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Vidal N, Climent MÁ, Pérez S, Méndez-Vidal MJ, Anguera G, Martínez Salas I, Gallardo E, Cuéllar-Rivas MA, Molina-Cerrillo J, Martín A, Rodriguez-Vida A, Almagro Casado E, Gonzalez M, Domènech M, Martínez Kareaga M, Fernández Calvo O, Villa Guzmán JC, Vázquez Estévez S, González-Del-Alba A, Puente J. Impact of COVID-19 infection on genitourinary cancer management. SOGUG-COVID-19: A spanish, multicenter, observational study. Clin Transl Oncol 2024:10.1007/s12094-024-03744-6. [PMID: 39369361 DOI: 10.1007/s12094-024-03744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 09/21/2024] [Indexed: 10/07/2024]
Abstract
INTRODUCTION The COVID-19 pandemic is a great burden worldwide, but its impact on patients with genitourinary cancer (GUC) is poorly characterized. This study aimed to characterize the clinical features and evolution of GUC patients affected by COVID-19 in Spain. PATIENTS AND METHODS SOGUG-COVID-19 was an observational ambispective non-interventional study that recruited patients with SARS-CoV-2 infection who had been treated for GUC in 32 Spanish hospitals. Data were collected from patients' medical records in a short period of time, coinciding with the first waves of COVID-19, when the mortality was also higher in the general population. RESULTS From November 2020 to April 2021, 408 patients were enrolled in the study. The median age was 70 years, and 357 patients (87.5%) were male. Most frequent Cancer Origin was: prostate (40.7%), urothelial (31.4%) and kidney (22.1%). Most patients (71.3%) were diagnosed at the metastatic stage, and 33.3% had poorly differentiated histology. Anticancer treatment during the infection was reported in 58.3% of patients, and 21.3% had received immunotherapy prior to or concurrent with the infection. The most frequent COVID-19 symptoms were pyrexia (49.0%), cough (38.2%) and dyspnea (31.9%). Median age was higher for patients with pneumonia (p < 0.001), patchy infiltrates (p = 0.005), ICU admission (p < 0.001) and death (p < 0.001). Tumor stage was associated with complications (p = 0.006). The fatality rate was 19.9% and the 6-month COVID-19-specific survival rate was 79.7%. CONCLUSION Patients with genitourinary cancers seem exceptionally vulnerable to COVID-19 regardless of tumor type or anticancer therapy. Age and tumor stage were the only identified risk factors for severe COVID-19.
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Affiliation(s)
- Natalia Vidal
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | | | - Sara Pérez
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - María José Méndez-Vidal
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC) Hospital Universitario Reina Sofía, Medical Oncology Department, Córdoba, Spain
| | - Georgia Anguera
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Enrique Gallardo
- Medical Oncology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Miler Andrés Cuéllar-Rivas
- Medical Oncology Department, Institut Català d'Oncologia (ICO) L'Hospitalet del Llobregat, Barcelona, Spain
| | | | - Almudena Martín
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar, IMIM Research Institute, CIBERONC, Barcelona, Spain
| | - Elena Almagro Casado
- Medical Oncology Department, Hospital Universitario Quirón Salud Madrid, Pozuelo de Alarcón, Spain
| | - Macarena Gonzalez
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | | | | | - Ovidio Fernández Calvo
- Medical Oncology Department, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | | | - Aránzazu González-Del-Alba
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, C/Joaquin Rodrigo 2, Majadahonda, 28222, Madrid, Spain.
| | - Javier Puente
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
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Claveau S, Mahmood F, Amir B, Kwan JJW, White C, Vipond J, Iannattone L. COVID-19 and Cancer Care: A Review and Practical Guide to Caring for Cancer Patients in the Era of COVID-19. Curr Oncol 2024; 31:5330-5343. [PMID: 39330021 PMCID: PMC11431468 DOI: 10.3390/curroncol31090393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/21/2024] [Accepted: 08/26/2024] [Indexed: 09/28/2024] Open
Abstract
COVID-19, a novel infectious disease caused by the emergence of the SARS-CoV-2 virus in 2020, has had a profound impact on healthcare, both at the individual and population level. The impact at the population level was felt most acutely during the emergency phase of the pandemic, with hospital capacity issues leading to widespread disruptions and delays in the delivery of healthcare services such as screening programs and elective surgeries. While hospitals are no longer being acutely overwhelmed by COVID-19 patients, the impact of the virus on vulnerable patient populations such as cancer patients continues to be of ongoing consequence. Cancer patients remain at high risk of hospitalization, ICU admission, and death due to COVID-19, even in the era of vaccination. Infection prevention and risk mitigation strategies such air quality control, masking, testing, vaccination, and treatment should therefore be integrated into the usual care and counseling of cancer patients moving forward to avoid preventable morbidity and mortality from this infection and ensure the safety of this vulnerable cohort as they navigate their cancer diagnosis and treatment in the era of COVID-19.
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Affiliation(s)
- Simon Claveau
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Farhan Mahmood
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Baraa Amir
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | | | - Cheryl White
- Independent Researcher, Toronto, ON M6P 3X9, Canada
| | - Joe Vipond
- Department of Emergency Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lisa Iannattone
- Department of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
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Sun L, Zhao F, Xiang Y, Chen S, Shu Q. Association of immune checkpoint inhibitors with SARS-CoV-2 infection rate and prognosis in patients with solid tumors: a systematic review and meta-analysis. Front Immunol 2024; 15:1259112. [PMID: 38887296 PMCID: PMC11180804 DOI: 10.3389/fimmu.2024.1259112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 05/15/2024] [Indexed: 06/20/2024] Open
Abstract
The rate and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with solid cancer tumors actively treated with immune checkpoint inhibitors (ICIs) have not been fully determined. The goal of this meta-analysis was to explore this issue, which can be helpful to clinicians in their decision-making concerning patient treatment. We conducted a thorough search for relevant cohort studies in the databases PubMed, Embase, Cochrane Library, and Web of Science. Mortality and infection rate were the primary endpoints, and the incidence of severe or critical disease was the secondary result. A total of 6,267 cases (individual patients) were represented in 15 studies. Prior exposure to ICIs was not correlated with an elevated risk of SARS-CoV-2 infection (relative risk (RR) 1.04, 95% CI 0.57-1.88, z = 0.12, P = 0.905) or mortality (RR 1.22, 95% CI 0.99-1.50, z = 1.90, P = 0.057). However, the results of the meta-analysis revealed that taking ICIs before SARS-CoV-2 diagnosis increased the chance of developing severe or critical disease (RR 1.51, 95% CI 1.09-2.10, z = 2.46, P = 0.014). No significant inter-study heterogeneity was observed. The infection and mortality rates of SARS-CoV-2 in patients with solid tumors who previously received ICIs or other antitumor therapies did not differ significantly. However, secondary outcomes showed that ICIs treatment before the diagnosis of SARS-CoV-2 infection was significantly associated with the probability of severe or critical illness. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails PROSPERO, identifier CRD42023393511.
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Affiliation(s)
- Lin Sun
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fangmin Zhao
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuying Xiang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shuyi Chen
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Qijin Shu
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
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Kumar S, Singh B, Dey B, Jagtap VK, Verma S, Nongkynrih A. Impact of COVID-19 on Cancer Patients: An Experience From a Tertiary Care Center in Northeast India. Cureus 2024; 16:e52247. [PMID: 38352085 PMCID: PMC10861845 DOI: 10.7759/cureus.52247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic affected the healthcare system worldwide. Cancer patients and oncologists faced challenges equally in the context of the pandemic. The present study was undertaken to assess the impact of COVID-19 on cancer patients, encompassing infection source, care type, treatment delays, and infection outcomes. MATERIALS AND METHOD This single-center retrospective study was conducted between March 2020 and January 2022 at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India. It examined COVID-19 cases in cancer patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) results. Data collection included demographics, clinical details, COVID-19 specifics, treatment delays, and infection outcomes. RESULT In our study of 9,854 oncology patients' visits, 26 (0.26%) tested COVID-19 positive by RT-PCR, aged three to 70 years with a male-female ratio of 1:1.67. Twenty-three percent had comorbidities, mainly hypertension. Gastrointestinal cancers (30.8%) and hepatobiliary origin (15.5%) were common. Most patients (69.2%) had stage IV cancer, and 34.6% aimed for curative treatment. The majority of the patients (76.9%) were community-acquired, and the rest (23.1%) contracted during hospital stay. Fever (34.5%) and asymptomatic infection (30.8%) were common presentations. Six (23.1%) comorbid patients required ICU care. Median treatment delay was three weeks, with one COVID-19-related death (3.8%) and six cancer-related deaths. On follow-up, 19.2% had stable disease, 7.7% partial response, 7.7% recurrence, and 23.1% had progression. CONCLUSION Amid the pandemic, cancer patients safely received treatment. Mild cases were managed at home. Poor outcome was found in comorbid, severe COVID-19 cancer patients. However, the impact of treatment delays on long-term oncological outcomes needs further study.
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Affiliation(s)
- Sumit Kumar
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Binoy Singh
- Neurosurgery, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Biswajit Dey
- Pathology and Laboratory Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Vikas K Jagtap
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Shalini Verma
- Medical Oncology, Kasturba Medical College, Manipal, Manipal, IND
| | - Anthialisha Nongkynrih
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
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Ocanto A, Mielgo-Rubio X, Luna Tirado J, Linares Mesa N, López Valcárcel M, Pedraza S, Barragan VV, Nieto PV, Martín JZ, Couñago F. Coronavirus disease 2019 and lung cancer: where are we? EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:1082-1094. [PMID: 38023992 PMCID: PMC10651354 DOI: 10.37349/etat.2023.00182] [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: 02/16/2023] [Accepted: 08/26/2023] [Indexed: 12/01/2023] Open
Abstract
Oncology patients are more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to hospital contact and an immunological system that can be compromised by antineoplastic therapy and supportive treatments. Certain similarities have been described in the physiopathology of coronavirus disease 2019 (COVID-19) and lung cancer (LC) that may explain the higher probability of these patients of developing a more serious disease with more frequent hospitalizations and even death, especially with the addition of smoking, cardiovascular and respiratory comorbidities, old age and corticosteroids use. Pre-existing lesions and cancer therapies change the normal architecture of the lungs, so diagnostic scales such as COVID-19 Reporting and Data System (CO-RADS) are of vital importance for a correct diagnosis and patient homogenization, with a high inter-observer correlation. Moreover, anticancer treatments have required an adaptation to reduce the number of visits to the hospital [hypofractionated radiotherapy (RT), larger intervals between chemotherapy cycles, delay in follow-up tests, among others]. In a way, this has also caused a delay in the diagnosis of new cancers. On the other hand, vaccination has had a positive impact on the mortality of these patients, who maintain a similar seroprevalence to the rest of the population, with a similar impact in mortality.
