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Wazqar DY. Challenges Experienced by Saudi Patients With Cancer and Their Family Caregivers in Using Digital Healthcare Technology Platforms in the COVID-19 Pandemic. Comput Inform Nurs 2024; 42:495-503. [PMID: 38376412 DOI: 10.1097/cin.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
COVID-19 has provided a unique boost to the use of digital healthcare technology, putting many vulnerable people at risk of digital exclusion. To promote digital healthcare equity, it is important to identify the challenges that may inhibit cancer patients and family caregivers from benefiting from such technology. This study explored the challenges that cancer patients and family caregivers experience in using digital healthcare technology platforms during the COVID-19 pandemic. A qualitative descriptive study using face-to-face semistructured individual interviews was carried out. A purposive sample of 21 participants was recruited from a public cancer hospital in Saudi Arabia. Qualitative content analysis with an inductive approach was utilized. The factors that challenged the ability of participants to benefit from digital healthcare technology were similar. Four themes related to the challenges the two groups experienced emerged: access to platforms, use of platforms for cancer health-related purposes, attitudes toward these platforms, and individual user preferences. This study identified numerous areas for improvement regarding digital healthcare technology platform implementation, which could increase future benefits and equal use. This study's findings also provide useful information to investigators who intend to create digital nursing interventions for both groups amid COVID-19 and other worldwide health crises.
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Affiliation(s)
- Dhuha Youssef Wazqar
- Author Affiliation: Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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2
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Mack PC, Hsu CY, Rodilla AM, Gomez JE, Cagan J, Huang Y, Tavolacci S, Valanparambil RM, Rohs N, Brody R, Nichols B, Carreño JM, Bhalla S, Rolfo C, Gerber DE, Moore A, King JC, Ahmed R, Minna JD, Bunn PA, García-Sastre A, Krammer F, Hirsch FR, Shyr Y. Time-Dependent Effects of Clinical Interventions on SARS-CoV-2 Immunity in Patients with Lung Cancer. Vaccines (Basel) 2024; 12:713. [PMID: 39066351 PMCID: PMC11281667 DOI: 10.3390/vaccines12070713] [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: 05/01/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 07/28/2024] Open
Abstract
In patients with lung cancer (LC), understanding factors that impact the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike antibody (SAb) titers over time is critical, but challenging, due to evolving treatments, infections, vaccinations, and health status. The objective was to develop a time-dependent regression model elucidating individual contributions of factors influencing SAb levels in LC patients using a prospective, longitudinal, multi-institutional cohort study initiated in January 2021. The study evaluated 296 LC patients-median age 69; 55% female; 50% stage IV. Blood samples were collected every three months to measure SAb levels using FDA-approved ELISA. Asymptomatic and unreported infections were documented through measurement of anti-nucleocapsid Ab levels (Meso Scale Discovery). Associations between clinical characteristics and titers were evaluated using a time-dependent linear regression model with a generalized estimating equation (GEE), considering time-independent variables (age, sex, ethnicity, smoking history, histology, and stage) and time-dependent variables (booster vaccinations, SARS-CoV-2 infections, cancer treatment, steroid use, and influenza vaccination). Significant time-dependent effects increasing titer levels were observed for prior SARS-CoV-2 infection (p < 0.001) and vaccination/boosters (p < 0.001). Steroid use (p = 0.043) and chemotherapy (p = 0.033) reduced titer levels. Influenza vaccination was associated with increased SAb levels (p < 0.001), independent of SARS-CoV-2 vaccine boosters. Prior smoking significantly decreased titers in females (p = 0.001). Age showed no association with titers. This GEE-based linear regression model unveiled the nuanced impact of multiple variables on patient anti-spike Ab levels over time. After controlling for the major influences of vaccine and SARS-CoV-2 infections, chemotherapy and steroid use were found to have negatively affected titers. Smoking in females significantly decreased titers. Surprisingly, influenza vaccinations were also significantly associated, likely indirectly, with improved SARS-CoV-2 titers.
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Affiliation(s)
- Philip C. Mack
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Chih-Yuan Hsu
- Department of Biostatistics, Vanderbilt University, Nashville, TN 37235, USA; (C.-Y.H.); (Y.S.)
| | - Ananda M. Rodilla
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Jorge E. Gomez
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Jazz Cagan
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Yuanhui Huang
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sooyun Tavolacci
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Rajesh M. Valanparambil
- Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA; (R.M.V.); (R.A.)
- Department of Microbiology and Immunology, Emory University, Atlanta, GA 30322, USA
| | - Nicholas Rohs
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - Rachel Brody
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (R.B.); (A.G.-S.); (F.K.)
| | - Brittney Nichols
- GO2 Foundation for Lung Cancer, Washington, DC 20006, USA; (B.N.); (J.C.K.)
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sheena Bhalla
- Hamon Center for Therapeutic Oncology Research, Departments of Internal Medicine and Pharmacology UT Southwestern Medical Center, Dallas, TX 75235, USA; (S.B.); (D.E.G.); (J.D.M.)
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
| | - David E. Gerber
- Hamon Center for Therapeutic Oncology Research, Departments of Internal Medicine and Pharmacology UT Southwestern Medical Center, Dallas, TX 75235, USA; (S.B.); (D.E.G.); (J.D.M.)
| | - Amy Moore
- LUNGevity Foundation, Bethesda, MD 20814, USA;
| | - Jennifer C. King
- GO2 Foundation for Lung Cancer, Washington, DC 20006, USA; (B.N.); (J.C.K.)
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA; (R.M.V.); (R.A.)
- Department of Microbiology and Immunology, Emory University, Atlanta, GA 30322, USA
| | - John D. Minna
- Hamon Center for Therapeutic Oncology Research, Departments of Internal Medicine and Pharmacology UT Southwestern Medical Center, Dallas, TX 75235, USA; (S.B.); (D.E.G.); (J.D.M.)
| | - Paul A. Bunn
- Department of Internal Medicine, University of Colorado Cancer Center, Denver, CO 80045, USA;
| | - Adolfo García-Sastre
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (R.B.); (A.G.-S.); (F.K.)
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Florian Krammer
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (R.B.); (A.G.-S.); (F.K.)
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Fred R. Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (A.M.R.); (J.E.G.); (J.C.); (Y.H.); (S.T.); (N.R.); (C.R.); (F.R.H.)
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (R.B.); (A.G.-S.); (F.K.)
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University, Nashville, TN 37235, USA; (C.-Y.H.); (Y.S.)
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Xu J, Ding Y, Qu Z, Yu F. Differences in risk of serious infections between patients with secondary versus primary nephropathy following rituximab treatment: a retrospective cohort study. Front Immunol 2024; 15:1390997. [PMID: 38919606 PMCID: PMC11196396 DOI: 10.3389/fimmu.2024.1390997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Background The incidence of severe infections (SIs) in patients with autoimmune nephropathy after rituximab (RTX) treatment varies significantly. Our study aims to identify high-risk populations, specifically by comparing the differences in the risk of SIs between patients with primary nephropathy and those with nephropathy in the context of systemic autoimmune diseases (referred to as secondary nephropathy). Methods This retrospective cohort study investigated the occurrence of SIs in adult patients with immune-related kidney disease who received RTX treatment at our institution from 2017 to 2022. Multivariable COX regression models were used to analyze the association between the type of nephropathy (primary or secondary) and SIs. Propensity score analyses, subgroup analyses, and E-value calculations were performed to ensure the reliability of the results. Results Out of 123 patients, 32 (26%) developed 39 cases of SIs during a mean follow-up period of 19.7 ± 14.6 months post-RTX treatment, resulting in an incidence rate of 18.9/100 patient-years. The multivariable COX regression analysis indicated that patients with secondary nephropathy had a significantly higher risk of SIs compared to those with primary nephropathy (HR = 5.86, 95% CI: 1.05-32.63, P = 0.044), even after accounting for confounding variables including gender, age, BMI, history of prior SIs, baseline eGFR, lymphocyte counts, IgG levels, and the utilization of other immunosuppressive therapies. Various sensitivity analyses consistently supported these findings, with an E-value of 5.99. Furthermore, advanced age (HR: 1.03; 95% CI: 1.01-1.06; P = 0.023), low baseline IgG levels (HR: 0.75; 95% CI: 0.64-0.89; P < 0.001), and recent history of SIs (HR: 5.68; 95% CI: 2.2-14.66; P < 0.001) were identified as independent risk factors. Conclusion The incidence of SIs following RTX administration in patients with autoimmune nephropathy is significant. It is crucial to note that there are distinct differences between the subgroups of primary and secondary nephropathy. Patients with secondary nephropathy, particularly those who are elderly, have low baseline IgG levels, and have a recent history of SI, are more susceptible to SIs.
