *Correspondence: Wan Qin, ; Bo Liu, ; Xianglin Yuan,
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Health influence of SARS-CoV-2 (COVID-19) on cancer: a review. Acta Biochim Biophys Sin (Shanghai) 2022; 54:1395-1405. [PMID: 36269132 PMCID: PMC9828497 DOI: 10.3724/abbs.2022147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The novel coronavirus, namely, SARS-CoV-2 (COVID-19), broke out two years ago and has caused major global health issues. Adequate treatment options are still lacking for the management of COVID-19 viral infections. Many patients afflicted with COVID-19 may range from asymptomatic to severe symptomatic, triggering poor clinical outcomes, morbidity, and mortality. Cancer is one of the leading causes of death worldwide. It is pertinent to re-examine cancer prevalence during the COVID-19 pandemic to prevent mortality and complications. Understanding the impact of SARS-CoV-2 on cancer is key to appropriate healthcare measures for the treatment and prevention of this vulnerable population. Data was acquired from PubMed using key search terms. Additional databases were utilized, such as the Centers for Disease Prevention and Control, American Cancer Society (ACS), and National Cancer Institute (NCI). Cancer patients are more prone to SARS-CoV-2 infection and exhibit poor health outcomes, possibly due to a chronic immunosuppressive state and anticancer therapies. Male sex, older age, and active cancer disease or previous cancer are risk factors for COVID-19 infection, leading to possible severe complications, including morbidity or mortality. The speculated mechanism for potentially higher mortality or COVID-19 complications is through reduced immune system function and inflammatory processes through cancer disease, anticancer therapy, and active COVID-19 infection. This review includes prostate, breast, ovarian, hematologic, lung, colorectal, esophageal, bladder, pancreatic, cervical, and head and neck cancers. This review should help better maintain the health of cancer patients and direct clinicians for COVID-19 prevention to improve the overall health outcomes.
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Cellular Landscaping of COVID-19 and Gynaecological Cancers: An Infrequent Correlation. JOURNAL OF ONCOLOGY 2022; 2022:5231022. [PMID: 36299504 PMCID: PMC9592241 DOI: 10.1155/2022/5231022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/16/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 resulted in a mortality rate of 3–6% caused by SARS-CoV-2 and its variant leading to unprecedented consequences of acute respiratory distress septic shock and multiorgan failure. In such a situation, evaluation, diagnosis, treatment, and care for cancer patients are difficult tasks faced by medical staff. Moreover, patients with gynaecological cancer appear to be more prone to severe infection and mortality from COVID-19 due to immunosuppression by chemotherapy and coexisting medical disorders. To deal with such a circumtances oncologists have been obliged to reconsider the entire diagnostic, treatment, and management approach. This review will provide and discuss the molecular link with gynaecological cancer under COVID-19 infection, providing a novel bilateral relationship between the two infections. Moreover, the authors have provided insights to discuss the pathobiology of COVID-19 in gynaecological cancer and their risks associated with such comorbidity. Furthermore, we have depicted the overall impact of host immunity along with guidelines for the treatment of patients with gynaecological cancer under COVID-19 infection. We have also discussed the feasible scope for the management of COVID-19 and gynaecological cancer.
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Schiff JP, Zhao T, Huang Y, Sun B, Hugo GD, Spraker MB, Abraham CD. Simulation-Free Radiation Therapy: An Emerging Form of Treatment Planning to Expedite Plan Generation for Patients Receiving Palliative Radiation Therapy. Adv Radiat Oncol 2022; 8:101091. [PMID: 36304132 PMCID: PMC9594122 DOI: 10.1016/j.adro.2022.101091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Herein we report the clinical and dosimetric experience for patients with metastases treated with palliative simulation-free radiation therapy (SFRT) at a single institution. Methods and Materials SFRT was performed at a single institution. Multiple fractionation regimens were used. Diagnostic imaging was used for treatment planning. Patient characteristics as well as planning and treatment time points were collected. A matched cohort of patients with conventional computed tomography simulation radiation therapy (CTRT) was acquired to evaluate for differences in planning and treatment time. SFRT dosimetry was evaluated to determine the fidelity of SFRT. Descriptive statistics were calculated on all variables and statistical significance was evaluated using the Wilcoxon signed rank test and t test methods. Results Thirty sessions of SFRT were performed and matched with 30 sessions of CTRT. Seventy percent of SFRT and 63% of CTRT treatments were single fraction. The median time to plan generation was 0.88 days (0.19-1.47) for SFRT and 1.90 days (0.39-5.23) for CTRT (P = .02). The total treatment time was 41 minutes (28-64) for SFRT and 30 minutes (21-45) for CTRT (P = .02). In the SFRT courses, the maximum and mean deviations in the actual delivered dose from the approved plans for the maximum dose were 4.1% and 0.07%, respectively. All deliveries were within a 5% threshold and deemed clinically acceptable. Conclusions Palliative SFRT is an emerging technique that allowed for a statistically significant lower time to plan generation and was dosimetrically acceptable. This benefit must be weighed against increased total treatment time for patients receiving SFRT compared with CTRT, and appropriate patient selection is critical.
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Rucinska M, Nawrocki S. COVID-19 Pandemic: Impact on Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12470. [PMID: 36231769 PMCID: PMC9564768 DOI: 10.3390/ijerph191912470] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
In December 2019, there were first reports of an atypical pneumonia detected in Wuhan city, China [...]
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Aguiar JEATD, Carvalho MAL, Viana SS, Martins-Filho PR, Cipolotti R. SARS-CoV-2 infection and mortality in pediatric patients with hematological malignancies and solid tumors. Pediatr Hematol Oncol 2022; 40:429-432. [PMID: 36094799 DOI: 10.1080/08880018.2022.2120937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | | | | | - Rosana Cipolotti
- Department of Medicine, Federal University of Sergipe, Aracaju, Brazil
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Lau MC, Yi Y, Goh D, Cheung CCL, Tan B, Lim JCT, Joseph CR, Wee F, Lee JN, Lim X, Lim CJ, Leow WQ, Lee JY, Ng CCY, Bashiri H, Cheow PC, Chan CY, Koh YX, Tan TT, Kalimuddin S, Tai WMD, Ng JL, Low JGH, Lim TKH, Liu J, Yeong JPS. Case report: Understanding the impact of persistent tissue-localization of SARS-CoV-2 on immune response activity via spatial transcriptomic analysis of two cancer patients with COVID-19 co-morbidity. Front Immunol 2022; 13:978760. [PMID: 36172383 PMCID: PMC9510984 DOI: 10.3389/fimmu.2022.978760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected half a billion people, including vulnerable populations such as cancer patients. While increasing evidence supports the persistence of SARS-CoV-2 months after a negative nasopharyngeal swab test, the effects on long-term immune memory and cancer treatment are unclear. In this report, we examined post-COVID-19 tissue-localized immune responses in a hepatocellular carcinoma (HCC) patient and a colorectal cancer (CRC) patient. Using spatial whole-transcriptomic analysis, we demonstrated spatial profiles consistent with a lymphocyte-associated SARS-CoV-2 response (based on two public COVID-19 gene sets) in the tumors and adjacent normal tissues, despite intra-tumor heterogeneity. The use of RNAscope and multiplex immunohistochemistry revealed that the spatial localization of B cells was significantly associated with lymphocyte-associated SARS-CoV-2 responses within the spatial transcriptomic (ST) niches showing the highest levels of virus. Furthermore, single-cell RNA sequencing data obtained from previous (CRC) or new (HCC) ex vivo stimulation experiments showed that patient-specific SARS-CoV-2 memory B cells were the main contributors to this positive association. Finally, we evaluated the spatial associations between SARS-CoV-2-induced immunological effects and immunotherapy-related anti-tumor immune responses. Immuno-predictive scores (IMPRES) revealed consistent positive spatial correlations between T cells/cytotoxic lymphocytes and the predicted immune checkpoint blockade (ICB) response, particularly in the HCC tissues. However, the positive spatial correlation between B cells and IMPRES score was restricted to the high-virus ST niche. In addition, tumor immune dysfunction and exclusion (TIDE) analysis revealed marked T cell dysfunction and inflammation, alongside low T cell exclusion and M2 tumor-associated macrophage infiltration. Our results provide in situ evidence of SARS-CoV-2-generated persistent immunological memory, which could not only provide tissue protection against reinfection but may also modulate the tumor microenvironment, favoring ICB responsiveness. As the number of cancer patients with COVID-19 comorbidity continues to rise, improved understanding of the long-term immune response induced by SARS-CoV-2 and its impact on cancer treatment is much needed.
