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Kengne MF, Tsobeng OD, Dadjo BST, Kuete V, Mbaveng AT. Multidrug Resistant Enteric Bacteria from Cancer Patients Admitted in Douala Laquintinie Hospital, Littoral Region of Cameroon. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:2084884. [PMID: 39036470 PMCID: PMC11259499 DOI: 10.1155/2024/2084884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/16/2024] [Accepted: 06/22/2024] [Indexed: 07/23/2024]
Abstract
Patients with cancer have weakened immune systems, making them more vulnerable to infections. This study was carried out to determine the bacterial origins of enteric disorders in cancer patients and noncancer patients at the Oncology Department of Laquintinie Hospital in Douala. A cross-sectional study was conducted from October 2021 to March 2023. Stool samples from 307 cancer patients with enteric disorders and 200 noncancer patients with enteric disorders were examined to diagnose the presence of bacteria using various techniques. Among all participants in this study, 62.13% were female and 37.87% were male. The average age of the participants was 46.38 ± 15.81 years, with a minimum age of 10 years and a maximum age of 84 years. The average age of participants was significantly higher (p < 0.000) in cancer patients (49.54 ± 14.65 years) compared to noncancer patients (41.53 ± 16.33 years). Proteus mirabilis, Proteus vulgaris, Salmonella typhi, Enterobacter cloacae, Klebsiella pneumoniae, Yersinia intemedia, and Klebsiella oxytoca were more frequently isolated in cancer patients than in noncancer patients, with the respective percentages of 56.25% versus 43.75%, 50.00% versus 50.00%, 61.66% versus 38.34%, 66.66% versus 33.34%, 72.22% versus 27.78%, 80.00 versus 20.00%, and 100% versus 0.00%. Most isolates were sensitive to imipenem (IMP), gentamicin (GEN), and amikacin (AMK). Proteus vulgaris, the most prevalent isolate, showed significantly high resistance (with p < 0.05) in cancer patients compared to noncancer patients at amoxicillin/clavuranic acid (AMC) (89.13% versus 41.30%), ceftriaxone (CTR) (63.04% versus 39.13%), ciprofloxacin (CIP) (65.22% versus 34.18%), and tetracycline (TET) (93.48% versus 63.04%). Multidrug resistance was observed in cancer patients compared to noncancer patients for Klebsiella pneumoniae (85.00% versus 60.00%), Salmonella typhi (84.62% versus 60.00%), and Klebsiella oxytoca (86.49% versus 43.48%). The increase in the number of Gram-negative infections among cancer patients, as shown in the present study, highlights the need for broad-spectrum therapy and effective planning of control programs to reduce bacterial diseases among cancer patients.
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Affiliation(s)
- Michael F. Kengne
- Department of BiochemistryFaculty of ScienceUniversity of Dschang, Dschang, Cameroon
| | - Ornella D. Tsobeng
- Department of BiochemistryFaculty of ScienceUniversity of Dschang, Dschang, Cameroon
| | - Ballue S. T. Dadjo
- Department of BiochemistryFaculty of ScienceUniversity of Dschang, Dschang, Cameroon
| | - Victor Kuete
- Department of BiochemistryFaculty of ScienceUniversity of Dschang, Dschang, Cameroon
| | - Armelle T. Mbaveng
- Department of BiochemistryFaculty of ScienceUniversity of Dschang, Dschang, Cameroon
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Fonseca J, Cano-Sarabia M, Cortés P, Saldo J, Montpeyó D, Lorenzo J, Llagostera M, Imaz I, Maspoch D. Metal-Organic Framework-Based Antimicrobial Touch Surfaces to Prevent Cross-Contamination. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2403813. [PMID: 38771625 DOI: 10.1002/adma.202403813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/30/2024] [Indexed: 05/22/2024]
Abstract
Infection diseases are a major threat to global public health, with nosocomial infections being of particular concern. In this context, antimicrobial coatings emerge as a promising prophylactic strategy to reduce the transmission of pathogens and control infections. Here, antimicrobial door handle covers to prevent cross-contamination are prepared by incorporating iodine-loaded UiO-66 microparticles into a potentially biodegradable polyurethane polymer (Baycusan eco E 1000). These covers incorporate MOF particles that serve as both storage reservoirs and delivery systems for the biocidal iodine. Under realistic touching conditions, the door handle covers completely inhibit the transmission of Gram-positive bacterial species (Staphylococcus aureus, and Enterococcus faecalis), Gram-negative bacterial species (Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii), and fungi (Candida albicans). The covers remain effective even after undergoing multiple contamination cycles, after being cleaned, and when tinted to improve discretion and usability. Furthermore, as the release of iodine from the door handle covers follow hindered Fickian diffusion, their antimicrobial lifetime is calculated to be as long as approximately two years. Together, these results demonstrate the potential of these antimicrobial door handle covers to prevent cross-contamination, and underline the efficacy of integrating MOFs into innovative technologies.
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Affiliation(s)
- Javier Fonseca
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona, 08193, Spain
- Departament de Química, Facultat de Ciències, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Mary Cano-Sarabia
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona, 08193, Spain
- Departament de Química, Facultat de Ciències, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Pilar Cortés
- Departament de Genètica i Microbiologia, Facultat de Ciències, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Jordi Saldo
- Centre d'Innovació, Recerca i Transferència en Tecnologia dels Aliments (CIRTTA), Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - David Montpeyó
- Institut de Biotecnologia i Biomedicina, Departament de Bioquímica i de Biologia Molecular, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Julia Lorenzo
- Institut de Biotecnologia i Biomedicina, Departament de Bioquímica i de Biologia Molecular, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
- Centro de Investigación Biomédica en Red, Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Montserrat Llagostera
- Departament de Genètica i Microbiologia, Facultat de Ciències, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
| | - Inhar Imaz
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona, 08193, Spain
| | - Daniel Maspoch
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona, 08193, Spain
- Departament de Química, Facultat de Ciències, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, 08193, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, 08010, Spain
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Chen F, Zhang M, Yang F, Wang L, Liu J, Liu J, Pang Y. Dual-Antigen-Displaying Nanovaccines Elicit Synergistic Immunoactivation for Treating Cancer and Preventing Infectious Complications. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2307748. [PMID: 38037689 DOI: 10.1002/smll.202307748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/30/2023] [Indexed: 12/02/2023]
Abstract
As one of the most common complications, infection causes the majority of mortality in cancer patients. However, therapeutic strategies that can simultaneously suppress tumors and protect patients from infection have been rarely reported. Here, the use of dual-antigen-displaying nanovaccines (DADNs) is described to elicit synergistic immunoactivation for treating cancer and preventing infectious complications. DADNs are prepared by wrapping immunoadjuvant-loaded nanoparticles with a hybrid coating, which is fused from cell membranes that are separately genetically engineered to express tumor and infectious pathogenic antigens. Due to the presence of a dual-antigen combination, DADNs are able to promote the maturation of dendritic cells and more importantly to trigger cross-presentation of both combined antigens. During in vivo investigations, we find that DADNs can reverse immunosuppression by stimulating tumor-associated antigen-specific T-cell responses, resulting in significantly delayed tumor growth in mice. These nanovaccines also elicit effective protective immunity against tumor challenges and induce robust production of pathogenic antigen-specific immunoglobulin G antibody in a prophylactic study. This work offers a unique approach to develop dual-mode vaccines, which are promising for synchronously treating cancer and preventing infection.
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Affiliation(s)
- Fangjie Chen
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine Institute of Molecular Medicine, State Key Laboratory of Systems Medicine for Cancer Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, 250117, China
| | - Mengmeng Zhang
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine Institute of Molecular Medicine, State Key Laboratory of Systems Medicine for Cancer Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Fengmin Yang
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine Institute of Molecular Medicine, State Key Laboratory of Systems Medicine for Cancer Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Lu Wang
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine Institute of Molecular Medicine, State Key Laboratory of Systems Medicine for Cancer Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Jinyao Liu
- Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine Institute of Molecular Medicine, State Key Laboratory of Systems Medicine for Cancer Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Junqiu Liu
- College of Material, Chemistry and Chemical Engineering, Key Laboratory of Organosilicon Chemistry and Material Technology, Ministry of Education, Key Laboratory of Organosilicon Material Technology, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China
| | - Yan Pang
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China
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Weischendorff S, Rathe M, Petersen MJ, Weimann A, Enevold C, Nielsen CH, Als-Nielsen B, Nygaard U, Moser C, Müller K. Markers of intestinal mucositis to predict blood stream infections at the onset of fever during treatment for childhood acute leukemia. Leukemia 2024; 38:14-20. [PMID: 37919603 PMCID: PMC10776407 DOI: 10.1038/s41375-023-02077-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
Despite chemotherapy-induced intestinal mucositis being a main risk factor for blood stream infections (BSIs), no studies have investigated mucositis severity to predict BSI at fever onset during acute leukemia treatment. This study prospectively evaluated intestinal mucositis severity in 85 children with acute leukemia, representing 242 febrile episodes (122 with concurrent neutropenia) by measuring plasma levels of citrulline (reflecting enterocyte loss), regenerating islet-derived-protein 3α (REG3α, an intestinal antimicrobial peptide) and CCL20 (a mucosal immune regulatory chemokine) along with the general neutrophil chemo-attractants CXCL1 and CXCL8 at fever onset. BSI was documented in 14% of all febrile episodes and in 20% of the neutropenic febrile episodes. In age-, sex-, diagnosis- and neutrophil count-adjusted analyses, decreasing citrulline levels and increasing REG3α and CCL20 levels were independently associated with increased odds of BSI (OR = 1.6, 1.5 and 1.7 per halving/doubling, all p < 0.05). Additionally, higher CXCL1 and CXCL8 levels increased the odds of BSI (OR = 1.8 and 1.7 per doubling, all p < 0.0001). All three chemokines showed improved diagnostic accuracy compared to C-reactive protein and procalcitonin. These findings underline the importance of disrupted intestinal integrity as a main risk factor for BSI and suggest that objective markers for monitoring mucositis severity may help predicting BSI at fever onset.
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Affiliation(s)
- Sarah Weischendorff
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.
- Institute for Inflammation Research, Center for Rheumatology and Spine Disease, Rigshospitalet, Copenhagen, Denmark.
| | - Mathias Rathe
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Allan Weimann
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Christian Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Disease, Rigshospitalet, Copenhagen, Denmark
| | - Claus H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Disease, Rigshospitalet, Copenhagen, Denmark
| | - Bodil Als-Nielsen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Ulrikka Nygaard
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Claus Moser
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Müller
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
- Institute for Inflammation Research, Center for Rheumatology and Spine Disease, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Kanazawa A, Yan Y, Yuda M, Fukui N, Saita M, Mori H, Naito T. Risk factors for progressing to severe COVID-19 among people living with HIV in Japan: A hospital claims database study. J Infect Chemother 2024; 30:40-47. [PMID: 37708941 DOI: 10.1016/j.jiac.2023.09.009] [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: 05/06/2023] [Revised: 08/27/2023] [Accepted: 09/10/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Risk factors for severe COVID-19 associated with people living with HIV (PLWH) have not been well studied in Japan. In this study, we aim to reveal how having AIDS and comorbidities affect adverse COVID-19 outcomes. METHODS This observational, retrospective study examined the clinical outcomes for PLWH hospitalized as COVID-19 inpatients in Japan, using data extracted from hospitals with the Diagnosis Procedure Combination (DPC) system between January 2020 and December 2021. From 4672 records of HIV patients receiving antiretroviral therapy, 85 adult PLWH became hospitalized with COVID-19. The associations between patients' AIDS diagnosis, comorbidities, and their adverse COVID-19 outcomes (mild/moderate and severe/death) were analyzed. RESULTS Among 85 studied patients, 78 were male (91.8%) with mean (SD) age of 48 (14.4) years. 75 (88.2%) were found to be COVID-19 mild/moderate; 9 (10.6%) were severe; 1 (1.2%) died. Older age (p = 0.002) and hypertension (p = 0.032) were significantly associated with progressing to severe COVID-19 or death. AIDS and other AIDS-defining illnesses were not found to be significant risk factors in this study. CONCLUSIONS While interpretation of the results from this hospital claim database study warrants caution, we found that among PLWH hospitalized as COVID-19 inpatients in Japan, those who are older or with hypertension have a higher risk for progression to severe COVID-19 outcomes, suggesting a careful monitoring of clinical course for these patients.