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Affiliation(s)
- Abrahams Ocanto
- Department of Radiation Oncology, Hospital Universitario San Francisco de Asís, GenesiCare Madrid, 28002 Madrid, Spain
- Department of Radiation Oncology, Hospital Universitario Vithas La Milagrosa, GenesiCare Madrid, 28002 Madrid, Spain
| | - Xabier Mielgo-Rubio
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
| | - Javier Luna Tirado
- Department of Radiation Oncology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Nuria Linares Mesa
- Department of Radiation Oncology, Hospital Universitario Juan Ramón Jiménez, 21005 Huelva, Spain
| | - Marta López Valcárcel
- Department of Radiation Oncology, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain
| | - Sara Pedraza
- Department of Radiation Oncology, Hospital Universitario 12 de Octubre Madrid, 28041 Madrid, Spain
| | - Victoria Vera Barragan
- Department of Radiation Oncology, Hospital Universitario de Badajoz, 06080 Badajoz, Spain
| | - Patricia Valencia Nieto
- Department of Radiation Oncology, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Juan Zafra Martín
- Group of Translational Research in Cancer Immunotherapy, Centro de Investigaciones Médico-Sanitarias (CIMES), Universidad de Málaga (UMA), Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Felipe Couñago
- Department of Radiation Oncology, Hospital Universitario San Francisco de Asís, GenesiCare Madrid, 28002 Madrid, Spain
- Department of Radiation Oncology, Hospital Universitario Vithas La Milagrosa, GenesiCare Madrid, 28002 Madrid, Spain
- Department of Radiation Oncology, Emilio Vargas, GenesisCare Madrid, 28002 Madrid, Spain
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6
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Nagaraj G, Vinayak S, Khaki AR, Sun T, Kuderer NM, Aboulafia DM, Acoba JD, Awosika J, Bakouny Z, Balmaceda NB, Bao T, Bashir B, Berg S, Bilen MA, Bindal P, Blau S, Bodin BE, Borno HT, Castellano C, Choi H, Deeken J, Desai A, Edwin N, Feldman LE, Flora DB, Friese CR, Galsky MD, Gonzalez CJ, Grivas P, Gupta S, Haynam M, Heilman H, Hershman DL, Hwang C, Jani C, Jhawar SR, Joshi M, Kaklamani V, Klein EJ, Knox N, Koshkin VS, Kulkarni AA, Kwon DH, Labaki C, Lammers PE, Lathrop KI, Lewis MA, Li X, Lopes GDL, Lyman GH, Makower DF, Mansoor AH, Markham MJ, Mashru SH, McKay RR, Messing I, Mico V, Nadkarni R, Namburi S, Nguyen RH, Nonato TK, O'Connor TL, Panagiotou OA, Park K, Patel JM, Patel KG, Peppercorn J, Polimera H, Puc M, Rao YJ, Razavi P, Reid SA, Riess JW, Rivera DR, Robson M, Rose SJ, Russ AD, Schapira L, Shah PK, Shanahan MK, Shapiro LC, Smits M, Stover DG, Streckfuss M, Tachiki L, Thompson MA, Tolaney SM, Weissmann LB, Wilson G, Wotman MT, Wulff-Burchfield EM, Mishra S, French B, Warner JL, Lustberg MB, Accordino MK, Shah DP. Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study. eLife 2023; 12:e82618. [PMID: 37846664 PMCID: PMC10637772 DOI: 10.7554/elife.82618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
Background Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results 1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32-1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83-12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63-3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20-2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66-3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89-22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients. Funding This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication. Clinical trial number CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.
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Affiliation(s)
| | - Shaveta Vinayak
- Fred Hutchinson Cancer Research CenterSeattleUnited States
- University of WashingtonSeattleUnited States
- Seattle Cancer Care AllianceSeattleUnited States
| | | | - Tianyi Sun
- Vanderbilt University Medical CenterNashvilleUnited States
| | - Nicole M Kuderer
- University of WashingtonSeattleUnited States
- Advanced Cancer Research GroupKirklandUnited States
| | | | - Jared D Acoba
- University of Hawaii Cancer CenterHonoluluUnited States
| | - Joy Awosika
- University of Cincinnati Cancer CenterCincinnatiUnited States
| | | | | | - Ting Bao
- Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Babar Bashir
- Sidney Kimmel Comprehensive Cancer Center, Thomas Jefferson UniversityPhiladelphiaUnited States
| | | | - Mehmet A Bilen
- Winship Cancer Institute, Emory UniversityAtlantaUnited States
| | - Poorva Bindal
- Beth Israel Deaconess Medical CenterBostonUnited States
| | - Sibel Blau
- Northwest Medical SpecialtiesTacomaUnited States
| | - Brianne E Bodin
- Herbert Irving Comprehensive Cancer Center, Columbia UniversityNew YorkUnited States
| | - Hala T Borno
- Helen Diller Family Comprehensive Cancer Center, University of California, San FranciscoSan FranciscoUnited States
| | | | - Horyun Choi
- University of Hawaii Cancer CenterHonoluluUnited States
| | - John Deeken
- Inova Schar Cancer InstituteFairfaxUnited States
| | | | | | - Lawrence E Feldman
- University of Illinois Hospital & Health Sciences SystemChicagoUnited States
| | | | | | - Matthew D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiNew YorkUnited States
| | - Cyndi J Gonzalez
- Rogel Cancer Center, University of Michigan-Ann ArborAnn ArborUnited States
| | - Petros Grivas
- Fred Hutchinson Cancer Research CenterSeattleUnited States
- University of WashingtonSeattleUnited States
- Seattle Cancer Care AllianceSeattleUnited States
| | | | - Marcy Haynam
- The Ohio State University Comprehensive Cancer CenterColumbusUnited States
| | - Hannah Heilman
- University of Cincinnati Cancer CenterCincinnatiUnited States
| | - Dawn L Hershman
- Herbert Irving Comprehensive Cancer Center, Columbia UniversityNew YorkUnited States
| | - Clara Hwang
- Henry Ford Cancer Institute, Henry Ford HospitalDetroitUnited States
| | | | - Sachin R Jhawar
- The Ohio State University Comprehensive Cancer CenterColumbusUnited States
| | - Monika Joshi
- Penn State Health St Joseph Cancer CenterReadingUnited States
| | - Virginia Kaklamani
- Mays Cancer Center, The University of Texas Health San Antonio MD Anderson Cancer CenterSan AntonioUnited States
| | | | - Natalie Knox
- Stritch School of Medicine, Loyola UniversityMaywoodUnited States
| | - Vadim S Koshkin
- Helen Diller Family Comprehensive Cancer Center, University of California, San FranciscoSan FranciscoUnited States
| | - Amit A Kulkarni
- Masonic Cancer Center, University of MinnesotaMinneapolisUnited States
| | - Daniel H Kwon
- Helen Diller Family Comprehensive Cancer Center, University of California, San FranciscoSan FranciscoUnited States
| | | | | | - Kate I Lathrop
- Mays Cancer Center, The University of Texas Health San Antonio MD Anderson Cancer CenterSan AntonioUnited States
| | - Mark A Lewis
- Intermountain HealthcareSalt Lake CityUnited States
| | - Xuanyi Li
- Vanderbilt University Medical CenterNashvilleUnited States
| | - Gilbert de Lima Lopes
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of MedicineMiamiUnited States
| | - Gary H Lyman
- Fred Hutchinson Cancer Research CenterSeattleUnited States
- University of WashingtonSeattleUnited States
- Seattle Cancer Care AllianceSeattleUnited States
| | - Della F Makower
- Montefiore Medical Center, Albert Einstein College of MedicineBronxUnited States
| | | | - Merry-Jennifer Markham
- Division of Hematology and Oncology, University of Florida Health Cancer CenterGainesvilleUnited States
| | | | - Rana R McKay
- Moores Cancer Center, University of California, San DiegoSan DiegoUnited States
| | - Ian Messing
- Division of Radiation Oncology, George Washington UniversityWashingtonUnited States
| | - Vasil Mico
- Sidney Kimmel Comprehensive Cancer Center, Thomas Jefferson UniversityPhiladelphiaUnited States
| | | | | | - Ryan H Nguyen
- University of Illinois Hospital & Health Sciences SystemChicagoUnited States
| | | | | | | | - Kyu Park
- Loma Linda University Cancer CenterLoma LindaUnited States
| | | | | | | | - Hyma Polimera
- Penn State Health St Joseph Cancer CenterReadingUnited States
| | | | - Yuan James Rao
- Division of Radiation Oncology, George Washington UniversityWashingtonUnited States
| | - Pedram Razavi
- Moores Cancer Center, University of California, San DiegoSan DiegoUnited States
| | - Sonya A Reid
- Vanderbilt University Medical CenterNashvilleUnited States
| | - Jonathan W Riess
- UC Davis Comprehensive Cancer Center, University of California, DavisDavisUnited States
| | - Donna R Rivera
- Division of Cancer Control and Population Sciences, National Cancer InstituteRockvilleUnited States
| | - Mark Robson
- Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Suzanne J Rose
- Carl & Dorothy Bennett Cancer Center, Stamford HospitalStamfordUnited States
| | - Atlantis D Russ
- Division of Hematology and Oncology, University of Florida Health Cancer CenterGainesvilleUnited States
| | | | - Pankil K Shah
- Mays Cancer Center, The University of Texas Health San Antonio MD Anderson Cancer CenterSan AntonioUnited States
| | | | - Lauren C Shapiro
- Montefiore Medical Center, Albert Einstein College of MedicineBronxUnited States
| | | | - Daniel G Stover
- The Ohio State University Comprehensive Cancer CenterColumbusUnited States
| | | | - Lisa Tachiki
- Fred Hutchinson Cancer Research CenterSeattleUnited States
- University of WashingtonSeattleUnited States
- Seattle Cancer Care AllianceSeattleUnited States
| | | | | | | | - Grace Wilson
- Masonic Cancer Center, University of MinnesotaMinneapolisUnited States
| | - Michael T Wotman
- Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiNew YorkUnited States
| | | | - Sanjay Mishra
- Vanderbilt University Medical CenterNashvilleUnited States
| | | | | | - Maryam B Lustberg
- Yale Cancer Center, Yale University School of MedicineNew HavenUnited States
| | - Melissa K Accordino
- Herbert Irving Comprehensive Cancer Center, Columbia UniversityNew YorkUnited States
| | - Dimpy P Shah
- Mays Cancer Center, The University of Texas Health San Antonio MD Anderson Cancer CenterSan AntonioUnited States
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7
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Hardy N, Vegivinti CTR, Mehta M, Thurnham J, Mebane A, Pederson JM, Tarchand R, Shivakumar J, Olaniran P, Gadodia R, Ganguly A, Kelagere Y, Nallabolu RR, Gaddam M, Keesari PR, Pulakurthi YS, Reddy R, Kallmes K, Musunuru TN. Mortality of COVID-19 in patients with hematological malignancies versus solid tumors: a systematic literature review and meta-analysis. Clin Exp Med 2023; 23:1945-1959. [PMID: 36795239 PMCID: PMC9933827 DOI: 10.1007/s10238-023-01004-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Cancer patients are more vulnerable to COVID-19 compared to the general population, but it remains unclear which types of cancer have the highest risk of COVID-19-related mortality. This study examines mortality rates for those with hematological malignancies (Hem) versus solid tumors (Tumor). PubMed and Embase were systematically searched for relevant articles using Nested Knowledge software (Nested Knowledge, St Paul, MN). Articles were eligible for inclusion if they reported mortality for Hem or Tumor patients with COVID-19. Articles were excluded if they were not published in English, non-clinical studies, had insufficient population/outcomes reporting, or were irrelevant. Baseline characteristics collected included age, sex, and comorbidities. Primary outcomes were all-cause and COVID-19-related in-hospital mortality. Secondary outcomes included rates of invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission. Effect sizes from each study were computed as logarithmically transformed odds ratios (ORs) with random-effects, Mantel-Haenszel weighting. The between-study variance component of random-effects models was computed using restricted effects maximum likelihood estimation, and 95% confidence intervals (CIs) around pooled effect sizes were calculated using Hartung-Knapp adjustments. In total, 12,057 patients were included in the analysis, with 2,714 (22.5%) patients in the Hem group and 9,343 (77.5%) patients in the Tumor group. The overall unadjusted odds of all-cause mortality were 1.64 times higher in the Hem group compared to the Tumor group (95% CI: 1.30-2.09). This finding was consistent with multivariable models presented in moderate- and high-quality cohort studies, suggestive of a causal effect of cancer type on in-hospital mortality. Additionally, the Hem group had increased odds of COVID-19-related mortality compared to the Tumor group (OR = 1.86 [95% CI: 1.38-2.49]). There was no significant difference in odds of IMV or ICU admission between cancer groups (OR = 1.13 [95% CI: 0.64-2.00] and OR = 1.59 [95% CI: 0.95-2.66], respectively). Cancer is a serious comorbidity associated with severe outcomes in COVID-19 patients, with especially alarming mortality rates in patients with hematological malignancies, which are typically higher compared to patients with solid tumors. A meta-analysis of individual patient data is needed to better assess the impact of specific cancer types on patient outcomes and to identify optimal treatment strategies.