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Affiliation(s)
- Mai Chan Lau
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yang Yi
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Denise Goh
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chun Chau Lawrence Cheung
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Benedict Tan
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jeffrey Chun Tatt Lim
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Craig Ryan Joseph
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Felicia Wee
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Justina Nadia Lee
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Xinru Lim
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chun Jye Lim
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Wei Qiang Leow
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Jing Yi Lee
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | | | - Hamed Bashiri
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Peng Chung Cheow
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Chun Yip Chan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Ye Xin Koh
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Thuan Tong Tan
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
| | - Shirin Kalimuddin
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
| | - Wai Meng David Tai
- National Cancer Centre Singapore, Division of Medical Oncology, Singapore, Singapore
| | - Jia Lin Ng
- Department of Colorectal Surgery, Singapore General Hospital, Singapore, Singapore
| | - Jenny Guek-Hong Low
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tony Kiat Hon Lim
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
- *Correspondence: Joe Poh Sheng Yeong, ; Jin Liu, ; Tony Kiat Hon Lim,
| | - Jin Liu
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Joe Poh Sheng Yeong, ; Jin Liu, ; Tony Kiat Hon Lim,
| | - Joe Poh Sheng Yeong
- Institute of Molecular and Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore, Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- *Correspondence: Joe Poh Sheng Yeong, ; Jin Liu, ; Tony Kiat Hon Lim,
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Ding Y, Li X, Li J. COVID-19–associated lncRNAs as predictors of survival in uterine corpus endometrial carcinoma: A prognostic model. Front Genet 2022; 13:986453. [PMID: 36147497 PMCID: PMC9486303 DOI: 10.3389/fgene.2022.986453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Patients with uterine corpus endometrial carcinoma (UCEC) may be susceptible to the coronavirus disease-2019 (COVID-19). Long non–coding RNAs take on a critical significance in UCEC occurrence, development, and prognosis. Accordingly, this study aimed to develop a novel model related to COVID-19–related lncRNAs for optimizing the prognosis of endometrial carcinoma. Methods: The samples of endometrial carcinoma patients and the relevant clinical data were acquired in the Carcinoma Genome Atlas (TCGA) database. COVID-19–related lncRNAs were analyzed and obtained by coexpression. Univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses were performed to establish a COVID-19–related lncRNA risk model. Kaplan–Meier analysis, principal component analysis (PCA), and functional enrichment annotation were used to analyze the risk model. Finally, the potential immunotherapeutic signatures and drug sensitivity prediction targeting this model were also discussed. Results: The risk model comprising 10 COVID-19–associated lncRNAs was identified as a predictive ability for overall survival (OS) in UCEC patients. PCA analysis confirmed a reliable clustering ability of the risk model. By regrouping the patients with this model, different clinic-pathological characteristics, immunotherapeutic response, and chemotherapeutics sensitivity were also observed in different groups. Conclusion: This risk model was developed based on COVID-19–associated lncRNAs which would be conducive to the precise treatment of patients with UCEC.
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Affiliation(s)
- Yang Ding
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, HongKong, China
| | - Xia Li
- Department of Obstetrics and Gynaecology, Heze Municipal Hospital, Heze, Shandong, China
| | - Jiena Li
- Department of Obstetrics and Gynaecology, Heze Municipal Hospital, Heze, Shandong, China
- *Correspondence: Jiena Li, ; Liqun Zhu,
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COVID-19 vs. Cancer Immunosurveillance: A Game of Thrones within an Inflamed Microenviroment. Cancers (Basel) 2022; 14:cancers14174330. [PMID: 36077865 PMCID: PMC9455004 DOI: 10.3390/cancers14174330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic accounts for more than 500 million confirmed infections and over 6 million deaths worldwide in the last 2 years. SARS-CoV-2 causes a highly complex form of inflammation that affects the human organism both acutely and chronically. In the same line, cancer as an inflammation-induced and immune-editing disease appears to cross-react with immune system at different levels including early interactions during carcinogenesis and later cross-talks within the tumor microenvironment. With all that in mind, a reasonable question one might address is whether the SARS-CoV-2 infection and the derived "long lasting inflammatory status" that is frequently observed in patients, might affect the cancer immunosurveillance mechanisms and consequently their risk of developing cancer, as well as the tumor and immune cell behaviors within the inflamed microenvironment. On this context, this review intends to outline and discuss the existing knowledge on SARS-CoV-2-mediated immunomodulation under the prism of changes that might be able to interfere with cancer cell immunoescape and the overall tumor progression and response to conventional therapeutics. Our goal is to highlight a potential interplay between the COVID-19 immunopathology and cancer immune-microenvironment that may pave the way for thorough investigation in the future.
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Mukherjee KK, Dam A, Chakrabarti D, Jatu D, Sengupta S, Dutta R, Majumdar S, Mandal SS, Basu B, Bhattacharjee P, Mukherjee D, Sengupta S, Chakrabarti J. Is cancer significant comorbid condition in COVID 19 infected patients? -A retrospective analysis experienced in a tertiary care center in Eastern India. Ann Med Surg (Lond) 2022; 81:104248. [PMID: 35937633 PMCID: PMC9347138 DOI: 10.1016/j.amsu.2022.104248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 10/28/2022] Open
Abstract
Background It was formerly thought that patients with a history of active cancer were more likely to acquire COVID-19; however, new research contradicts this belief due to the impact of economic stress, malnutrition, fear of hospitalization, or therapeutic discontinuation. A cohort-based study was undertaken in Indian regional cancer centre to understand cancer-covid link in patients. Method A total of 1565 asymptomatic patients were admitted based on thermal screening and evaluation from the screening form from June 2020 to November 2020. The RT-PCR technology was used to assess the COVID 19, and patients who tested positive for COVID 19 were transported to a hospital designated by the government for COVID 19 patients. Patients who tested negative for the COVID 19 virus were transferred to the normal cancer unit to complete their treatment. Patients who tested positive for COVID 19 were referred to the COVID hospital, where their findings were analyzed and correlated with patient age, gender, and cancer stage. Findings Out of 1565 patients, 54 patients (3.4%) tested positive. Most of the patients are in 45-59 years age group. As female patients admitted were more in number than males, so predominance of disease is higher in female. 3 patients were symptomatic after admission and 2 were severe and were admitted to the ICU with ventilations. 8 patients died in Cancer and one patient died in COVID 19. Interpretation As only 3.4% patients tested positive and only one patient out of 54 had died, so cancer is found not to be a comorbid condition towards COVID 19 patients in the Indian population studied.Funding: This project is not funded.
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Affiliation(s)
- Kalyan K Mukherjee
- Department of Medical Oncology and Clinical and Translational Research, Chittaranjan National Cancer Institute, India
| | - Aniruddha Dam
- Department of ENT and Covid strategy committee, Chittaranjan National Cancer Institute, India
| | - Deepa Chakrabarti
- Department of Anesthesia and Critical Care and Covid Strategy Committee, Chittaranjan National Cancer Institute, India
| | - Debasish Jatu
- Department of Anesthesia, Pain and Palliative Care and Covid Strategy Committee, Chittaranjan National Cancer Institute, India
| | - Saubhik Sengupta
- COVID- RT-PCR lab, Chittaranjan National Cancer Institute, India
| | - Rita Dutta
- Covid-19 ward, Chittaranjan National Cancer Institute, India
| | - Suparna Majumdar
- Department of Radio-oncology, Chittaranjan National Cancer Institute, India
| | - Shyam Sundar Mandal
- Department of Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, India
| | - Biswarup Basu
- Department of Neuroendocrinology and Experimental Hematology, Chittaranjan National Cancer Institute, India
| | - Pratiti Bhattacharjee
- Department of Neuroendocrinology and Experimental Hematology, Chittaranjan National Cancer Institute, India
| | - Dattatreya Mukherjee
- Department of Community Medicine, Raiganj Government Medical College and Hospital, India
| | - Sankar Sengupta
- COVID- RT-PCR lab, Chittaranjan National Cancer Institute, India
| | - Jayanta Chakrabarti
- Department of Surgical Oncology, Chittaranjan National Cancer Institute, India
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Wang J, Ma S, Li L, Chen Y, Yang Q, Wang F, Zheng M, Miao S, Shi X. Investigation into the in vivo mechanism of diosmetin in patients with breast cancer and COVID-19 using bioinformatics. Front Pharmacol 2022; 13:983821. [PMID: 36060002 PMCID: PMC9433109 DOI: 10.3389/fphar.2022.983821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
Patients with breast cancer are prone to SARS-CoV-2 infection [the causative virus of coronavirus disease (COVID-19)] due to their lack of immunity. In the current study, we examined the mechanism of action of Diosmetin, a flavonoid with anti-inflammatory properties, in patients with BRCA infected with SARS-CoV-2.We used bioinformatics technology to analyze the binding ability, biological function, and other biological characteristics of Diosmetinin vivo and examine the core target and potential mechanism of action of Diosmetin in patients with patients with breast cancer infected with SARS-CoV-2. A prognostic model of SARS-COV-2–infected breast cancer patients was constructed, and the core genes were screened out, revealing the correlation between these core genes and clinicopathological characteristics, survival rate, and high-risk and low-risk populations. The docking results revealed that Diosmetin binds well to the core genes of patients with breast cancer with COVID-19. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that Diosmetin inhibited inflammation, enhanced immune function, and regulated the cellular microenvironment in patients with BRCA/COVID-19. For the first time, we reveal the molecular functions and potential targets of Diosmetin in patients with breast cancer infected with SARS-CoV-2, improving the reliability of the new drug and laying the foundation for further research and development.