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Affiliation(s)
- Akio Kanazawa
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yan Yan
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mayumi Yuda
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Fukui
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizue Saita
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hirotake Mori
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
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Krishna N, K P S, G K R. Identifying diseases associated with Post-COVID syndrome through an integrated network biology approach. J Biomol Struct Dyn 2024; 42:652-671. [PMID: 36995291 DOI: 10.1080/07391102.2023.2195003] [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: 12/04/2022] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
A growing body of research shows that COVID-19 is now recognized as a multi-organ disease with a wide range of manifestations that can have long-lasting repercussions, referred to as post-COVID-19 syndrome. It is unknown why the vast majority of COVID-19 patients develop post-COVID-19 syndrome, or why patients with pre-existing disorders are more likely to experience severe COVID-19. This study used an integrated network biology approach to obtain a comprehensive understanding of the relationship between COVID-19 and other disorders. The approach involved building a PPI network with COVID-19 genes and identifying highly interconnected regions. The molecular information contained within these subnetworks, as well as the pathway annotations, were used to reveal the link between COVID-19 and other disorders. Using Fisher's exact test and disease-specific gene information, significant COVID-19-disease associations were discovered. The study discovered diseases that affect multiple organs and organ systems, thus proving the theory of multiple organ damage caused by COVID-19. Cancers, neurological disorders, hepatic diseases, cardiac disorders, pulmonary diseases, and hypertensive diseases are just a few of the conditions linked to COVID-19. Pathway enrichment analysis of shared proteins revealed the shared molecular mechanism of COVID-19 and these diseases. The findings of the study shed new light on the major COVID-19-associated disease conditions and how their molecular mechanisms interact with COVID-19. The novelty of studying disease associations in the context of COVID-19 provides new insights into the management of rapidly evolving long-COVID and post-COVID syndromes, which have significant global implications.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Navami Krishna
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Sijina K P
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Rajanikant G K
- School of Biotechnology, National Institute of Technology Calicut, Calicut, Kerala, India
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Ghaffary S, Javidnia A, Beheshtirouy S, Sadeghi J, Akbari AM, Hamishehkar H, Sarbakhsh P, Sanaat Z, Nikanfar A, Esfahani A, Chavoshi SH, Nejati B, Raeisi M, Gholami N. Comparison of global decolonization efficacy with mupirocin nasal drop and chlorhexidine mouthwash in acute leukemia patients: randomized clinical trial. Support Care Cancer 2023; 32:42. [PMID: 38110726 DOI: 10.1007/s00520-023-08232-1] [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: 04/18/2023] [Accepted: 12/03/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE Neutropenic fever remains a major complication in acute leukemia. Decolonization is assumed as a promising intervention for eradicating causative agents of infection. METHODS In this randomized clinical trial, 96 patients with acute leukemia were assigned randomly to mupirocin nasal drop 2% (n = 32), chlorhexidine mouthwash 0.2% (n = 33), and control group (n = 31). In control group, patients did not receive any medication for decolonization. All patients received treatment for 5 days (2 days prior to chemotherapy until 3 days after chemotherapy). Pharynx and nasal swabs were taken prior to the intervention and at the end of decolonization period in all groups. Antibiotic susceptibility testing was performed by the disc diffusion method in order to identify bacterial isolates. RESULTS Bacterial recovery of both nasal and pharynx swabs was observed after global decolonization with mupirocin nasal drop. Decolonization with mupirocin significantly eradicated Coagulase-negative staphylococci (CONS) in both nasal and pharynx swabs (p-value = 0.000). Moreover, mupirocin decreased Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) species. Chlorhexidine mouthwash significantly eradicated CONS in pharynx swabs (p-value = 0.000). In addition, both decolonization strategies decreased both antibiotic use and frequency of fever in leukemic patients. CONCLUSION Global decolonization with mupirocin nasal drop not only eradicates both nasal and pharynx microorganisms, but also reduces antibiotic requirement and frequency of fever in patients with acute leukemia. The protocol of the present study was approved on December 2016 (registry number: IRCT20160310026998N6).
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Affiliation(s)
- Saba Ghaffary
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Aref Javidnia
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Javid Sadeghi
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Sanaat
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Nikanfar
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Esfahani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Hadi Chavoshi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Nejati
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mortaza Raeisi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Gholami
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Alio I, Moll R, Hoffmann T, Mamat U, Schaible UE, Pappenfort K, Alawi M, Schie M, Thünauer R, Stamm J, Rohde H, Streit WR. Stenotrophomonas maltophilia affects the gene expression profiles of the major pathogens Pseudomonas aeruginosa and Staphylococcus aureus in an in vitro multispecies biofilm model. Microbiol Spectr 2023; 11:e0085923. [PMID: 37819084 PMCID: PMC10714729 DOI: 10.1128/spectrum.00859-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/21/2023] [Indexed: 10/13/2023] Open
Abstract
IMPORTANCE In the past, studies have focused on bacterial pathogenicity in mono-species infections, in part ignoring the clinical relevance of diseases caused by more than one pathogen (i.e., polymicrobial infections). However, it is now common knowledge that multiple bacteria species are often involved in the course of an infection. For treatment of such infections, it is absolutely important to understand the dynamics of species interactions at possible infection sites and the molecular mechanisms behind these interactions. Here, we studied the impact of Stenotrophomonas maltophilia on its commensals Pseudomonas aeruginosa and Staphylococcus aureus in multispecies biofilms. We analyzed the 3D structural architectures of dual- and triple-species biofilms, niche formation within the biofilms, and the interspecies interactions on a molecular level. RNAseq data identified key genes involved in multispecies biofilm formation and interaction as potential drug targets for the clinical combat of multispecies infection with these major pathogens.
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Affiliation(s)
- Ifey Alio
- Department of Microbiology and Biotechnology, University Hamburg, Hamburg, Germany
| | - Raphael Moll
- Department of Microbiology and Biotechnology, University Hamburg, Hamburg, Germany
| | - Tim Hoffmann
- Department of Microbiology and Biotechnology, University Hamburg, Hamburg, Germany
| | - Uwe Mamat
- Cellular Microbiology, Priority Research Area Infections, Research Center Borstel, Leibniz Lung Center,Leibniz Research Alliance Infection , Borstel Gemany, Borstel, Germany
| | - Ulrich E. Schaible
- Cellular Microbiology, Priority Research Area Infections, Research Center Borstel, Leibniz Lung Center,Leibniz Research Alliance Infection , Borstel Gemany, Borstel, Germany
| | - Kai Pappenfort
- Institute of Microbiology, Friedrich Schiller University of Jena, Jena, Germany
| | - Malik Alawi
- Bioinformatics Core, UKE Hamburg, Hamburg, Germany
| | - Marcel Schie
- LIV, Leibniz Institute of Experimental Virology, Hamburg, Germany
| | - Roland Thünauer
- LIV, Leibniz Institute of Experimental Virology, Hamburg, Germany
| | - Johanna Stamm
- Institute for Medical Microbiology, Virology and Hygiene, UKE, Eppendorf, Hamburg, Germany
| | - Holger Rohde
- Institute for Medical Microbiology, Virology and Hygiene, UKE, Eppendorf, Hamburg, Germany
| | - Wolfgang R. Streit
- Department of Microbiology and Biotechnology, University Hamburg, Hamburg, Germany
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9
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Madrigal J, Tie EK, Verma A, Benharash P, Rapkin DA, St John MA. The Increasing Burden of Depression in Patients Undergoing Head and Neck Cancer Operations. Laryngoscope 2023; 133:3396-3402. [PMID: 37161918 DOI: 10.1002/lary.30735] [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: 02/07/2023] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Depression remains prevalent in patients undergoing head and neck cancer (HNCA) operations. The present study aimed to assess the impact of depression on perioperative and readmission outcomes following HNCA resection. METHODS All elective hospitalizations involving HNCA resection were identified from the 2010-2019 Nationwide Readmissions Database. Patients were stratified by history of depression. To perform risk-adjustment in assessing perioperative and readmission outcomes, 3:1 nearest neighbor matching was performed. A subpopulation analysis was also conducted to assess interval development of depression in the postoperative period. RESULTS Of an estimated 133,018 patients undergoing HNCA operations, 8.9% (n = 11,855) had comorbid depression. Over the decade-long study period, the prevalence of depression in this population increased (7.8% in 2010 vs. 10.0% in 2019, NPTrend<0.001). Among 24,938 propensity matched patients, those with depression had similar incidence of in-hospital mortality (0.4 vs. 0.7%, p = 0.14) as well as perioperative medical (22.0 vs. 21.9%, p = 0.93) and surgical (10.2 vs. 10.3, p = 0.84) complications, though had higher rates of non-home discharge (16.9 vs. 13.5%, p < 0.001) and 30-day readmission (13.6 vs. 11.8%, p = 0.030). Predictors of depression in the postoperative period included primary coverage by Medicare or Medicaid as well as comorbid anxiety or drug use disorder. CONCLUSION The prevalence of depression in HNCA patients continues to increase. Although depression was not associated with increased in-hospital mortality and complications, it did impact rates of rehospitalization as well as non-routine discharge. Screening and therapeutic interventions addressing such postoperative events may serve to improve long-term clinical and financial outcomes in this at-risk population. LEVEL OF EVIDENCE 3-Retrospective cohort study Laryngoscope, 133:3396-3402, 2023.
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Affiliation(s)
- Josef Madrigal
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Edward K Tie
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, California, USA
| | - Arjun Verma
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - David A Rapkin
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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10
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Bernacchia L, Gupta A, Paris A, Moores AA, Kad NM. Developing novel antimicrobials by combining cancer chemotherapeutics with bacterial DNA repair inhibitors. PLoS Pathog 2023; 19:e1011875. [PMID: 38060607 PMCID: PMC10729960 DOI: 10.1371/journal.ppat.1011875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/19/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023] Open
Abstract
Cancer chemotherapeutics kill rapidly dividing cells, which includes cells of the immune system. The resulting neutropenia predisposes patients to infection, which delays treatment and is a major cause of morbidity and mortality. To tackle this problem, we have isolated several compounds that inhibit bacterial DNA repair, alone they are non-toxic, however in combination with DNA damaging anti-cancer drugs, they prevent bacterial growth. These compounds were identified through screening of an FDA-approved drug library in the presence of the anti-cancer compound cisplatin. Using a series of triage tests, the screen was reduced to a handful of drugs that were tested for specific activity against bacterial nucleotide excision DNA repair (NER). Five compounds emerged, of which three possess promising antimicrobial properties including cell penetrance, and the ability to block replication in a multi-drug resistant clinically relevant E. coli strain. This study suggests that targeting NER could offer a new therapeutic approach tailor-made for infections in cancer patients, by combining cancer chemotherapy with an adjuvant that targets DNA repair.
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Affiliation(s)
- Lorenzo Bernacchia
- School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom
| | - Arya Gupta
- School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom
| | - Antoine Paris
- School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom
| | | | - Neil M. Kad
- School of Biosciences, University of Kent, Canterbury, Kent, United Kingdom
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11
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Beard KR, Borca F, Phan H, Brown E, Fenton PA, Stansby J, Defty J, Clark TW. Routine, molecular point-of-care testing for SARS-CoV-2 and other respiratory viruses within an acute oncology service improves patient care. J Infect 2023; 87:516-523. [PMID: 37802471 DOI: 10.1016/j.jinf.2023.09.012] [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: 04/02/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV-2, within an Acute Oncology Service (AOS). METHODS This pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK. We collected data from two periods: November 25th, 2019 to November 24th, 2020, when respiratory virus testing utilised laboratory PCR, and December 1st, 2020 to May 31st, 2021 following the introduction of mPOCT. The primary outcome was the time to results. RESULTS 2189 patients were tested in the pre-implementation period and 1540 in the post implementation period. Median (IQR) time to results was 5.8 h (4.2-10.6) pre-implementation and 1.9 h (1.5-3.0) post-implementation (difference -3.6 h [95%CI to -3.8 to -3.5]; p < 0.0001). Median time spent in assessment areas was 6.0 h (4.1-7.9) pre-implementation and 5.5 h (3.8-7.4) post-implementation (p < 0.0001). 20 (0.9%) patients admitted via AOS assessment unit developed hospital-acquired respiratory virus infection pre-implementation versus 0 (0%) post-implementation (p = 0.031). CONCLUSIONS Routine mPOCT for respiratory viruses, including SARS-CoV-2, was associated with a reduced time to results, reduced time in assessment areas, and a reduction in the rates of hospital-acquired respiratory virus infection in an acute oncology assessment unit.
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Affiliation(s)
- Kate R Beard
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Florina Borca
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Hang Phan
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Emma Brown
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul A Fenton
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jessica Stansby
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Defty
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Health Sciences, University of Southampton, Southampton, UK
| | - Tristan W Clark
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK Trust, Southampton, UK
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12
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Sobhani N, Mondani G, Roviello G, Catalano M, Sirico M, D'Angelo A, Scaggiante B, Generali D. Cancer management during the COVID-19 world pandemic. Cancer Immunol Immunother 2023; 72:3427-3444. [PMID: 37642709 DOI: 10.1007/s00262-023-03524-1] [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: 06/09/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
Since 2019, the world has been experiencing an outbreak of a novel beta-coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV)-2. The worldwide spread of this virus has been a severe challenge for public health, and the World Health Organization declared the outbreak a public health emergency of international concern. As of June 8, 2023, the virus' rapid spread had caused over 767 million infections and more than 6.94 million deaths worldwide. Unlike previous SARS-CoV-1 and Middle East respiratory syndrome coronavirus outbreaks, the COVID-19 outbreak has led to a high death rate in infected patients; this has been caused by multiorgan failure, which might be due to the widespread presence of angiotensin-converting enzyme 2 (ACE2) receptors-functional receptors of SARS-CoV-2-in multiple organs. Patients with cancer may be particularly susceptible to COVID-19 because cancer treatments (e.g., chemotherapy, immunotherapy) suppress the immune system. Thus, patients with cancer and COVID-19 may have a poor prognosis. Knowing how to manage the treatment of patients with cancer who may be infected with SARS-CoV-2 is essential. Treatment decisions must be made on a case-by-case basis, and patient stratification is necessary during COVID-19 outbreaks. Here, we review the management of COVID-19 in patients with cancer and focus on the measures that should be adopted for these patients on the basis of the organs or tissues affected by cancer and by the tumor stage.