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Affiliation(s)
| | | | - Mansi Mehta
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - John M Pederson
- Nested Knowledge, Inc, St Paul, MN, USA
- Superior Medical Experts, St. Paul, MN, USA
| | | | - Jeevan Shivakumar
- Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA
| | | | - Ritika Gadodia
- Medstar Washington Hospital Center/Georgetown University, Washington, DC, USA
| | - Arup Ganguly
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Yashaswini Kelagere
- Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | | | | | - Praneeth R Keesari
- Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Rohit Reddy
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Tejo N Musunuru
- Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA.
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8
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Huang JX, Liu B, Cong XF, Guan YJ, Zhang YQ, Song W, Li Z, Liu ZL, Wang NY. Anti-cancer treatment within two weeks serves as a risk factor for clinical outcomes among cancer patients with COVID-19. Front Oncol 2023; 13:1193082. [PMID: 37675234 PMCID: PMC10478212 DOI: 10.3389/fonc.2023.1193082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/25/2023] [Indexed: 09/08/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in infections among patients with cancer. Our study aimed to investigate the potential adverse impact of anti-cancer treatments within 2 weeks of COVID-19 infection on clinical outcomes in patients with cancer. Methods This retrospective cohort study analyzed 70 cancer patients with COVID-19 infection from the First Hospital of Jilin University in Changchun City, Jilin Province, between March and June 2022. Data on demographic characteristics, vaccination status, COVID-19 clinical classification, symptoms, complications, tumor-related characteristics, laboratory examinations and medical interventions were extracted from electronic medical record. The primary outcome of our study was Intensive Care Unit (ICU) admission. Logistic regression model was performed to investigate the association between anti-cancer treatments within 2 weeks after COVID-19 infection and the risk of ICU admission. Results Of the 70 patients enrolled in this study, 37 received anti-cancer treatments within 2 weeks after COVID-19 infection. Patients receiving anti-cancer treatment were more likely to experience non-mild COVID-19, require oxygen therapy, develop acute respiratory distress syndrome (ARDS) and exhibit elevated inflammatory levels. The risk of ICU admission (P<0.001) and 30-day mortality after reverse transcriptase polymerase chain reaction (RT-PCR) negative conversion (P=0.007) was significantly higher in patients receiving anti-cancer treatments. In multivariate Logistic regression analysis, non-mild classification of COVID-19, anti-cancer treatments within 2 weeks and ECOG > 1were all independently associated with ICU admission after adjusting for confounder factors. The risk of ICU admission rose to 43.63 times (95% confidence interval=1.31-1452.94, P=0.035) in patients receiving anti-cancer treatments within 2 weeks. Conclusion Anti-cancer treatments within 2 weeks of COVID-19 infection increase the risk of ICU admission and 30-day mortality after RT-PCR negative conversion in patients with cancer. It may be recommended to postpone cancer-related treatments for more than 2 weeks in cancer patients with COVID-19 infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nan-Ya Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, China
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9
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Avigan ZM, Paredes R, Boussi LS, Lam BD, Shea ME, Weinstock MJ, Peters MLB. Updated COVID-19 clearance time among patients with cancer in the Delta and Omicron waves. Cancer Med 2023; 12:16869-16875. [PMID: 37392171 PMCID: PMC10501268 DOI: 10.1002/cam4.6311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND COVID-19 infection delays therapy and in-person evaluation for oncology patients, but clinic clearance criteria are not clearly defined. METHODS We conducted a retrospective review of oncology patients with COVID-19 at a tertiary care center during the Delta and Omicron waves and compared clearance strategies. RESULTS Median clearance by two consecutive negative tests was 32.0 days (Interquartile Range [IQR] 22.0-42.5, n = 153) and was prolonged in hematologic malignancy versus solid tumors (35.0 days for hematologic malignancy, 27.5 days for solid tumors, p = 0.01) and in patients receiving B-cell depletion versus other therapies. Median clearance by single negative test was reduced to 23.0 days (IQR 16.0-33.0), with recurrent positive rate 25.4% in hematologic malignancy versus 10.6% in solid tumors (p = 0.02). Clearance by a predefined waiting period required 41 days until an 80% negative rate. CONCLUSIONS COVID-19 clearance remains prolonged in oncology patients. Single-negative test clearance can balance delays in care with risk of infection in patients with solid tumors.
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Affiliation(s)
- Zachary M. Avigan
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Rodrigo Paredes
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Leora S. Boussi
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Barbara D. Lam
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Meghan E. Shea
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Matthew J. Weinstock
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Mary Linton B. Peters
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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10
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Dennis LK, Brown HE, Arrington AK. Comparison of Prognostic Factors for Merkel Cell Carcinoma, Mucosal Melanoma and Cutaneous Malignant Melanoma: Insights into Their Etiologies. Curr Oncol 2023; 30:3974-3988. [PMID: 37185414 PMCID: PMC10136436 DOI: 10.3390/curroncol30040301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Little is known about the epidemiology of Merkel cell carcinoma (MCC) and mucosal melanoma (MM). Using the United States (US) National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program data, we compared MCC and MM with cutaneous malignant melanoma (CMM) with respect to incidence rates and prognostic factors to better understand disease etiologies. We describe the proportional incidences of the three cancers along with their survival rates based on 20 years of national data. The incidence rates in 2000–2019 were 203.7 per 1,000,000 people for CMM, 5.9 per 1,000,000 people for MCC and 0.1 per 1,000,000 people for MM. The rates of these cancers increased over time, with the rate of MM tripling between 2000–2009 and 2010–2019. The incidences of these cancers increased with age and rates were highest among non-Hispanic Whites. Fewer MCCs and MMS were diagnosed at the local stage compared with CMM. The cases in the 22 SEER registries in California were not proportional to the 2020 population census but instead were higher than expected for CMM and MCC and lower than expected for MM. Conversely, MM rates were higher than expected in Texas and New York. These analyses highlight similarities in the incidence rates of CMM and MCC—and differences between them and MM rates—by state. Understanding more about MCC and MM is important because of their higher potential for late diagnosis and metastasis, which lead to poor survival.
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Affiliation(s)
- Leslie K. Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Heidi E. Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
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11
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Nagaraj G, Vinayak S, Khaki AR, Sun T, Kuderer NM, Aboulafia DM, Acoba JD, Awosika J, Bakouny Z, Balmaceda NB, Bao T, Bashir B, Berg S, Bilen MA, Bindal P, Blau S, Bodin BE, Borno HT, Castellano C, Choi H, Deeken J, Desai A, Edwin N, Feldman LE, Flora DB, Friese CR, Galsky MD, Gonzalez CJ, Grivas P, Gupta S, Haynam M, Heilman H, Hershman DL, Hwang C, Jani C, Jhawar SR, Joshi M, Kaklamani V, Klein EJ, Knox N, Koshkin VS, Kulkarni AA, Kwon DH, Labaki C, Lammers PE, Lathrop KI, Lewis MA, Li X, de Lima Lopes G, Lyman GH, Makower DF, Mansoor AH, Markham MJ, Mashru SH, McKay RR, Messing I, Mico V, Nadkarni R, Namburi S, Nguyen RH, Nonato TK, O’Connor TL, Panagiotou OA, Park K, Patel JM, Patel KG, Peppercorn J, Polimera H, Puc M, Rao YJ, Razavi P, Reid SA, Riess JW, Rivera DR, Robson M, Rose SJ, Russ AD, Schapira L, Shah PK, Shanahan MK, Shapiro LC, Smits M, Stover DG, Streckfuss M, Tachiki L, Thompson MA, Tolaney SM, Weissmann LB, Wilson G, Wotman MT, Wulff-Burchfield EM, Mishra S, French B, Warner JL, Lustberg MB, Accordino MK, Shah DP. Clinical Characteristics, Racial Inequities, and Outcomes in Patients with Breast Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Cohort Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.09.23287038. [PMID: 37205429 PMCID: PMC10187350 DOI: 10.1101/2023.03.09.23287038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results 1,383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32 - 1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70 - 6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83 - 12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63 - 3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20 - 2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66 - 3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89 - 22.6]). Hispanic ethnicity, timing and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions Using one of the largest registries on cancer and COVID-19, we identified patient and BC related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to Non-Hispanic White patients.
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Affiliation(s)
| | - Shaveta Vinayak
- Fred Hutchinson Cancer Research Center, Seattle, WA
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
| | | | - Tianyi Sun
- Vanderbilt University Medical Center, Nashville, TN
| | - Nicole M. Kuderer
- University of Washington, Seattle, WA
- Advanced Cancer Research Group, Kirkland, WA
| | | | | | - Joy Awosika
- University of Cincinnati Cancer Center, Cincinnati, OH
| | | | | | - Ting Bao
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Babar Bashir
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
| | | | | | | | - Sibel Blau
- Northwest Medical Specialties, Tacoma, WA
| | - Brianne E. Bodin
- Herbert Irving Comprehensive Cancer Center at Columbia University, New York, NY
| | - Hala T. Borno
- UCSF Helen Diller Family Comprehensive Cancer Center at the University of California at San Francisco, San Francisco, CA
| | | | - Horyun Choi
- University of Hawaii Cancer Center, Honolulu, HI
| | | | | | | | | | | | | | - Matthew D. Galsky
- Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Petros Grivas
- Fred Hutchinson Cancer Research Center, Seattle, WA
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
| | | | - Marcy Haynam
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Dawn L. Hershman
- Herbert Irving Comprehensive Cancer Center at Columbia University, New York, NY
| | - Clara Hwang
- Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, MI
| | | | - Sachin R. Jhawar
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Virginia Kaklamani
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX
| | | | - Natalie Knox
- Stritch School of Medicine at Loyola University, Maywood, IL
| | - Vadim S. Koshkin
- UCSF Helen Diller Family Comprehensive Cancer Center at the University of California at San Francisco, San Francisco, CA
| | - Amit A. Kulkarni
- Masonic Cancer Center at the University of Minnesota, Minneapolis, MN
| | - Daniel H. Kwon
- UCSF Helen Diller Family Comprehensive Cancer Center at the University of California at San Francisco, San Francisco, CA
| | | | | | - Kate I. Lathrop
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX
| | | | - Xuanyi Li
- Vanderbilt University Medical Center, Nashville, TN
| | - Gilberto de Lima Lopes
- Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami, FL
| | - Gary H. Lyman
- Fred Hutchinson Cancer Research Center, Seattle, WA
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
| | - Della F. Makower
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | | | - Merry-Jennifer Markham
- University of Florida, Division of Hematology and Oncology, UF Health Cancer Center, Gainesville, FL
| | | | - Rana R. McKay
- Moores Cancer Center, University of California, San Diego, CA
| | - Ian Messing
- Division of Radiation Oncology, George Washington University, Washington, DC
| | - Vasil Mico
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
| | | | | | - Ryan H. Nguyen
- University of Illinois Hospital & Health Sciences System, Chicago, IL
| | | | | | | | - Kyu Park
- Loma Linda University Cancer Center, Loma Linda, CA
| | | | | | | | | | | | - Yuan James Rao
- Division of Radiation Oncology, George Washington University, Washington, DC
| | - Pedram Razavi
- Moores Cancer Center, University of California, San Diego, CA
| | | | - Jonathan W. Riess
- UC Davis Comprehensive Cancer Center at the University of California at Davis, CA
| | - Donna R. Rivera
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, USA
| | - Mark Robson
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Suzanne J. Rose
- Carl & Dorothy Bennett Cancer Center at Stamford Hospital, Stamford, CT
| | - Atlantis D. Russ
- University of Florida, Division of Hematology and Oncology, UF Health Cancer Center, Gainesville, FL
| | | | - Pankil K. Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX
| | | | - Lauren C. Shapiro
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | | | - Daniel G. Stover
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Lisa Tachiki
- Fred Hutchinson Cancer Research Center, Seattle, WA
- University of Washington, Seattle, WA
- Seattle Cancer Care Alliance, Seattle, WA
| | | | | | | | - Grace Wilson
- Masonic Cancer Center at the University of Minnesota, Minneapolis, MN
| | - Michael T. Wotman
- Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | | | | | | | - Dimpy P. Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX
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12
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Ban Y, Hoshi M, Oebisu N, Shimatani A, Takada N, Iwai T, Nakamura H. Impact of the COVID-19 pandemic on bone and soft tissue tumor treatment: A single-institution study. PLoS One 2023; 18:e0283835. [PMID: 37093805 PMCID: PMC10124828 DOI: 10.1371/journal.pone.0283835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/18/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVE The spread of coronavirus disease 2019 (COVID-19) has caused a great deal of damage to daily medical care. We investigated the impact of the COVID-19 pandemic on bone and soft tissue tumor treatment at our hospital. METHODS We conducted a retrospective comparative study of two groups of patients at Osaka City University Hospital during the period of increasing COVID-19 infections (February-December 2020, group C) and the same period the previous year (February- December 2019, group NC). Clinical data, including patient's age, gender, type of tumor, neoplasms, number of surgical cases for inpatients and outpatients, operation time, use of implants, length of hospital stay, inpatient hospital costs, number of inpatients receiving anticancer drugs, and postoperative complications in these two groups were retrospectively evaluated. RESULTS The number of cases of malignant bone and soft tissue tumors that were resected during hospitalization was predominantly higher in group C than in group NC (P = 0.01). There were no significant differences in operation time, use of implants, and postoperative complications between group C and group NC, but there were significant differences in the length of hospital stay and hospital costs (P<0.001). CONCLUSIONS The COVID-19 pandemic has been recognized throughout the world to have adverse effects in a variety of areas. It had a negative impact on hospital costs and the length of hospital stay in the field of bone and soft tissue tumor treatment.