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Affiliation(s)
| | | | - Zhen Qu
- Department of Nephrology, Peking University International Hospital, Beijing, China
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Reimann P, Petzer V, Mündlein A, Hartmann B, Severgnini L, Winkler A, Lang T, Huynh M, Gasser K, Rüger J, Atzl M, Mink S, Fraunberger P, Schmidt S, Steiner N, Griesmacher A, Gunsilius E, Nachbaur D, Willenbacher W, Wolf D, Winder T, Benda MA. Efficacy and safety of tixagevimab/cilgavimab as passive immunisation against COVID-19 infections in patients with hematological malignancies. Ann Hematol 2024; 103:2123-2131. [PMID: 38436671 DOI: 10.1007/s00277-024-05671-6] [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: 11/20/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
Monoclonal antibodies, as tixagevimab/cilgavimab, have been introduced as prophylaxis against COVID-19 infections in high-risk populations. However, data on efficacy are limited. This study investigates efficacy and tolerability of tixagevimab/cilgavimab in hematological patients under real-life conditions. Tixagevimab/cilgavimab was administered to 155 hematological patients (March-August 2022) at two Austrian centres. S/RBD-antibody assessments were performed before (T0), four weeks (T1), and six months (T2) after application. Side effects, the occurrence of COVID-19 infections, and the course of S/RBD-antibody titres were analysed retrospectively in relation to clinical variables. 155 hematological patients, who refused tixagevimab/cilgavimab, were included as a control group to compare the frequency of COVID-19 infections. Of all immunised patients (52.3% males; 91% triple vaccinated), 25.8% had a COVID-19 breakthrough infection (76% mild) compared to 43.9% in the control group. Patients with chronic lymphocytic leukaemia (CLL)/lymphoma were at highest risk of a COVID-19 infection (OR = 2.21; 95% CI 1.05-4.65; p = 0.037). After immunisation, a steep increase in median antibody levels (1193.4BAU/ml, IQR 0-2318.94) was observed in 67.8%, followed by a rapid decrease between T1 and T2 (465.95BAU/ml, IQR 0-1900.65.3) with the greatest declines in CLL/lymphoma (848.7BAU/ml, IQR 0-1949.6, p = 0.026). Side-effects occurred in 21.2% (CTCAE I/II). These real-world data indicate that S/RBD antibodies respond rapidly after passive immunisation in all hematological patients without safety concerns. Given the rapid decline in S/RBD antibodies, early booster immunisations should be considered for future scenarios in this vulnerable group.
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Affiliation(s)
- Patrick Reimann
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Principality of Liechtenstein
| | - Verena Petzer
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - Axel Mündlein
- Molecular Biology Laboratory, Vorarlberg Institute for Vascular Investigation and Treatment, Dornbirn, Austria
| | - Bernd Hartmann
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Luciano Severgnini
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Principality of Liechtenstein
| | - Alex Winkler
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Theresia Lang
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Minh Huynh
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Klaus Gasser
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Julia Rüger
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Michele Atzl
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Sylvia Mink
- Private University of the Principality of Liechtenstein, Triesen, Principality of Liechtenstein
- Medical Central Laboratories, Feldkirch, Austria
| | | | - Stefan Schmidt
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - Normann Steiner
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute for Med. and Chem. Laboratory Diagnostics (ZIMCL) With Interdisciplinary Hematological Competence Centre (IHK), Medical University Innsbruck, Innsbruck, Austria
| | - Eberhard Gunsilius
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - David Nachbaur
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
- Syndena,GmbH Connect to Cure, Innsbruck, Austria
| | - Dominik Wolf
- Innsbruck University Hospital, Internal Medicine V: Haematology & Oncology, Innsbruck, Austria
| | - Thomas Winder
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
- University of Zurich, Zurich, Switzerland
| | - Magdalena Anna Benda
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria.
- Private University of the Principality of Liechtenstein, Triesen, Principality of Liechtenstein.
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Carrillo-García J, Lacerenza S, Hindi N, Moura DS, Marquina G, Parra Corral D, Olalla J, María Cano Cano J, Hoyos S, Renshaw M, Mondaza-Hernández JL, Di Lernia D, Casado A, Manzano A, Gutierrez A, Martin-Broto J. Circulating TNF-RII, IP-10 and HGF are associated with severity of COVID-19 in oncologic patients. Cytokine 2024; 177:156542. [PMID: 38364458 DOI: 10.1016/j.cyto.2024.156542] [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: 12/05/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
The COVID-19 patients showed hyperinflammatory response depending on the severity of the disease but little have been reported about this response in oncologic patients that also were infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sixty-five circulating cytokines/chemokines were quantified in 15 oncologic patients, just after SARS-CoV-2 infection and fourteen days later, and their levels were compared in patients who required hospitalisation by COVID-19 versus non-hospitalised patients. A higher median age of 72 years (range 61-83) in oncologic patients after SARS-CoV-2 infection was associated with hospitalisation requirement by COVID-19 versus a median age of 49 years (20-75) observed in the non-hospitalised oncologic patients (p = 0.008). Moreover, oncologic patients at metastatic stage or with lung cancer were significantly associated with hospitalisation by COVID-19 (p = 0.044). None of these hospitalised patients required ICU treatment. Higher basal levels of tumour necrosis factor receptor II (TNF-RII), interferon-γ (IFNγ)-induced protein 10 (IP-10) and hepatocyte growth factor (HGF) in plasma were significantly observed in oncologic patients who required hospitalisation by COVID-19. Higher TNF-RII, IP-10 and HGF levels after the SARS-CoV-2 infection in oncologic patients could be used as biomarkers of COVID-19 severity associated with hospitalisation requirements.
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Affiliation(s)
- Jaime Carrillo-García
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain.
| | - Serena Lacerenza
- Institute of Biomedicine of Seville (IBIS), HUVR-CSIC-University of Seville, 41013 Seville, Spain.
| | - Nadia Hindi
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain; Medical Oncology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain.
| | - David S Moura
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain.
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, 28040 Madrid, Spain.
| | - Daniel Parra Corral
- Department of Medical Oncology, Hospital Clínico San Carlos, 28040 Madrid, Spain.
| | - Jennifer Olalla
- Department of Medical Oncology, Hospital Clínico San Carlos, 28040 Madrid, Spain.
| | - Juana María Cano Cano
- Medical Oncology Department, University Hospital General de Ciudad Real, 13005 Ciudad Real, Spain.
| | - Sergio Hoyos
- Medical Oncology Department, University Hospital Rey Juan Carlos, 28933 Móstoles, Spain.
| | - Marta Renshaw
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain.
| | - Jose L Mondaza-Hernández
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain.
| | - Davide Di Lernia
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain.
| | - Antonio Casado
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, 28040 Madrid, Spain.
| | - Arantxa Manzano
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, 28040 Madrid, Spain.
| | - Antonio Gutierrez
- Department of Hematology, University Hospital Son Espases, 07210 Palma, Spain.
| | - Javier Martin-Broto
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), 28040 Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, 28400 Madrid, Spain; Medical Oncology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain.
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Pop-Vicas AE, Anderson L, Hatas G, Stevens L, Buys A, O’Connor D, Wilson N, Riemersma K, Haddock Soto LA, Richardson A, Clemens C, Packham J, Shirley D, Safdar N. A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned. Infect Control Hosp Epidemiol 2024; 45:635-643. [PMID: 38173365 PMCID: PMC11027079 DOI: 10.1017/ice.2023.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest. SETTING This study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital. METHODS We conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal testing was performed for asymptomatic carriage for patients and staff. Whole-genome sequencing was conducted for all available clinical isolates from patients and healthcare workers (HCWs) to identify transmission clusters. RESULTS In the immunosuppressed ward, 19 cases (4 patients, 15 HCWs) shared a genetically related SARS-CoV-2 isolate. Of these 4 patients, 3 died in the hospital or within 1 week of discharge. The suspected index case was a patient with new dyspnea, diagnosed during preprocedure screening. In the rehabilitation hospital, 20 cases (5 patients and 15 HCWs) positive for COVID-19, of whom 2 patients and 3 HCWs had an isolate genetically related to the above cluster. The suspected index case was a patient from the immune suppressed ward whose positive status was not detected at admission to the rehabilitation facility. Our response to this cluster included the following interventions in both settings: restricting visitors, restricting learners, restricting overflow admissions, enforcing strict compliance with escalated PPE, access to on-site free and frequent testing for staff, and testing all patients prior to hospital discharge and transfer to other facilities. CONCLUSIONS Stringent infection control measures can prevent nosocomial COVID-19 transmission in healthcare facilities with high-risk patients during pandemic surges. These interventions were successful in ending these outbreaks.
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Affiliation(s)
- Aurora E. Pop-Vicas
- Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Laura Anderson
- Department of Infection Control and Prevention, University of Wisconsin Health University Hospital, Madison, Wisconsin
| | - Gabrielle Hatas
- Department of Infection Control and Prevention, University of Wisconsin Health University Hospital, Madison, Wisconsin
| | - Linda Stevens
- Nursing Quality and Safety, University of Wisconsin Health University Hospital, Madison, Wisconsin
| | - Ashley Buys
- Employee Health Services, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
| | - David O’Connor
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin
| | - Nancy Wilson
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin
| | - Kasen Riemersma
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin
| | - Luis A Haddock Soto
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, Wisconsin
| | - Abby Richardson
- University of Wisconsin Health Rehabilitation Hospital, Madison, Wisconsin
| | - Christine Clemens
- University of Wisconsin Health Rehabilitation Hospital, Madison, Wisconsin
| | - Jennylynde Packham
- University of Wisconsin Health Rehabilitation Hospital, Madison, Wisconsin
| | - Daniel Shirley
- Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Nasia Safdar
- Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- William S. Middleton Memorial Veterans’ Affairs Medical Center, Madison, Wisconsin
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Qin L, Li H, Zheng D, Lin S, Ren X. Glioblastoma patients' survival and its relevant risk factors during the pre-COVID-19 and post-COVID-19 pandemic: real-world cohort study in the USA and China. Int J Surg 2024; 110:2939-2949. [PMID: 38376848 PMCID: PMC11093471 DOI: 10.1097/js9.0000000000001224] [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: 11/20/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Although the COVID-19 pandemic has exerted potential impact on patients with glioblastomas (GBMs), it remains unclear whether the survival and its related risk factors of GBM patients would be altered or not during the period spanning from pre-COVID-19 to post-COVID-19 pandemic era. This study aimed to clarify the important issues above. METHODS Two observational cohorts were utilized, including the nationwide American cohort from the Surveillance, Epidemiology, and End-Results (SEER) and the Chinese glioblastoma cohort (CGC) at our institution during 2018-2020. Demographics, tumour features, treatment regimens and clinical outcomes were collected. Cox regression model, competing risk model, and subgroup and sensitivity analysis were used to dynamically estimate the survival and its relevant risk factors over different diagnosis years from the pre-COVID-19 (2018 and 2019) to post-COVID-19 (2020) pandemic. Causal mediation analysis was further adopted to explore the potential relationship between risk factors and mortality. RESULTS This study included 11321 GBM cases in SEER and 226 GBM patients in CGC, respectively. Instead of the diagnostic years of 2018-2020, the prognostic risk factors, such as advanced age, bilateral tumour and absence of comprehensive therapy (surgery combined with chemoradiotherapy), were identified to persistently affect GBM survival independently during the period from 2018 to 2020 in the SEER cohort (all P < 0.05). In CGC, lack of comprehensive therapy for GBM patients were restated as survival risk factors during the same timeframe. Causal mediation analysis showed that the effect of comprehensive therapy on all-cause mortality played a determinant role (direct effect value -0.227, 95% CI -0.248 to -0.207), which was partially mediated by age (9.11%) rather than tumour laterality. CONCLUSIONS As the timeframe shifted from pre-COVID-19 to post-COVID-19 pandemic, survival of GBM patients remained stable, yet advanced age, bilateral tumours, and passive treatment continuingly impacted GBM survival. It is necessary to optimize the comprehensive treatment for GBM patients even in the post-pandemic era.