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Affiliation(s)
- Navid Sobhani
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - Giuseppina Mondani
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Martina Catalano
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Marianna Sirico
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, Italy
| | - Alberto D'Angelo
- Department of Biology and Biochemistry, University of Bath, Bath, BA2 7AX, UK
| | - Bruna Scaggiante
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
| | - Daniele Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127, Trieste, Italy
- Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, 26100, Cremona, Italy
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13
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Ko RE, Kim Z, Jeon B, Ji M, Chung CR, Suh GY, Chung MJ, Cho BH. Deep Learning-Based Early Warning Score for Predicting Clinical Deterioration in General Ward Cancer Patients. Cancers (Basel) 2023; 15:5145. [PMID: 37958319 PMCID: PMC10647448 DOI: 10.3390/cancers15215145] [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: 09/27/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Cancer patients who are admitted to hospitals are at high risk of short-term deterioration due to treatment-related or cancer-specific complications. A rapid response system (RRS) is initiated when patients who are deteriorating or at risk of deteriorating are identified. This study was conducted to develop a deep learning-based early warning score (EWS) for cancer patients (Can-EWS) using delta values in vital signs. METHODS A retrospective cohort study was conducted on all oncology patients who were admitted to the general ward between 2016 and 2020. The data were divided into a training set (January 2016-December 2019) and a held-out test set (January 2020-December 2020). The primary outcome was clinical deterioration, defined as the composite of in-hospital cardiac arrest (IHCA) and unexpected intensive care unit (ICU) transfer. RESULTS During the study period, 19,739 cancer patients were admitted to the general wards and eligible for this study. Clinical deterioration occurred in 894 cases. IHCA and unexpected ICU transfer prevalence was 1.77 per 1000 admissions and 43.45 per 1000 admissions, respectively. We developed two models: Can-EWS V1, which used input vectors of the original five input variables, and Can-EWS V2, which used input vectors of 10 variables (including an additional five delta variables). The cross-validation performance of the clinical deterioration for Can-EWS V2 (AUROC, 0.946; 95% confidence interval [CI], 0.943-0.948) was higher than that for MEWS of 5 (AUROC, 0.589; 95% CI, 0.587-0.560; p < 0.001) and Can-EWS V1 (AUROC, 0.927; 95% CI, 0.924-0.931). As a virtual prognostic study, additional validation was performed on held-out test data. The AUROC and 95% CI were 0.588 (95% CI, 0.588-0.589), 0.890 (95% CI, 0.888-0.891), and 0.898 (95% CI, 0.897-0.899), for MEWS of 5, Can-EWS V1, and the deployed model Can-EWS V2, respectively. Can-EWS V2 outperformed other approaches for specificities, positive predictive values, negative predictive values, and the number of false alarms per day at the same sensitivity level on the held-out test data. CONCLUSIONS We have developed and validated a deep learning-based EWS for cancer patients using the original values and differences between consecutive measurements of basic vital signs. The Can-EWS has acceptable discriminatory power and sensitivity, with extremely decreased false alarms compared with MEWS.
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Affiliation(s)
- Ryoung-Eun Ko
- Department of Critical Care Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea; (R.-E.K.); (C.R.C.); (G.Y.S.)
| | - Zero Kim
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea; (Z.K.); (B.J.); (M.J.); (M.J.C.)
- Department of Data Convergence and Future Medicine, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Bomi Jeon
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea; (Z.K.); (B.J.); (M.J.); (M.J.C.)
| | - Migyeong Ji
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea; (Z.K.); (B.J.); (M.J.); (M.J.C.)
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea; (R.-E.K.); (C.R.C.); (G.Y.S.)
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea; (R.-E.K.); (C.R.C.); (G.Y.S.)
- Devision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Myung Jin Chung
- Medical AI Research Center, Samsung Medical Center, Seoul 06351, Republic of Korea; (Z.K.); (B.J.); (M.J.); (M.J.C.)
- Department of Data Convergence and Future Medicine, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Baek Hwan Cho
- Department of Biomedical Informatics, School of Medicine, CHA University, Seongnam 13497, Republic of Korea
- Institute of Biomedical Informatics, School of Medicine, CHA University, Seongnam 13497, Republic of Korea
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14
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Chu M, Ji H, Li K, Liu H, Peng M, Wang Z, Zhu X. Investigating the potential mechanism of quercetin against cervical cancer. Discov Oncol 2023; 14:170. [PMID: 37704909 PMCID: PMC10499770 DOI: 10.1007/s12672-023-00788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cervical cancer is emerging as a potential target of increased susceptibility to coronavirus disease-2019 (COVID-19), leading to compromised survival rates. Despite this critical link, efficacious anti-cervical cancer/COVID-19 interventions remain limited. Quercetin, known for its efficacy against both cancer and viral infections, holds promise as a therapeutic agent. This study aims to elucidate quercetin's anti-cervical cancer/COVID-19 mechanisms and potential targets. METHODS We initiated our investigation with differential gene expression analysis using cervical cancer transcriptome data from The Cancer Genome Atlas (TCGA) and The Genotype-Tissue Expression (GTEx), focusing on intersections with COVID-19-related genes. Network pharmacology was employed to identify the shared targets between cervical cancer/COVID-19 DEGs and quercetin's targets. Subsequently, Cox proportional hazards analyses were employed to establish a risk score based on these genes. Molecular docking techniques were applied to predict quercetin's therapeutic targets and mechanisms for mitigating cervical cancer and COVID-19. RESULTS Our findings unveiled 45 potential quercetin targets with anti-cervical cancer/COVID-19 actions. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses highlighted significant enrichment in immune pathways and COVID-19-related pathways. A refined risk score model, comprising PLA2G7, TNF, TYK2, F2, and NRP1, effectively stratified cervical cancer patients into distinct risk groups. Importantly, molecular docking analyses illuminated quercetin's remarkable binding affinity to the primary protease of the coronavirus. CONCLUSIONS In summation, our study suggests that quercetin holds promise as a potential therapeutic agent for mitigating coronavirus function, specifically through its interaction with the primary protease. This research offers novel insights into exploring COVID-19 susceptibility and enhancing survival in cervical cancer patients.
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Affiliation(s)
- Man Chu
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China
| | - Huihui Ji
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kehan Li
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hejing Liu
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China
| | - Mengjia Peng
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhiwei Wang
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Xueqiong Zhu
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, 325027, China.
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15
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Budin CE, Nemeș AF, Râjnoveanu RM, Nemeș RM, Rajnoveanu AG, Sabău AH, Cocuz IG, Mareș RG, Oniga VI, Pătrîntașu DE, Cotoi OS. The Inflammatory Profile Correlates with COVID-19 Severity and Mortality in Cancer Patients. J Pers Med 2023; 13:1235. [PMID: 37623485 PMCID: PMC10455536 DOI: 10.3390/jpm13081235] [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: 07/16/2023] [Revised: 07/30/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The correlation of the inflammatory profile with the severity of the disease in neoplastic patients with SARS-CoV-2 infection was addressed. METHODS A database of 1537 patients hospitalized in the pneumology department was analyzed. After applying the inclusion and exclusion criteria, 83 patients (67% males, 33% females) were included. RESULTS Most of the analyzed patients were hospitalized with a moderate form of disease, explaining the significant percentage of 25% mortality. The frequency of the type of neoplasm was higher for lung cancer, followed by malignant colon tumor. We identified a significant association between the increased value of ferritin (p < 0.0001, OR = 22.31), fibrinogen (p = 0.009, OR = 13.41), and C-reactive protein (p = 0.01, OR = 7.65), respectively, and the level of severity of COVID-19. The results of the univariate logistic regression analysis for predicting the severity of the disease revealed that the increased values of ferritin (p = 0.001, OR = 22.31) and fibrinogen (p = 0.02, OR = 13.41) represent a risk for a serious negative prognosis of COVID-19. CONCLUSIONS Our study demonstrated that the value of the analyzed inflammatory parameters increased in direct proportion to the severity of the disease and that higher values were associated with increased mortality in the study group.
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Affiliation(s)
- Corina Eugenia Budin
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania; (C.E.B.); (A.H.S.); (I.G.C.); (R.G.M.)
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania
| | | | - Ruxandra-Mioara Râjnoveanu
- Palliative Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Roxana Maria Nemeș
- Faculty of Medicine, Titu Maiorescu University, 67A Gheorghe Petrascu Str., 031593 Bucharest, Romania;
| | - Armand Gabriel Rajnoveanu
- Occupational Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Adrian Horațiu Sabău
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania; (C.E.B.); (A.H.S.); (I.G.C.); (R.G.M.)
- Pathology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania
| | - Iuliu Gabriel Cocuz
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania; (C.E.B.); (A.H.S.); (I.G.C.); (R.G.M.)
- Pathology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania
| | - Răzvan Gheorghita Mareș
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania; (C.E.B.); (A.H.S.); (I.G.C.); (R.G.M.)
| | - Vlad Iustinian Oniga
- Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania;
| | | | - Ovidiu Simion Cotoi
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania; (C.E.B.); (A.H.S.); (I.G.C.); (R.G.M.)
- Pathology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania
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16
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Edi D, Ejiohuo O, Ordinioha B. Occurrence and prevalence of bacteria on door handles at the University of Port Harcourt Teaching Hospital and the multidrug resistance implications. Access Microbiol 2023; 5:acmi000615.v4. [PMID: 37601439 PMCID: PMC10436018 DOI: 10.1099/acmi.0.000615.v4] [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: 04/13/2023] [Accepted: 06/16/2023] [Indexed: 08/22/2023] Open
Abstract
Background. The coronavirus disease 2019 (COVID-19) pandemic has heightened concerns regarding transmitting hospital-acquired infections through high-contact points in healthcare facilities, such as door handles, which can serve as reservoirs for pathogenic micro-organisms. With the increased infectivity of the serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, there is greater awareness of the risk of multidrug-resistant bacteria on these surfaces, necessitating strict surveillance prevention protocols. Objective. This study assesses the occurrence and prevalence of bacteria on toilet door handles at the University of Port Harcourt Teaching Hospital in Nigeria and the multidrug resistance implications. We examined the hospital infection level and overall sanitary conditions. Method. Experimental data from our study on hospital door handles in different locations were assessed. Eighty-six samples were collected from toilet door handles at the University of Port Harcourt Teaching Hospital. Ethical approval was obtained from the hospital departments and the university research ethics committee. Samples from private offices and doors without handles were excluded. Bacteria were isolated from the samples, and antibiotic sensitivity testing was performed. Result. Of the 329 bacteria isolated, 55.5 % were Gram-positive and 44.4 % Gram-negative. The most prevalent bacteria were Staphylococcus epidermidis , followed by Bacillus sp. The prevalence of multidrug-resistant bacteria was also low, with Enterococcus sp. having the highest prevalence of 28.57%, followed by Micrococcus sp. at 3.45 % and S. epidermidis at 1.96 %. Conclusion The results show that, despite the occurrence of pathogenic micro-organisms, there has been a reduction in the prevalence of multidrug-resistant bacteria strains. This study can be used as an example for environmental microbiological surveillance in suspected outbreak investigations and assessment of sanitary conditions and the prevalence of multidrug-resistant bacteria in healthcare facilities.
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Affiliation(s)
- Deinmo Edi
- The Department of Preventive and Social Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Ovinuchi Ejiohuo
- Department of Pharmacognosy and Biomaterials, Poznan University of Medical Sciences, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Best Ordinioha
- The Department of Preventive and Social Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
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17
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Prajoko YW, Supit T. Radiotherapy service amidst COVID-19: Experience from Tertiary Referral Hospital in Semarang, Indonesia. J Public Health Res 2023; 12:22799036231197189. [PMID: 37711727 PMCID: PMC10498704 DOI: 10.1177/22799036231197189] [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: 01/25/2023] [Accepted: 08/09/2023] [Indexed: 09/16/2023] Open
Abstract
Background Several changes in hospital policies took place to mitigate the spread of Coronavirus disease 2019 (COVID-19). However, the patient's perception to these abrupt changes in medical services is not known. This study analyzed the quality of radiotherapy service during the COVID-19 pandemic and the patient's perception of them. Methods This descriptive study will qualitatively assess cancer patient perception of the quality of radiotherapy service during COVID-19 pandemic. Willing participants were given a questionnaire that explore two major aspects: the patient's general knowledge of COVID-19 and their perception of radiotherapy service during the pandemic. Results The 145 participants of this study were generally well-informed about the significance of COVID-19 pandemic. Most respondents claimed to adequately practice preventive measures and put high regards in personal protective equipment (PPE) worn by them and healthcare workers for their safety. Their level of trust to all healthcare workers remained high and identified hospital announcements (television, brochures) educated them the most in regards to the relationship of COVID-19 and cancer. Conclusion The changes in hospital policies and radiation oncology service in our institution were well-received by the study population. Despite the majority of respondents were afraid and anxious of being infected of COVID-19 while undergoing treatment, only a minority of them contemplated to delay or completely stop going for treatment. By adhering to major guidelines and adjustments of local resources, the delivery of radiotherapy service can remain consistent during the pandemic.