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Affiliation(s)
- Yoshitaka Ban
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Manabu Hoshi
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Naoto Oebisu
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akiyoshi Shimatani
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Naoki Takada
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Iwai
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Ai Y, Wang H, Zheng Q, Li S, Liu J, Huang J, Tang J, Meng X. Add fuel to the fire: Inflammation and immune response in lung cancer combined with COVID-19. Front Immunol 2023; 14:1174184. [PMID: 37033918 PMCID: PMC10076709 DOI: 10.3389/fimmu.2023.1174184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
The corona virus disease 2019 (COVID-19) global pandemic has had an unprecedented and persistent impact on oncological practice, especially for patients with lung cancer, who are more vulnerable to the virus than the normal population. Indeed, the onset, progression, and prognosis of the two diseases may in some cases influence each other, and inflammation is an important link between them. The original chronic inflammatory environment of lung cancer patients may increase the risk of infection with COVID-19 and exacerbate secondary damage. Meanwhile, the acute inflammation caused by COVID-19 may induce tumour progression or cause immune activation. In this article, from the perspective of the immune microenvironment, the pathophysiological changes in the lungs and whole body of these special patients will be summarised and analysed to explore the possible immunological storm, immunosuppression, and immune escape phenomenon caused by chronic inflammation complicated by acute inflammation. The effects of COVID-19 on immune cells, inflammatory factors, chemokines, and related target proteins in the immune microenvironment of tumours are also discussed, as well as the potential role of the COVID-19 vaccine and immune checkpoint inhibitors in this setting. Finally, we provide recommendations for the treatment of lung cancer combined with COVID-19 in this special group.
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Affiliation(s)
- Yanling Ai
- Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hengyi Wang
- Department of Infectious Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiao Zheng
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Songtao Li
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingwen Liu
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ju Huang
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jianyuan Tang
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Jianyuan Tang, ; Xiangrui Meng,
| | - Xiangrui Meng
- Traditional Chinese Medicine (TCM) Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Jianyuan Tang, ; Xiangrui Meng,
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14
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El Majzoub I, Kalot N, Khalifeh M, Estelly N, El Zahran T. "Predictors of in-hospital mortality in adult cancer patients with COVID-19 infection presenting to the emergency department: A retrospective study". PLoS One 2023; 18:e0278898. [PMID: 36701309 PMCID: PMC9879530 DOI: 10.1371/journal.pone.0278898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 11/23/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Adult cancer patients are at higher risk of morbidity and mortality following COVID-19 infection. Being on the front lines, it is crucial for emergency physicians to identify those who are at higher risk of mortality. The aim of our study was to determine the predictors of in-hospital mortality in COVID-19 positive cancer patients who present to the emergency department. METHODS This is a retrospective cohort study conducted on adult cancer patients who presented to the ED of the American university of Beirut medical center from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data was extracted and analyzed. The association between different variables and in-hospital mortality was tested using Student's t test and Fisher's exact test or Pearson's Chi-square where appropriate. Logistic regression was applied to factors with p <0.2 in the univariate models. RESULTS The study included 89 distinct patients with an average age of 66 years (± 13.6). More than half of them were smokers (52.8%) and had received chemotherapy within 1 month of presentation (52.8%). About one third of the patients died (n = 31, 34.8%). Mortality was significantly higher in patients who had recently received chemotherapy (67.7% vs 44.8%, p = .039), a history of congestive heart failure (CHF)(p = .04), higher levels of CRP (p = 0.048) and/or PCT(p<0.04) or were tachypneic in the ED (P = 0.016). CONCLUSIONS Adult cancer patients with COVID-19 infection are at higher risks of mortality if they presented with tachypnea, had a recent chemotherapy, history of CHF, high CRP, and high procalcitonin levels at presentation.
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Affiliation(s)
- Imad El Majzoub
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Kalot
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Malak Khalifeh
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Natalie Estelly
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Tharwat El Zahran
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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Clinical Outcomes in COVID-19 Patients Treated with Immunotherapy. Cancers (Basel) 2022; 14:cancers14235954. [PMID: 36497435 PMCID: PMC9735726 DOI: 10.3390/cancers14235954] [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: 09/06/2022] [Revised: 11/19/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction: The full impact of COVID-19 infections on patients with cancer who are actively being treated with chemotherapy or immune checkpoint inhibitors (ICIs) has not been fully defined. Our goal was to track clinical outcomes in this specific patient population. Methods: We performed a retrospective chart review of 121 patients (age > 18 years) at the University of Alabama at Birmingham from January 2020 to December 2021 with an advanced solid malignancy that were eligible to be treated with ICIs or on current therapy within 12 months of their COVID-19 diagnosis. Results: A total of 121 patients were examined in this study, and 61 (50.4%) received immunotherapy treatment within 12 months. One quarter of the patients on ICIs passed away, compared to 13% of the post-chemotherapy cohort. Patients who were vaccinated for COVID-19 had lower mortality compared to unvaccinated patients (X2 = 15.19, p < 0.001), and patients with lower ECOG (0.98) were associated with lower mortality compared to patients with worse functional status (0.98 vs. 1.52; t = 3.20; p < 0.01). Conclusions: COVID-19-related ICI mortality was higher compared to patients receiving chemotherapy. However, ICI cessation or delay is unwarranted as long there has been a risk−benefit assessment undertaken with the patient.
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16
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Xie R, Zhang Y, Huang Z, Cheng S, Guo J, Zhang Y, Liu M, Zhu X, You Y, Zou P, Chen W, Yan H, Cheng F, Zhong Z. Changes in the medical-seeking pattern and daily behavior of hematopoietic stem-cell transplant recipients during the COVID-19 epidemic: An online survey in Hubei Province, China. Front Public Health 2022; 10:918081. [PMID: 36268003 PMCID: PMC9577240 DOI: 10.3389/fpubh.2022.918081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/12/2022] [Indexed: 01/22/2023] Open
Abstract
Background To curb the spread of the coronavirus disease 2019 (COVID-19) epidemic, the Chinese government shut down Wuhan city from January 23rd to April 8th, 2020. The COVID-19 epidemic not only leads to widespread illness but also affects the diagnosis and treatment of hematopoietic stem-cell transplant (HSCT) recipients. Objective To investigate the medical-seeking pattern and daily behavior changes in Hubei Province during the COVID-19 epidemic in Hubei Province during the lockdown. Methods We conducted a multicenter, cross-sectional, web-based investigation among 325 HSCT recipients by online questionnaires in Hubei Province during the COVID-19 epidemic. Results A total of 145 complete responses were collected both before and during the epidemic questionnaires. The participants from pre-epidemic group preferred to go to hospital (68.29%) when they experienced influenza-like symptoms. The majority of the patients elected to take oral drugs by themselves (40%) or consulted their attending physicians online or by telephone during the lockdown (23.33%). 64.83% had difficulties in purchasing drugs during the lockdown, which was significantly higher than the proportion of the pre-epidemic group (24.83%) (P < 0.05). The participants preferred to purchase drugs online (23.40%) and decrease or withdraw drugs (18.09%) during the epidemic. The number of participants received regular re-examinations during the epidemic decreased sharply. The proportion of wearing masks and isolating themselves at home increased significantly during the epidemic. No statistic difference was observed in the incidence of graft-versus-host disease (GVHD)complications in participants between the during the epidemic group and the pre-epidemic group. In our study, six patients were confirmed to have COVID-19, and half of them died due to COVID-19-related complications. Conclusion The medical-seeking pattern and daily behavior of HSCT recipients changed during the lockdown; the methods of self-protection, online consultation and drug delivery can help patients receive necessary follow-up and reduce the occurrence of COVID-19.
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Affiliation(s)
- Rong Xie
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yicheng Zhang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiping Huang
- Department of Hematology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | - Si Cheng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingming Guo
- Department of Hematology, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China
| | - Youshan Zhang
- Department of Hematology, Jingzhou First People's Hospital and First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Min Liu
- Department of Hematology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | - Xiaojian Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong You
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Zou
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenlan Chen
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Yan
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fanjun Cheng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Fanjun Cheng
| | - Zhaodong Zhong
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Zhaodong Zhong
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17
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Martín M, Vallejo C, López-Campos F, Quereda C, Muñoz T, Sánchez-Conde M, Dominguez JA, Soriano C, Martín M, Suárez-Carantoña C, Muriel A, Garrido P, Acero J, Alvarez-Diaz A, de la Pinta C, Martínez-García L, Hernánz R, Fernández E, Alarza M, Hervás A, Sancho S. SARS-CoV-2 Virus in Cancer Patients: A New Unknown in an Unsolved Equation. Oncology 2022; 101:1-11. [PMID: 36063800 PMCID: PMC9747739 DOI: 10.1159/000525802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/07/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Cancer patients are more susceptible to infections, and infection can be more severe than in patients without cancer diagnosis. We conducted this retrospective study in patients admitted for SARS-CoV-2 infection in order to find differences in inflammatory markers and mortality in cancer patients compared to others. METHODS We reviewed the electronic records of patients admitted for SARS-CoV-2 infection confirmed by PCR from March to September 2020. Data on socio-demographics, comorbidities, inflammatory makers, and cancer-related features were analyzed. RESULTS 2,772 patients were admitted for SARS-CoV-2, to the Hospital Universitario Ramón y Cajal in Madrid during this period. Of these, 2,527 (91%) had no history of neoplastic disease, 164 (5.9%) patients had a prior history of cancer but were not undergoing oncological treatment at the time of infection, and 81 (2.9%) were in active treatment. Mortality in patients without a history of cancer was 19.5%, 28.6% for patients with a prior history of cancer, and 34% in patients with active cancer treatment. Patients in active oncology treatment with the highest mortality rate were those diagnosed with lung cancer (OR 5.6 95% CI: 2.2-14.1). In the multivariate study, active oncological treatment (OR 2.259 95% CI: 1.35-3.77) and chemotherapy treatment (OR 3.624 95% CI: 1.17-11.17), were statistically significant factors for the risk of death for the whole group and for the group with active oncological treatment, respectively. CONCLUSION Cancer patients on active systemic treatment have an increased risk of mortality after SARS-CoV-2 infection, especially with lung cancer or chemotherapy treatment.