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Affiliation(s)
- Ling Qin
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Haoyi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Alemu J, Gumi B, Tsegaye A, Rahimeto Z, Fentahun D, Ibrahim F, Abubeker A, Gebremedhin A, Gelanew T, Howe R. Seroprevalence of SARS-CoV-2 and Hepatitis B Virus Coinfections among Ethiopians with Acute Leukemia. Cancers (Basel) 2024; 16:1606. [PMID: 38672687 PMCID: PMC11049053 DOI: 10.3390/cancers16081606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
SARS-CoV-2 and blood-borne viral coinfections are well reported. Nevertheless, little is known regarding the seroprevalence of SARS-CoV-2 and coinfection with blood-borne viruses in hematologic malignancy patients in Ethiopia. We aimed to assess the seroprevalence of SARS-CoV-2 and associated infections with hepatitis B and other viruses among adolescent and adult acute leukemia patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from July 2020 to June 2021. Blood samples were tested for the presence of anti-SARS-CoV-2, HBV, HCV, and HIV with ELISA kits and occult hepatitis B infection with a real-time polymerase chain reaction assay. Out of a total 110 cases, the SARS-CoV-2 seroprevalence was 35.5%. The prevalence showed a significant increment from July 2020 to the end of June 2021 (p = 0.015). In 22.7% and 2.7% of leukemia cases, HBV and HIV, respectively, were detected. No HCV was identified. The rate of SARS-CoV-2 coinfection with HBV and HIV was 28% (11/39) and 2.6% (1/39), respectively; however, there was no statistically significant association between SARS-CoV-2 seropositivity with HBV and HIV (p > 0.05). There is a need for viral screening in leukemia cases to monitor infections and inform management.
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Affiliation(s)
- Jemal Alemu
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Ziyada Rahimeto
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Dessalegn Fentahun
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Fozia Ibrahim
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Abdulaziz Abubeker
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (A.A.); (A.G.)
| | - Amha Gebremedhin
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (A.A.); (A.G.)
| | - Tesfaye Gelanew
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Rawleigh Howe
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
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Liao Y, Zhang Y, Li H, Hu H, Li M, Liao C. ACE2: the node connecting the lung cancer and COVID-19. Am J Cancer Res 2024; 14:1466-1481. [PMID: 38726281 PMCID: PMC11076241 DOI: 10.62347/xjve4569] [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: 10/15/2023] [Accepted: 01/04/2024] [Indexed: 05/12/2024] Open
Abstract
Angiotensin-converting Enzyme 2 (ACE2) collaborates with Angiotensin (Ang) 1-7 and Mas receptors to establish the ACE2-Ang (1-7)-Mas receptor axis. ACE2 impacts lung function and can cause lung injury due to its inflammatory effects. Additionally, ACE2 contributes to pulmonary vasculature dysfunction, resulting in pulmonary hypertension. In addition, ACE2 is a receptor for coronavirus entry into host cells, leading to coronavirus infection. Lung cancer, one of the most common respiratory diseases worldwide, has a high rate of infection. Elevated levels of ACE2 in lung cancer patients, which increase the risk of SARS-CoV-2 infection and severe disease, have been demonstrated in clinical studies and by molecular mechanisms. The association between lung cancer and SARS-CoV-2 is closely linked to ACE2. This review examines the basic pathophysiological role of ACE2 in the lung, the long-term effects of SARS-CoV-2 infection on lung function, the development of pulmonary fibrosis, chronic inflammation in long-term COVID patients, and the clinical research and mechanisms underlying the increased susceptibility of lung cancer patients to the virus. Possible mechanisms of lung cancer in SARS-CoV-2-infected individuals and the potential role of ACE2 in this process are also explored in this review. The role of ACE2 as a therapeutic target in the novel coronavirus infection process is also summarized. This will help to inform prevention and treatment of long-term pulmonary complications in patients.
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Affiliation(s)
- Yan Liao
- School of Anesthesiology, Naval Medical UniversityShanghai 200433, China
| | - Ying Zhang
- Graduate School, Hebei North UniversityZhangjiakou 075000, Hebei, China
| | - Houfeng Li
- Graduate School, Hebei North UniversityZhangjiakou 075000, Hebei, China
| | - Huixiu Hu
- Graduate School, Hebei North UniversityZhangjiakou 075000, Hebei, China
| | - Mi Li
- School of Anesthesiology, Naval Medical UniversityShanghai 200433, China
| | - Chunhua Liao
- School of Anesthesiology, Naval Medical UniversityShanghai 200433, China
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Al-Mhanna SB, Batrakoulis A, Sheikh AM, Aldayel AA, Sabo A, Mohamed M, Afolabi HA, Ahmed AY, Mohamed SI, Gülü M, Ghazali WSW. Impact of COVID-19 lockdown on physical activity behavior among students in Somalia. AIMS Public Health 2024; 11:459-476. [PMID: 39027387 PMCID: PMC11252570 DOI: 10.3934/publichealth.2024023] [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: 01/29/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 07/20/2024] Open
Abstract
Background Due to the worldwide reach of the COVID-19 pandemic, authorities across the globe deemed it essential to enforce exceptional containment measures. Maintaining physical activity (PA) during this time was only feasible through engaging in activities at home. Therefore, this study focused on elucidating the levels of PA and well-being among Somali students in the aftermath of the lockdown measures implemented by governments at the onset of the COVID-19 pandemic. Methods This study was conducted in Somalia among undergraduate students studying at Somali International University. A total of 1266 students were included in the present study. An online survey was utilized to measure participant PA behavior. The assessment of PA was conducted in the aftermath of the COVID-19 pandemic, utilizing the Godin Leisure questionnaire. The study showed that 85.8% of the study participants (n = 1086) were between the ages of 17 and 22. More than half of the participants (58.7%, n = 743) were female and had no other employment (57.3%, n = 743). Results Jogging was the most frequently reported PA (57.3%, n = 726), and PA level was on average 59.7 minutes per day (SD = 25.9). Also, most of the study participants were in their last year (82.1%). In the regression analysis, age, gender, academic year, and work status were significant predictors of being physically active after the COVID-19 pandemic. Conclusion Factors affecting PA after the COVID-19 pandemic include age, gender, academic year, and work status. Males, younger individuals, and those who engage in outdoor exercise are more likely to be physically active. Once the COVID-19 restrictions were relaxed, undergraduate students in Somalia were physically active. A high level of PA appears to be advantageous for public health. Universities in Somalia should uphold school policies that promote an active lifestyle among students, aiming to maintain or enhance the existing level of PA.