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Affiliation(s)
- Yan Wisnu Prajoko
- Department of Surgical Oncology, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Tommy Supit
- Department of Surgery, Faculty of Medicine, Universitas Diponegoro, Dr. Kariadi General Hospital, Semarang, Indonesia
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18
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Jiang A, Li Y, Zhao N, Shang X, Liu N, Wang J, Gao H, Fu X, Ruan Z, Liang X, Tian T, Yao Y. A novel risk classifier to predict the in-hospital death risk of nosocomial infections in elderly cancer patients. Front Cell Infect Microbiol 2023; 13:1179958. [PMID: 37234774 PMCID: PMC10206213 DOI: 10.3389/fcimb.2023.1179958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Background Elderly cancer patients are more predisposed to developing nosocomial infections during anti-neoplastic treatment, and are associated with a bleaker prognosis. This study aimed to develop a novel risk classifier to predict the in-hospital death risk of nosocomial infections in this population. Methods Retrospective clinical data were collected from a National Cancer Regional Center in Northwest China. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was utilized to filter the optimal variables for model development and avoid model overfitting. Logistic regression analysis was performed to identify the independent predictors of the in-hospital death risk. A nomogram was then developed to predict the in-hospital death risk of each participant. The performance of the nomogram was evaluated using receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA). Results A total of 569 elderly cancer patients were included in this study, and the estimated in-hospital mortality rate was 13.9%. The results of multivariate logistic regression analysis showed that ECOG-PS (odds ratio [OR]: 4.41, 95% confidence interval [CI]: 1.95-9.99), surgery type (OR: 0.18, 95%CI: 0.04-0.85), septic shock (OR: 5.92, 95%CI: 2.43-14.44), length of antibiotics treatment (OR: 0.21, 95%CI: 0.09-0.50), and prognostic nutritional index (PNI) (OR: 0.14, 95%CI: 0.06-0.33) were independent predictors of the in-hospital death risk of nosocomial infections in elderly cancer patients. A nomogram was then constructed to achieve personalized in-hospital death risk prediction. ROC curves yield excellent discrimination ability in the training (area under the curve [AUC]=0.882) and validation (AUC=0.825) cohorts. Additionally, the nomogram showed good calibration ability and net clinical benefit in both cohorts. Conclusion Nosocomial infections are a common and potentially fatal complication in elderly cancer patients. Clinical characteristics and infection types can vary among different age groups. The risk classifier developed in this study could accurately predict the in-hospital death risk for these patients, providing an important tool for personalized risk assessment and clinical decision-making.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Tao Tian
- *Correspondence: Yu Yao, ; Tao Tian,
| | - Yu Yao
- *Correspondence: Yu Yao, ; Tao Tian,
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19
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Hermansyah D, Kurniawan D, Rahayu Y, Joseph B, Mohammad F, Siregar DR, Pasaribu ET. Incidence of COVID-19 in cancer patients in a teaching hospital faculty of medicine, in Medan, Indonesia. IJID REGIONS 2023:S2772-7076(23)00035-8. [PMID: 37363191 PMCID: PMC10157385 DOI: 10.1016/j.ijregi.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/28/2023]
Abstract
Objective The aim of this study was to determine the incidence of COVID-19 in cancer patients in the Teaching Hospital Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. Methods This descriptive study was conducted at H. Adam Malik Hospital and USU General Hospital, Medan, from March 2020 to August 2021. The main inclusion criteria for the participants were COVID-19 and confirmed cancer. A total sampling technique was used. Results Among the 3308 COVID-19 patients studied, the mean age was 44 years, ranging from 1 day to 92 years. Male participants were slightly more prevalent (51.8% vs 48.2%). Twenty-five of these patients (0.75%) had both COVID-19 and cancer, and thus met the inclusion criteria. The most common types of cancer were leukemia (20.0%), breast cancer (20.0%), ovarian cancer (16.0%), lymphoma (8.0%), and osteosarcoma (8.0%). The proportions of patients with mild, moderate, and severe degrees of COVID-19 where 48.0%, 24.0%, and 28.0%, respectively. Seven patients required intensive care, and five died. Conclusion The incidence of COVID-19 in patients with cancer was relatively low. Nevertheless, almost a third of cancer patients with COVID-19 developed severe disease and had poor prognoses. Vaccination among cancer patients is important to protect them from poor outcomes if exposed to COVID-19.
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Affiliation(s)
- Dedy Hermansyah
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dede Kurniawan
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Yolanda Rahayu
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Batara Joseph
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Fawzan Mohammad
- Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Denny Rifsal Siregar
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Emir Taris Pasaribu
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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20
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Hassan AM, Nogueira L, Lin YL, Rogers JE, Nori-Sarma A, Offodile AC. Impact of Heatwaves on Cancer Care Delivery: Potential Mechanisms, Health Equity Concerns, and Adaptation Strategies. J Clin Oncol 2023:JCO2201951. [PMID: 37098249 DOI: 10.1200/jco.22.01951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- Abbas M Hassan
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Yu-Li Lin
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jane E Rogers
- Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Anaeze Chidiebele Offodile
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
- Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX
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21
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Agadzhanov VG, Khorobrykh TV, Khmyrova SE, Khusainova NR, Begunova AK. [Surgical treatment of COVID-19 patients during the pandemic]. Khirurgiia (Mosk) 2023:5-11. [PMID: 37379400 DOI: 10.17116/hirurgia20230715] [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: 06/30/2023]
Abstract
OBJECTIVE To analyze the results of emergency surgery in COVID-19 patients with viral pneumonia. MATERIAL AND METHODS A retrospective study included 75 COVID-19 patients who underwent emergency surgical interventions. Comorbidities included cardiac diseases, nonspecific lung diseases, type 2 diabetes, kidney diseases, overweight, and cancer. Various combinations of these diseases were also noted. RESULTS We carried out emergency surgeries for abdominal, thoracic, soft tissue and venous diseases. Postoperative mortality was 42.6%. The best results were obtained after minimally invasive interventions without mechanical ventilation. Extended surgery with mechanical ventilation was followed by fast progression of pneumonia according to clinical and CT data. CONCLUSION Surgical interventions undoubtedly worsen prognosis of treatment in patients with COVID-19. Emergency minimally invasive surgery without mechanical ventilation can reduce the risk of unfavorable outcomes in patients with viral pneumonia, especially in case of concomitant cancer and other severe comorbidities.
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Affiliation(s)
- V G Agadzhanov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - T V Khorobrykh
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - S E Khmyrova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - N R Khusainova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A K Begunova
- Sechenov First Moscow State Medical University, Moscow, Russia
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22
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Khosravifar M, Koolaji S, Rezaei N, Ghanbari A, Hashemi SM, Ghasemi E, Bitaraf A, Tabatabaei‐Malazy O, Rezaei N, Fateh SM, Dilmaghani‐Marand A, Haghshenas R, Kazemi A, Pakatchian E, Kompani F, Djalalinia S. A year of experience with COVID-19 in patients with cancer: A nationwide study. Cancer Rep (Hoboken) 2022; 6:e1678. [PMID: 36437484 PMCID: PMC9875662 DOI: 10.1002/cnr2.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cancer is a major public health problem and comorbidity associated with COVID-19 infection. According to previous studies, a higher mortality rate of COVID-19 in cancer patients has been reported. AIMS This study was undertaken to determine associated risk factors and epidemiological characteristics of hospitalized COVID-19 patients with cancer using a nationwide COVID-19 hospital data registry in Iran for the first time. METHODS In this retrospective study, we used a national data registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) symptoms and patients with confirmed positive COVID-19 PCR between 18 February 2020 and 18 November 2020. The patients were classified into two groups patients with/without malignancy. Logistic regression model was utilized to analyze demographic factors, clinical features, comorbidities, and their associations with the disease outcomes. RESULTS In this study, 11 068 and 645 186 in-patients with SARS symptoms with and without malignancy were included, respectively. About 1.11% of our RT-PCR-positive patients had cancer. In patients with malignancy and COVID-19, older ages than 60 (OR: 1.88, 95% CI: 1.29-2.74, p-value: .001), male gender (OR: 1.43, 95% CI: 1.16-1.77, p-value: .001), concomitant chronic pulmonary diseases (CPD) (OR: 1.75, 95% CI: 1.14-2.68, p-value: .009), and presence of dyspnea (OR; 2.00, 95% CI: 1.60-2.48, p-value: <.001) were associated with increased mortality rate. CONCLUSION Given the immunocompromised state of patients with malignancy and their vulnerability to Covid-19 complications, collecting data on the comorbidities and their effects on the disease outcome can build on a better clinical view and help clinicians make decisions to manage these cases better; for example, determining special clinical care, especially in the shortage of health services.
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Affiliation(s)
- Mina Khosravifar
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sogol Koolaji
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Negar Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Ghanbari
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Seyedeh Melika Hashemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Ghasemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Bitaraf
- School of MedicineKermanshah University of Medical sciencesKermanshahIran
| | - Ozra Tabatabaei‐Malazy
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nazila Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sahar Mohammadi Fateh
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Arezou Dilmaghani‐Marand
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Rosa Haghshenas
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ameneh Kazemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Pakatchian
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farzad Kompani
- Division of Hematology and OncologyChildren's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical SciencesTehranIran
| | - Shirin Djalalinia
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Deputy of Research and TechnologyMinistry of Health and Medical EducationTehranIran
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Alaeddini M, Etemad-Moghadam S. SARS-Cov-2 infection in cancer patients, susceptibility, outcome and care. Am J Med Sci 2022; 364:511-520. [PMID: 35605680 PMCID: PMC9119956 DOI: 10.1016/j.amjms.2022.05.017] [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: 08/24/2021] [Revised: 04/18/2022] [Accepted: 05/16/2022] [Indexed: 01/25/2023]
Abstract
The COVID-19 pandemic has led to many problems in cancer patients, which in part are due to insufficient knowledge of the exact implications of the virus on these individuals. Perceptions based on known facts about previous pandemics and coronaviruses might not agree with actual real-life experience and objective findings. We present a compilation of scientific facts and actual observations on different aspects of SARS-CoV-2 infection in cancer patients. These patients are at increased risk of viral contraction and have higher chances of severe disease/mortality. The latter is impacted by other factors and is still debated. In contrast to preliminary impressions, the benefits of anti-cancer treatments outweigh their risks and should be continued. Cancer patients generate antibodies in response to vaccination but in lower amounts than healthy people, especially those with hematologic cancers. Boosters, including third doses, have shown increased immune-responses in most patients. Vaccination should be prioritized in these individuals.
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Affiliation(s)
| | - Shahroo Etemad-Moghadam
- Corresponding author at: Shahroo Etemad-Moghadam, Dentistry Research Institute, Dental Research Centre, Ghods St, Enghelab Ave, P.O. Box: 14155-5583; Postal code: 14174, Tehran, Iran
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24
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Huang CL, Fang XL, Mao YP, Guo R, Li WF, Xu SS, Ma J, Chen L, Tang LL. Association of delayed chemoradiotherapy with elevated Epstein-Barr virus DNA load and adverse clinical outcome in nasopharyngeal carcinoma treatment during the COVID-19 pandemic: a retrospective study. Cancer Cell Int 2022; 22:331. [PMID: 36316696 PMCID: PMC9623943 DOI: 10.1186/s12935-022-02748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To summarize the impact of radiotherapy (RT) and chemotherapy delays on patients with nasopharyngeal carcinoma (NPC) during the COVID-19 pandemic. METHODS We retrospectively included 233 patients with stage II-IVa NPC treated with RT and chemotherapy between December 11, 2019 and March 11, 2020. The outcomes were elevation in the EBV DNA load between two adjacent cycles of chemotherapy or during RT, and 1-year disease-free survival (DFS). RESULTS RT delay occurred in 117 (50%) patients, and chemotherapy delay occurred in 220 (94%) patients. RT delay of ≥ 6 days was associated with a higher EBV DNA elevation rate (20.4% vs. 3.6%, odds ratio [OR] = 6.93 [95% CI = 2.49-19.32], P < 0.001), and worse 1-year DFS (91.2% vs. 97.8%, HR = 3.61 [95% CI = 1.37-9.50], P = 0.006), compared with on-schedule RT or delay of < 6 days. Chemotherapy delay of ≥ 10 days was not associated with a higher EBV DNA elevation rate (12.5% vs. 6.8%, OR = 1.94 [95% CI = 0.70-5.40], P = 0.20), or worse 1-year DFS (93.8% vs. 97.1%, HR = 3.73 [95% CI = 0.86-16.14], P = 0.059), compared with delay of < 10 days. Multivariable analyses showed RT delay of ≥ 6 days remained an independent adverse factor for both EBV DNA elevation and DFS. CONCLUSION To ensure treatment efficacy for patients with nonmetastatic NPC, initiation of RT should not be delayed by more than 6 days; the effect of chemotherapy delay requires further investigation.