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Affiliation(s)
- Margarita Martín
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain,*Margarita Martín,
| | - Carmen Vallejo
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Fernando López-Campos
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Carmen Quereda
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Teresa Muñoz
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Matilde Sánchez-Conde
- Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Cruz Soriano
- Intensive Medicine Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Mercedes Martín
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Alfonso Muriel
- Biostatistics Clinic Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Pilar Garrido
- Médical Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Julio Acero
- Oral and Maxillofacial Surgery Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Ana Alvarez-Diaz
- Pharmacy Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Carolina de la Pinta
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | | | - Raúl Hernánz
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Eva Fernández
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Marina Alarza
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Asunción Hervás
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sonsoles Sancho
- Radiation Oncology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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18
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Bian DJH, Sabri S, Abdulkarim BS. Interactions between COVID-19 and Lung Cancer: Lessons Learned during the Pandemic. Cancers (Basel) 2022; 14:cancers14153598. [PMID: 35892857 PMCID: PMC9367272 DOI: 10.3390/cancers14153598] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary COVID-19 is a respiratory infectious disease caused by the coronavirus SARS-CoV-2. Lung cancer is the leading cause of all cancer-related deaths worldwide. As both SARS-CoV-2 and lung cancer affect the lungs, the aim of this narrative review is to provide a consolidation of lessons learned throughout the pandemic regarding lung cancer and COVID-19. Risk factors found in lung cancer patients, such as advanced cancers, smoking, male, etc., have been associated with severe COVID-19. The cancer treatments hormonal therapy, immunotherapy, and targeted therapy have shown no association with severe COVID-19 disease, but chemotherapy and radiation therapy have shown conflicting results. Logistical changes and modifications in treatment plans were instituted during the pandemic to minimize SARS-CoV-2 exposure while maintaining life-saving cancer care. Finally, medications have been developed to treat early COVID-19, which can be highly beneficial in vulnerable cancer patients, with paxlovid being the most efficacious drug currently available. Abstract Cancer patients, specifically lung cancer patients, show heightened vulnerability to severe COVID-19 outcomes. The immunological and inflammatory pathophysiological similarities between lung cancer and COVID-19-related ARDS might explain the predisposition of cancer patients to severe COVID-19, while multiple risk factors in lung cancer patients have been associated with worse COVID-19 outcomes, including smoking status, older age, etc. Recent cancer treatments have also been urgently evaluated during the pandemic as potential risk factors for severe COVID-19, with conflicting findings regarding systemic chemotherapy and radiation therapy, while other therapies were not associated with altered outcomes. Given this vulnerability of lung cancer patients for severe COVID-19, the delivery of cancer care was significantly modified during the pandemic to both proceed with cancer care and minimize SARS-CoV-2 infection risk. However, COVID-19-related delays and patients’ aversion to clinical settings have led to increased diagnosis of more advanced tumors, with an expected increase in cancer mortality. Waning immunity and vaccine breakthroughs related to novel variants of concern threaten to further impede the delivery of cancer services. Cancer patients have a high risk of severe COVID-19, despite being fully vaccinated. Numerous treatments for early COVID-19 have been developed to prevent disease progression and are crucial for infected cancer patients to minimize severe COVID-19 outcomes and resume cancer care. In this literature review, we will explore the lessons learned during the COVID-19 pandemic to specifically mitigate COVID-19 treatment decisions and the clinical management of lung cancer patients.
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Affiliation(s)
- David J. H. Bian
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada;
| | - Siham Sabri
- Cancer Research Program, Research Institute, McGill University Health Center Glen Site, McGill University, Montreal, QC H4A 3J1, Canada;
| | - Bassam S. Abdulkarim
- Cancer Research Program, Research Institute, and Department of Oncology, Cedars Cancer Center, McGill University Health Center Glen Site, McGill University, Montreal, QC H4A 3J1, Canada
- Correspondence:
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19
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Anastasopoulou A, Gkoufa A, Diamantopoulos P, Kazanas S, Eliadi I, Samarkos M, Gogas H. Clinical course of COVID-19 infection in a melanoma patient treated with nivolumab and bempegaldesleukin: a case report. Immunotherapy 2022; 14:1015-1020. [PMID: 35852114 PMCID: PMC9295713 DOI: 10.2217/imt-2021-0331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The exact impact of immune checkpoint inhibitors in the course and outcome of COVID-19 in cancer patients is currently unclear. Herein, we present the first description of an elderly melanoma patient who developed COVID-19 pneumonia while under treatment with nivolumab and bempegaldesleukin in combination with an investigational PEGylated interleukin (IL-2). We present the clinical characteristics and the laboratory and imaging findings of our patient during the course of COVID-19 pneumonia. Moreover, we discuss the currently available data regarding the mechanism of action of immune checkpoint inhibitors and IL-2 analogs in the treatment of COVID-19. The administration of these agents did not have a negative effect on the outcome of COVID-19 pneumonia in an elderly melanoma patient. Immune checkpoint inhibitors represent a major advance in the treatment of several solid malignancies, including melanoma. Bempegaldesleukin is an investigational PEGylated IL-2 that is being evaluated, in combination with nivolumab, in the management of a variety of cancers. The immunomodulation caused by these agents may also modify the immune response in COVID-19. Currently available data regarding the impact of immune checkpoint inhibitors in reducing the severity of COVID-19 in patients with cancer are mixed, whereas no clinical data are available for bempegaldesleukin. Herein, we report the case of an elderly female melanoma patient who developed COVID-19 pneumonia while under treatment with nivolumab and bempegaldesleukin. The administration of these agents did not have a negative effect on the outcome of COVID-19 pneumonia in our patient.
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Affiliation(s)
- Amalia Anastasopoulou
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Aikaterini Gkoufa
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Panagiotis Diamantopoulos
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Spyridon Kazanas
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Irene Eliadi
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Michael Samarkos
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Helen Gogas
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
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20
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Royo-Cebrecos C, Robert-Montaner Ï, Vilanova D, Bailles E, Serrano-Pons J, Valero O, Buldon JM, Bermudez-de-Castro L, Mahia E, Pujadas J, Cobo F, Piqué JM, Albiol S. Seroprevalence study prior and post vaccination in cancer patients in principality of Andorra (COVONCO study). J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04141-8. [PMID: 35809113 PMCID: PMC10064610 DOI: 10.1007/s00432-022-04141-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND COVID-19 serologic response in patients with cancer may be lower than in the general population and may be influenced by the type of tumor or anticancer treatment. This study aims to analyze serological response prior and after vaccination of COVID-19 within the oncological population in Andorra. We set out to identify risk factors for a higher or lower serological response. PATIENTS AND METHODS Observational, unicentric, prospective cohort study of oncologic patients in Andorra. We calculated the seroprevalence of antibodies against SARS-CoV-2 (May 2020-June 2021) and analyzed the main demographic, oncologic features and factors associated with being seropositive. RESULTS A total of 373 patients were analyzed, mainly with solid tumours (n = 334, 89.5%). At baseline, seroprevalence was 13%, increasing during follow-up to 19%; lower seroprevalence was observed in patients with hematologic malignancies (2.6% vs 14.2%; p = 0.041) and patients receiving biological therapies (0% vs 15%, p = 0.005). In the overall seroprevalence analysis, women (23% vs 11.9%; p = 0.006) and tumour-free patients (p = 0.034) showed higher seroprevalence. The multivariable analysis showed that odds of being seropositive were higher among women (OR: 2.44, 95% CI 1.28-4.64), and patients who underwent surgery (OR: 3.35, 95% CI 1.10-10.20). About 80% of the cohort received at least one dose of COVID-19 vaccination, showing a higher seroprevalence of patients who received ChAdOx1-S than those who received BNT162b2 (24.4% vs 6.4%: p = 0.001). CONCLUSION The seroprevalence of antibodies against SARS-COV-2 in oncologic patients in Andorra was higher among females and patients who received hormonal therapy and surgery while patients with hematologic malignancies and biologic therapies showed lower seropositivity without finding differences in the type of tumour or anticancer treatment.
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Affiliation(s)
- Cristina Royo-Cebrecos
- Department of Internal Medicine, Hospital Nostra Senyora de Meritxell, Andorra Andorra Health Services (SAAS), Av. Fiter i Rosell 1-13, AD700, Escaldes-Engordany, Andorra.
| | - Ïa Robert-Montaner
- University of Nottingham Medical School, Queens Medical Centre, Nottingham, UK
| | | | - Eva Bailles
- Psychology Department, Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
| | - Jordi Serrano-Pons
- Founder of UniversalDoctor: The Digital Global Health Company, Barcelona, Spain
| | - Oliver Valero
- Servei d'Estadística Aplicada, Universitat Autònoma de Barcelona. Cerdanyola del Vallès, Barcelona, Spain
| | - Josep Maria Buldon
- Biostatistics, Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
| | | | - Eva Mahia
- Oncology Department of Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
| | - Jaume Pujadas
- Oncology Department of Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
| | - Francesc Cobo
- Hematology Department of Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
| | | | - Santiago Albiol
- Oncology Department of Hospital Nostra Senyora de Meritxell, SAAS, Escaldes-Engordany, Andorra
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21
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Moghimi M, Jozpanahi M, Khodadadi K, Saeed SP, Pirsaraie SVA, Jalili N. Red cell distribution width, a predictive factor in immunocompromised patients with COVID-19: A comparison retrospective study between cancer and kidney transplant patients. Eur J Transl Myol 2022; 32. [PMID: 35723624 PMCID: PMC9295171 DOI: 10.4081/ejtm.2022.10582] [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: 04/30/2022] [Accepted: 05/21/2022] [Indexed: 12/16/2022] Open
Abstract
We aimed to review the records of cancer and kidney transplant patients of out of 1135 COVID-19 patients, who were referred to our hospital (Valiasr) in Zanjan, from March 16th, 2020, to June 11th, 2020. This was single-center, historical cohort study. Patients were divided into different subgroups and compared of disease outcomes. The only predictor of death was lactate dehydrogenase (LDH). The rate of red cell distribution width (RDW) in patients with active cancer was higher than kidney transplant patients and was statistically significant. There was no statistically significant difference in mortality between active and non-active cancer groups. Female sex and low SpO2 has increased the chances of ICU admission. Patients with active cancer generally have severe and more complicated disease and RDW can be a predictable option.
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Affiliation(s)
- Minoosh Moghimi
- Department of Internal Medicine, Zanjan University of Medical Sciences, Zanjan.
| | - Manijeh Jozpanahi
- Department of Infectious Disease, Zanjan University of Medical Sciences, Zanjan.
| | - Kasra Khodadadi
- Department of Internal Medicine, Zanjan University of Medical Sciences, Zanjan.
| | | | | | - Nooshin Jalili
- Department of Internal Medicine, Zanjan University of Medical Sciences, Zanjan.
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22
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Naimi A, Yashmi I, Jebeleh R, Imani Mofrad M, Azimian Abhar S, Jannesar Y, Heidary M, Pakzad R. Comorbidities and mortality rate in COVID-19 patients with hematological malignancies: A systematic review and meta-analysis. J Clin Lab Anal 2022; 36:e24387. [PMID: 35385130 PMCID: PMC9102765 DOI: 10.1002/jcla.24387] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The global pandemic of coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It seems that there is an association between blood cancer and an increased risk of severe COVID-19. This study aimed to review the literature reporting the COVID-19 outcomes in patients with hematological malignancies. MATERIAL AND METHODS In this systematic review and meta-analysis, Pubmed, Embase, and Web of Science databases were searched using the following keywords: COVID-19, SARS-CoV-2, blood cancer, myeloma, lymphoma, and leukemia. All the published articles in English from January 1, 2019, until March 10, 2021 were collected and evaluated. RESULTS In total, 53 studies with 2395 patients were included based on inclusion criteria. Most of these studies took place in Spain (14.81%), followed by the USA (11.11%), China (9.26%), and the UK (9.26%). More than half of COVID-19 patients with hematological malignancy were male (56.73%). Oxygen therapy played an important role in COVID-19 treatment. Moreover, anticoagulant therapies such as enoxaparin and heparin were two great assists for these patients. Fever (74.24%), cough (67.64%), and fatigue (53.19%) were the most reported clinical manifestations. In addition, hypertension and dyslipidemia were the most common comorbidities. The mortality rate due to COVID-19 in patients with hematological malignancies was 21.34%. CONCLUSION This study demonstrated that hematologic cancer patients were more susceptible to a severe COVID-19 than patients without blood cancer. Thus, the management of COVID-19 in these patients requires much more attention, and their screening should perform regularly.