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Affiliation(s)
- Jin Wang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Shanbo Ma
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Long Li
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Yuhan Chen
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Qian Yang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
| | - Feiyan Wang
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Meiling Zheng
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- School of Pharmacy, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China
| | - Shan Miao
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- *Correspondence: Shan Miao, ; Xiaopeng Shi,
| | - Xiaopeng Shi
- Department of Pharmacy, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China
- *Correspondence: Shan Miao, ; Xiaopeng Shi,
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Immunogenicity and Safety of the BNT162b2 mRNA COVID-19 Vaccine in Patients with Melanoma Treated with Immunotherapy. Cancers (Basel) 2022; 14:cancers14153791. [PMID: 35954454 PMCID: PMC9367332 DOI: 10.3390/cancers14153791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 07/31/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The efficacy and safety of the BNT126b2 vaccine against SARS-CoV-2 has not been thoroughly studied in cancer patients treated with immunotherapy. This research aims to investigate the efficacy and safety of the vaccine in patients with melanoma under immunotherapy; at the same time, through the immunophenotyping of T cells and myeloid cells of the peripheral blood, it will be possible to look for changes in the subpopulations of such cells after vaccinations. The results of the study help establish the efficacy and safety of the vaccine in this population, especially since a theoretical concern exists about the vaccine triggering irAEs. Abstract The BNT162b2 vaccine against SARS-CoV-2 has a proven efficacy and a favorable safety profile. In cancer patients under immunotherapy in the form of immune-checkpoint inhibitors (ICIs), the efficacy of the vaccine has not been thoroughly studied, while a theoretical concern has also been raised about triggering immune-related adverse events (irAEs) by the vaccine. We conducted a prospective, non-interventional study on the immunogenicity and safety of the BNT162b2 vaccine in patients with advanced or metastatic melanoma treated with ICIs. Blood samples were obtained 0–4 days before the first dose and 12–21 days after the second dose of the vaccine for the quantification of the SARS-CoV-2 anti-spike antibody using an ELISA and immunophenotyping of the T and myeloid cell subpopulations. The active recording of AEs for a two-month period was conducted. Forty patients were included in the study. All but one (97.3%) achieved seroconversion after two doses of the vaccine and no correlations of the antibody titers with any of the studied parameters (age, gender, stage and duration of the disease, type of ICI, previous treatment, etc.) were found. Moreover, no differences in the subpopulations of the T cells (including the T-regulatory cells) or the myeloid cells were found pre- and post-vaccination. All AEs were low-grade, while one case of arthritis exacerbation was noted. The seroconversion rate in the studied population was high and was comparable to that of healthy subjects, while no major safety issues were raised during the safety follow-up. Finally, no derangements in the subpopulations of T cells or myeloid cells were noted. This is the first study focusing on the immunogenicity, safety, and effect of anti-SARS-CoV-2 vaccines on the blood-cell immunophenotype status of patients with melanoma treated with ICIs.
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The Effects of the COVID-19 Pandemic in Oncology Patient Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159041. [PMID: 35897414 PMCID: PMC9330710 DOI: 10.3390/ijerph19159041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic has changed the way cancer patients should be managed. Using published literature on best practices on oncology patient management, we developed checklists to establish which recommendations were followed and differences between healthcare staff and institutions in a local health unit (overseeing two regional hospitals and 14 primary Healthcare Centers) in an interior region in Portugal. Checklists were delivered and completed by 15 physicians, 18 nurses and 5 pharmacists working at the Hospitals, and 29 physicians and 46 nurses from primary healthcare centers. Hospital staff do not show statistically significant differences regarding most proposed recommendations for the oncology clinical pathway, human resources, treatments, patient management and service management. Primary healthcare centers seem to follow a similar trend. As a local health unit, general recommendations for Oncology Patient Management show statistically significantly different values on education of suspected cases, identification, isolation procedures and samples collection; extension of work schedules; and education on cancer patient and COVID-19 positive referral procedures. All the checklists indicated good-to-high internal consistency. Our analysis showed cohesive work between groups regarding control and prevention of sources of infection; therefore, it is considered the highest priority to ensure that all other services, including oncology, continue functioning. Patient management measures such as adjustments in treatments, analysis, patient care, referrals and emergencies were not ranked higher by responders.
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Yang D, Li H, Chen Y, Ren W, Dong M, Li C, Jiao Q. Immunomodulatory mechanisms of abatacept: A therapeutic strategy for COVID-19. Front Med (Lausanne) 2022; 9:951115. [PMID: 35957855 PMCID: PMC9357915 DOI: 10.3389/fmed.2022.951115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by coronavirus-2 (SARS-CoV-2) infection has rapidly spread throughout the world and become a major threat to human beings. Cytokine storm is a major cause of death in severe patients. Abatacept can suppress cytokines used as antirheumatic drugs in clinical applications. This study analyzed the molecular mechanisms of abatacept treatment for COVID-19. Differentially expressed genes (DEGs) were identified by analyzing expression profiling of abatacept treatment for rheumatoid arthritis (RA) patients and SARS-CoV-2 infection patients. We found that 59 DEGs were upregulated in COVID-19 patients and downregulated following abatacept treatment. Gene set enrichment analysis (GSEA) and Gene Ontology (GO) analysis showed that immune and inflammatory responses were potential regulatory mechanisms. Moreover, we verified 8 targeting genes and identified 15 potential drug candidates for the treatment of COVID-19. Our study illustrated that abatacept could be a promising property for preventing severe COVID-19, and we predicted alternative potential drugs for the treatment of SARS-CoV-2 infection.
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Affiliation(s)
- Dinglong Yang
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Hetong Li
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yujing Chen
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Weiping Ren
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Mingjie Dong
- Second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Chunjiang Li
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiang Jiao
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- *Correspondence: Qiang Jiao
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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Ismail A, Riachy M, Awali M, Farah F, Haddad S, Kerbage A, Aoun N, Sleilaty G. Pulmonary artery enlargement: an independent risk factor for mortality in hospitalized COVID-19 patients. Mayo Clin Proc Innov Qual Outcomes 2022; 6:399-408. [PMID: 35880237 PMCID: PMC9300717 DOI: 10.1016/j.mayocpiqo.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective To assess whether baseline pulmonary artery diameter (PAD), obtained from Non-contrast non-gated computed tomography (NCCT), can be associated with COVID-19 outcomes. Patients and Methods This is a retrospective study of hospitalized COVID-19 patients admitted to Hôtel-Dieu de France university hospital (Beirut, Lebanon) between March 2020 and March 2021. PAD was measured on baseline NCCT. Various outcomes were assessed, including hospital length of stay, ICU admission, invasive mechanical ventilation, mortality, and post-covid functional scale (PCFS) status at discharge and at 2-month follow-up. Results 465 patients had a baseline NCCT, including 315 males (67.7%) with a mean age of 63.7±16 years. Baseline PAD was higher in critically ill patients admitted to the ICU (mean difference 0.8 mm [95% CI 0.4-1.59 mm]) and those receiving invasive mechanical ventilation (mean difference 1.1 mm [95% CI 0.11-2.04 mm]). PAD at baseline correlated significantly with hospital length of stay (r = 0.130, p=0.005), discharge status (r=0.117, p=0.023) and with PCFS at 2-month follow-up (r=0.121, p=0.021). Moreover, multivariable logistic regression showed that a PAD ≥ 24.5 mm independently predicted in-hospital all-cause mortality remained unaffected in COVID-19 patients (OR 2.07 (95% CI 1.05 - 4.09)). Conclusion Baseline PAD measurement using NCCT can be a useful prognostic parameter. Its measurement can help identify early severe cases and adapt the initial management of hospitalized Covid-19 patients.
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Affiliation(s)
- Anis Ismail
- Faculty of Medicine, Saint Joseph University of Beirut, Lebanon
| | - Moussa Riachy
- Division of Pulmonary and critical care medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Mohamad Awali
- Division of Radiology, Faculty of Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Fadi Farah
- Division of Radiology, Faculty of Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Sarah Haddad
- Faculty of Medicine, Saint Joseph University of Beirut, Lebanon
| | - Anthony Kerbage
- Faculty of Medicine, Saint Joseph University of Beirut, Lebanon
| | - Noel Aoun
- Division of Radiology, Faculty of Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Ghassan Sleilaty
- Division of Cardiovascular Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon
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Arayici ME, Kipcak N, Kayacik U, Kelbat C, Keskin D, Kilicarslan ME, Kilinc AV, Kirgoz S, Kirilmaz A, Kizilkaya MA, Kizmaz IG, Kocak EB, Kochan E, Kocpinar B, Kordon F, Kurt B, Ellidokuz H. Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04191-y. [PMID: 35831763 PMCID: PMC9281353 DOI: 10.1007/s00432-022-04191-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
Background Cancer patients constitute one of the highest-risk patient groups during the COVID-19 pandemic. In this study, it was aimed to perform a systematic review and meta-analysis to determine both the incidence and ICU (Intensive Care Unit) admission rates and mortality in SARS-CoV-2 infected cancer patients. Methods The PRISMA guidelines were closely followed during the design, analysis, and reporting of this systematic review and meta-analysis. A comprehensive literature search was performed for the published papers in PubMed/Medline, Scopus, medRxiv, Embase, and Web of Science (WoS) databases. SARS-CoV-2 infection pooled incidence in the cancer populations and the risk ratio (RR) of ICU admission rates/mortality in cancer and non-cancer groups, with 95% confidence intervals (CIs), were calculated using the random-effects model. Results A total of 58 studies, involving 709,908 participants and 31,732 cancer patients, were included in this study. The incidence in cancer patients was calculated as 8% (95% CI: 8–9%). Analysis results showed that mortality and ICU admission rate was significantly higher in patients with cancer (RR = 2.26, 95% CI: 1.94–2.62, P < 0.001; RR = 1.45, 95% CI: 1.28–1.64, p < 0.001, respectively). Conclusion As a result, cancer was an important comorbidity and risk factor for all SARS-CoV-2 infected patients. This infection could result in severe and even fatal events in cancer patients. Cancer is associated with a poor prognosis in the COVID-19 pandemic. Cancer patients should be assessed more sensitively in the COVID-19 outbreak. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04191-y.