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Affiliation(s)
- Cheng-Long Huang
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Xue-Liang Fang
- grid.506261.60000 0001 0706 7839Department of Otolaryngology, Peking Union Medical College Hospital, Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan-Ping Mao
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Rui Guo
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Wen-Fei Li
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Si-Si Xu
- grid.506261.60000 0001 0706 7839National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Jun Ma
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Lei Chen
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
| | - Ling-Long Tang
- grid.488530.20000 0004 1803 6191Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, 510060 Guangzhou, China
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Wu M, Liu S, Yang Y, Lin J, Liu J. Clinical characteristics and outcomes of lung cancer patients with COVID-19: A systematic review and meta-analysis protocol. PLoS One 2022; 17:e0273691. [PMID: 36044455 PMCID: PMC9432718 DOI: 10.1371/journal.pone.0273691] [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: 05/08/2022] [Accepted: 08/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 is spreading rapidly worldwide, and the population is generally susceptible to SARS-CoV-2, especially those with cancer. Hence, our study aims to design a protocol for a systematic review and meta-analysis of the clinical characteristics and prognoses of lung cancer patients with COVID-19. Methods The protocol is prepared following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The literature will be searched in Embase, Pubmed, the Cochrane Library, LitCovid, and CNKI for potentially eligible articles. The quality of the articles will be used in the Newcastle-Ottawa Quality Assessment Scale (NOS) and Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis will be performed through RevMan 5 software. This review protocol has been registered in PROSPERO (CRD42022306866). Discussion To clarify whether COVID-19 affects the clinical symptoms and prognoses of lung cancer patients. Further study is needed to establish the best evidence-based for the management of lung cancer patients with COVID-19. Conclusion The definitive conclusion will be important to physicians effectively manage lung cancer patients with COVID-19.
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Affiliation(s)
- Mingyue Wu
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Siru Liu
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Yi Yang
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Lin
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail: (JL); (JL)
| | - Jialin Liu
- Information Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Informatics, West China Medical School, Sichuan University, Chengdu, China
- * E-mail: (JL); (JL)
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26
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Relation of Malnutrition and Nosocomical Infections in Cancer Patients in Hospital: An Observational Study. J Nutr Metab 2022; 2022:5232480. [PMID: 36016842 PMCID: PMC9398872 DOI: 10.1155/2022/5232480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Aim To investigate the relation between malnutrition and nosocomial infections (NI) in hospitalized cancer patients. Methods This observational, cross-sectional, noninterventional, descriptive study was conducted in a 500-bed university hospital in Valencia (Spain). Adult cancer patients admitted to the oncology ward were consecutively enrolled regardless of their nutritional status between November 2019 and March 2020. Patients were nutritionally assessed 24 to 48 hours after admission. Body weight, height and BMI, body composition through measurement of bioelectrical impedance analysis (BIA), and muscle strength and functionality using hand grip strength (HGS) were prospectively collected. The diagnosis of malnutrition and sarcopenia was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively. Patients were followed up during their hospital stay or outpatient oncology visits to identify possible NI. Results A total of 107 patients were included in this study (mean age 66 years; 66.4% were men). The most frequent reason for admission was cancer treatment (19.6%), followed by infections (18.7%) and digestive tract symptoms (18.7%). Overall, 77.5% (83/107) of the patients were malnourished at admission according to the GLIM criteria, while 52.3% (56/107) were sarcopenic. Nosocomial infections (NI) were significantly more frequent in malnourished (52.1%; 25/48) and severely malnourished (42.1%; 8/19) patients, compared with well-nourished patients without malnutrition (25%; 10/40; p=0.035). The mean length of hospital stay was 13.9 days, significantly longer in patients with an NI compared to those without infections (18.6 vs. 10.8 days, p < 0.024). Conclusion This study evidenced the need to implement a routine protocol for the nutritional assessment and support of cancer patients at risk of malnutrition and sarcopenia to reduce the risk of NI during their hospital stay.
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COVID-19, Mucormycosis and Cancer: The Triple Threat-Hypothesis or Reality? J Pers Med 2022; 12:jpm12071119. [PMID: 35887616 PMCID: PMC9320339 DOI: 10.3390/jpm12071119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 01/09/2023] Open
Abstract
COVID-19 has been responsible for widespread morbidity and mortality worldwide. Invasive mucormycosis has death rates scaling 80%. India, one of the countries hit worst by the pandemic, is also a hotbed with the highest death rates for mucormycosis. Cancer, a ubiquitously present menace, also contributes to higher case fatality rates. All three entities studied here are individual, massive healthcare threats. The danger of one disease predisposing to the other, the poor performance status of patients with all three diseases, the impact of therapeutics for one disease on the pathology and therapy of the others all warrant physicians having a better understanding of the interplay. This is imperative so as to effectively establish control over the individual patient and population health. It is important to understand the interactions to effectively manage all three entities together to reduce overall morbidity. In this review article, we search for an inter-relationship between the COVID-19 pandemic, emerging mucormycosis, and the global giant, cancer.
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Sena GR, Lima JTO, Lima TPF, Vidal SA, Sales MJT, Goes PSA, Mello MJG. Inequity in inequity: Disproportional mortality risk in patients with cancer with COVID-19 in Brazil - a call to action. J Geriatr Oncol 2022; 13:885-887. [PMID: 35654724 PMCID: PMC9110538 DOI: 10.1016/j.jgo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Gabrielle R Sena
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil.
| | - Jurema T O Lima
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil
| | - Tiago P F Lima
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Instituto Federal de Pernambuco- IFPE, Pernambuco, Brazil
| | - Suely A Vidal
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil
| | - Mozart J T Sales
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil; Faculdade Pernambucana de Saúde, Pernambuco, Brazil
| | - Paulo S A Goes
- Universidade Federal de Pernambuco-UFPE, Pernambuco, Brazil; Faculdade de Medicina de Olinda-FMO, Pernambuco, Brazil
| | - Maria Julia G Mello
- Instituto de Medicina Integral Prof Fernando Figueira - IMIP, Pernambuco, Brazil
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Du G, Xu X, Wang J, Wang X, Ding Y, Li F, Sun Y, Tao H, Luo Y, Li H, Bo X, Chen H. The accessible promoter-mediated supplementary effect of host factors provides new insight into the tropism of SARS-CoV-2. MOLECULAR THERAPY. NUCLEIC ACIDS 2022; 28:249-258. [PMID: 35313658 PMCID: PMC8925281 DOI: 10.1016/j.omtn.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
In the past year, the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in the worldwide coronavirus disease 2019 (COVID-19) pandemic. Yet our understanding of the SARS-CoV-2 tropism mechanism is still insufficient. In this study, we examined the chromatin accessibility at the promoters of host factor genes (ACE2, TMPRSS2, NRP1, BSG, CTSL, and FURIN) in 14 tissue types, 23 tumor types, and 189 cell lines. We showed that the promoters of ACE2 and TMPRSS2 were accessible in a tissue- and cell-specific pattern, which is accordant with previous clinical research on SARS-CoV-2 tropism. We were able to further verify that type I interferon (IFN) could induce angiotensin-converting enzyme 2 (ACE2) expression in Caco-2 cells by enhancing the binding of HNF1A, the transcription factor of ACE2, to ACE2 promoter without changing chromatin accessibility. We then performed transcription factor (TF)-gene interactions network and pathway analyses and discovered that the TFs regulating host factor genes are enriched in pathways associated with viral infection. Finally, we established a novel model that suggests that open chromatin at the promoter mediates the host factors’ supplementary effect and ensures SARS-CoV-2 entry. Our work uncovers the relationship between epigenetic regulation and SARS-CoV-2 tropism and provides clues for further investigation of COVID-19 pathogenesis.
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Affiliation(s)
- Guifang Du
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China.,Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - Xiang Xu
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Junting Wang
- The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xuejun Wang
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Yang Ding
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Fei Li
- Computer Network Information Center, Chinese Academy of Sciences, Beijing 100190, China
| | - Yu Sun
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Huan Tao
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Yawen Luo
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Hao Li
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Xiaochen Bo
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
| | - Hebing Chen
- Institute of Health Service and Transfusion Medicine, Beijing 100850, China
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30
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Liang W, Li X, Yao Y, Meng Q, Wu X, Wang H, Xue J. Puerarin: A Potential Therapeutic for Colon Adenocarcinoma (COAD) Patients Suffering From SARS-CoV-2 Infection. Front Pharmacol 2022; 13:921517. [PMID: 35677450 PMCID: PMC9168431 DOI: 10.3389/fphar.2022.921517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/06/2022] [Indexed: 12/11/2022] Open
Abstract
Patients with colonic adenocarcinoma (COAD) are at relatively high risk of SARS-CoV-2 infection. However, there is a lack of medical strategies to treat COVID-19/COAD comorbidity. Puerarin, a natural product, is a known antiviral, antitumor, and immunomodulatory effect. Therefore, we hypothesised that puerarin could be used to treat COVID-19/COAD patients. Based on network pharmacology and bioinformatics analysis, the potential targets and pharmacological mechanisms of puerarin in COVID-19/COAD were identified. By intersecting therapeutic target genes for puerarin, COVID-19-related genes and COAD-related genes, 42 target genes of puerarin that could potentially treat COVID-19/COAD comorbidity were obtained. By using the 42 potential target genes to construct the protein-protein interaction (PPI) network, we obtained five core target genes, namely RELA, BCL2, JUN, FOS, and MAPK1. The results of bioinformatics analysis revealed that puerarin could be able to treat COVID-19/COAD comorbidity through apoptosis, antiviral, antioxidant, NF-κB signaling pathway, MAPK signaling pathway, IL-17 signaling pathway, TNF signaling pathway, and HIF-1 signaling pathway etc. This study found that puerarin has the potential to treat COVID-19/COAD patients and that the therapeutic target genes obtained in the study may provide clues for the treatment of COVID19/COAD comorbidity.
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Affiliation(s)
- Weizheng Liang
- Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.,Department of General Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Xiushen Li
- Department of Obstetrics and Gynecology, Shenzhen University General Hospital, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Health Science Center, Shenzhen, China.,Shenzhen Key Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Yue Yao
- Department of Internal Medicine of Traditional Chinese Medicine, The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qingxue Meng
- Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Xueliang Wu
- Department of General Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Hao Wang
- Department of Obstetrics and Gynecology, Shenzhen University General Hospital, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Health Science Center, Shenzhen, China.,Shenzhen Key Laboratory, Shenzhen University General Hospital, Shenzhen, China
| | - Jun Xue
- Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.,Department of General Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
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31
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Shachar E, Hasson SP, Ferro L, Pundak C, Nikolaevski-Berlin A, Waller E, Safra T, Rubinek T, Wolf I. Real-life daily activity: the impact of misbeliefs on quality of life among cancer patients. ESMO Open 2022; 7:100498. [PMID: 35642988 PMCID: PMC9271513 DOI: 10.1016/j.esmoop.2022.100498] [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: 01/24/2022] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background While side-effects and health-related quality of life (QoL) are routinely assessed in clinical trials, commonly used tools do not measure patients’ ability to maintain normal daily activities. QoL can be severely affected directly by the disease, the treatment side-effects and by personal and societal misconceptions promoting avoidance from activities perceived as dangerous for cancer patients. We examined practices of actively treated patients with cancer. Methods A questionnaire was designed, assessing daily activities (11 items) and dietary limitations (7 items) distributed between October and December 2019 (before the coronavirus pandemic) among patients treated at the Oncology Division of Tel Aviv Sourasky Medical Center. Results The study population comprised 208 patients who participated in the survey. The majority reported at least one social-environmental avoidance or dietary limitation (136, 65% and 120, 57.7%, respectively), including abstaining from social contact, avoiding pets, public domains, traveling and maintaining dietary constraints. Adoption of these measures was not associated with clinical, demographic factors and treatment type. The major sources guiding restrictions came from advice of non-medical personnel (55.7%), the Internet (7.2%) and personal choice by the patients themselves (24%). Conclusions Most cancer patients reported compromised daily activities, which are likely attributed to misbeliefs about disease and treatment, and have a deleterious impact on QoL, in its wider sense, namely, the ability to conduct a full and meaningful life. These findings call for the development and implementation of tools examining patients’ real-life activity, beyond side-effects or health-related QoL (HRQoL). We propose this assessment as an integral part in the evaluation of new drugs and technologies and as an additional endpoint in pivotal clinical trials. Side-effects and HRQoL routinely assessed in clinical trials do not fully measure patients’ maintenance of daily activities. We developed a questionnaire examining daily practices and implications of misbeliefs among actively treated cancer patients. Most patients reported compromised daily activities, affecting QoL in its wider sense: conducting a full and meaningful life. These findings call for the development and implementation of tools examining patients’ real-life activity, beyond HRQoL. We propose accounting for a more comprehensive assessment of QoL, and patient health care education dispelling misbeliefs.