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Affiliation(s)
- Sameer Badri Al-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Tamil Nadu, India
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | | | | | - Abdulwali Sabo
- Department of Public and Environmental Health, Faculty of Basic Medical Sciences, College of Medicine and Allied Medical Sciences, Federal University Dutse, Dutse, Nigeria
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Hospital Universiti Sains Malaysia, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Sahra Isse Mohamed
- National Public Health Reference Laboratory, Ministry of Health, Mogadishu, Somalia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Llanos AAM, Fong AJ, Ghosh N, Devine KA, O'Malley D, Paddock LE, Bandera EV, Hudson SV, Evens AM, Manne SL. COVID-19 perceptions, impacts, and experiences: a cross-sectional analysis among New Jersey cancer survivors. J Cancer Surviv 2024; 18:439-449. [PMID: 35904727 PMCID: PMC9336177 DOI: 10.1007/s11764-022-01236-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cancer survivors are particularly vulnerable to adverse COVID-19-related outcomes, but limited data exist on perceptions about the pandemic and related experiences in this group. METHODS In a cross-sectional analysis of 494 survivors of genitourinary, breast, gynecologic, colorectal, lung, melanoma, or thyroid cancer, from a larger study of cancer survivors in New Jersey, we assessed perceptions about COVID-19 threat, impacts, and experiences using three validated instruments. Responses were coded on a 7-point Likert scale, and subscales were averaged across included items, with higher scores indicating greater perceptions of COVID-19 threat and greater impacts and experiences because of the pandemic. Multivariable linear regression models were used to determine factors associated with higher scores, with Bonferroni correction for multiple comparisons. RESULTS In general, cancer survivors reported moderate perceived COVID-19 threat (3 items, mean score = 3.71 ± 1.97), minimal COVID-19-related impacts (6 items, mean score = 2.23 ± 1.34), and COVID-19-related experiences (7 items, mean score = 2.17 ± 1.00). COVID-19 impact subscale scores varied little (mean subscale score range = 2.09 to 2.29), while COVID-19 experiences subscale scores were quite variable (mean subscale score range = 1.52 to 3.39). Asian American/Pacific Islander race, Black race, female sex, and having more cardiovascular and metabolic and other comorbidities were associated with higher scores on the perceived coronavirus threat questionnaire. Having completed the COVID-19 questionnaires earlier in the pandemic, younger age, American/Pacific Islander race, Hispanic ethnicity, and having more comorbidities were associated with higher scores on the COVID-19 impact questionnaire. Younger age, racial minority status, and having more cardiovascular and metabolic comorbidities were associated with higher scores on the COVID-19 experience questionnaire. CONCLUSION Among cancer survivors in New Jersey-a state that experienced high rates of COVID-19 infection-sociodemographic and health-related factors (e.g., race and ethnicity, sex, and multimorbidity) correlate with greater perceptions of COVID-19 threat, impacts, and experiences. IMPLICATIONS FOR CANCER SURVIVORS Studies are needed to examine the influence of vaccination status on COVID-19 perceptions and identify inequities in clinical outcomes due to pandemic-related disruptions to cancer care.
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Affiliation(s)
- Adana A M Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Angela J Fong
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Nabarun Ghosh
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Denalee O'Malley
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Lisa E Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA
| | - Elisa V Bandera
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Andrew M Evens
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Sharon L Manne
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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12
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Ordaya EE, Razonable RR. Emerging anti-spike monoclonal antibodies against SARS-CoV-2. Expert Opin Biol Ther 2024:1-11. [PMID: 38432691 DOI: 10.1080/14712598.2024.2326647] [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: 12/15/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Anti-spike monoclonal antibodies (mAbs) were previously authorized for the prevention and treatment of COVID-19 in immunocompromised patients. However, they are no longer authorized in the U.S. due to their lack of neutralizing activity against current circulating SARS-CoV-2 Omicron variants. AREAS COVERED We summarized the available data on emergent mAbs in the early stages of clinical development. Consistent with data on prior mAbs, these novel agents have been well tolerated and demonstrated a good safety profile in early clinical trials. Additionally, many of them have been engineered to ensure prolonged half-life and combined with other mAbs to overcome the potential for emerging resistant mutants. Interestingly, one of these agents has been evaluated using an inhaled route of administration, and another agent is being evaluated for treatment of long COVID. EXPERT OPINION Although the available data of novel mAbs holds promise, we anticipate that these agents will face similar challenges encountered by prior authorized agents, including the continued evolution of SARS-CoV-2 and emergence of new escape mutations. Strategies to potentially mitigate this are discussed. Based on prior successful experience, immunocompromised patients will certainly benefit from the utilization of mAbs for the prevention and treatment of COVID-19; thus, we need to design potential interventions to ensure the sustained activity of these agents.
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Affiliation(s)
- Eloy E Ordaya
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Raymund R Razonable
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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13
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Huang Y, Zhou H, Wang Y, Xiao L, Qin W, Li L. A comprehensive investigation on the receptor BSG expression reveals the potential risk of healthy individuals and cancer patients to 2019-nCoV infection. Aging (Albany NY) 2024; 16:5412-5434. [PMID: 38484369 PMCID: PMC11006473 DOI: 10.18632/aging.205655] [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: 10/25/2023] [Accepted: 02/08/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a newly emerging coronavirus. BSG (basigin) is involved in the tumorigenesis of multiple tumors and recently emerged as a novel viral entry receptor for SARS-CoV-2. However, its expression profile in normal individuals and cancer patients are still unclear. METHODS We performed a comprehensive analysis of the expression and distribution of BSG in normal tissues, tumor tissues, and cell lines via bioinformatics analysis and experimental verification. In addition, we investigated the expression of BSG and its isoforms in multiple malignancies and adjacent normal tissues, and explored the prognostic values across pan-cancers. Finally, we conducted function analysis for co-expressed genes with BSG. RESULTS We found BSG was highly conserved in different species, and was ubiquitously expressed in almost all normal tissues and significantly increased in some types of cancer tissues. Moreover, BSG at mRNA expression level was higher than ACE2 in normal lung tissues, and lung cancer tissues. High expression of BSG indicated shorter overall survival (OS) in multiple tumors. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses indicated that BSG is mostly enriched in genes for mitochondria electron transport, oxidoreduction-driven active transmembrane transporter activity, mitochondrial inner membrane, oxidative phosphorylation, and genes involving COVID-19. CONCLUSIONS Our present work emphasized the value of targeting BSG in the treatment of COVID-19 and cancer, and also provided several novel insights for understanding the SARS-CoV-2 pandemic.
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Affiliation(s)
- Yongbiao Huang
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Haiting Zhou
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Wang
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Lingyan Xiao
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Wan Qin
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Long Li
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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Haddad AJ, Hachem RY, Moussa M, Jiang Y, Dagher HR, Chaftari P, Chaftari AM, Raad II. Comparing Molnupiravir to Nirmatrelvir/Ritonavir (Paxlovid) in the Treatment of Mild-to-Moderate COVID-19 in Immunocompromised Cancer Patients. Cancers (Basel) 2024; 16:1055. [PMID: 38473412 DOI: 10.3390/cancers16051055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Nirmatrelvir/Ritonavir has been shown to reduce the risk of COVID-19 progression by 88% compared to placebo, while Molnupiravir reduced it by 31%. However, these two agents have not been compared head-to-head. We therefore compared the safety and efficacy of both agents for the treatment of mild-to-moderate COVID-19 in immunocompromised cancer patients. METHODS We identified 240 cancer patients diagnosed with COVID-19 and treated with Molnupiravir or Nirmatrelvir/Ritonavir. Patients were matched using a 1:2 ratio based on age group (18-64 years vs. ≥65) and type of cancer. The collected data included demographics, comorbidities, and treatment outcome. RESULTS Both groups had comparable characteristics and presenting symptoms. However, dyspnea was more prevalent in the Molnupiravir group, while sore throat was more prevalent in the Nirmatrelvir/Ritonavir group. The rate of disease progression was comparable in both groups by univariate and multivariable analysis. Treatment with Molnupiravir versus Nirmatrelvir/Ritonavir revealed no significant difference in disease progression by multivariable analysis (adjusted OR = 1.31, 95% CI: 0.56-3.14, p = 0.70). Patients who received Nirmatrelvir/Ritonavir, however, were significantly more prone to having drug-drug interactions/adverse events (30% vs. 0%, p < 0.0001). CONCLUSIONS In the treatment of mild-to-moderate COVID-19 in cancer patients, Molnupiravir was comparable to Nirmatrelvir/Ritonavir in preventing progression to severe disease/death and rebound events, and it had a superior safety profile.
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Affiliation(s)
- Andrea J Haddad
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ray Y Hachem
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mohamed Moussa
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ying Jiang
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hiba R Dagher
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Patrick Chaftari
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Olivier M, Julian P, Acya BT, Sophie S, Benoît G, Laurent P, Hugues F, Charles D, Julie O, Cécile D, Patrick D, Sylvie J, Nicolas M, Alexia L, Hugues M, Didier D. COVID-19 among lung cancer patients: Data from a real-life prospective French multicentric study. Respir Med Res 2024; 86:101093. [PMID: 38848641 DOI: 10.1016/j.resmer.2024.101093] [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: 05/31/2023] [Revised: 12/18/2023] [Accepted: 02/25/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND COVID-19 started to spread early in 2020, the precise year that lung cancer (LC) patients were recruited into the prospective epidemiological cohort KBP-2020-CPHG in French hospitals. This provides a unique opportunity to study COVID-19 incidence, survival risk factors, and overall prognosis. METHODS COVID data was collected before vaccination was made available. Clinical characteristics were compared (COVID vs non-COVID), incidence rate ratios were calculated based on clinical characteristics, survival (1 and 3 months) was estimated and the impact of COVID-19 on the overall prognosis of the cohort was studied. RESULTS In 2020, 285 out of 8,999 lung cancer patients were diagnosed with COVID-19. Diagnosis was mainly based on PCR tests (86.3 %). The annual incidence was 8.3 % (95 % CI [7.4, 9.3]); it was higher in former smokers and patients with squamous cell carcinoma or small cell carcinoma than in those with adenocarcinoma, in those with a PS score ≥2 versus 0-1, and with stages III-IV versus stages I-II. The incidence was reduced in patients who received chemotherapy or immunotherapy. 64.9 % of patients were hospitalized due to COVID-19. Risk factors for death at 1 and 3 months in COVID-19 patients were age, LC stage, and PS score. Multivariate analysis showed a major prognostic impact of COVID-19 on mortality of LC patients (hazard ratio: 4.12, 95 % CI [3.42, 4.97], p < 0.001). CONCLUSIONS This prospective study demonstrated the high incidence of COVID-19 in LC patients and identified as risk factors for COVID-19: smoking status, histology, PS, and stage. The impact of COVID-19 on lung cancer mortality appears major.