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Affiliation(s)
- Mehmet Emin Arayici
- Department of Preventive Oncology, Institute of Health Sciences, Dokuz Eylul University, 15 July Medicine and Art Campus, Inciralti-Balcova 35340, Izmir, Turkey
| | - Nazlican Kipcak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ufuktan Kayacik
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Cansu Kelbat
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Keskin
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Ahmet Veli Kilinc
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sumeyye Kirgoz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Anil Kirilmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Melih Alihan Kizilkaya
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Irem Gaye Kizmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enes Berkin Kocak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enver Kochan
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Begum Kocpinar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatmanur Kordon
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Batuhan Kurt
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hulya Ellidokuz
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Department of Preventive Oncology, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey
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Impacts of COVID-19 Pandemic on Dietary Consumption among Chinese Residents: Evidence from Provincial-Level Panel Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137612. [PMID: 35805271 PMCID: PMC9265380 DOI: 10.3390/ijerph19137612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic has profoundly affected people’s daily lives, including their dietary behaviors. Using a panel data set of 31 provinces from 2015 to 2020, this study employed two-way fixed effects (FE) models to examine the impacts of the COVID-19 pandemic on dietary consumption among Chinese residents. The results showed that the COVID-19 pandemic positively affected residents’ consumption of grain, eggs, dairy, and white meat (poultry and aquatic products), while it had a negative effect on individuals’ red meat consumption in both urban and rural areas. These results were robust to different measures of the COVID-19 pandemic, including the number of confirmed cases, suspect cases, and dead cases. Comparatively, the changes in food consumption induced by the COVID-19 pandemic were more prominent for Chinese residents who lived in rural areas than urban areas. In addition, compared to their counterparts, the dietary consequences of the pandemic were more pronounced for residents living in the eastern region and regions with a high old-age dependency ratio and low illiteracy rate. Furthermore, the estimation results of the quantile regression model for panel data suggested that the COVID-19 pandemic had relatively larger impacts on the dietary consumption of Chinese residents at lower quantiles of food consumption compared with those at higher quantiles. Overall, the results of this study suggested that Chinese residents had a healthier diet after the outbreak of the COVID-19 pandemic. We discussed possible mechanisms, including health awareness, income, food supply and prices, and other behavioral changes during COVID-19 (e.g., physical activity and cooking). To further improve residents’ dietary behaviors and health, our study proposed relevant measures, such as increasing residents’ dietary knowledge, ensuring employment and income, and strengthening the food supply chain resilience during the pandemic.
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Yi M, Jiang D, Wang J, Zhang Z, Jia Y, Zhao B, Guo L, Chen O. Relationships among thriving at work, organisational commitment and job satisfaction among Chinese front-line primary public health workers during COVID-19 pandemic: a structural equation model analysis. BMJ Open 2022; 12:e059032. [PMID: 35672077 PMCID: PMC9174534 DOI: 10.1136/bmjopen-2021-059032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aims to explore the mediating effect and influence mechanism of organisational commitment on the association among thriving at work and job satisfaction among frontline primary public health workers (PHWs) in China during the COVID-19 pandemic. DESIGN This study is a cross-sectional written survey. SETTING We included 20 primary care units in northern provinces of China. PARTICIPANTS A total of 601 PHWs who worked in primary organisations and against COVID-19 on the front line were included. METHODS We collected the data from the participants' written questionnaire (Minnesota Satisfaction Questionnaire, thriving at work scale and organisational commitment scale), and programmed AMOS V.26.0 to develop a structural equation model (SEM) based on the relationships among the three variables. RESULTS The thriving at work scores of the primary PHWs were (M=3.17, SD=0.65), and job satisfaction was (M=3.05, SD=0.69); the scores of their thriving at work, organisational commitment and job satisfaction were all significantly correlated (p<0.01); and the SEM indicated that organisational commitment had a significant partial mediating effect between thriving at work and job satisfaction. The overall effect value was 0.867, and the mediated effect value was 0.422, accounting for 48.7% of the total effect size. CONCLUSION The thriving at work and job satisfaction scores of primary PHWs in China are moderate, and thriving at work not only affects job satisfaction directly, but also indirectly through organisational commitment. This study suggests that health policy-makers should promote job satisfaction among PHWs through relative inventions aiming to improve their thriving at work and organisational commitment.
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Affiliation(s)
- Mo Yi
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Di Jiang
- Department of Nursing, Peking Union Medical College Hospital Eastern Branch, Beijing, China
| | - Jingjing Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zeyi Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuanmin Jia
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Baosheng Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lei Guo
- Centre for Health Management and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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75
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Exercise oncology during and beyond the COVID-19 pandemic: Are virtually supervised exercise interventions a sustainable alternative? Crit Rev Oncol Hematol 2022; 174:103699. [PMID: 35526668 PMCID: PMC9069989 DOI: 10.1016/j.critrevonc.2022.103699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/08/2023] Open
Abstract
During the COVID-19 pandemic, new challenges are presented in clinical research settings to increase exercise levels, particularly in vulnerable populations such as cancer survivors. While in-person supervised exercise is an effective format to improve patient-reported outcomes and physical function for cancer survivors, the COVID-19 pandemic limited this form of exercise as a feasible option within research and cancer care. As such, exercise oncology interventions were adapted to home-based instruction. In this review, we examine the current evidence of exercise interventions in cancer populations during and beyond the COVID-19 pandemic. We identified that group-based virtually supervised home-based exercise was the most used format among exercise oncology interventions during the pandemic. Preliminary results support feasibility and effectiveness of this emerging exercise setting in cancer survivors; however, it needs to be further investigated in adequately designed larger trials. Additionally, we provide recommendations and perspective for the implementation of virtually supervised home-based exercise.
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76
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Zhou J, Lakhani I, Chou O, Leung KSK, Lee TTL, Wong MV, Li Z, Wai AKC, Chang C, Wong ICK, Zhang Q, Tse G, Cheung BMY. Clinical characteristics, risk factors and outcomes of cancer patients with COVID-19: A population-based study. Cancer Med 2022; 12:287-296. [PMID: 35642123 PMCID: PMC9348317 DOI: 10.1002/cam4.4888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Cancer patients may be susceptible to poorer outcomes in COVID-19 infection owing to the immunosuppressant effect of chemotherapy/radiotherapy and cancer growth, along with the potential for nosocomial transmission due to frequent hospital admissions. METHODS This was a population-based retrospective cohort study of COVID-19 patients who presented to Hong Kong public hospitals between 1 January 2020 and 8 December 2020. The primary outcome was a composite endpoint of requirement for intubation, ICU admission and 30-day mortality. RESULTS The following study consisted of 6089 COVID-19 patients (median age 45.9 [27.8.1-62.7] years; 50% male), of which 142 were cancer subjects. COVID-19 cancer patients were older at baseline and tended to present with a higher frequency of comorbidities, including diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, ventricular tachycardia/fibrillation and gastrointestinal bleeding (p < 0.05). These subjects also likewise tended to present with higher serum levels of inflammatory markers, including D-dimer, lactate dehydrogenase, high sensitivity troponin-I and C-reactive protein. Multivariate Cox regression showed that any type of cancer presented with an almost four-fold increased risk of the primary outcome (HR: 3.77; 95% CI: 1.63-8.72; p < 0.002) after adjusting for significant demographics, Charlson comorbidity index, number of comorbidities, past comorbidities and medication history. This association remained significant when assessing those with colorectal (HR: 5.07; 95% CI: 1.50-17.17; p < 0.009) and gastrointestinal malignancies (HR: 3.79; 95% CI: 1.12-12.88; p < 0.03), but not with lung, genitourinary, or breast malignancies, relative to their respective cancer-free COVID-19 counterparts. CONCLUSIONS COVID-19 cancer patients are associated with a significantly higher risk of intubation, ICU admission and/or mortality.
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Affiliation(s)
- Jiandong Zhou
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Ishan Lakhani
- Cardiovascular Analytics Group, Laboratory of Cardiovascular PhysiologyHong KongChina
| | - Oscar Chou
- Li Ka Shing Faculty of MedicineUniversity of Hong KongHong KongChina
| | | | | | - Michelle Vangi Wong
- Cardiovascular Analytics Group, Laboratory of Cardiovascular PhysiologyHong KongChina
| | - Zhen Li
- Department of RadiologyTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | | | - Carlin Chang
- Division of Neurology, Department of MedicineUniversity of Hong KongHong KongChina
| | - Ian Chi Kei Wong
- Department of Pharmacology and PharmacyUniversity of Hong KongHong KongChina,Medicines Optimisation Research and Education (CMORE)UCL School of PharmacyLondonUK
| | - Qingpeng Zhang
- Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Gary Tse
- Cardiovascular Analytics Group, Laboratory of Cardiovascular PhysiologyHong KongChina,Tianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina,Kent and Medway Medical SchoolCanterburyKentUK
| | - Bernard Man Yung Cheung
- Division of Clinical Pharmacology, Department of MedicineUniversity of Hong KongHong KongChina
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77
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Azhdari Tehrani H, Ramezaninejad S, Mardani M, Shokouhi S, Darnahal M, Hakamifard A. Hematologic malignancies and COVID‐19 infection: A monocenter retrospective study. Health Sci Rep 2022; 5:e638. [PMID: 35620550 PMCID: PMC9124951 DOI: 10.1002/hsr2.638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hamed Azhdari Tehrani
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Soodeh Ramezaninejad
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Shervin Shokouhi
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Maryam Darnahal
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
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78
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Bogaert B, Buisson V, Kozlakidis Z, Saintigny P. Organisation of cancer care in troubling times: A scoping review of expert guidelines and their implementation during the COVID-19 pandemic. Crit Rev Oncol Hematol 2022; 173:103656. [PMID: 35337970 PMCID: PMC8942466 DOI: 10.1016/j.critrevonc.2022.103656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
This scoping review mapped the main themes in existing expert guidelines for cancer care issued during the COVID-19 crisis from the period of March 2020-August 2021. The guidelines published during the research period principally relate to the first two waves in Europe and until the beginning of the vaccination campaign. They elaborated recommendations for cancer care reorganisation, in particular triage and quality of care issues. The article highlights the ethical, epistemological, as well as practical reasons that guidelines were not always followed to provide some lessons learned for future crises to enable better guideline development processes. We also elaborate early evidence on the impact of triage decisions and different perspectives on cancer care reorganisation from ethics and social science literature.