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Affiliation(s)
- Adel Naimi
- Cellular and Molecular Research CenterSabzevar University of Medical SciencesSabzevarIran
| | - Ilya Yashmi
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | - Reza Jebeleh
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | | | | | - Yasaman Jannesar
- Student Research CommitteeSabzevar University of Medical SciencesSabzevarIran
| | - Mohsen Heidary
- Cellular and Molecular Research CenterSabzevar University of Medical SciencesSabzevarIran
- Department of Laboratory SciencesSchool of Paramedical SciencesSabzevar University of Medical SciencesSabzevarIran
| | - Reza Pakzad
- Department of EpidemiologyFaculty of HealthIlam University of Medical SciencesIlamIran
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23
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Immunopathogenesis of patients with COVID-19: from the perspective of immune system 'evolution' and 'revolution'. Expert Rev Mol Med 2022; 24:e19. [PMID: 35535759 PMCID: PMC9884756 DOI: 10.1017/erm.2022.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The pandemic caused by severe acute respiratory syndrome coronavirus 2 is sweeping the world, threatening millions of lives and drastically altering our ways of living. According to current studies, failure to either activate or eliminate inflammatory responses timely and properly at certain stages could result in the progression of the disease. In other words, robust immune responses to coronavirus disease 2019 (COVID-19) are critical. However, they do not theoretically present in some special groups of people, including the young, the aged, patients with autoimmunity or cancer. Differences also do occur between men and women. Our immune system evolves to ensure delicate coordination at different stages of life. The innate immune cells mainly consisted of myeloid lineage cells, including neutrophils, basophils, eosinophils, dendritic cells and mast cells; they possess phagocytic capacity to different degrees at different stages of life. They are firstly recruited upon infection and may activate the adaptive immunity when needed. The adaptive immune cells, on the other way, are comprised mainly of lymphoid lineages. As one grows up, the adaptive immunity matures and expands its memory repertoire, accompanied by an adjustment in quantity and quality. In this review, we would summarise and analyse the immunological characteristics of these groups from the perspective of the immune system 'evolution' as well as 'revolution' that has been studied and speculated so far, which would aid the comprehensive understanding of COVID-19 and personalised-treatment strategy.
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24
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Lee M, Quinn R, Pradhan K, Fedorov K, Levitz D, Fromowitz A, Thakkar A, Shapiro LC, Kabarriti R, Ruiz RE, Andrews EM, Thota R, Chu E, Kalnicki S, Goldstein Y, Loeb D, Racine A, Halmos B, Mehta V, Verma A. Impact of COVID-19 on case fatality rate of patients with cancer during the Omicron wave. Cancer Cell 2022; 40:343-345. [PMID: 35219358 PMCID: PMC8860706 DOI: 10.1016/j.ccell.2022.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Matthew Lee
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ryann Quinn
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kith Pradhan
- Department of Epidemiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kateryna Fedorov
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Levitz
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ariel Fromowitz
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Astha Thakkar
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lauren C Shapiro
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rafi Kabarriti
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; MECC Cancer Therapeutics Program, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rafael E Ruiz
- Department of Network Performance Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Erin M Andrews
- Department of Network Performance Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Raja Thota
- Department of Network Performance Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Edward Chu
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA; MECC Cancer Therapeutics Program, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Shalom Kalnicki
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; MECC Cancer Therapeutics Program, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yitz Goldstein
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Loeb
- Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrew Racine
- Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Balazs Halmos
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA; MECC Cancer Therapeutics Program, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Vikas Mehta
- Department of Otolaryngology and Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; MECC Cancer Epidemiology Prevention and Control Program, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Amit Verma
- Department of Oncology, Montefiore Medical Center, Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA; MECC Stem Cell Cancer Biology Program Montefiore Einstein Cancer Center (MECC), Albert Einstein College of Medicine, Bronx, NY, USA.
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25
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Al-Mozaini MA, Islam M, Noman ASM, Karim AR, Farhat WA, Yeger H, Islam SS. Decline in Respiratory Functions in Hospitalized SARS-CoV-2 Infected Cancer Patients Following Cytotoxic Chemotherapy-An Additional Risk for Post-chemotherapy Complications. Front Med (Lausanne) 2022; 9:835098. [PMID: 35360723 PMCID: PMC8960442 DOI: 10.3389/fmed.2022.835098] [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: 12/24/2021] [Accepted: 02/11/2022] [Indexed: 01/08/2023] Open
Abstract
Background Patients recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection demonstrate impaired lung function and those requiring chemotherapy after recovering from SARS-CoV-2 infection have yet to be explored. In this study, we sought to investigate the possible pulmonary functional changes during and after administering chemotherapy in patients with prior SARS-CoV-2 infection. Methods In this study, a total of 37 SARS-CoV-2 infected patients with cancer who were discharged from hospital and received subsequent cytotoxic chemotherapy were enrolled and prospectively followed-up. The following parameters were prospectively measured before (P1), after first chemotherapy cycle (P2), and 10 weeks after the end of chemotherapy (P3), to assess their impact on respiratory complications in terms of diffusion capacity of the lungs for carbon monoxide (DLCO), forced expiratory volume in 1-s (FEV1), forced vital capacity (FVC), 6-min walking distance (6MWD) test and levels of key inflammatory markers. Results All patients completed at least 2 cycles of chemotherapy without showing overt respiratory complications. Six patients (16%) complained about dyspnea during chemotherapy or at follow-up period. DLCO was significantly impaired during follow-up period [from P1 78 to P3 60% of predicted values; interquartile range (IQR) 55–89] and in 32 of 37 (86% of patients) from P1 to P2 (65% of predictive value; IQR 58–70; p < 0.001). Several patients experienced post-chemotherapy respiratory complications. As expected, all patients from control groups showed persistent improved pulmonary functions. Conclusion The risk of pulmonary impairments due to cytotoxic chemotherapy in prior SARS-CoV-2 infected patients is linked to the loss of DLCO. Accordingly, we recommend that for patients with cancer requiring chemotherapy after recovering from prior SARS-CoV-2 infection, pulmonary tests to be performed routinely before and during chemotherapy treatment to monitor the pulmonary performance.
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Affiliation(s)
- Maha Ahmed Al-Mozaini
- Department of Infectious Disease and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mihyar Islam
- Department of Medicine, Parkview Hospital, Chittagong, Bangladesh
| | - Abu Shadat M Noman
- Department Biochemistry and Molecular Biology, University of Chittagong, Chittagong, Bangladesh
| | - Atm Rezaul Karim
- Department of Medicine, Parkview Hospital, Chittagong, Bangladesh
| | - Walid A Farhat
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Herman Yeger
- Developmental and Stem Cell Biology, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Syed S Islam
- Department of Molecular Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,School of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
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26
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Bungaro M, Passiglia F, Scagliotti GV. COVID-19 and Lung Cancer: A Comprehensive Overview from Outbreak to Recovery. Biomedicines 2022; 10:776. [PMID: 35453526 PMCID: PMC9027516 DOI: 10.3390/biomedicines10040776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Lung cancer patients have been associated with an increased risk of COVID-19 infection, pulmonary complications, and worse survival outcomes compared to the general population. The world's leading professional organizations provided new recommendations for the diagnosis, treatment, and follow-up of lung cancer patients during the pandemic as a guide for prioritizing cancer care issues. Telemedicine was preferred for non-urgent consultations, and screening programs were temporarily suspended, leading to possible diagnostic delays along with an estimated increase in cause-specific mortality. A vaccine campaign has recently emerged as the main weapon to fight the COVID-19 pandemic, inverting this negative trend. This work aims to provide a comprehensive overview of the epidemiology and immune-pathophysiology of SARS-CoV-2 infection in cancer patients, highlighting the most relevant changes in the clinical management of lung cancer patients during the pandemic.
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Affiliation(s)
| | - Francesco Passiglia
- Department of Oncology, University of Turin, San Luigi Hospital, 10043 Orbassano, Italy; (M.B.); (G.V.S.)
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27
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Cao C, Gan X, Hu X, Su Y, Zhang Y, Peng X. Association of active immunotherapy with outcomes in cancer patients with COVID-19: a systematic review and meta-analysis. Aging (Albany NY) 2022; 14:2062-2080. [PMID: 35271463 PMCID: PMC8954969 DOI: 10.18632/aging.203945] [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: 11/13/2021] [Accepted: 01/25/2022] [Indexed: 02/05/2023]
Abstract
Background: During the COVID-19 pandemic, there are growing concerns about the safety of administering immunotherapy in cancer patients with COVID-19. However, current clinical guidelines provided no clear recommendation. Methods: Studies were searched and retrieved from electronic databases. The meta-analysis was performed by employing the generic inverse-variance method. A random-effects model was used to calculate the unadjusted odds ratios (ORs) and adjusted ORs with the corresponding 95% CIs. Results: This meta-analysis included 20 articles with 6,042 cancer patients diagnosed with COVID-19. According to the univariate analysis, the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the mortality of cancer patients (OR: 0.92; 95% CI: 0.68-1.25; P=0.61). Moreover, after adjusting for confounders, the adjusted OR for mortality was 0.51, with borderline significance (95% CI: 0.25-1.01; P=0.053). Similarly, the univariate analysis showed that the acceptance of immunotherapy within 30 days before COVID-19 diagnosis did not increase the risk of severe/critical disease in cancer patients (OR: 1.07; 95% CI: 0.78-1.47; P=0.66). No significant between-study heterogeneity was found in these analyses. Conclusions: Accepting immunotherapy within 30 days before the diagnosis of COVID-19 was not significantly associated with a higher risk of mortality or severe/critical disease of infected cancer patients. Further prospectively designed studies with large sample sizes are required to evaluate the present results.
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Affiliation(s)
- Chang Cao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology/Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Xinyan Gan
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology/Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Yonglin Su
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Yu Zhang
- Affiliated Hospital of Chengdu University, Chengdu 610041, Sichuan, P.R. China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R. China
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28
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Riise J, Meyer S, Blaas I, Chopra A, Tran TT, Delic-Sarac M, Hestdalen ML, Brodin E, Rustad EH, Dai KZ, Vaage JT, Nissen-Meyer LSH, Sund F, Wader KF, Bjornevik AT, Meyer PA, Nygaard GO, König M, Smeland S, Lund-Johansen F, Olweus J, Kolstad A. Rituximab-treated lymphoma patients develop strong CD8 T-cell responses following COVID-19 vaccination. Br J Haematol 2022; 197:697-708. [PMID: 35254660 PMCID: PMC9111866 DOI: 10.1111/bjh.18149] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/25/2022] [Accepted: 03/05/2022] [Indexed: 11/29/2022]
Abstract
B‐cell depletion induced by anti‐cluster of differentiation 20 (CD20) monoclonal antibody (mAb) therapy of patients with lymphoma is expected to impair humoral responses to severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) vaccination, but effects on CD8 T‐cell responses are unknown. Here, we investigated humoral and CD8 T‐cell responses following two vaccinations in patients with lymphoma undergoing anti‐CD20‐mAb therapy as single agent or in combination with chemotherapy or other anti‐neoplastic agents during the last 9 months prior to inclusion, and in healthy age‐matched blood donors. Antibody measurements showed that seven of 110 patients had antibodies to the receptor‐binding domain of the SARS‐CoV‐2 Spike protein 3–6 weeks after the second dose of vaccination. Peripheral blood CD8 T‐cell responses against prevalent human leucocyte antigen (HLA) class I SARS‐CoV‐2 epitopes were determined by peptide‐HLA multimer analysis. Strong CD8 T‐cell responses were observed in samples from 20/29 patients (69%) and 12/16 (75%) controls, with similar median response magnitudes in the groups and some of the strongest responses observed in patients. We conclude that despite the absence of humoral immune responses in fully SARS‐CoV‐2‐vaccinated, anti‐CD20‐treated patients with lymphoma, their CD8 T‐cell responses reach similar frequencies and magnitudes as for controls. Patients with lymphoma on B‐cell depleting therapies are thus likely to benefit from current coronavirus disease 2019 (COVID‐19) vaccines, and development of vaccines aimed at eliciting T‐cell responses to non‐Spike epitopes might provide improved protection.