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Affiliation(s)
- Molinier Olivier
- Respiratory Medicine Department, Centre Hospitalier Le Mans, Le Mans, France.
| | - Pinsolle Julian
- Respiratory Medicine Department, Centre Hospitalier Métropole Savoie, Aix-les-Bains, France
| | - Bizieux-Thaminy Acya
- Respiratory Medicine Department, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France
| | - Schneider Sophie
- Respiratory Medicine Department, Centre Hospitalier de la Côte Basque, Bayonne, France
| | - Godbert Benoît
- Respiratory Medicine Department, Hôpital Robert Schuman - UNEOS, Metz, France
| | - Portel Laurent
- Respiratory Medicine Department, Centre Hospitalier Robert Boulin, Libourne, France
| | - Francois Hugues
- Respiratory Medicine Department, Centre Hospitalier de Polynésie française, Papeete, France
| | - Dayen Charles
- Respiratory Medicine Department, Centre Hospitalier de Saint-Quentin, Saint-Quentin, France
| | - Obert Julie
- Respiratory Medicine Department, Groupe Hospitalier Intercommunal Le Raincy Montfermeil, France
| | - Dujon Cécile
- Respiratory Medicine Department, Centre Hospitalier de Versailles, Versailles, France
| | - Dumont Patrick
- Respiratory Medicine Department, Centre Hospitalier de Chauny, Chauny, France
| | - Julien Sylvie
- Respiratory Medicine Department, Centre Hospitalier Rodez, Rodez, France
| | - Meyer Nicolas
- Biostatistician, Public Health Department, CHU de Strasbourg, GMRC, Strasbourg, France
| | | | - Morel Hugues
- Respiratory Medicine Department, Centre Hospitalier Régional D'Orléans Hôpital de La Source, Orléans, France
| | - Debieuvre Didier
- Respiratory Medicine Department, Hospital Group of the Mulhouse Sud-Alsace Region, Emile Muller Hospital, Mulhouse, France
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16
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Bertini CD, Khawaja F, Sheshadri A. Coronavirus Disease-2019 in the Immunocompromised Host. Infect Dis Clin North Am 2024; 38:213-228. [PMID: 38280765 DOI: 10.1016/j.idc.2023.12.007] [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] [Indexed: 01/29/2024]
Abstract
Immunocompromised hosts, which encompass a diverse population of persons with malignancies, human immunodeficiency virus disease, solid organ, and hematologic transplants, autoimmune diseases, and primary immunodeficiencies, bear a significant burden of the morbidity and mortality due to coronavirus disease-2019 (COVID-19). Immunocompromised patients who develop COVID-19 have a more severe illness, higher hospitalization rates, and higher mortality rates than immunocompetent patients. There are no well-defined treatment strategies that are specific to immunocompromised patients and vaccines, monoclonal antibodies, and convalescent plasma are variably effective. This review focuses on the specific impact of COVID-19 in immunocompromised patients and the gaps in knowledge that require further study.
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Affiliation(s)
- Christopher D Bertini
- Department of Internal Medicine, UTHealth Houston McGovern Medical School, 6431 Fannin, MSB 1.150, Houston, TX 77030, USA
| | - Fareed Khawaja
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1469, Houston, TX 77030, USA
| | - Ajay Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1462, Houston, TX 77030, USA.
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17
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Liao YT, Shen HC, Huang JR, Sun CY, Ko HJ, Chang CJ, Chen YM, Feng JY, Chen WC, Yang KY. Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure. BMC Pulm Med 2024; 24:34. [PMID: 38225613 PMCID: PMC10789018 DOI: 10.1186/s12890-024-02850-z] [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: 09/18/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has affected individuals worldwide, and patients with cancer are particularly vulnerable to COVID-19-related severe illness, respiratory failure, and mortality. The relationship between COVID-19 and cancer remains a critical concern, and a comprehensive investigation of the factors affecting survival among patients with cancer who develop COVID-19-related respiratory failure is warranted. We aim to compare the characteristics and outcomes of COVID-19-related acute respiratory failure in patients with and without underlying cancer, while analyzing factors affecting in-hospital survival among cancer patients. METHODS We conducted a retrospective observational study at Taipei Veterans General Hospital in Taiwan from May to September 2022, a period during which the omicron variant of the severe acute respiratory syndrome coronavirus 2 was circulating. Eligible patients had COVID-19 and acute respiratory failure. Clinical data, demographic information, disease severity markers, treatment details, and outcomes were collected and analyzed. RESULTS Of the 215 enrolled critically ill patients with COVID-19, 65 had cancer. The patients with cancer were younger and had lower absolute lymphocyte counts, higher ferritin and lactate dehydrogenase (LDH) concentrations, and increased vasopressor use compared with those without cancer. The patients with cancer also received more COVID-19 specific treatments but had higher in-hospital mortality rate (61.5% vs 36%, P = 0.002) and longer viral shedding (13 vs 10 days, P = 0.007) than those without cancer did. Smoking [odds ratio (OR): 5.804, 95% confidence interval (CI): 1.847-39.746], elevated LDH (OR: 1.004, 95% CI: 1.001-1.012), vasopressor use (OR: 5.437, 95% CI: 1.202-24.593), and new renal replacement therapy (OR: 3.523, 95% CI: 1.203-61.108) were independent predictors of in-hospital mortality among patients with cancer and respiratory failure. CONCLUSION Critically ill patients with cancer experiencing COVID-19-related acute respiratory failure present unique clinical features and worse clinical outcomes compared with those without cancer. Smoking, elevated LDH, vasopressor use, and new renal replacement therapy were risk factors for in-hospital mortality in these patients.
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Affiliation(s)
- Ying-Ting Liao
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Chin Shen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jhong-Ru Huang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chuan-Yen Sun
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Jui Ko
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Jung Chang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Kuang-Yao Yang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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18
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Carrillo-García J, Lacerenza S, Hindi N, García IC, Marquina G, Cano Cano JM, Trufero JM, Sevillano Tripero AR, Luis García T, Cuesta Rioboo MJ, Moura DS, Renshaw M, Mondaza-Hernández JL, Di Lernia D, Gutierrez A, Martin-Broto J. Delays in diagnosis and surgery of sarcoma patients during the COVID-19 outbreak in Spain. Ther Adv Med Oncol 2024; 16:17588359231220611. [PMID: 38205079 PMCID: PMC10777772 DOI: 10.1177/17588359231220611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
Background and objectives Social distancing and quarantine implanted during the COVID-19 outbreak could have delayed the accession of oncologic patients to hospitals and treatments. This study analysed the management of sarcoma patients during this period in five Spanish hospitals. Design and methods Clinical data from adult sarcoma patients, soft tissue and bone sarcomas, managed during the COVID-19 outbreak, from 15 March to 14 September 2020 (Covid cohort), were retrospectively collected and time for diagnosis, surgery and active treatments were compared with sarcoma patients managed during the same pre-pandemic period in 2018 (Control cohort). Results A total of 126 and 182 new sarcoma patients were enrolled in the Covid and Control cohorts, respectively, who were mainly diagnosed as soft tissue sarcomas (81.0% and 80.8%) and at localized stage (80.2% and 79.1%). A diagnostic delay was observed in the Covid cohort with a median time for the diagnosis of 102.5 days (range 6-355) versus 83 days (range 5-328) in the Control cohort (p = 0.034). Moreover, a delay in surgery was observed in cases with localized disease from the Covid cohort with a median time of 96.0 days (range 11-265) versus 54.5 days (range 2-331) in the Control cohort (p = 0.034). However, a lower delay for neoadjuvant radiotherapy was observed in the Covid cohort with a median time from the diagnosis to the neoadjuvant radiotherapy of 47 days (range 27-105) versus 91 days (range 27-294) in the Control cohort (p = 0.039). No significant differences for adjuvant radiotherapy, neoadjuvant/adjuvant chemotherapy and neoadjuvant/adjuvant palliative chemotherapy were observed between both cohorts. Neither progression-free survival (PFS) nor overall survival (OS) was significantly different. Conclusion Delays in diagnosis and surgery were retrospectively observed in sarcoma patients during the COVID-19 outbreak in Spain, while the time for neoadjuvant radiotherapy was reduced. However, no impact on the PFS and OS was observed.