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Affiliation(s)
- Brenda Bogaert
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Victoria Buisson
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Zizis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Pierre Saintigny
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Univ Lyon, Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.
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79
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Outcomes of Cancer Patients with COVID-19 in a Hospital System in the Chicago Metropolitan Area. Cancers (Basel) 2022; 14:cancers14092209. [PMID: 35565336 PMCID: PMC9105648 DOI: 10.3390/cancers14092209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
Patients with a history of malignancy have been shown to be at an increased risk of COVID-19-related morbidity and mortality. Poorer clinical outcomes in that patient population are likely due to the underlying systemic illness, comorbidities, and the cytotoxic and immunosuppressive anti-tumor treatments they are subjected to. We identified 416 cancer patients with SARS-CoV-2 infection being managed for their malignancy at Northwestern Medicine in Chicago, Illinois, between March and July of 2020. Seventy-five (18.0%) patients died due to COVID-related complications. Older age (>60), male gender, and current treatment with immunotherapy were associated with shorter overall survival. Laboratory findings showed that higher platelet counts, ALC, and hemoglobin were protective against critical illness and death from COVID-19. Conversely, elevated inflammatory markers such as ferritin, d-dimer, procalcitonin, CRP, and LDH led to worse clinical outcomes. Our findings suggest that a thorough clinical and laboratory assessment of infected patients with cancer might help identify a more vulnerable population and implement more aggressive proactive strategies.
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80
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Müller J, Szűcs-Farkas D, Szegedi I, Csóka M, Garami M, Tiszlavicz LG, Hauser P, Kriván G, Csanádi K, Ottóffy G, Nagy B, Kiss C, Kovács G. Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary. Pathol Oncol Res 2022; 28:1610261. [PMID: 35431663 PMCID: PMC9008132 DOI: 10.3389/pore.2022.1610261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/01/2022] [Indexed: 12/25/2022]
Abstract
We report on children with cancer in Hungary suffering from COVID-19, surveying a 13-months-long period of time. We performed a retrospective clinical trial studying the medical documentation of children treated in seven centers of the Hungarian Pediatric Oncology-Hematology Group. About 10% of children admitted to tertiary hemato-oncological centers for anti-neoplastic treatment or diagnosis for de novo malignancies were positive for SARS-CoV-2 infection. Nearly two-thirds of the infected patients were asymptomatic or had only mild symptoms but showed seropositivity by 1–4.5 months after positive PCR. One third of the SARS-CoV-2-positive children were hospitalized due to symptomatic COVID-19. Five children required antiviral treatment with remdesivir. One child was referred to the intensive care unit, requiring intubation and mechanical ventilation. Delay in the scheduled anti-cancer treatment did not exceed 2 weeks in the majority (89%) of cases. There was only one patient requiring treatment deferral longer than a month. There was no COVID-19-related death in patients under 18 years of age, and nor was multisystem inflammatory syndrome diagnosed. In conclusion, SARS-CoV-2 infection did not represent an untoward risk factor among children with cancer in Hungary.
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Affiliation(s)
- Judit Müller
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Dóra Szűcs-Farkas
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Szegedi
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Monika Csóka
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | | | - Péter Hauser
- Haematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Child Health Centre, Borsod-Abauj-Zemplen County Hospital, Miskolc, Hungary
| | - Gergely Kriván
- Pediatric Bone Marrow Transplantation Department, South-Pest Centrum Hospital, Budapest, Hungary
| | - Krisztina Csanádi
- Hemato-Oncology Unit, Heim Pal Children's Hospital, Budapest, Hungary
| | - Gábor Ottóffy
- Department of Pediatrics, University of Pecs, Pecs, Hungary
| | - Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csongor Kiss
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Kovács
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
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81
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Wu X, Shen M, Quan H, Zhang X, Xu F, Li J, He M, Pan D, Cao L, Yue C, Liu T, Jia X. Shedding of SARS-CoV-2 for 85 Days in COVID-19 Patients With Type 2 Diabetes Mellitus and Lung Metastasis: A Case Report. Front Med (Lausanne) 2022; 9:828819. [PMID: 35419368 PMCID: PMC8996196 DOI: 10.3389/fmed.2022.828819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background COVID-19 (coronavirus disease 2019) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seriously endangers people's lives. The variation in SARS-CoV-2 makes the research and development of vaccines and specific drugs particularly important. However, the prevention and diagnosis of COVID-19 cannot be underestimated in the control of the epidemic. Case Presentation We introduced a 65-year-old female patient who was diagnosed with COVID-19. The SARS-CoV-2 nucleic acid test result of this patient was positive again during treatment. It took 85 days from the first symptom to the final cure. According to the known reports, she is currently the patient with the longest virus shedding in Sichuan Province, China. Due to the patient's special condition, she was treated in four hospitals before and after, and she was diagnosed with type 2 diabetes mellitus (T2DM) and right lung metastatic adenocarcinoma. We fully introduced the patient's epidemiological history, diagnosis, testing, and treatment process. The patient was finally discharged from the hospital under the treatment of antiviral, hypoglycaemic, anti-anxiety, and a combination of Chinese and Western medicine. Conclusions The epidemic is still rampant, and we should not relax our efforts in the prevention and control of viruses. For the elderly, especially those who are suffering from complications or vulnerable to diseases, it is recommended to extend the observation time. Additionally, medical workers should pay attention to the mental state of patients.
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Affiliation(s)
- Xiaoheng Wu
- Yan'an Key Laboratory of Microbial Drug Innovation and Transformation, School of Basic Medicine, Yan'an University, Yan'an, China.,Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Min Shen
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Hui Quan
- The 2nd Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, China
| | - Xianqin Zhang
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China.,School of Basic Medical Sciences, Chengdu Medical College, Chengdu, China
| | - Fengcheng Xu
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Juan Li
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Dongmei Pan
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Ling Cao
- Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Changwu Yue
- Yan'an Key Laboratory of Microbial Drug Innovation and Transformation, School of Basic Medicine, Yan'an University, Yan'an, China
| | - Tianhu Liu
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Xu Jia
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China.,School of Basic Medical Sciences, Chengdu Medical College, Chengdu, China
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Eidininkienė M, Cesarskaja J, Talačkaitė S, Traškaitė-Juškevičienė V, Macas A. Mini Review: Co-Existing Diseases and COVID-19—A One Way Ticket? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084738. [PMID: 35457604 PMCID: PMC9029116 DOI: 10.3390/ijerph19084738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023]
Abstract
Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and the most common comorbidities is key to the successful management of these patients. Methods. We systematically searched Medline, Springer and Elsevier databases and accessed the full text on SARS-CoV-2 virus infection and the following conditions: cardiovascular, renal, immunosuppression, metabolic disorder and hematological in order to prepare a narrative review on this topic. Results. Patients with underlying cardiovascular diseases are more likely to suffer from severe forms of COVID-19. Cardiovascular diseases were also noted as the most frequent comorbidities among coronavirus patients. Metabolic syndrome and its components have been identified as the second most common comorbidity among fatal cases of COVID-19. Infected patients with acute kidney injury also show a higher mortality rate among the others. Immunocompromised patients, such as organ recipients and cancer and hematologic patients, develop more severe forms of COVID-19 and are at higher risk of admission to ICUs and requiring mechanical ventilation. Higher mortality rates among those patients have also been observed. Conclusions. Based on recent studies, patients with co-existing diseases are at higher risk for severe courses of COVID-19 virus infection and unfavorable outcomes. Cardiovascular diseases, metabolic syndrome and immunosuppressive and kidney diseases in the presence of coronavirus may lead to longer and more aggressive treatment in the ICU and increased mortality rate.