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Affiliation(s)
- Jon Riise
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Saskia Meyer
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Isaac Blaas
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Adity Chopra
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Trung T Tran
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Marina Delic-Sarac
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Malu Lian Hestdalen
- Department of Hematology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ellen Brodin
- Hematological Research Group, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Even Holth Rustad
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Hematological Research Group, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ke-Zheng Dai
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - John Torgils Vaage
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Immunology, Oslo University Hospital, Oslo, Norway
| | | | - Fredrik Sund
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Karin F Wader
- Department of Oncology, St Olav University Hospital, Trondheim, Norway
| | - Anne T Bjornevik
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Peter A Meyer
- Department of Oncology and Hematology, Stavanger University Hospital, Stavanger, Norway
| | - Gro O Nygaard
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Marton König
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Sigbjørn Smeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Fridtjof Lund-Johansen
- Department of Immunology, Oslo University Hospital, Oslo, Norway.,ImmunoLingo Convergence Center, University of Oslo, Oslo, Norway
| | - Johanna Olweus
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Arne Kolstad
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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29
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Aghamirza Moghim Aliabadi H, Eivazzadeh‐Keihan R, Beig Parikhani A, Fattahi Mehraban S, Maleki A, Fereshteh S, Bazaz M, Zolriasatein A, Bozorgnia B, Rahmati S, Saberi F, Yousefi Najafabadi Z, Damough S, Mohseni S, Salehzadeh H, Khakyzadeh V, Madanchi H, Kardar GA, Zarrintaj P, Saeb MR, Mozafari M. COVID-19: A systematic review and update on prevention, diagnosis, and treatment. MedComm (Beijing) 2022; 3:e115. [PMID: 35281790 PMCID: PMC8906461 DOI: 10.1002/mco2.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 01/09/2023] Open
Abstract
Since the rapid onset of the COVID-19 or SARS-CoV-2 pandemic in the world in 2019, extensive studies have been conducted to unveil the behavior and emission pattern of the virus in order to determine the best ways to diagnosis of virus and thereof formulate effective drugs or vaccines to combat the disease. The emergence of novel diagnostic and therapeutic techniques considering the multiplicity of reports from one side and contradictions in assessments from the other side necessitates instantaneous updates on the progress of clinical investigations. There is also growing public anxiety from time to time mutation of COVID-19, as reflected in considerable mortality and transmission, respectively, from delta and Omicron variants. We comprehensively review and summarize different aspects of prevention, diagnosis, and treatment of COVID-19. First, biological characteristics of COVID-19 were explained from diagnosis standpoint. Thereafter, the preclinical animal models of COVID-19 were discussed to frame the symptoms and clinical effects of COVID-19 from patient to patient with treatment strategies and in-silico/computational biology. Finally, the opportunities and challenges of nanoscience/nanotechnology in identification, diagnosis, and treatment of COVID-19 were discussed. This review covers almost all SARS-CoV-2-related topics extensively to deepen the understanding of the latest achievements (last updated on January 11, 2022).
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Affiliation(s)
- Hooman Aghamirza Moghim Aliabadi
- Protein Chemistry LaboratoryDepartment of Medical BiotechnologyBiotechnology Research CenterPasteur Institute of IranTehranIran
- Advance Chemical Studies LaboratoryFaculty of ChemistryK. N. Toosi UniversityTehranIran
| | | | - Arezoo Beig Parikhani
- Department of Medical BiotechnologyBiotechnology Research CenterPasteur InstituteTehranIran
| | | | - Ali Maleki
- Department of ChemistryIran University of Science and TechnologyTehranIran
| | | | - Masoume Bazaz
- Department of Medical BiotechnologyBiotechnology Research CenterPasteur InstituteTehranIran
| | | | | | - Saman Rahmati
- Department of Medical BiotechnologyBiotechnology Research CenterPasteur InstituteTehranIran
| | - Fatemeh Saberi
- Department of Medical BiotechnologySchool of Advanced Technologies in MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Zeinab Yousefi Najafabadi
- Department of Medical BiotechnologySchool of Advanced Technologies in MedicineTehran University of Medical SciencesTehranIran
- ImmunologyAsthma & Allergy Research InstituteTehran University of Medical SciencesTehranIran
| | - Shadi Damough
- Department of Medical BiotechnologyBiotechnology Research CenterPasteur InstituteTehranIran
| | - Sara Mohseni
- Non‐metallic Materials Research GroupNiroo Research InstituteTehranIran
| | | | - Vahid Khakyzadeh
- Department of ChemistryK. N. Toosi University of TechnologyTehranIran
| | - Hamid Madanchi
- School of MedicineSemnan University of Medical SciencesSemnanIran
- Drug Design and Bioinformatics UnitDepartment of Medical BiotechnologyBiotechnology Research CenterPasteur Institute of IranTehranIran
| | - Gholam Ali Kardar
- Department of Medical BiotechnologySchool of Advanced Technologies in MedicineTehran University of Medical SciencesTehranIran
- ImmunologyAsthma & Allergy Research InstituteTehran University of Medical SciencesTehranIran
| | - Payam Zarrintaj
- School of Chemical EngineeringOklahoma State UniversityStillwaterOklahomaUSA
| | - Mohammad Reza Saeb
- Department of Polymer TechnologyFaculty of ChemistryGdańsk University of TechnologyGdańskPoland
| | - Masoud Mozafari
- Department of Tissue Engineering & Regenerative MedicineIran University of Medical SciencesTehranIran
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30
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Najjar M, Albuaini S, Fadel M, Aljbawi A, Mohsen F, Sulaiman S, Koudsi A. COVID-19 Disease in Syrian Patients With Cancer: Clinical Manifestations, Laboratory Findings, Treatment, and Outcomes. JCO Glob Oncol 2022; 8:e2100283. [PMID: 35230875 PMCID: PMC8887951 DOI: 10.1200/go.21.00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/16/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This study aims to describe the clinical manifestations, laboratory findings, treatment, and outcomes of patients with cancer with COVID-19 infection in Syria. The primary objective was to identify the overall survival (OS) time, and the secondary objectives were to identify factors associated with severe COVID-19 infection. METHODS This multicenter retrospective study was undertaken at four hospitals in Damascus, Syria, between March 28, 2020, and March 29, 2021. Data extracted from medical records included clinical manifestations, radiologic findings, laboratory results, treatment, and outcomes. Survival analysis was done by using the Kaplan-Meier method and Cox regression model for follow-up and anticancer treatment patients to study the effect on OS time. The effects of potential risk factors of developing severe COVID-19 were studied by multivariable logistic regression. RESULTS Of 114 patients included, 61 (53.51%) were male. Smokers represented 29 (25.44%), and 63 (55.26%) patients had a history of coexisting chronic diseases. The most common cancer type was breast cancer 17 (14.91%). Sixty-eight (59.65%) patients were receiving anticancer treatment within 1 month of being diagnosed with COVID-19 infection and 46 (40.35%) were outpatient follow-ups. Multiple logistic regression analysis showed that comorbidities (odds ratio: 2.814, P = .044) and anticancer treatment (odds ratio: 8.790, P < .05) were risk factors linked to severe to critical COVID-19 infection. OS time was 245 (95% CI, 217.96 to 272.47) days, lower among patients with cancer with COVID-19 infection receiving anticancer treatment compared with follow-up patients (P value < .05). CONCLUSION Patients with cancer with COVID-19 infection receiving anticancer treatment had a lower OS time. It may be worth considering stopping anticancer treatment in patients with cancer with COVID-19 when possible in search of better outcomes.
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Affiliation(s)
- Michel Najjar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Sara Albuaini
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Mohammad Fadel
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Ahmed Aljbawi
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Seham Sulaiman
- Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
- Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Abir Koudsi
- Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria
- Department of Family and Community Medicine, Faculty of Medicine, Syrian Private University, Damascus, Syria
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31
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Al-Omari A, Al-Rawashdeh N, Damsees R, Ammar K, Alananzeh I, Inserat B, Al-Rimawi D, Tbayshat S, Ababneh H, Alishreim H, Abu Serhan H, Al-Noaaimi F, Abdel-Razeq H. Supportive Care Needs Assessment for Cancer Survivors at a Comprehensive Cancer Center in the Middle East: Mending the Gap. Cancers (Basel) 2022; 14:1002. [PMID: 35205749 PMCID: PMC8870293 DOI: 10.3390/cancers14041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cancer survivors are often underprepared for what to expect post-treatment, and there are knowledge gaps regarding cancer survivors' supportive care needs in Jordan and neighboring Arab countries. This study aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, and explore predictors of unmet needs. METHODS This was an observational cross-sectional study using a modified version of the Supportive Care Needs Survey 34 item short form (SCNS-SF34). RESULTS Two hundred and forty adult cancer survivors completed the study questionnaire. The assessed needs were highest in the financial domain, including covering living expenses, managing cancer treatment adverse effects and co-morbidities. The least prevalent reported needs were in sexuality and reproductive consultations. Late-stage diagnosis was independently associated with higher physical, psychological, health system/information, financial and overall need scores, with p-values of 0.032, 0.027, 0.052, 0.002 and 0.024, respectively. The overall quality of life score was independently and inversely associated with physical, psychological, health system/information, financial and overall need domains, with p-values of 0.015, <0.0001, 0.015, 0.004 and 0.0003, respectively. CONCLUSIONS This needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population, and understanding these findings highlights opportunities for intervention to address gaps in care.
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Affiliation(s)
- Amal Al-Omari
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Nedal Al-Rawashdeh
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Rana Damsees
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Khawlah Ammar
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia;
| | - Bayan Inserat
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Dalia Al-Rimawi
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Shrouq Tbayshat
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan; (S.T.); (H.A.-R.)
| | - Hazim Ababneh
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Haneen Alishreim
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Hashem Abu Serhan
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Faisal Al-Noaaimi
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan; (N.A.-R.); (R.D.); (K.A.); (B.I.); (D.A.-R.); (H.A.); (H.A.); (H.A.S.); (F.A.-N.)
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan; (S.T.); (H.A.-R.)
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32
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Lafarge A, Mabrouki A, Yvin E, Bredin S, Binois Y, Clere-Jehl R, Azoulay E. Coronavirus disease 2019 in immunocompromised patients: a comprehensive review of coronavirus disease 2019 in hematopoietic stem cell recipients. Curr Opin Crit Care 2022; 28:83-89. [PMID: 34813523 PMCID: PMC8711307 DOI: 10.1097/mcc.0000000000000907] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Immunocompromised patients are notably vulnerable to severe coronavirus disease 2019. This review summarizes COVID-19 features and outcomes in autologous and allogeneic hematopoietic stem cell transplantation (HSCT) recipients. RECENT FINDINGS Recent findings suggest that HSCT recipients exhibit a high burden of comorbidities and COVID-19 clinical features almost similar to the general COVID population. Furthermore, HSCT recipients exhibit a protracted SARS-CoV-2 shedding, prolonging duration of symptoms and promoting the generation of highly mutated viruses. Last, most of studies report a higher COVID-19 mortality in HSCT recipients, mainly driven by age, comorbidities, time from transplantation, and immunosuppression because of both treatments and underlying hematological malignancy. SUMMARY Further studies are warranted to determine the proper impact of HSCT-related immune disorders on COVID-19 outcomes, and to evaluate specific treatments and vaccination strategy in this high-risk population. Taken together, those findings emphasize the need for more rigorous surveillance and preemptive measures for all HSCT recipients.