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Affiliation(s)
- Jaime Carrillo-García
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
| | - Serena Lacerenza
- Institute of Biomedicine of Seville (IBIS), HUVR-CSIC-University of Seville, Seville, Spain
| | - Nadia Hindi
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
- Medical Oncology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | | | - Gloria Marquina
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| | - Juana María Cano Cano
- Medical Oncology Department, University Hospital General de Ciudad Real, Ciudad Real, Spain
| | | | - Alberto Rafael Sevillano Tripero
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
- Medical Oncology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Tania Luis García
- Department of Medical Oncology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | | | - David S. Moura
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
| | - Marta Renshaw
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
| | - Jose L. Mondaza-Hernández
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
| | - Davide Di Lernia
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
| | - Antonio Gutierrez
- Department of Hematology, University Hospital Son Espases, Palma, Spain
| | - Javier Martin-Broto
- Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Reyes Católicos 2, Madrid 28040, Spain
- Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain
- Medical Oncology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
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19
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Chu Y, Li M, Sun M, Wang J, Xin W, Xu L. Gene crosstalk between COVID-19 and preeclampsia revealed by blood transcriptome analysis. Front Immunol 2024; 14:1243450. [PMID: 38259479 PMCID: PMC10800816 DOI: 10.3389/fimmu.2023.1243450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background The extensive spread of coronavirus disease 2019 (COVID-19) has led to a rapid increase in global mortality. Preeclampsia is a commonly observed pregnancy ailment characterized by high maternal morbidity and mortality rates, in addition to the restriction of fetal growth within the uterine environment. Pregnant individuals afflicted with vascular disorders, including preeclampsia, exhibit an increased susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection via mechanisms that have not been fully delineated. Additionally, the intricate molecular mechanisms underlying preeclampsia and COVID-19 have not been fully elucidated. This study aimed to discern commonalities in gene expression, regulators, and pathways shared between COVID-19 and preeclampsia. The objective was to uncover potential insights that could contribute to novel treatment strategies for both COVID-19 and preeclampsia. Method Transcriptomic datasets for COVID-19 peripheral blood (GSE152418) and preeclampsia blood (GSE48424) were initially sourced from the Gene Expression Omnibus (GEO) database. Subsequent to that, we conducted a subanalysis by selecting females from the GSE152418 dataset and employed the "Deseq2" package to identify genes that exhibited differential expression. Simultaneously, the "limma" package was applied to identify differentially expressed genes (DEGs) in the preeclampsia dataset (GSE48424). Following that, an intersection analysis was conducted to identify the common DEGs obtained from both the COVID-19 and preeclampsia datasets. The identified shared DEGs were subsequently utilized for functional enrichment analysis, transcription factor (TF) and microRNAs (miRNA) prediction, pathway analysis, and identification of potential candidate drugs. Finally, to validate the bioinformatics findings, we collected peripheral blood mononuclear cell (PBMC) samples from healthy individuals, COVID-19 patients, and Preeclampsia patients. The abundance of the top 10 Hub genes in both diseases was assessed using real-time quantitative polymerase chain reaction (RT-qPCR). Result A total of 355 overlapping DEGs were identified in both preeclampsia and COVID-19 datasets. Subsequent ontological analysis, encompassing Gene Ontology (GO) functional assessment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, revealed a significant association between the two conditions. Protein-protein interactions (PPIs) were constructed using the STRING database. Additionally, the top 10 hub genes (MRPL11, MRPS12, UQCRH, ATP5I, UQCRQ, ATP5D, COX6B1, ATP5O, ATP5H, NDUFA6) were selected based on their ranking scores using the degree algorithm, which considered the shared DEGs. Moreover, transcription factor-gene interactions, protein-drug interactions, co-regulatory networks of DEGs and miRNAs, and protein-drug interactions involving the shared DEGs were also identified in the datasets. Finally, RT-PCR results confirmed that 10 hub genes do exhibit distinct expression profiles in the two diseases. Conclusion This study successfully identified overlapping DEGs, functional pathways, and regulatory elements between COVID-19 and preeclampsia. The findings provide valuable insights into the shared molecular mechanisms and potential therapeutic targets for both diseases. The validation through RT-qPCR further supports the distinct expression profiles of the identified hub genes in COVID-19 and preeclampsia, emphasizing their potential roles as biomarkers or therapeutic targets in these conditions.
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Affiliation(s)
| | | | | | | | | | - Lin Xu
- Department of Obstetrics, the Affiliated Hospital of Qingdao University, Qingdao, China
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20
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Kalim M, Jing R, Li X, Jiang Z, Zheng N, Wang Z, Wei G, Lu Y. Essentials of CAR-T Therapy and Associated Microbial Challenges in Long Run Immunotherapy. JOURNAL OF CELLULAR IMMUNOLOGY 2024; 6:22-50. [PMID: 38883270 PMCID: PMC11172397 DOI: 10.33696/immunology.6.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Chimeric antigen receptor (CAR)-T cell therapy has shown potential in improving outcomes for individuals with hematological malignancies. However, achieving long-term full remission for blood cancer remains challenging due to severe life-threatening toxicities such as limited anti-tumor efficacy, antigen escape, trafficking restrictions, and limited tumor invasion. Furthermore, the interactions between CAR-T cells and their host tumor microenvironments have a significant impact on CAR-T function. To overcome these considerable hurdles, fresh methodologies and approaches are needed to produce more powerful CAR-T cells with greater anti-tumor activity and less toxicity. Despite advances in CAR-T research, microbial resistance remains a significant obstacle. In this review, we discuss and describe the basics of CAR-T structures, generations, challenges, and potential risks of infections in CAR-T cell therapy.
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Affiliation(s)
- Muhammad Kalim
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Rui Jing
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Xin Li
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Zhiwu Jiang
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Ningbo Zheng
- Department of Microbiology & Immunology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Ziyu Wang
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Guo Wei
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
| | - Yong Lu
- Houston Methodist Cancer Center/Weill Cornell Medicine, Houston, TX 77030, USA
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21
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Kumar S, Singh B, Dey B, Jagtap VK, Verma S, Nongkynrih A. Impact of COVID-19 on Cancer Patients: An Experience From a Tertiary Care Center in Northeast India. Cureus 2024; 16:e52247. [PMID: 38352085 PMCID: PMC10861845 DOI: 10.7759/cureus.52247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic affected the healthcare system worldwide. Cancer patients and oncologists faced challenges equally in the context of the pandemic. The present study was undertaken to assess the impact of COVID-19 on cancer patients, encompassing infection source, care type, treatment delays, and infection outcomes. MATERIALS AND METHOD This single-center retrospective study was conducted between March 2020 and January 2022 at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India. It examined COVID-19 cases in cancer patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) results. Data collection included demographics, clinical details, COVID-19 specifics, treatment delays, and infection outcomes. RESULT In our study of 9,854 oncology patients' visits, 26 (0.26%) tested COVID-19 positive by RT-PCR, aged three to 70 years with a male-female ratio of 1:1.67. Twenty-three percent had comorbidities, mainly hypertension. Gastrointestinal cancers (30.8%) and hepatobiliary origin (15.5%) were common. Most patients (69.2%) had stage IV cancer, and 34.6% aimed for curative treatment. The majority of the patients (76.9%) were community-acquired, and the rest (23.1%) contracted during hospital stay. Fever (34.5%) and asymptomatic infection (30.8%) were common presentations. Six (23.1%) comorbid patients required ICU care. Median treatment delay was three weeks, with one COVID-19-related death (3.8%) and six cancer-related deaths. On follow-up, 19.2% had stable disease, 7.7% partial response, 7.7% recurrence, and 23.1% had progression. CONCLUSION Amid the pandemic, cancer patients safely received treatment. Mild cases were managed at home. Poor outcome was found in comorbid, severe COVID-19 cancer patients. However, the impact of treatment delays on long-term oncological outcomes needs further study.
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Affiliation(s)
- Sumit Kumar
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Binoy Singh
- Neurosurgery, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Biswajit Dey
- Pathology and Laboratory Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Vikas K Jagtap
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Shalini Verma
- Medical Oncology, Kasturba Medical College, Manipal, Manipal, IND
| | - Anthialisha Nongkynrih
- Radiation Oncology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
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22
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Xu D, Wang X, Zhou D. Exploring the Potential Association between COVID-19 and Thyroid Cancer: A Mendelian Randomization Study. ACS OMEGA 2023; 8:49158-49164. [PMID: 38162775 PMCID: PMC10753739 DOI: 10.1021/acsomega.3c07287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/08/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
In order to address the ongoing debate surrounding the potential link between COVID-19 and thyroid cancer, our study was specifically designed to investigate the association between these two factors. We acquired summary data from a genome-wide association study (GWAS) concerning COVID-19 susceptibility and severity of COVID-19 in the European population, with a focus on their relationship with thyroid cancer. We applied three distinct methodologies to evaluate the causality between COVID-19 and thyroid cancer, employing Mendelian randomization (MR)-Egger, weighted median (WM), and inverse variance-weighted (IVW) approaches. Furthermore, we utilized a variety of techniques to assess pleiotropy and heterogeneity, including the MR-Egger intercept, MR-pleiotropy residual sum and outlier method (PRESSO), and Cochran's Q test. The MR analysis revealed associations between the susceptibility of COVID-19 and thyroid cancer (IVW odds ratio [OR]: 2.826, 95% confidence interval [CI]: [0.842, 9.483], P = 0.093) as well as between the risk of COVID-19 hospitalization and thyroid cancer (IVW OR: 1.630, 95% CI: [1.050, 2.529], P = 0.029). However, the relationship between COVID-19 and the occurrence of severe thyroid cancer cases was less evident (IVW OR: 1.061, 95% CI: [0.575, 1.956], P = 0.850). Our sensitivity analyses did not reveal any signs of horizontal pleiotropy or heterogeneity. Our MR study provided compelling evidence supporting a causal connection between the risk of COVID-19 hospitalization and thyroid cancer. Nevertheless, the MR results derived from genetic data do not support a causal link between susceptibility to COVID-19 and the risk of thyroid cancer or between very severe cases of COVID-19 and the risk of thyroid cancer. These findings have significant implications for further investigations into the impact of COVID-19 on health and the etiology of thyroid cancer.