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Affiliation(s)
- Mantė Eidininkienė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Correspondence: ; Tel.: +370-606-797-54
| | - Jelena Cesarskaja
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
| | - Simona Talačkaitė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
| | - Vilma Traškaitė-Juškevičienė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Department of Anesthesiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, LT-50160 Kaunas, Lithuania
| | - Andrius Macas
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Department of Anesthesiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, LT-50160 Kaunas, Lithuania
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Health-related quality of life in cancer immunotherapy: a systematic perspective, using causal loop diagrams. Qual Life Res 2022; 31:2357-2366. [PMID: 35298735 PMCID: PMC8929267 DOI: 10.1007/s11136-022-03110-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/26/2022]
Abstract
Purpose System science offers a unique set of tools, including causal loop diagrams (CLDs), for stakeholders to better grasp the complexity of factors surrounding quality of life. Because the health-related quality of life (HRQoL) of cancer immunotherapy patients exists within an intricate system affected by and affecting many factors across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid the understanding of this complexity. We developed a CLD for HRQoL of cancer immunotherapy patients. Methods We first applied a literature-based approach to construct a CLD for patients following immunotherapy. We then iteratively reviewed and enhanced the CLD through interviews with subject matter experts. Results Based on the reviewed literature and subject matter expert input, we produced a CLD representing the system surrounding cancer immunotherapy patients’ HRQoL. Several feedback loops are identified that span clinical experiences, oncology teams’ perceptions about immunotherapy, social support structures, and further research and development in cancer immunotherapy, in addition to other components. The CLD enables visualization of thought experiments regarding how a change anywhere in the system can ultimately worsen or improve patients’ HRQoL. Conclusion The CLD illustrates the valuable contribution of a systems perspective to quality-of-life research. This systems-based qualitative representation gives insight on strategies to inhibit harmful effects, enhance beneficial effects, and inherent tradeoffs within the system. The CLD identifies gaps in the literature and offers a communication tool for diverse stakeholders. Our research method provides an example for studying the complexities of quality of life in other health domains. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03110-5.
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84
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Latif MB, Shukla S, Del Rio Estrada PM, Ribeiro SP, Sekaly RP, Sharma AA. Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection. Transl Res 2022; 241:83-95. [PMID: 34871809 PMCID: PMC8641406 DOI: 10.1016/j.trsl.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/09/2023]
Abstract
Patients with cancers have been severely affected by the COVID-19 pandemic. This is highlighted by the adverse outcomes in cancer patients with COVID-19 as well as by the impact of the COVID-19 pandemic on cancer care. Patients with cancer constitute a heterogeneous population that exhibits distinct mechanisms of immune dysfunction, associated with distinct systemic features of hot (T-cell-inflamed/infiltrated) and cold (Non-T-cell-inflamed and/or infiltrated) tumors. The former show hyper immune activated cells and a highly inflammatory environment while, contrastingly, the latter show the profile of a senescent and/or quiescent immune system. Thus, the evolution of SARS-CoV-2 infection in different types of cancers can show distinct trajectories which could lead to a variety of clinical and pathophysiological outcomes. The altered immunological environment including cytokines that characterizes hot and cold tumors will lead to different mechanisms of immune dysfunction, which will result in downstream effects on the course of SARS-CoV-2 infection. This review will focus on defining the known contributions of soluble pro- and anti-inflammatory mediators on immune function including altered T-cells and B-cells responses and as well on how these factors modulate the expression of SARS-CoV-2 receptor ACE2, TMPRSS2 expression, and lymph node fibrosis in cancer patients. We will propose immune mechanisms that underlie the distinct courses of SARS-CoV-2 infection in cancer patients and impact on the success of immune based therapies that have significantly improved cancer outcomes. Better understanding of the immune mechanisms prevalent in cancer patients that are associated to the outcomes of SARS-CoV-2 infection will help to identify the high-risk cancer patients and develop immune-based approaches to prevent significant adverse outcomes by targeting these pathways.
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Affiliation(s)
- Muhammad Bilal Latif
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Sudhanshu Shukla
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Perla Mariana Del Rio Estrada
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Susan Pereira Ribeiro
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Rafick Pierre Sekaly
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia.
| | - Ashish Arunkumar Sharma
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
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85
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Liu A, Raja xavier J, Singh Y, Brucker SY, Salker MS. Molecular and Physiological Aspects of SARS-CoV-2 Infection in Women and Pregnancy. Front Glob Womens Health 2022; 3:756362. [PMID: 35284910 PMCID: PMC8908006 DOI: 10.3389/fgwh.2022.756362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/01/2022] [Indexed: 01/08/2023] Open
Abstract
Whilst scientific knowledge about SARS-CoV-2 and COVID-19 is rapidly increasing, much of the effects on pregnant women is still unknown. To accommodate pregnancy, the human endometrium must undergo a physiological transformation called decidualization. These changes encompass the remodeling of endometrial immune cells leading to immunotolerance of the semi-allogenic conceptus as well as defense against pathogens. The angiotensin converting enzyme 2 (ACE2) plays an important regulatory role in the renin-angiotensin-system (RAS) and has been shown to be protective against comorbidities known to worsen COVID-19 outcomes. Furthermore, ACE2 is also crucial for decidualization and thus for early gestation. An astounding gender difference has been found in COVID-19 with male patients presenting with more severe cases and higher mortality rates. This could be attributed to differences in sex chromosomes, hormone levels and behavior patterns. Despite profound changes in the female body during pregnancy, expectant mothers do not face worse outcomes compared with non-pregnant women. Whereas mother-to-child transmission through respiratory droplets during labor or in the postnatal period is known, another question of in utero transmission remains unanswered. Evidence of placental SARS-CoV-2 infection and expression of viral entry receptors at the maternal-fetal interface suggests the possibility of in utero transmission. SARS-CoV-2 can cause further harm through placental damage, maternal systemic inflammation, and hindered access to health care during the pandemic. More research on the effects of COVID-19 during early pregnancy as well as vaccination and treatment options for gravid patients is urgently needed.
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Affiliation(s)
- Anna Liu
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Janet Raja xavier
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Yogesh Singh
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls University, Tübingen, Germany
| | - Sara Y. Brucker
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Madhuri S. Salker
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
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86
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Guarnera A, Santini E, Podda P. COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiological Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies. Tomography 2022; 8:513-528. [PMID: 35202206 PMCID: PMC8875889 DOI: 10.3390/tomography8010041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 12/21/2022] Open
Abstract
The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis leading to patients’ poor prognosis and late medical treatment. The radiologist plays a pivotal role as CT represents a non-invasive radiological technique which may help to identify possible overlap and differential diagnosis between COVID-19 pneumonia and lung cancer, which represents the most frequent cancer histology in COVID-19 patients. Our aims are: to present the main CT features of COVID-19 pneumonia; to provide the main differential diagnosis with lung cancer, chemotherapy-, immunotherapy-, and radiotherapy-induced lung disease; and to suggest practical tips and key radiological elements to identify possible overlap between COVID-19 pneumonia and lung cancer. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis. It is crucial to search for typical COVID-19 pneumonia phase progression and typical radiological features on HRTC. The evidence of atypical findings such as lymphadenopathies and mediastinal and vessel invasion, as well as the absence of response to therapy, should arouse the suspicion of lung cancer and require contrast administration. Ground-glass areas and/or consolidations bound to radiotherapy fields or pneumonitis arising during and after oncological therapy should always arouse the suspicion of radiation-induced lung disease and chemo/immunotherapy-induced lung disease. The radiological elements we suggest for COVID-19 and lung cancer differential diagnosis may be used to develop AI protocols to guarantee an early and proper diagnosis and treatment to improve patients’ quality of life and life expectancy.
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Affiliation(s)
- Alessia Guarnera
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, 00189 Rome, Italy
- Correspondence:
| | - Elena Santini
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
| | - Pierfrancesco Podda
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
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87
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Brain Damage in COVID-19. Case Reports and Summary of Data in Literature. ARS MEDICA TOMITANA 2022. [DOI: 10.2478/arsm-2020-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
SARS-CoV-2 (severe acute respiratory syndrome), rapidly escalated to a pandemic and has a significant impact on the quality of human life and activity, affecting millions of people.
The presentation resumes data regarding the neurological impairment of patients affected by COVID-19; although the data was observational and limited, this examination would help us to broaden our understanding on the association between COVID-19 and the stroke. In order to support such observations I will present two cases of patients diagnosed with COVID-19 that have shown neurological damage, but with different altogether outcomes.
The first case analysed, the age and comorbidities of the patient determined an unfavourable evolution, partly also due to tardiness in getting admitted. The apparition of the stroke after the serological negative bias SARS-CoV-2 denotes the complications recently emerged after the severe infection with COV-2, therefore while the viral infection remitted, the physical and pathological tumult determined the emergence of complications with unfavourable evolution. Although similar in certain ways to the first case, the second patient that also presented multiple unfavourable factors, such as old age, severe comorbidities and beyond that - multiple hospital admissions, recent neurosurgical intervention- clinical, immune-serum and biological evolutions have been favourable.
Cerebrovascular events are somewhat common findings in COVID-19 infected patients and they could bare a multifactorial etiology. In order to better understand the impact of cerebrovascular events in COVID-19 infection, more precise and prospective data are needed.