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Affiliation(s)
- E Shachar
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - S P Hasson
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - L Ferro
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - C Pundak
- Division of Psychology, Tel Aviv University, Israel
| | | | - E Waller
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - T Safra
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - T Rubinek
- Division of Oncology, Tel Aviv Sourasky Medical Center, Israel
| | - I Wolf
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Oncology, Tel Aviv Sourasky Medical Center, Israel.
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Castelo-Branco L, Tsourti Z, Gennatas S, Rogado J, Sekacheva M, Viñal D, Lee R, Croitoru A, Vitorino M, Khallaf S, Šušnjar S, Soewoto W, Cardeña A, Djerouni M, Rossi M, Alonso-Gordoa T, Ngelangel C, Whisenant JG, Choueiri TK, Dimopoulou G, Pradervand S, Arnold D, Harrington K, Michielin O, Dafni U, Pentheroudakis G, Peters S, Romano E. COVID-19 in patients with cancer: first report of the ESMO international, registry-based, cohort study (ESMO-CoCARE). ESMO Open 2022; 7:100499. [PMID: 35644101 PMCID: PMC9080222 DOI: 10.1016/j.esmoop.2022.100499] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). PATIENTS AND METHODS ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection. RESULTS This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m2, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. CONCLUSIONS Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.
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Affiliation(s)
- L Castelo-Branco
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal
| | - Z Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | - S Gennatas
- Medical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, UK
| | - J Rogado
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M Sekacheva
- World-Class Research Center 'Digital Biodesign and Personalized Healthcare', Sechenov First Moscow State Medical University, Moscow, Russia
| | - D Viñal
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - R Lee
- Medical Oncology Department, The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - A Croitoru
- Medical Oncology Department, Fundeni Clinical Institute, Bucharest, Romania
| | - M Vitorino
- Servico Oncologia, Hospital Prof. Dr Fernando Fonseca EPE (Hospital Amadora/Sintra), Amadora, Portugal
| | - S Khallaf
- Medical Oncology Department, South Egypt Cancer Institute (SECI), Assiut University, Assiut, Egypt
| | - S Šušnjar
- Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - W Soewoto
- Department of Surgery, Oncology Division, Sebelas Maret University, Surakarta, Indonesia
| | - A Cardeña
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Djerouni
- Oncology Department, Dr Saadane Hospital, Biskra, Algeria
| | - M Rossi
- Oncology Deparment, ASO 'SS. Antonio, Biagio e Cesare Arrigo', Alessandria, Italy
| | - T Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Ngelangel
- Asian Cancer Institute - Asian Hospital and Medical Center, Metro Manila, the Philippines
| | - J G Whisenant
- Vanderbilt University Medical Center, Nashville, USA
| | - T K Choueiri
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA
| | - G Dimopoulou
- Frontier Science Foundation-Hellas, Athens, Greece
| | - S Pradervand
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - D Arnold
- Oncology, Haematology, Palliative Care Department, Asklepios Klinik Altona - Asklepios Kliniken, Hamburg, Germany
| | - K Harrington
- Division of Radiotherapy and Imaging, The Royal Marsden/The Institute of Cancer Research NIHR Biomedical Research Centre, London, UK
| | - O Michielin
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - U Dafni
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens Frontier Science Foundation-Hellas, Athens, Greece
| | - G Pentheroudakis
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland
| | - S Peters
- Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - E Romano
- Center for Cancer Immunotherapy, Department of Oncology, PSL Research University, Institut Curie, Paris, France.
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Wu X, Shen M, Quan H, Zhang X, Xu F, Li J, He M, Pan D, Cao L, Yue C, Liu T, Jia X. Shedding of SARS-CoV-2 for 85 Days in COVID-19 Patients With Type 2 Diabetes Mellitus and Lung Metastasis: A Case Report. Front Med (Lausanne) 2022; 9:828819. [PMID: 35419368 PMCID: PMC8996196 DOI: 10.3389/fmed.2022.828819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background COVID-19 (coronavirus disease 2019) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seriously endangers people's lives. The variation in SARS-CoV-2 makes the research and development of vaccines and specific drugs particularly important. However, the prevention and diagnosis of COVID-19 cannot be underestimated in the control of the epidemic. Case Presentation We introduced a 65-year-old female patient who was diagnosed with COVID-19. The SARS-CoV-2 nucleic acid test result of this patient was positive again during treatment. It took 85 days from the first symptom to the final cure. According to the known reports, she is currently the patient with the longest virus shedding in Sichuan Province, China. Due to the patient's special condition, she was treated in four hospitals before and after, and she was diagnosed with type 2 diabetes mellitus (T2DM) and right lung metastatic adenocarcinoma. We fully introduced the patient's epidemiological history, diagnosis, testing, and treatment process. The patient was finally discharged from the hospital under the treatment of antiviral, hypoglycaemic, anti-anxiety, and a combination of Chinese and Western medicine. Conclusions The epidemic is still rampant, and we should not relax our efforts in the prevention and control of viruses. For the elderly, especially those who are suffering from complications or vulnerable to diseases, it is recommended to extend the observation time. Additionally, medical workers should pay attention to the mental state of patients.
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Affiliation(s)
- Xiaoheng Wu
- Yan'an Key Laboratory of Microbial Drug Innovation and Transformation, School of Basic Medicine, Yan'an University, Yan'an, China.,Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Min Shen
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Hui Quan
- The 2nd Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, China
| | - Xianqin Zhang
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China.,School of Basic Medical Sciences, Chengdu Medical College, Chengdu, China
| | - Fengcheng Xu
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Juan Li
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Dongmei Pan
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Ling Cao
- Public Health and Clinical Center of Chengdu, Chengdu, China
| | - Changwu Yue
- Yan'an Key Laboratory of Microbial Drug Innovation and Transformation, School of Basic Medicine, Yan'an University, Yan'an, China
| | - Tianhu Liu
- The 3rd Affiliated Hospital of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
| | - Xu Jia
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China.,School of Basic Medical Sciences, Chengdu Medical College, Chengdu, China
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Plais H, Labruyère M, Creutin T, Nay P, Plantefeve G, Tapponnier R, Jonas M, Ngapmen NT, Le Guennec L, De Roquetaillade C, Argaud L, Jamme M, Goulenok C, Merouani K, Leclerc M, Sauneuf B, Shidasp S, Stoclin A, Bardet A, Mir O, Ibrahimi N, Llitjos JF. Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study. Front Oncol 2022; 12:858276. [PMID: 35359407 PMCID: PMC8960921 DOI: 10.3389/fonc.2022.858276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background Several studies report an increased susceptibility to SARS-CoV-2 infection in cancer patients. However, data in the intensive care unit (ICU) are scarce. Research Question We aimed to investigate the association between active cancer and mortality among patients requiring organ support in the ICU. Study Design and Methods In this ambispective study encompassing 17 hospitals in France, we included all adult active cancer patients with SARS-CoV-2 infection requiring organ support and admitted in ICU. For each cancer patient, we included 3 non cancer patients as controls. Patients were matched at the same ratio using the inverse probability weighting approach based on a propensity score assessing the probability of cancer at admission. Mortality at day 60 after ICU admission was compared between cancer patients and non-cancer patients using primary logistic regression analysis and secondary multivariable analyses. Results Between March 12, 2020 and March 8, 2021, 2608 patients were admitted with SARS-CoV-2 infection in our study, accounting for 2.8% of the total population of patients with SARS-CoV-2 admitted in all French ICUs within the same period. Among them, 105 (n=4%) presented with cancer (51 patients had hematological malignancy and 54 patients had solid tumors). 409 of 420 patients were included in the propensity score matching process, of whom 307 patients in the non-cancer group and 102 patients in the cancer group. 145 patients (35%) died in the ICU at day 60, 59 (56%) with cancer and 86 (27%) without cancer. In the primary logistic regression analysis, the odds ratio for death associated to cancer was 2.3 (95%CI 1.24 - 4.28, p=0.0082) higher for cancer patients than for a non-cancer patient at ICU admission. Exploratory multivariable analyses showed that solid tumor (OR: 2.344 (0.87-6.31), p=0.062) and hematological malignancies (OR: 4.144 (1.24-13.83), p=0.062) were independently associated with mortality. Interpretation Patients with cancer and requiring ICU admission for SARS-CoV-2 infection had an increased mortality, hematological malignancy harboring the higher risk in comparison to solid tumors.
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Affiliation(s)
- Henri Plais
- Intensive Care Unit, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Marie Labruyère
- Department of Intensive Care, Dijon Bourgogne University Hospital, Dijon, France
| | - Thibault Creutin
- Service de Médecine Intensive and Réanimation, APHP-CUP, Hôpital Cochin, Paris, France
| | - Paula Nay
- Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - Gaëtan Plantefeve
- Service de Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Romain Tapponnier
- Medical Intensive Care Unit, Hôpital Jean Minjoz Hospital, Besançon, France
| | - Maud Jonas
- Centre Hospitalier Général de Saint-Nazaire, Service de Médecine Intensive Réanimation, Saint-Nazaire, France
| | | | - Loïc Le Guennec
- Médecine Intensive Réanimation Neurologique, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles De Roquetaillade
- Department of Anesthesiology and Critical Care, Hôpital Lariboisière, FHU PROMICE, DMU Parabol, APHP, Paris, France
| | - Laurent Argaud
- Medical ICU, Edouard Herriot University Hospital, Lyon, France
| | - Matthieu Jamme
- Intensive Care Unit, Poissy-Saint-Germain-en-Laye Hospital, Poissy, France
| | - Cyril Goulenok
- Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France
| | - Karim Merouani
- Medical and Surgical Intensive Care Unit, Alençon Hospital, Alençon, France
| | - Maxime Leclerc
- Intensive Care Unit, Centre Hospitalier Mémorial France Etats-Unis, Saint-Lô, France
| | - Bertrand Sauneuf
- Réanimation - Médecine Intensive, Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Sami Shidasp
- Intensive Care Unit, Etampes Hospital, Etampes, France
| | - Annabelle Stoclin
- Intensive Care Unit, Centre Hospitalier de Château-Thierry, Château-Thierry, France
| | - Aurélie Bardet
- Bureau of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France and U1018 INSERM Oncostat, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - Olivier Mir
- Gustave-Roussy, Département d'oncologie Médicale, Villejuif, France
| | - Nusaibah Ibrahimi
- Bureau of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France and U1018 INSERM Oncostat, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
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Gupta A, Marzook H, Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med 2022; 23:313-331. [PMID: 35362771 PMCID: PMC8972750 DOI: 10.1007/s10238-022-00821-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes major challenges to the healthcare system. SARS-CoV-2 infection leads to millions of deaths worldwide and the mortality rate is found to be greatly associated with pre-existing clinical conditions. The existing dataset strongly suggests that cardiometabolic diseases including hypertension, coronary artery disease, diabetes and obesity serve as strong comorbidities in coronavirus disease (COVID-19). Studies have also shown the poor outcome of COVID-19 in patients associated with angiotensin-converting enzyme-2 polymorphism, cancer chemotherapy, chronic kidney disease, thyroid disorder, or coagulation dysfunction. A severe complication of COVID-19 is mostly seen in people with compromised medical history. SARS-CoV-2 appears to attack the respiratory system causing pneumonia, acute respiratory distress syndrome, which lead to induction of severe systemic inflammation, multi-organ dysfunction, and death mostly in the patients who are associated with pre-existing comorbidity factors. In this article, we highlighted the key comorbidities and a variety of clinical complications associated with COVID-19 for a better understanding of the etiopathogenesis of COVID-19.
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Affiliation(s)
- Anamika Gupta
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Hezlin Marzook
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Firdos Ahmad
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE. .,Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, UAE.
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36
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Latif MB, Shukla S, Del Rio Estrada PM, Ribeiro SP, Sekaly RP, Sharma AA. Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection. Transl Res 2022; 241:83-95. [PMID: 34871809 PMCID: PMC8641406 DOI: 10.1016/j.trsl.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/09/2023]
Abstract
Patients with cancers have been severely affected by the COVID-19 pandemic. This is highlighted by the adverse outcomes in cancer patients with COVID-19 as well as by the impact of the COVID-19 pandemic on cancer care. Patients with cancer constitute a heterogeneous population that exhibits distinct mechanisms of immune dysfunction, associated with distinct systemic features of hot (T-cell-inflamed/infiltrated) and cold (Non-T-cell-inflamed and/or infiltrated) tumors. The former show hyper immune activated cells and a highly inflammatory environment while, contrastingly, the latter show the profile of a senescent and/or quiescent immune system. Thus, the evolution of SARS-CoV-2 infection in different types of cancers can show distinct trajectories which could lead to a variety of clinical and pathophysiological outcomes. The altered immunological environment including cytokines that characterizes hot and cold tumors will lead to different mechanisms of immune dysfunction, which will result in downstream effects on the course of SARS-CoV-2 infection. This review will focus on defining the known contributions of soluble pro- and anti-inflammatory mediators on immune function including altered T-cells and B-cells responses and as well on how these factors modulate the expression of SARS-CoV-2 receptor ACE2, TMPRSS2 expression, and lymph node fibrosis in cancer patients. We will propose immune mechanisms that underlie the distinct courses of SARS-CoV-2 infection in cancer patients and impact on the success of immune based therapies that have significantly improved cancer outcomes. Better understanding of the immune mechanisms prevalent in cancer patients that are associated to the outcomes of SARS-CoV-2 infection will help to identify the high-risk cancer patients and develop immune-based approaches to prevent significant adverse outcomes by targeting these pathways.