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Affiliation(s)
- Dingtao Xu
- Department
of Anesthesia and Perioperative Medicine, Shanghai Fourth People’s Hospital Affiliated to Tongji University
School of Medicine, Shanghai 200434, China
| | - Xinyu Wang
- Department
of Thyroid, Breast and Vascular Surgery, Shanghai Fourth People’s Hospital Affiliated to Tongji University
School of Medicine, Shanghai 200434, China
| | - Dehua Zhou
- Department
of Gastrointestinal Surgery, Shanghai Fourth
People’s Hospital Affiliated to Tongji University School of
Medicine, Shanghai 200434, China
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23
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da Silva JL, de Souza BSW, de Albuquerque LZ, Aleixo SB, Resende GADS, de Oliveira DGB, dos Santos EN, Nogueira-Rodrigues A, Clara RO, Gaui MDFD, Mota ACDA, de Lima VCC, Rosa DD, Munhoz RR, Morbeck IAP, Gelatti ACZ, Mathias CMDC, de Melo AC. Factors influencing COVID-19 mortality among cancer patients: A Brazilian multi-institutional study. PLoS One 2023; 18:e0295597. [PMID: 38127882 PMCID: PMC10734930 DOI: 10.1371/journal.pone.0295597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE This study aimed to describe the demographic and clinical characteristics of cancer patients with COVID-19, exploring factors associated with adverse outcomes. PATIENTS AND METHODS This retrospective cohort study methodically extracted and curated data from electronic medical records (EMRs) of numerous healthcare institutions on cancer patients diagnosed with a confirmed SARS-CoV-2 infection between May 2020 and August 2021, to identify risk factors linked to extended hospitalization and mortality. The retrieved information encompassed the patients' demographic and clinical characteristics, including the incidence of prolonged hospitalization, acute complications, and COVID-19-related mortality. RESULTS A total of 1446 cancer patients with COVID-19 were identified (mean [Standard deviation] age, 59.2 [14.3] years). Most patients were female (913 [63.1%]), non-white (646 [44.7%]), with non-metastatic (818 [56.6%]) solid tumors (1318 [91.1%]), and undergoing chemotherapy (647 [44.7%]). The rate of extended hospitalization due to COVID-19 was 46% (n = 665), which was significantly impacted by age (p = 0.012), sex (p = 0.003), race and ethnicity (p = 0.049), the presence of two or more comorbidities (p = 0.006), hematologic malignancies (p = 0.013), metastatic disease (p = 0.002), and a performance status ≥ 2 (p = 0.001). The COVID-19-related mortality rate was 18.9% (n = 273), and metastatic disease (<0.001), performance status ≥2 (<0.001), extended hospitalization (p = 0.028), renal failure (p = 0.029), respiratory failure (p < 0.001), sepsis (p = 0.004), and shock (p = 0.040) significantly and negatively influenced survival. CONCLUSION The rate of extended hospitalization and COVID-19-specific death in cancer patients was notably high and could be influenced by comorbidities, cancer treatment status, and clinical fragility. These observations may aid in developing risk counseling strategies regarding COVID-19 in individuals diagnosed with cancer.
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Affiliation(s)
- Jessé Lopes da Silva
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Clinical Oncology, Galeao Air Force Hospital, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lucas Zanetti de Albuquerque
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sabina Bandeira Aleixo
- Department of Clinical Oncology, Evangelical Hospital of Cachoeiro de Itapemirim, Cachoeiro de Itapemirim, Espírito Santo, Brazil
| | | | | | | | - Angélica Nogueira-Rodrigues
- Department of General Medicine UFMG, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Brazilian Society of Clinical Oncology, São Paulo, São Paulo, Brazil
| | | | | | | | | | - Daniela Dornelles Rosa
- Brazilian Society of Clinical Oncology, São Paulo, São Paulo, Brazil
- Department of Clinical Oncology, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Ana Caroline Zimmer Gelatti
- Oncoclinicas Group of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Brazilian Group of Thoracic Tumors, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Andréia Cristina de Melo
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
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Sahin M, Demirci İ, Haymana C, Taşçı İ, Sonmez A. Reply to Reply: The clinical outcome of COVID-19 infection in patients with a history of thyroid cancer: A nationwide study. Clin Endocrinol (Oxf) 2023; 99:533-534. [PMID: 34967024 DOI: 10.1111/cen.14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - İbrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - İlker Taşçı
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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25
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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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26
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Wu XC, Yu Q, Yi Y, Maniscalco LS, Hsieh MC, Gruber D, Mendoza L, Subbiah S, Sokol T, Shrestha P, Chen VW, Mederos ET, Ochoa A. Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients. J Natl Cancer Inst 2023; 115:1204-1212. [PMID: 37697664 PMCID: PMC10560601 DOI: 10.1093/jnci/djad150] [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: 04/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. METHODS We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. RESULTS Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. CONCLUSION Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.
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Affiliation(s)
- Xiao-Cheng Wu
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Qingzhao Yu
- Biostatistics Program, School of Public Health, LSU Health, New Orleans, LA, USA
| | - Yong Yi
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Lauren S Maniscalco
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Mei-Chin Hsieh
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Lee Mendoza
- Bureau of Health Informatics, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Suki Subbiah
- Section of Hematology-Oncology, School of Medicine, LSU Health, New Orleans, LA, USA
| | - Theresa Sokol
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Pratibha Shrestha
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Vivien W Chen
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Eileen T Mederos
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
| | - Augusto Ochoa
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
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27
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Hajikarimloo B, Fahim F, Sabbagh Alvani M, Oveisi S, Zali A, Anvari H, Oraee-Yazdani S. Management of Glioblastoma Multiforme During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic: A Review of the Literature. World Neurosurg 2023; 178:87-92. [PMID: 37429378 DOI: 10.1016/j.wneu.2023.05.094] [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: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Patients with glioblastoma multiforme (GBM) and other patients with cancer are at a greater risk of developing severe complications as a result of coronavirus disease 2019 (COVID-19) infection. Therefore, it is crucial to adjust therapeutic approaches to reduce exposure and complications and achieve the most appropriate treatment outcomes. OBJECTIVE Our goal was to help physicians to make decisions based on the latest data in the literature. METHOD We provide a comprehensive review of the literature on the current issues of GBM and COVID-19 infection. RESULTS The mortality of patients with diffuse glioma as a result of COVID-19 infection was 39%, which is higher than in the general population. The statistics showed that 84.5% of patients with diagnosed brain cancer (mostly GBM) and 89.9% of their caregivers received COVID-19 vaccines. The decision to apply different therapeutic approaches must be made individually based on age, tumor grade, molecular profile, and performance status. The advantages and disadvantages of adjuvant radiotherapy and chemotherapy after the surgery should be evaluated carefully. In the setting of the follow-up period, special considerations must be considered to minimize COVID-19 exposure. CONCLUSIONS The pandemic altered medical approaches worldwide, and the management of patients in an immunocompromised state, such as patients with GBM, is challenging; therefore, special considerations must be considered.
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Affiliation(s)
- Bardia Hajikarimloo
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzan Fahim
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadamin Sabbagh Alvani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayeh Oveisi
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Anvari
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Oraee-Yazdani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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28
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Kim D, Biancon G, Bai Z, VanOudenhove J, Liu Y, Kothari S, Gowda L, Kwan JM, Buitrago-Pocasangre NC, Lele N, Asashima H, Racke MK, Wilson JE, Givens TS, Tomayko MM, Schulz WL, Longbrake EE, Hafler DA, Halene S, Fan R. Microfluidic Immuno-Serolomic Assay Reveals Systems Level Association with COVID-19 Pathology and Vaccine Protection. SMALL METHODS 2023; 7:e2300594. [PMID: 37312418 PMCID: PMC10592458 DOI: 10.1002/smtd.202300594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/23/2023] [Indexed: 06/15/2023]
Abstract
How to develop highly informative serology assays to evaluate the quality of immune protection against coronavirus disease-19 (COVID-19) has been a global pursuit over the past years. Here, a microfluidic high-plex immuno-serolomic assay is developed to simultaneously measure50 plasma or serum samples for50 soluble markers including 35proteins, 11 anti-spike/receptor binding domian (RBD) IgG antibodies spanningmajor variants, and controls. This assay demonstrates the quintuplicate test in a single run with high throughput, low sample volume, high reproducibilityand accuracy. It is applied to the measurement of 1012 blood samples including in-depth analysis of sera from 127 patients and 21 healthy donors over multiple time points, either with acute COVID infection or vaccination. The protein analysis reveals distinct immune mediator modules that exhibit a reduced degree of diversity in protein-protein cooperation in patients with hematologic malignancies or receiving B cell depletion therapy. Serological analysis identifies that COVID-infected patients with hematologic malignancies display impaired anti-RBD antibody response despite high level of anti-spike IgG, which can be associated with limited clonotype diversity and functional deficiency in B cells. These findings underscore the importance to individualize immunization strategies for these high-risk patients and provide an informative tool to monitor their responses at the systems level.