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88
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A SARS-CoV-2 Infection High-Uptake Program on Healthcare Workers and Cancer Patients of the National Cancer Institute of Naples, Italy. Healthcare (Basel) 2022; 10:healthcare10020205. [PMID: 35206819 PMCID: PMC8872409 DOI: 10.3390/healthcare10020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide, becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of the virus. Furthermore, cancer patients (CPs) are a vulnerable population, with an increased risk of developing severe and lethal forms of Coronavirus Disease 19 (COVID-19). Therefore, at the National Cancer Institute of Naples, where only cancer patients are treated, a surveillance program aimed to prevent the hospital access of SARS-CoV-2 positive subjects (HCWs and CPs) was implemented. The study aims to describe the results of the monitoring activity for the SARS-CoV-2 spread among HCWs and CPs, from March 2020 to March 2021. Methods: This surveillance program included a periodic sampling through nasopharyngeal molecular swabs for SARS-CoV-2 (Real-Time Polymerase Chain Reaction, RT-PCR). CPs were submitted to the molecular test at least 48 h before hospital admission. Survival analysis and multiple logistic regression models were performed among HCWs and CPs to assess the main SARS-CoV-2 risk factors. Results: The percentages of HCWs tested with RT-PCR for the detection of SARS-CoV-2, according to the first and the second wave, were 79.7% and 91.7%, respectively, while the percentages for the CPs were 24.6% and 39.6%. SARS-CoV-2 was detected in 20 (1.7%) HCWs of the 1204 subjects tested during the first wave, and in 127 (9.2%) of 1385 subjects tested in the second wave (p < 0.001); among CPs, the prevalence of patients tested varied from 100 (4.6%) during the first wave to 168 (4.9%) during the second wave (p = 0.8). The multivariate logistic analysis provided a significant OR for nurses (OR = 2.24, 95% CI 1.23–4.08, p < 0.001) compared to research, administrative staff, and other job titles. Conclusions: Our findings show that the positivity rate between the two waves in the HCWs increased over time but not in the CPs; therefore, the importance of adopting stringent measures to contain the shock wave of SARS-CoV-2 infection in the hospital setting was essential. Among HCWs, nurses are more exposed to contagion and patients who needed continuity in oncological care for diseases other than COVID-19, such as suspected cancer.
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89
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Bansal M, Sachdev M, Chakraborty S, Dua V. Second wave of COVID-19 – Not a matter of great concern for pediatric hematologist/oncologist. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2022. [PMCID: PMC8760525 DOI: 10.1016/j.phoj.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective Coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic and is giving rise to a serious health threat globally. SARS-CoV-2 infection ranges from asymptomatic carrier state to severe illness requiring intensive care unit (ICU) management. It is postulated that with COVID-19 infection, children are less prone to develop severe symptoms as compared with adults. The data on immunocompromised children affected with COVID-19 infection is limited and not many publications are there on the effects of 2nd wave of COVID-19 infection in pediatric hematology/oncology patients till date. Methods Retrospective data analysis of patients under the age of 18 years with underlying hematological and oncological conditions including those who underwent stem cell transplantation. All SARS-CoV-2-positive cases were included in the study. Results In our experience during second wave, 17 patients were found to be positive for SARS-CoV-2 with a male: female ratio of 2.4: 1 and median age of 8 years (range 1 – 18 years). Out of these 17 patients, 10 (58.8%) patients required hospital admission whereas the remaining were managed at home. Only 1 patient required ventilatory support and there was no mortality. Conclusion Though the number of pediatric patients with COVID-19 infection were more during the second wave but majority had mild to moderate symptoms and were easily managed.
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90
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Treatment with abiraterone or enzalutamide does not impair immunological response to COVID-19 vaccination in prostate cancer patients. Prostate Cancer Prostatic Dis 2022; 25:117-118. [PMID: 34628475 PMCID: PMC8501917 DOI: 10.1038/s41391-021-00455-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/23/2021] [Accepted: 08/31/2021] [Indexed: 02/04/2023]
Abstract
Data regarding the safety and efficacy of COVID-10 vaccines among cancer patients are lacking. Factors such as age, underlying disease and antineoplastic treatment confer negatively to the immune response due to vaccination. The degree of immunosuppression though may be lessen by targeted treatments like the androgen receptor-targeted agents (ARTA) that are commonly used in patients with metastatic prostate cancer. Herein, we report our data on 25 patients with prostate cancer under treatment with ARTA who were vaccinated for COVID-19. Our data suggest that these patients develop neutralizing antibodies against SARS-CoV-2 similarly to healthy volunteers. No safety issues were noted.
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91
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Internò V, Rudà R, Sergi MC, Soffietti R, Porta C. Newly diagnosed Glioblastoma Multiforme (GBM) during COVID-19 pandemic: changes in therapeutic approach to minimize in-hospital SARS-COV-2 contagion in pre-vaccine era. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022067. [PMID: 35775774 PMCID: PMC9335445 DOI: 10.23750/abm.v93i3.12452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022]
Abstract
COVID-19 pandemic revolutionized the way in which cancer patients are treated worldwide. Regarding neuro-oncological patients, usually considered frail and with lower life-expectancy in respect to other oncological patients, the international scientific community had to urgently reorganize the treatment approach in order to minimize the risk of in-hospital contagious. For GBM patients, adjuvant treatments have been evaluated with even much more attention with regard to the expected efficacy. As a consequence, an hypofractioned radiotherapy regimen has been preferred in order to reduce the daily hospital accesses and, especially in pMGMT unmethylated patients, chemotherapy with Temozolomide was avoided. Here, we made a comprehensive evaluation of the neurooncological community suggestions regarding GBM treatment in the pre-vaccine era of COVID-19 pandemic.
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Affiliation(s)
- Valeria Internò
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
| | - Roberta Rudà
- Department of Neurology, Castelfranco Veneto and Treviso Hospital, Italy, Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - Maria Chiara Sergi
- Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
| | - Riccardo Soffietti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Riccardo Soffietti and Camillo Porta are co-last authors
| | - Camillo Porta
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy, Riccardo Soffietti and Camillo Porta are co-last authors
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92
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Shariati L, Javanmard S, Sharifi M, Vaseghi G, Nasirian M, Arabzadeh S, Pourhadi M, Hajiahmadi S. Clinical characteristics of COVID-19-infected cancer patients, Isfahan, Iran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:73. [PMID: 36353349 PMCID: PMC9639711 DOI: 10.4103/jrms.jrms_541_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/03/2021] [Accepted: 08/09/2022] [Indexed: 12/15/2022]
Abstract
Background: Cancer patients, as a highly vulnerable population, are receiving a great deal of attention in the current crisis of coronavirus 2019 (COVID-19). To date, shreds of evidence are not sufficient to the description of COVID-19 outcomes in patients with cancer. This study was performed to evaluate the demographic and clinical characteristics and subsequent outcomes of COVID-19 in cancer patients. Materials and Methods: A hospital-based study was conducted involving 66 cancer patients with a confirmed diagnosis of COVID-19 from January 15, 2020, to December 21, 2020, in Isfahan, Iran. The clinical information was collected by interview and medical records. The statistical analyses were performed to describe categorical variables as well as mean, standard deviation, median, and the interquartile range for quantitative variables. Results: In our study, 66 cancer patients with confirmed COVID-19 (age: 17–97 years; 50% female) were included. Leukemia and bone marrow cancer with a frequency of 25.7% were the most common types of cancer among them. Cancer patients mostly complained of fever, cough and fatigue, and shortness of breath. Among 76.9% of patients discharged from the hospital with relative recovery, 23% died; the most common cause of death was acute respiratory distress syndrome. Age, gender, and type of cancer did not affect cancer mortality. COVID-19 had no potential effect to increase the risk of side effects of anticancer therapies. Conclusion: The results of our studies revealed that cancer is an important risk factor for the higher rate of mortality in patients with COVID-19. These findings could help physicians for the management, treatment, and supportive care of COVID-19 cancer patients.
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93
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Mohiuddin M, Kasahara K. Investigating the aggressiveness of the COVID-19 Omicron variant and suggestions for possible treatment options. Respir Med 2021; 191:106716. [PMID: 34923286 PMCID: PMC8668234 DOI: 10.1016/j.rmed.2021.106716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/12/2021] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic has put a strain on all the healthcare systems around the world. The World Health Organization (WHO) stated that the “highly mutated” Omicron variant, known as B.1.1.529, could represent a very high global risk of sudden increases in infections. As a result, it is urgently necessary to explore the most suitable treatments for this variant. The purpose of the study was to investigate the currently available studies regarding the Omicron variant and try to identify any potentially effective therapies for the Omicron variant.
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Affiliation(s)
- Md Mohiuddin
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan.
| | - Kazuo Kasahara
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan
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94
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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] [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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95
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Mohiuddin M, Kasahara K. Cancer metastasis may increase COVID-19 mortality: Suitable targets required to impede cancer metastasis. J Infect Public Health 2021; 15:153-155. [PMID: 34929552 PMCID: PMC8662903 DOI: 10.1016/j.jiph.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Md Mohiuddin
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan.
| | - Kazuo Kasahara
- Department of Respiratory Medicine, Kanazawa University, Ishikawa, Japan
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96
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Come for Information, Stay for Support: Harnessing the Power of Online Health Communities for Social Connectedness during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312743. [PMID: 34886468 PMCID: PMC8656945 DOI: 10.3390/ijerph182312743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic created a globally shared stressor that saw a rise in the emphasis on mental and emotional wellbeing. However, historically, these topics were not openly discussed, leaving those struggling without professional support. One powerful tool to bridge the gap and facilitate connectedness during times of isolation is online health communities (OHCs). This study surveyed Health Union OHC members during the pandemic to determine the degree of COVID-19 concern, social isolation, and mental health distress they are facing, as well as to assess where they are receiving information about COVID-19 and what sources of support they desire. The survey was completed in six independent waves between March 2020 and April 2021, and garnered 10,177 total responses. In the United States, OHCs were utilized significantly more during peak lockdown times, and the desire for emotional and/or mental health support increased over time. Open-ended responses demonstrated a strong desire for connection and validation, which are quintessential characteristics of OHCs. Through active moderation utilizing trained moderators, OHCs can provide a powerful, intermediate and safe space where conversations about mental and emotional wellbeing can be normalized and those in need are encouraged to seek additional assistance from healthcare professionals if warranted.