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Affiliation(s)
- Muhammad Bilal Latif
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Sudhanshu Shukla
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Perla Mariana Del Rio Estrada
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Susan Pereira Ribeiro
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Rafick Pierre Sekaly
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia.
| | - Ashish Arunkumar Sharma
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
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Gao YL, Yao Y, Zhang X, Chen F, Meng XL, Chen XS, Wang CL, Liu YC, Tian X, Shou ST, Chai YF. Regulatory T Cells: Angels or Demons in the Pathophysiology of Sepsis? Front Immunol 2022; 13:829210. [PMID: 35281010 PMCID: PMC8914284 DOI: 10.3389/fimmu.2022.829210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/07/2022] [Indexed: 12/12/2022] Open
Abstract
Sepsis is a syndrome characterized by life-threatening organ dysfunction caused by the dysregulated host response to an infection. Sepsis, especially septic shock and multiple organ dysfunction is a medical emergency associated with high morbidity, high mortality, and prolonged after-effects. Over the past 20 years, regulatory T cells (Tregs) have been a key topic of focus in all stages of sepsis research. Tregs play a controversial role in sepsis based on their heterogeneous characteristics, complex organ/tissue-specific patterns in the host, the multi-dimensional heterogeneous syndrome of sepsis, the different types of pathogenic microbiology, and even different types of laboratory research models and clinical research methods. In the context of sepsis, Tregs may be considered both angels and demons. We propose that the symptoms and signs of sepsis can be attenuated by regulating Tregs. This review summarizes the controversial roles and Treg checkpoints in sepsis.
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Affiliation(s)
- Yu-lei Gao
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Yan-fen Chai, ; Yu-lei Gao,
| | - Ying Yao
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiang Zhang
- Department of Emergency Medicine, Rizhao People’s Hospital of Shandong Province, Rizhao, China
| | - Fang Chen
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiang-long Meng
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin-sen Chen
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao-lan Wang
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-cun Liu
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Tian
- Department of Medical Research, Beijing Qiansong Technology Development Company, Beijing, China
| | - Song-tao Shou
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-fen Chai
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Yan-fen Chai, ; Yu-lei Gao,
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Di Felice G, Visci G, Teglia F, Angelini M, Boffetta P. Effect of cancer on outcome of COVID-19 patients: a systematic review and meta-analysis of studies of unvaccinated patients. eLife 2022; 11:74634. [PMID: 35171096 PMCID: PMC8956284 DOI: 10.7554/elife.74634] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Since the beginning of the SARS-CoV-2 pandemic, cancer patients affected by COVID-19 have been reported to experience poor prognosis; however, a detailed quantification of the effect of cancer on outcome of unvaccinated COVID-19 patients has not been performed. Methods: To carry out a systematic review of the studies comparing the outcome of unvaccinated COVID-19 patients with and without cancer, a search string was devised which was used to identify relevant publications in PubMed up to December 31, 2020. We selected three outcomes: mortality, access to ICU, and COVID-19 severity or hospitalization. We considered results for all cancers combined as well as for specific cancers. We conducted random-effects meta-analyses of the results, overall and after stratification by region. We also performed sensitivity analyses according to quality score and assessed publication bias. Results: For all cancer combined, the pooled odds ratio (OR) for mortality was 2.32 (95% confidence interval [CI] 1.82–2.94, I2 for heterogeneity 90.1%, 24 studies), that for ICU admission was 2.39 (95% CI 1.90–3.02, I2 0.0%, 5 studies), that for disease severity or hospitalization was 2.08 (95% CI 1.60–2.72, I2 92.1%, 15 studies). The pooled mortality OR for hematologic neoplasms was 2.14 (95% CI 1.87–2.44, I2 20.8%, 8 studies). Data were insufficient to perform a meta-analysis for other cancers. In the mortality meta-analysis for all cancers, the pooled OR was higher for studies conducted in Asia than studies conducted in Europe or North America. There was no evidence of publication bias. Conclusions: Our meta-analysis indicates a twofold increased risk of adverse outcomes (mortality, ICU admission, and severity of COVID-19) in unvaccinated COVID-19 patients with cancer compared to COVID-19 patients without cancer. These results should be compared with studies conducted in vaccinated patients; nonetheless, they argue for special effort to prevent SARS-CoV-2 infection in patients with cancer. Funding: No external funding was obtained.
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Affiliation(s)
- Giulia Di Felice
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federica Teglia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Angelini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Guarnera A, Santini E, Podda P. COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiological Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies. Tomography 2022; 8:513-528. [PMID: 35202206 PMCID: PMC8875889 DOI: 10.3390/tomography8010041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 12/21/2022] Open
Abstract
The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis leading to patients’ poor prognosis and late medical treatment. The radiologist plays a pivotal role as CT represents a non-invasive radiological technique which may help to identify possible overlap and differential diagnosis between COVID-19 pneumonia and lung cancer, which represents the most frequent cancer histology in COVID-19 patients. Our aims are: to present the main CT features of COVID-19 pneumonia; to provide the main differential diagnosis with lung cancer, chemotherapy-, immunotherapy-, and radiotherapy-induced lung disease; and to suggest practical tips and key radiological elements to identify possible overlap between COVID-19 pneumonia and lung cancer. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis. It is crucial to search for typical COVID-19 pneumonia phase progression and typical radiological features on HRTC. The evidence of atypical findings such as lymphadenopathies and mediastinal and vessel invasion, as well as the absence of response to therapy, should arouse the suspicion of lung cancer and require contrast administration. Ground-glass areas and/or consolidations bound to radiotherapy fields or pneumonitis arising during and after oncological therapy should always arouse the suspicion of radiation-induced lung disease and chemo/immunotherapy-induced lung disease. The radiological elements we suggest for COVID-19 and lung cancer differential diagnosis may be used to develop AI protocols to guarantee an early and proper diagnosis and treatment to improve patients’ quality of life and life expectancy.
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Affiliation(s)
- Alessia Guarnera
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, 00189 Rome, Italy
- Correspondence:
| | - Elena Santini
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
| | - Pierfrancesco Podda
- Radiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy; (E.S.); (P.P.)
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Jiang A, Shi X, Zheng H, Liu N, Chen S, Gao H, Ren M, Zheng X, Fu X, Liang X, Ruan Z, Tian T, Yao Y. Establishment and validation of a nomogram to predict the in-hospital death risk of nosocomial infections in cancer patients. Antimicrob Resist Infect Control 2022; 11:29. [PMID: 35130978 PMCID: PMC8822816 DOI: 10.1186/s13756-022-01073-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/27/2022] [Indexed: 12/29/2022] Open
Abstract
Background Attributed to the immunosuppression caused by malignancy itself and its treatments, cancer patients are vulnerable to developing nosocomial infections. This study aimed to develop a nomogram to predict the in-hospital death risk of these patients. Methods This retrospective study was conducted at a medical center in Northwestern China. The univariate and multivariate logistic regression analyses were adopted to identify predictive factors for in-hospital mortality of nosocomial infections in cancer patients. A nomogram was developed to predict the in-hospital mortality of each patient, with receiver operating characteristic curves and calibration curves being generated to assess its predictive ability. Furthermore, decision curve analysis (DCA) was also performed to estimate the clinical utility of the nomogram. Results A total of 1,008 nosocomial infection episodes were recognized from 14,695 cancer patients. Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (15.5%) was the most predominant causative pathogen. Besides, multidrug-resistant strains were discovered in 25.5% of cases. The multivariate analysis indicated that Eastern Cooperative Oncology Group Performance Status 3–4, mechanical ventilation, septic shock, hypoproteinemia, and length of antimicrobial treatment < 7 days were correlated with higher in-hospital mortality. Patients who received curative surgery were correlated with favorable survival outcomes. Ultimately, a nomogram was constructed to predict the in-hospital mortality of nosocomial infections in cancer patients. The area under the curve values of the nomogram were 0.811 and 0.795 in the training and validation cohorts. The calibration curve showed high consistency between the actual and predicted in-hospital mortality. DCA indicated that the nomogram was of good clinical utility and more credible net clinical benefits in predicting in-hospital mortality. Conclusions Nosocomial infections stay conjoint in cancer patients, with gram-negative bacteria being the most frequent causative pathogens. We developed and verified a nomogram that could effectively predict the in-hospital death risk of nosocomial infections among these patients. Precise management of high-risk patients, early recognition of septic shock, rapid and adequate antimicrobial treatment, and dynamic monitoring of serum albumin levels may improve the prognosis of these individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01073-3.
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Affiliation(s)
- Aimin Jiang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xin Shi
- School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Haoran Zheng
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Na Liu
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Shu Chen
- Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Huan Gao
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Mengdi Ren
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xiaoqiang Zheng
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xiao Fu
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xuan Liang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Zhiping Ruan
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Tao Tian
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Yu Yao
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
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Zekri AR, Ahmed OS, Asem N, Musa S, Ibrahem M, Soliman HK, Hafez MM, Nessim MS, Aboelkasem H, Bahnassy AA. SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction Positivity and Seroprevalence among Health Care Workers in a Referral Cancer Institute: A Cross-sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: During the ongoing coronavirus disease 2019 pandemic, healthcare workers (HCWs) are presumed to be at increased risk of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmitting the infection to vulnerable patients if they are not timeously isolated.
AIM: This study aimed to determine the point prevalence of SARS-CoV-2 infection in a cohort of HCWs providing oncology services.
METHODS AND RESULTS: HCWs in a large referral cancer hospital in Egypt were tested using real-time reverse transcription-polymerase chain reaction (RT-PCR) on nasopharyngeal swabs, and immunochromatography-based rapid serological test (RST). Clinical and epidemiological data were collected. In 2020, 999 HCWs were screened, of whom 86 tested positive for SARS-CoV-2 by RT-PCR (8.6%) and 127 subjects were seropositive for antibodies against SARS-CoV-2 by RST (12.8%). Immunoglobulin M seroprevalence demonstrated considerable concordance with RT-PCR positivity (sensitivity 82.14% and specificity 96.71%). Most HCWs (>95%) reported adherence to personal protective equipment. Patient transporters/cleaner were the group with the highest frequency of positive RT-PCR (19%) whereas laboratory and radiology technicians displayed the lowest frequency. Fever, dry cough, rhinorrhea, shortness of breath, fatigue and diarrhea were significantly associated with RT-PCR positivity, with increased likelihood of being positive with the presence of five or six simultaneous symptoms.
CONCLUSIONS: The point prevalence of SARS-CoV-2 infection in screened HCWs is 8.6% by RT-PCR and seroprevalence is 12.8% by RST. Strict measures should be implemented to minimize transmission within healthcare settings and to the community. Our data support the importance of HCWs screening for SARS-CoV-2, taking in account the significant proportion of asymptomatic carriers.
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COVID-19-Related Knowledge and Practices of Cancer Patients and Their Anxiety and Depression During the Early Surge Phase of the Pandemic: A Cross-sectional Online Survey. Disaster Med Public Health Prep 2022; 17:e73. [PMID: 35094745 DOI: 10.1017/dmp.2021.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to investigate the coronavirus disease 2019 (COVID-19)-related knowledge and practices of cancer patients and to assess their anxiety- and depression-related to COVID-19 during the early surge phase of the pandemic. METHODS An online questionnaire survey of cancer patients was conducted from February 10-29, 2020. Knowledge and practices related to COVID-19 were assessed using a custom-made questionnaire. The Hospital Anxiety and Depression Scale was used to assess the presence of anxiety and depression, with scores beyond 7 indicating anxiety or depressive disorder. Univariate and multiple linear regression analyses were used to identify the high-risk groups according to the level of knowledge, practices, anxiety, and depression scores. RESULTS A total of 341 patients were included. The rate of lower level of knowledge and practices was 49.9% and 18.8%, respectively. Education level of junior high school degree or lower showed a significant association with lower knowledge score (β: -3.503; P < 0.001) and lower practices score (β: -2.210; P < 0.001) compared to the education level of college degree and above. The prevalence of anxiety and depression among the respondents was 17.6% and 23.2%, respectively. A higher depression score was associated with older age, marital status of the widowed, and lower level of education, knowledge score, and practices score (P < 0.05). CONCLUSIONS Targeted COVID-19-related education interventions are required for cancer patients with a lower level of knowledge to help improve their practices. Interventions are also required to address the anxiety and depression of cancer patients.