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Affiliation(s)
- Antoine Lafarge
- Medical Intensive Care Unit, Saint Louis Hospital, Assistance Publique Hôpitaux de Paris (APHP), University de Paris, Paris, France
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Dennis LK, Hsu CH, Arrington AK. Reduction in Standard Cancer Screening in 2020 throughout the U.S. Cancers (Basel) 2021; 13:cancers13235918. [PMID: 34885028 PMCID: PMC8656505 DOI: 10.3390/cancers13235918] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/20/2022] Open
Abstract
Cancer screening is an important way to reduce the burden of cancer. The COVID-19 pandemic created delays in screening with the potential to increase cancer disparities in the United States (U.S.). Data from the 2014-2020 Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed to estimate the percentages of adults who reported cancer screening in the last 12 months consistent with the U.S. Preventive Services Task Force (USPSTF) recommendation for cervical (ages 21-65), breast (ages 50-74), and colorectal cancer (ages 50-75) prior to the pandemic. Cancer screening percentages for 2020 (April-December excluding January-March) were compared to screening percentages for 2014-2019 to begin to look at the impact of the COVID-19 pandemic. Screening percentages for 2020 were decreased from those for 2014-2019 including several underserved racial groups. Decreases in mammography and colonoscopy or sigmoidoscopy were higher among American Indian/Alaskan Natives, Hispanics, and multiracial participants, but decreases in pap test were also highest among Hispanics, Whites, Asians, and African-Americans/Blacks. Decreases in mammograms among women ages 40-49 were also seen. As the 2020 comparison is conservative, the 2021 decreases in cancer screening are expected to be much greater and are likely to increase cancer disparities substantially.
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Affiliation(s)
- Leslie K. Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, Tucson, AZ 85724, USA;
- Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
- Correspondence:
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- University of Arizona Cancer Center, Tucson, AZ 85724, USA;
| | - Amanda K. Arrington
- University of Arizona Cancer Center, Tucson, AZ 85724, USA;
- Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA
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Chavez-MacGregor M, Lei X, Zhao H, Scheet P, Giordano SH. Evaluation of COVID-19 Mortality and Adverse Outcomes in US Patients With or Without Cancer. JAMA Oncol 2021; 8:69-78. [PMID: 34709356 PMCID: PMC8554684 DOI: 10.1001/jamaoncol.2021.5148] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance As the COVID-19 pandemic continues, understanding the clinical outcomes of patients with cancer and COVID-19 has become critically important. Objective To compare the outcomes of patients with or without cancer who were diagnosed with COVID-19 and to identify the factors associated with mortality, mechanical ventilation, intensive care unit (ICU) stay, and hospitalization. Design, Setting, and Participants This cohort study obtained data from the Optum de-identified COVID-19 electronic health record data set. More than 500 000 US adults who were diagnosed with COVID-19 from January 1 to December 31, 2020, were analyzed. Exposures The patient groups were (1) patients without cancer, (2) patients with no recent cancer treatment, and (3) patients with recent cancer treatment (within 3 months before COVID-19 diagnosis) consisting of radiation therapy or systemic therapy. Main Outcomes and Measures Mortality, mechanical ventilation, ICU stay, and hospitalization within 30 days of COVID-19 diagnosis were the main outcomes. Unadjusted rates and adjusted odds ratios (ORs) of adverse outcomes were presented according to exposure group. Results A total of 507 307 patients with COVID-19 were identified (mean [SD] age, 48.4 [18.4] years; 281 165 women [55.4%]), of whom 493 020 (97.2%) did not have cancer. Among the 14 287 (2.8%) patients with cancer, 9991 (69.9%) did not receive recent treatment and 4296 (30.1%) received recent treatment. In unadjusted analyses, patients with cancer, regardless of recent treatment received, were more likely to have adverse outcomes compared with patients without cancer (eg, mortality rate: 1.6% for patients without cancer, 5.0% for patients with no recent cancer treatment, and 7.8% for patients with recent cancer treatment). After adjustment, patients with no recent cancer treatment had similar or better outcomes than patients without cancer (eg, mortality OR, 0.93 [95% CI, 0.84-1.02]; mechanical ventilation OR, 0.61 [95% CI, 0.54-0.68]). In contrast, a higher risk of death (OR, 1.74; 95% CI, 1.54-1.96), ICU stay (OR, 1.69; 95% CI, 1.54-1.87), and hospitalization (OR, 1.19; 95% CI, 1.11-1.27) was observed in patients with recent cancer treatment. Compared with patients with nonmetastatic solid tumors, those with metastatic solid tumors and hematologic malignant neoplasms had worse outcomes (eg, mortality OR, 2.36 [95% CI, 1.96-2.84]; mechanical ventilation OR, 0.87 [95% CI, 0.70-1.08]). Recent chemotherapy and chemoimmunotherapy were also associated with worse outcomes (eg, chemotherapy mortality OR, 1.84 [95% CI, 1.51-2.26]). Conclusions and Relevance This cohort study found that patients with recent cancer treatment and COVID-19 had a significantly higher risk of adverse outcomes, and patients with no recent cancer treatment had similar outcomes to those without cancer. The findings have risk stratification and resource use implications for patients, clinicians, and health systems.
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Affiliation(s)
- Mariana Chavez-MacGregor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston.,Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Xiudong Lei
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston
| | - Hui Zhao
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston
| | - Paul Scheet
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sharon H Giordano
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston.,Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
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Handa M, Beg S, Shukla R, Barkat MA, Choudhry H, Singh KK. Recent advances in lipid-engineered multifunctional nanophytomedicines for cancer targeting. J Control Release 2021; 340:48-59. [PMID: 34695523 DOI: 10.1016/j.jconrel.2021.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/12/2022]
Abstract
Cancer is a leading cause of death in many countries around the world. However, the efficacy of current treatments available for variety of cancers is considered to be suboptimal due to the pathophysiological challenges associated with the disease which limits the efficacy of the anticancer drugs. Moreover, the vulnerability towards off-target effects and high toxicity also limits the use of drugs for the treatment of cancers. Besides, the biopharmaceutical challenges like poor water solubility and permeability of the drugs, along with the absence of active targeting capability further decreases the utility of drugs in cancer therapy. As a result of these deficiencies, the current therapeutic strategies face noncompliance to patients for providing meaningful benefits after administration. With the advancements in nanotechnology, there has been a paradigm shift in the modalities for cancer treatment with the help of phytomedicine-based nanosized drug delivery systems coupled with variegated surface-engineering strategies for targeted drug delivery. Among these delivery systems, lipid-based nanoparticles are considered as one of the highly biocompatible, efficient and effective systems extensively explored for anticancer drug delivery. These include diverse range of systems including liposomes, nanoemulsions, solid lipid nanoparticles, nanostructured lipidic carriers and supramolecular carriers, which alters pharmacokinetic and biodistribution of the drugs for active targeting to the desired site of action by overcoming the biopharmaceutical challenges associated with anticancer drug delivery. The present review endeavours to provide a comprehensive account on the recent advances in the application of lipid-based nanostructured systems for improving the pharmacotherapeutic performance of phytomedicines for cancer targeting application.
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Affiliation(s)
- Mayank Handa
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow 226002, U.P., India
| | - Sarwar Beg
- School of Pharmacy and Biomedical Sciences, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK; Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi 110062, India.
| | - Rahul Shukla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow 226002, U.P., India.
| | - Md Abul Barkat
- Department of Pharmaceutics, College of Pharmacy, University of Hafr Al Batin, Al Jamiah, Hafr Al Batin 39524, Saudi Arabia
| | - Hani Choudhry
- Department of Biochemistry, Cancer Metabolism & Epigenetic Unit, Faculty of Science, King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kamalinder K Singh
- School of Pharmacy and Biomedical Sciences, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK.
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Risk stratification by anamnesis increases SARS-CoV-2 test efficiency in cancer patients. Strahlenther Onkol 2021; 198:354-360. [PMID: 34618171 PMCID: PMC8494759 DOI: 10.1007/s00066-021-01853-7] [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: 06/06/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To evaluate the impact of testing asymptomatic cancer patients, we analyzed all tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) before and during radiotherapy at a tertiary cancer center throughout the second wave of the pandemic in Germany. Methods Results of all real-time polymerase chain reaction (RT-PCR) tests for SARS-CoV‑2 performed at our radio-oncology department between 13 October 2020 and 11 March 2021 were included. Clinical data and anamnestic information at the time of testing were documented and examined for (i) the presence of COVID-19-related symptoms and (ii) virus-related anamnesis (high-risk [prior positive test or contact to a positive tested person within the last 14 days] or low-risk [inconspicuous anamnesis within the last 14 days]). Results A total of 1056 SARS-CoV‑2 tests in 543 patients were analyzed. Of those, 1015 tests were performed in asymptomatic patients and 41 tests in patients with COVID-19-associated symptoms. Two of 940 (0.2%) tests in asymptomatic patients with low-risk anamnesis and three of 75 (4.0%) tests in asymptomatic patients with high-risk anamnesis showed a positive result. For symptomatic patients, SARS-CoV‑2 was detected in three of 36 (8.3%) low-risk and three of five (60.0%) high-risk tests. Conclusion To the best of our knowledge, this is the first study evaluating the correlation between individual risk factors and positivity rates of SARS-CoV‑2 tests in cancer patients. The data demonstrate that clinical and anamnestic assessment is a simple and effective measure to distinctly increase SARS-CoV‑2 test efficiency. This might enable cancer centers to adjust test strategies in asymptomatic patients, especially when test resources are scarce. Supplementary Information The online version of this article (10.1007/s00066-021-01853-7) contains supplementary material, which is available to authorized users.
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Vos D, Smith DA, Martin S, Tirumani SH, Ramaiya NH. COVID-19 infection in the cancer population: a study of emergency department imaging utilization and findings. Emerg Radiol 2021; 28:1073-1081. [PMID: 34494165 PMCID: PMC8423077 DOI: 10.1007/s10140-021-01983-6] [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: 07/07/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Abstract
Purpose To analyze emergency department (ED) computerized tomography (CT) utilization in cancer patients with coronavirus disease 2019 (COVID-19). Methods A retrospective chart review was performed to identify cancer patients who received COVID-19 diagnosis within the single healthcare system and presented to the ED within 30 days of COVID-19 positive date between May 1 and December 31, 2020. Results In our 61 patients, the mean age was 72.5 years old, with 34% of patients (n = 21) on active cancer therapy and 66% (n = 40) on surveillance only. Most patients (n = 53) received their COVID-19 diagnosis within the ED, with 8 patients diagnosed prior to initial ED visit. The most common CT studies ordered within the ED were CT chest (n = 25), CT abdomen/pelvis (A/P) (n = 20), CT head (n = 8), and CT chest/abdomen/pelvis (C/A/P) (n = 7). COVID-19 findings were present on 33 scans, findings of worsening malignancy on 12 scans, and non-COVID non-cancer findings on 9 scans. Significant differences in CT severity score (p = 0.0001), indication for hospitalization (p = 0.026), length of hospitalization (p = 0.004), interventions (remdesivir, mechanical ventilation, and vasopressor support) while hospitalized (p < 0.05), and mortality (p = 0.042) were found between the prior diagnosis and ED diagnosis groups. No such differences were found between the active treatment and surveillance groups. Conclusion ED CT imaging findings in patients with cancer and COVID-19 are predominantly related to COVID-19 infection, rather than cancer history or anti-cancer therapy status.
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Affiliation(s)
- Derek Vos
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Daniel A Smith
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Sooyoung Martin
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Sree H Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Nikhil H Ramaiya
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, 44106, USA
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Re: A systematic review and meta-analysis: The effect of active cancer treatment on severity of COVID-19: Clinical outcomes of SARS-CoV-2-infected cancer patients undergoing surgery. Eur J Cancer 2021; 152:245-247. [PMID: 34006431 PMCID: PMC8123721 DOI: 10.1016/j.ejca.2021.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022]
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