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97
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Routine COVID-19 testing may not be necessary for most cancer patients. Sci Rep 2021; 11:23294. [PMID: 34857785 PMCID: PMC8640074 DOI: 10.1038/s41598-021-02692-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/17/2021] [Indexed: 12/19/2022] Open
Abstract
Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15–0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.
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98
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Gao L, Li GS, Li JD, He J, Zhang Y, Zhou HF, Kong JL, Chen G. Identification of the susceptibility genes for COVID-19 in lung adenocarcinoma with global data and biological computation methods. Comput Struct Biotechnol J 2021; 19:6229-6239. [PMID: 34840672 PMCID: PMC8605816 DOI: 10.1016/j.csbj.2021.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction The risk of infection with COVID-19 is high in lung adenocarcinoma (LUAD) patients, and there is a dearth of studies on the molecular mechanism underlying the high susceptibility of LUAD patients to COVID-19 from the perspective of the global differential expression landscape. Objectives To fill the research void on the molecular mechanism underlying the high susceptibility of LUAD patients to COVID-19 from the perspective of the global differential expression landscape. Methods Herein, we identified genes, specifically the differentially expressed genes (DEGs), correlated with the susceptibility of LUAD patients to COVID-19. These were obtained by calculating standard mean deviation (SMD) values for 49 SARS-CoV-2-infected LUAD samples and 24 non-affected LUAD samples, as well as 3931 LUAD samples and 3027 non-cancer lung samples from 40 pooled RNA-seq and microarray datasets. Hub susceptibility genes significantly related to COVID-19 were further selected by weighted gene co-expression network analysis. Then, the hub genes were further analyzed via an examination of their clinical significance in multiple datasets, a correlation analysis of the immune cell infiltration level, and their interactions with the interactome sets of the A549 cell line. Results A total of 257 susceptibility genes were identified, and these genes were associated with RNA splicing, mitochondrial functions, and proteasomes. Ten genes, MEA1, MRPL24, PPIH, EBNA1BP2, MRTO4, RABEPK, TRMT112, PFDN2, PFDN6, and NDUFS3, were confirmed to be the hub susceptibility genes for COVID-19 in LUAD patients, and the hub susceptibility genes were significantly correlated with the infiltration of multiple immune cells. Conclusion In conclusion, the susceptibility genes for COVID-19 in LUAD patients discovered in this study may increase our understanding of the high risk of COVID-19 in LUAD patients.
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Key Words
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- DEG
- DEG, differentially expressed genes
- FC, fold change
- FPKM, fragments per kilobase per million
- GTEx, Genotype-tissue Expression
- HPA, human protein atlas
- IHC, immunohistochemistry
- Immune infiltration
- LUAD
- LUAD, lung adenocarcinoma
- PPI, protein-to-protein interaction
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SMD, standard mean difference
- SROC, summarized receiver’s operating characteristics
- Susceptibility
- TF, transcription factor
- TPM, transcripts per million reads
- WGCNA
- WGCNA, weighted gene co-expression network analysis
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Affiliation(s)
- Li Gao
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Guo-Sheng Li
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Jian-Di Li
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Juan He
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Yu Zhang
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324. Jingwu Rd, Jinan, Shandong 250021, PR China
| | - Hua-Fu Zhou
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Jin-Liang Kong
- Ward of Pulmonary and Critical Care Medicine, Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
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Peng X, Gao P, Wang Q, Wu HG, Yan YL, Xia Y, Wang JY, Lu F, Pan H, Yang Y, Liang F, Zhao L, Cheng J. Prevalence and Impact Factors of COVID-19 Vaccination Hesitancy Among Breast Cancer Survivors: A Multicenter Cross-Sectional Study in China. Front Med (Lausanne) 2021; 8:741204. [PMID: 34805207 PMCID: PMC8595240 DOI: 10.3389/fmed.2021.741204] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/04/2021] [Indexed: 12/24/2022] Open
Abstract
Cancer patients are at a high risk of being infected with COVID-19 and have a poor prognosis after infection. Breast cancer is one of the most common cancers. Since vaccination is an effective measure to prevent the spread of COVID-19, we studied the vaccination rate among breast cancer survivors and analyzed their characteristics to provide evidence for boosting the vaccination rate. The researchers conducted a multicenter, cross-sectional study on 747 breast cancer survivors from six hospitals in Wuhan city between June 5, 2021, and June 12, 2021. The self-administrated questionnaires based on relevant studies were distributed. The researchers then compared differences in characteristics among vaccinated patients, hesitant patients, and non-vaccinated patients. Moreover, they performed univariable and multivariable logistic regression analyses to identify potential factors associated with vaccination hesitancy. The researchers assessed a total of 744 breast cancer survivors −94 cases in the vaccinated group, 103 in the planning group, 295 in the hesitancy group, and 252 in the refusal group. The vaccination rate was 12.63% (95% CI 10.25–15.02%) and 37.23% (95% CI 27.48–47.82%) patients reported adverse reactions. The vaccination hesitancy/refusal rate was 73.52% (95% CI 70.19–76.66%), which was independently associated with current endocrine or targeted therapy (odds ratio [OR] = 1.52, 95% CI 1.03–2.24), no notification from communities or units (OR = 2.46, 95% CI 1.69–3.59) and self-perceived feel (general vs. good, OR = 1.46, 95% CI 1.01–2.13; bad vs. good, OR = 4.75, 95% CI 1.85–12.16). In the hesitancy/refusal group, the primary reason was “I did not know who to ask whether I can get vaccinated” (46.07%), the person who would most influence decisions of patients was the doctor in charge of treatment (35.83%). Effective interaction between doctors and patients, simple and consistent practical guidelines on vaccination, and timely and positive information from authoritative media could combat misinformation and greatly reduce vaccine hesitancy among breast cancer survivors.
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Affiliation(s)
- Xin Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Gao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiong Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Ge Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Li Yan
- Department of Breast Center, Hebei Cancer Hospital, Wuhan, China
| | - Ying Xia
- Department of Thyroid Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Ying Wang
- Department of Thyroid Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fang Lu
- Department of Thyroid and Breast Gland Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Pan
- Department of Thyroid Breast Surgery, Wuhan Central Hospital, Wuhan, China
| | - Yi Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Liang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhao
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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100
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de Joode K, Tol J, Hamberg P, Cloos M, Kastelijn EA, Borgers JSW, Nuij VJAA, Klaver Y, Herder GJM, Mutsaers PGNJ, Dumoulin DW, Oomen-de Hoop E, van Diemen NGJ, Libourel EJ, Geraedts EJ, Bootsma GP, van der Leest CH, Peerdeman AL, Herbschleb KH, Visser OJ, Bloemendal HJ, van Laarhoven HWM, de Vries EGE, Hendriks LEL, Beerepoot LV, Westgeest HM, van den Berkmortel FWPJ, Haanen JBAG, Dingemans AMC, van der Veldt AAM. Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium. Eur J Cancer 2021; 160:261-272. [PMID: 34799210 PMCID: PMC8542445 DOI: 10.1016/j.ejca.2021.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 01/08/2023]
Abstract
Aim of the study The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. Methods The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. Results Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. Conclusion There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic.
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Affiliation(s)
- Karlijn de Joode
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Jolien Tol
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Paul Hamberg
- Department of Oncology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Marissa Cloos
- Department of Internal Medicine, Groene Hart Hospital, Gouda, the Netherlands
| | - Elisabeth A Kastelijn
- Department of Pulmonology, St. Antonius Hospital Utrecht/Nieuwegein, Utrecht, the Netherlands
| | - Jessica S W Borgers
- Department of Medical Oncology, Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Veerle J A A Nuij
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Yarne Klaver
- Department of Internal Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Gerarda J M Herder
- Department of Pulmonary Medicine, Meander Medical Center, Amersfoort, the Netherlands
| | - Pim G N J Mutsaers
- Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Daphne W Dumoulin
- Department of Pulmonary Medicine, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Esther Oomen-de Hoop
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | | | - Eduard J Libourel
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Erica J Geraedts
- Department of Pulmonology, Groene Hart Hospital, Gouda, the Netherlands
| | - Gerben P Bootsma
- Department of Pulmonology, Zuyderland Medical Center, Heerlen, the Netherlands
| | | | - Anne L Peerdeman
- Department of Internal Medicine, Bernhoven, Uden, the Netherlands
| | - Karin H Herbschleb
- Department of Internal Medicine, St. Antonius Hospital Utrecht/Nieuwegein, Utrecht, the Netherlands
| | - Otto J Visser
- Department of Hematology, Isala Hospital, Zwolle, the Netherlands
| | - Haiko J Bloemendal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Lizza E L Hendriks
- Department of Pulmonary Diseases GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Laurens V Beerepoot
- Department of Internal Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Hans M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands
| | | | - John B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Anne-Marie C Dingemans
- Department of Pulmonary Medicine, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Astrid A M van der Veldt
- Department of Medical Oncology and Department of Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
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