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BİLGİ A, AVCI F, KESER ŞAHİN HH, CAN B, GÜLER AH, KULHAN M, CELİK C. Comparison of prognostic factors in patients diagnosed with endometrial cancer before and after COVID 19 pandemic: a retrospective study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1017866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ghaleb N, Bulkhi A, Al-Qurashi E, Touman A, Aldobyany A, Alsaggaf R, Mabar H, Murtaza N, Rajab A. Clinical characteristics and risk factors for mortality of hospitalized cancer patients with COVID-2019 in Mecca, Saudi Arabia. Ann Thorac Med 2022; 17:220-228. [DOI: 10.4103/atm.atm_91_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/09/2022] [Indexed: 11/04/2022] Open
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Li Z, Li Q, Wang X, Chen W, Jin X, Liu X, Ye F, Dai Z, Zheng X, Li P, Sun C, Liu X, Zhang Q, Luo H, Liu R. Hyperthermia ablation combined with transarterial chemoembolization versus monotherapy for hepatocellular carcinoma: A systematic review and meta-analysis. Cancer Med 2021; 10:8432-8450. [PMID: 34655179 PMCID: PMC8633247 DOI: 10.1002/cam4.4350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/15/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS The existing evidence has indicated that hyperthermia ablation (HA) and HA combined with transarterial chemoembolization (HATACE) are the optimal alternative to surgical resection for patients with hepatocellular carcinoma (HCC) in the COVID-19 crisis. However, the evidence for decision-making is lacking in terms of comparison between HA and HATACE. Herein, a comprehensive evaluation was performed to compare the efficacy and safety of HATACE with monotherapy. MATERIALS AND METHODS Worldwide studies were collected to evaluate the HATACE regimen for HCC due to the practical need for global extrapolation of applicative population. Meta-analyses were performed using the RevMan 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). RESULTS Thirty-six studies involving a large sample of 5036 patients were included finally. Compared with HA alone, HATACE produced the advantage of 5-year overall survival (OS) rate (OR:1.90; 95%CI:1.46,2.46; p < 0.05) without increasing toxicity (p ≥ 0.05). Compared with TACE alone, HATACE was associated with superior 5-year OS rate (OR:3.54; 95%CI:1.96,6.37; p < 0.05) and significantly reduced the incidences of severe liver damage (OR:0.32; 95%CI:0.11,0.96; p < 0.05) and ascites (OR:0.42; 95%CI:0.20,0.88; p < 0.05). Subgroup analysis results of small (≤3 cm) HCC revealed that there were no significant differences between the HATACE group and HA monotherapy group in regard to the OS rates (p ≥ 0.05). CONCLUSIONS Compared with TACE alone, HATACE was more effective and safe for HCC. Compared with HA alone, HATACE was more effective for non-small-sized (>3 cm) HCC with comparable safety. However, the survival benefit of adjuvant TACE in HATACE regimen was not found for the patients with small (≤3 cm) HCC.
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Sawyers A, Chou M, Johannet P, Gulati N, Qian Y, Zhong J, Osman I. Clinical outcomes in cancer patients with COVID-19. Cancer Rep (Hoboken) 2021; 4:e1413. [PMID: 34409775 PMCID: PMC8420395 DOI: 10.1002/cnr2.1413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early reports on cancer patients with coronavirus disease 2019 (COVID-19) corroborated speculation that cancer patients are at increased risk for becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and developing severe COVID-19. However, cancer patients are a heterogeneous population and their corresponding risk may be different. AIM To compare COVID-19 presentation in patients with active malignancy to those with a history of cancer to determine the impact of cancer status on COVID-19 outcomes in the two groups. METHODS AND RESULTS Of the 6724 patients who were hospitalized at NYU Langone Health (3/16/20-7/31/20) and tested positive for SARS-CoV-2, 580 had either active cancer (n = 221) or a history of cancer (n = 359). We compared the baseline clinicodemographic characteristics and hospital courses of the two groups. We studied the relationship between cancer status and the rate of admission to the intensive care unit (ICU), use of invasive mechanical ventilation (IMV), and all-cause mortality. The two groups had similar laboratory results associated with COVID-19 infection, incidence of venous thromboembolism, and incidence of severe COVID-19. Active cancer status was not associated with the rate of ICU admission (p = .307) or use of IMV (p = .236), but was significantly associated with worse all-cause mortality in both univariate and multivariate analysis with odds ratios of 1.48 (95% confidence interval [CI]: 1.04-2.09; p = .028) and 1.71 (95% CI: 1.12-2.63; p = .014), respectively. CONCLUSION Active cancer patients had worse survival outcomes compared to patients with a history of cancer despite similar COVID-19 disease characteristics in the two groups. Our data suggest that cancer care should continue with minimal interruptions during the pandemic to bring about response and remission as soon as possible.
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Affiliation(s)
- Amelia Sawyers
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Margaret Chou
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Paul Johannet
- Department of MedicineNYU Grossman School of MedicineNew YorkUSA
| | - Nicholas Gulati
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Yingzhi Qian
- Department of Population HealthNYU Grossman School of MedicineNew YorkUSA
| | - Judy Zhong
- Department of Population HealthNYU Grossman School of MedicineNew YorkUSA
| | - Iman Osman
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
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Gurizzan C, Pedersini R, Fornaro C, Sardini C, Zamparini M, Monteverdi S, Tovazzi V, Cosentini D, Dalla Volta A, Baggi A, Turla A, Di Mauro P, Lorini L, Laganà M, Bianchi S, Grisanti S, Consoli F, Conti E, Bossi P, Berruti A. Accurate Triage of Oncological Patients for Safely Continuing Cancer Therapy During the SARS-CoV-2 Pandemic. Front Oncol 2021; 11:707346. [PMID: 34722252 PMCID: PMC8552044 DOI: 10.3389/fonc.2021.707346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
Objective To evaluate the efficacy of clinical triage of oncological patients for safe continuation of cancer therapy implemented during the first SARS-CoV-2 outbreak. Methods Between 25 February and 21 April 2020, patients attending the Medical Oncology Unit, Spedali Civili Hospital, Brescia (Italy) for cancer therapy underwent triage to identify those with no signs and symptoms suspicious for SARS-CoV-2 infection in which antineoplastic treatment could be continued as scheduled. Triage questions investigated common symptoms (e.g., fever, cough, dyspnea, anosmia, dysgeusia, headache, nasal congestion, conjunctival congestion, sore throat, diarrhea, nausea and vomiting); body temperature and pulse oximetry were also recorded. All patients were followed-up for overt SARS-CoV-2 through to 18th May 2020. Results Overall, 1180 patients (median age 65 years) underwent triage during the study period. The most frequent primary malignances were breast (32%), gastrointestinal (18%), and lung (16.5%) cancer. Thirty-one (2.5%) presented with clinically evident SARS-CoV-2 infection and tested positive on nasopharyngeal swab testing and/or radiological imaging. Triage identified 69 (6%) grey zone patients with symptoms suspicious for SARS-CoV-2; 5 (7.2%) subsequently developed symptomatic disease. Neither the symptomatic nor the grey zone patients received their scheduled treatment; instead, they were referred for hospitalization or home quarantine. Conclusion Triage of oncological patients at our Unit provided for safe continuation of scheduled cancer treatment in 91.5% of patients during the initial SARS-CoV-2 outbreak.
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Affiliation(s)
- Cristina Gurizzan
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Rebecca Pedersini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Carla Fornaro
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Chiara Sardini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Manuel Zamparini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Sara Monteverdi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Valeria Tovazzi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Deborah Cosentini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Alberto Dalla Volta
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Alice Baggi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Antonella Turla
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Pierluigi Di Mauro
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Luigi Lorini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Marta Laganà
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Susanna Bianchi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Salvatore Grisanti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Francesca Consoli
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Elisabetta Conti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
| | - Alfredo Berruti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia at the Azienda Socio Sanitaria Territoriale (ASST)-Spedali Civili, Brescia, Italy
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Boutros M, Moujaess E, Kourie HR. Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea. Crit Rev Oncol Hematol 2021; 167:103273. [PMID: 33737160 PMCID: PMC7959683 DOI: 10.1016/j.critrevonc.2021.103273] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023] Open
Abstract
COVID-19 was declared a "Public Health Emergency of International Concern" in March 2020. Since then, drastic measures were implemented to reduce the virus spread. These measures prevented cancer patients from receiving prompt medical care. A delay in testing and treating cancer patients is thought to protect them from serious COVID-19 complications but exposes them at the same time to the risk of disease progression and cancer related mortality. Healthcare providers are therefore facing the dilemma of choosing between two unpleasant scenarios. To shed light upon the matter, we present in this review article, based on an extensive search of the literature, an overview of the delay in the management of cancer patients, possible contributors to this delay and its benefits and risks on cancer patients' health.
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Affiliation(s)
- Marc Boutros
- Faculty of Medicine, Saint Joseph University of Beirut, Lebanon
| | - Elissar Moujaess
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Beirut, Lebanon,Corresponding author
| | - Hampig Raphael Kourie
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Beirut, Lebanon
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49
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COVID-19 in patients with cancer: can baseline radiologic severity and early evolution predict clinical outcomes? Eur Radiol 2021; 32:2661-2671. [PMID: 34718846 PMCID: PMC8556839 DOI: 10.1007/s00330-021-08341-7] [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: 03/30/2021] [Revised: 08/10/2021] [Accepted: 08/24/2021] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To determine whether the degree of parenchymal involvement on chest radiograph (CXR) at the time of COVID-19 diagnosis and its early radiologic evolution can predict adverse events including hospitalization, intubation, and death in patients with cancer. METHODS Retrospective study of 627 COVID-19-positive patients between March and April 2020, of which 248 had baseline CXR within 72 h of diagnosis and 64 patients had follow-up wihtin72 h. CXRs were classified as abnormal (i.e., radiologic findings suggestive of COVID-19 infection were noted), normal, or indeterminate. Baseline and follow-up severity scores were calculated based on lung regions in abnormal CXRs. Statistical analysis was performed to determine associations between abnormal CXR or severity score with adverse events. RESULTS Of 248 patients (median age = 65) with a baseline CXR, 172/248 (69%) had an abnormal baseline study, which was associated with hospitalization (p < 0.001), intubation (p = 0.001), and death (p = 0.005). For patients with solid neoplasms, when adjusted for stage, it was associated with hospitalization (p = 0.0002), intubation (p = 0.019), and death (p = 0.03). The median baseline severity score was 3 (range = 1-10); the greater the score, the higher the likelihood of adverse outcome (p < 0.003 for all). A baseline severity score > 9 predicted > 50% probability of intubation and a score of ≥ 10 predicted > 50% of probability of death. The baseline severity score was not correlated with cancer-related treatment. Early radiologic progression was not correlated with hospitalization, intubation, or death. CONCLUSION The degree of parenchymal involvement on CXR within 72 h of COVID-19 diagnosis is associated with adverse outcomes in patients with cancer. KEY POINTS • In patients with cancer, the presence and severity of radiologic manifestation of COVID-19 on chest radiographs within 72 h of COVID-19 diagnosis are associated with hospitalization, intubation, and death. • Early radiologic progression on chest radiographs is not correlated with adverse outcomes.
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50
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Haddad S, Jabbour JF, Hindy JR, Makki M, Sabbagh A, Nayfeh M, Boustany M, El-Zein S, Tamim H, Zakhem AE, El Cheikh J, Bazarbachi A, Kanj SS. Bacterial bloodstream infections and patterns of resistance in patients with haematological malignancies at a tertiary centre in Lebanon over 10 years. J Glob Antimicrob Resist 2021; 27:228-235. [PMID: 34607062 DOI: 10.1016/j.jgar.2021.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Bacterial bloodstream infections (BSIs) with resistant pathogens in patients with haematological malignancies are rising due to increased use of novel chemotherapeutic agents and prophylactic antibiotics. Our goal was to understand the epidemiology and resistance patterns of bacterial pathogens in patients with haematological malignancies to help tailor empirical antibiotics and to limit resistance. METHODS This was a retrospective chart review looking at bacterial BSI episodes between 2007-2017 in patients previously diagnosed with haematological malignancy at a tertiary-care centre in Lebanon. RESULTS Among 165 hospitalised patients with haematological malignancy and bacterial BSI over 10 years, Gram-negative bacteria (GNB) caused 65.0% of all episodes, with the most common pathogens being Escherichia coli (45.6%), 79.6% of which were ESBL-producers, Pseudomonas aeruginosa (7.5%) and Acinetobacter baumannii (4.0%). The majority of the organisms (61.0%) were multidrug-resistant (MDR), with ANC < 100 neutrophils/μL (OR = 0.12, 95% CI 0.03-0.54) identified as an independent marker for increased multidrug resistance. The risk factors associated with increased mortality included recent use of amikacin (p<0.001) and infections with organisms resistant to amikacin (p<0.001) or ciprofloxacin (p=0.04). Our results reflect a persistent pattern of Gram-negative predominance with E. coli remaining the most common isolated pathogen in bacterial BSIs in patients with haematological malignancies. The relative frequency of GNB to Gram-positive bacteria remains similar to our data from 2007. CONCLUSION The persistent divergence between worldwide data and the results observed in our centre and the increasing rates of MDR pathogens emphasise the importance of tailoring empirical antimicrobial therapy according to the centre's epidemiology.
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Affiliation(s)
- Sara Haddad
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jean-Francois Jabbour
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joya-Rita Hindy
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maha Makki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Sabbagh
- American University of Beirut, Beirut, Lebanon
| | | | | | - Saeed El-Zein
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Aline El Zakhem
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jean El Cheikh
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Bazarbachi
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha S Kanj
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
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