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Affiliation(s)
- Dongjoo Kim
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
| | - Giulia Biancon
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Zhiliang Bai
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
| | - Jennifer VanOudenhove
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Yuxin Liu
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Shalin Kothari
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Lohith Gowda
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Jennifer M Kwan
- Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | | | - Nikhil Lele
- Department of Neurology, Yale University, New Haven, CT, 06520, USA
| | | | | | | | | | - Mary M Tomayko
- Departments of Dermatology, Yale University, New Haven, CT, 06520, USA
- Department of Pathology, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Wade L Schulz
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Erin E Longbrake
- Department of Neurology, Yale University, New Haven, CT, 06520, USA
| | - David A Hafler
- Department of Neurology, Yale University, New Haven, CT, 06520, USA
- Department of Immunobiology, Yale University, New Haven, CT, 06520, USA
| | - Stephanie Halene
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
- Department of Pathology, Yale School of Medicine, New Haven, CT, 06520, USA
- Yale Center for RNA Science and Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
- Yale Cancer Center and Stem Cell Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Rong Fan
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
- Department of Pathology, Yale School of Medicine, New Haven, CT, 06520, USA
- Yale Cancer Center and Stem Cell Center, Yale School of Medicine, New Haven, CT, 06520, USA
- Human and Translational Immunology, Yale School of Medicine, New Haven, CT, 06520, USA
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29
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Lee J, Kim AR, Kang SW, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Kim SH. Protracted course of SARS-CoV-2 pneumonia in moderately to severely immunocompromised patients. Clin Exp Med 2023; 23:2255-2264. [PMID: 36607462 DOI: 10.1007/s10238-022-00984-0] [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: 09/06/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023]
Abstract
There have been few studies comparing the clinical characteristics and outcomes of SARS-CoV-2 pneumonia in individuals with and without moderately to severely immunocompromised conditions. We reviewed adult patients with SARS-CoV-2 infection who had radiologic evidence of pneumonia at a tertiary hospital in Seoul, South Korea, from February 2020 to April 2022. Moderately to severely immunocompromised status was defined as medical conditions or treatments that resulted in increased risk of severe COVID-19 and weakened immune response to COVID-19 vaccine as recommended by Centers for Disease Control and Prevention. The time to pneumonia development was defined as the time from symptom onset to the time when radiologic evidence of pneumonia was obtained. Viral clearance was defined as a Ct value > 30. COVID-19-related death was defined as 90-day death following imaging-confirmed pneumonia without any other plausible cause of death. A total of 467 patients with SARS-CoV-2 pneumonia were analyzed. Of these, 102 (22%) were moderately to severely immunocompromised. The median (IQR) time to pneumonia development was significantly longer in moderately to severely immunocompromised patients (9.5 [6-14] days) than the comparator (6 [3-8] days), p < 0.001), as was the median time to viral clearance (21 versus 12 days, p < 0.001). Moderately to severely immunocompromised status (aOR, 18.39; 95% CI, 5.80-58.30; p < 0.001) was independently associated with COVID-19-related death. Patients with moderately to severely immunocompromised conditions are likely to experience a more protracted course of SARS-CoV-2 pneumonia and a worse outcome than those without these conditions.
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Affiliation(s)
- Jeongjae Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - A Reum Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sung Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea.
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30
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Hardy N, Vegivinti CTR, Mehta M, Thurnham J, Mebane A, Pederson JM, Tarchand R, Shivakumar J, Olaniran P, Gadodia R, Ganguly A, Kelagere Y, Nallabolu RR, Gaddam M, Keesari PR, Pulakurthi YS, Reddy R, Kallmes K, Musunuru TN. Mortality of COVID-19 in patients with hematological malignancies versus solid tumors: a systematic literature review and meta-analysis. Clin Exp Med 2023; 23:1945-1959. [PMID: 36795239 PMCID: PMC9933827 DOI: 10.1007/s10238-023-01004-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Cancer patients are more vulnerable to COVID-19 compared to the general population, but it remains unclear which types of cancer have the highest risk of COVID-19-related mortality. This study examines mortality rates for those with hematological malignancies (Hem) versus solid tumors (Tumor). PubMed and Embase were systematically searched for relevant articles using Nested Knowledge software (Nested Knowledge, St Paul, MN). Articles were eligible for inclusion if they reported mortality for Hem or Tumor patients with COVID-19. Articles were excluded if they were not published in English, non-clinical studies, had insufficient population/outcomes reporting, or were irrelevant. Baseline characteristics collected included age, sex, and comorbidities. Primary outcomes were all-cause and COVID-19-related in-hospital mortality. Secondary outcomes included rates of invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission. Effect sizes from each study were computed as logarithmically transformed odds ratios (ORs) with random-effects, Mantel-Haenszel weighting. The between-study variance component of random-effects models was computed using restricted effects maximum likelihood estimation, and 95% confidence intervals (CIs) around pooled effect sizes were calculated using Hartung-Knapp adjustments. In total, 12,057 patients were included in the analysis, with 2,714 (22.5%) patients in the Hem group and 9,343 (77.5%) patients in the Tumor group. The overall unadjusted odds of all-cause mortality were 1.64 times higher in the Hem group compared to the Tumor group (95% CI: 1.30-2.09). This finding was consistent with multivariable models presented in moderate- and high-quality cohort studies, suggestive of a causal effect of cancer type on in-hospital mortality. Additionally, the Hem group had increased odds of COVID-19-related mortality compared to the Tumor group (OR = 1.86 [95% CI: 1.38-2.49]). There was no significant difference in odds of IMV or ICU admission between cancer groups (OR = 1.13 [95% CI: 0.64-2.00] and OR = 1.59 [95% CI: 0.95-2.66], respectively). Cancer is a serious comorbidity associated with severe outcomes in COVID-19 patients, with especially alarming mortality rates in patients with hematological malignancies, which are typically higher compared to patients with solid tumors. A meta-analysis of individual patient data is needed to better assess the impact of specific cancer types on patient outcomes and to identify optimal treatment strategies.
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Affiliation(s)
| | | | - Mansi Mehta
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - John M Pederson
- Nested Knowledge, Inc, St Paul, MN, USA
- Superior Medical Experts, St. Paul, MN, USA
| | | | - Jeevan Shivakumar
- Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA
| | | | - Ritika Gadodia
- Medstar Washington Hospital Center/Georgetown University, Washington, DC, USA
| | - Arup Ganguly
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Yashaswini Kelagere
- Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | | | | | - Praneeth R Keesari
- Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Rohit Reddy
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Tejo N Musunuru
- Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA.
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31
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Talko AV, Nevzorova VA, Dubov VS, Muzychenko NS, Gurbanov ER, Dubov SK, Beniova SN, Simakova AI. [Features of the course and adverse events risk of coronavirus infection COVID-19 in hematological diseases (data from the CHRONOS19 register for the Primorsky Territory, intermediate stage)]. TERAPEVT ARKH 2023; 95:537-542. [PMID: 38159002 DOI: 10.26442/00403660.2023.07.202279] [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: 01/17/2022] [Indexed: 01/03/2024]
Abstract
AIM To assess the characteristics of the course of coronavirus infection COVID-19 and to determine the risk factors for adverse events in patients of the regional hematological center. MATERIALS AND METHODS As part of an observational prospective cohort study, data from 144 medical records of patients in Primorsky Krai with hematological diseases and COVID-19 were analyzed. The data of the developed standardized questionnaire of the CHRONOS19 study were used. The primary endpoint (adverse outcome) was a composite point that included mortality from any cause during the observation period, development of acute respiratory distress syndrome, hospitalization in the intensive care unit, and the need for mechanical ventilation. RESULTS A study of the features of the course of COVID-19 in hematological patients showed an increase in the number of adverse events in patients with neoplastic blood diseases, especially in chronic lymphoproliferative diseases and acute myeloid leukemia. Significant predictors of an unfavorable course of COVID-19 include a refractory/recurrent variant of the course of a blood tumor, glucocorticoid therapy as part of the protocol for the treatment of the underlying disease, stage 3-4 lung damage according to computerised tomography scans at the onset of COVID-19, and the presence of diabetes mellitus. CONCLUSION Predictors of an unfavorable course of COVID-19 in hematological patients have been identified. Hematological patients in the context of the COVID-19 pandemic require a coordinated interdisciplinary approach involving hematologists and therapists, careful monitoring of clinical and laboratory parameters to reduce the risk of adverse events.
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32
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Wu M, Liu S, Wang C, Wu Y, Liu J. Risk factors for mortality among lung cancer patients with covid-19 infection: A systematic review and meta-analysis. PLoS One 2023; 18:e0291178. [PMID: 37682957 PMCID: PMC10490932 DOI: 10.1371/journal.pone.0291178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Lung cancer patients with coronavirus disease 2019 (COVID-19) infection experience high mortality rates. The study aims to determine the risk factors for mortality in lung cancer patients with COVID-19 infection. MATERIALS AND METHODS Followed the PRISMA reporting guidelines, PubMed, Embase, and Web of Science were systematically searched to February 20, 2023, for studies of lung cancer patients with COVID-19 infection. The main outcome of interest was the risk factor for mortality. We also compared the mortality rate of those patients among different continents. A pooled risk ratio (RR) with 95% CI was presented as the result of this meta-analysis. RESULTS Meta-analysis of 33 studies involving 5018 patients showed that pooled mortality rate of lung cancer in COVID-19 patients was 0.31 (95% CI: 0.25-0.36). Subgroup analysis based on the continents showed significant difference of the mortality rate was observed between Asia and the rest of world (χ2 = 98.96, P < 0.01). Older age (SMD: 0.24, 95% CI: 0.09-0.40, P < 0.01), advanced lung cancer (RR: 1.14, 95% CI: 1.04-1.26, P < 0.01), coexisting comorbidities such as hypertension (RR: 1.17, 95% CI: 1.01-1.35, P = 0.04) and cardiovascular disease (RR: 1.40, 95% CI: 1.03-1.91, P = 0.03) were associated with higher risk of mortality rate in those patients. CONCLUSIONS Findings of this meta-analysis confirms an increased risk of mortality in lung cancer patients with COVID-19 infection, whose risk factors for these patients appear to be exacerbated by older age, advanced-stage lung cancer, and comorbidities such as hypertension and cardiovascular disease.
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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, TN, United States of America
| | - Changyu Wang
- West China College of Stomatology, Sichuan University, Chengdu, China
| | - Yuxuan Wu
- Department of Medical Informatics, West China Medical School, Sichuan University, Chengdu, China
| | - Jialin Liu
- Information Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Informatics, West China Medical School, Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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De Muro M, Janssen AJ, Amadori S, de Fabritiis P, Sabatino D, Niscola P, Torti L, Trawinska MM, Tesei C, Bombaci F, Tarricone M, Bocchia M, Fava C, Galimberti S, Iurlo A, Luciano L, Abruzzese E. Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy. Ther Adv Hematol 2023; 14:20406207231190683. [PMID: 37693118 PMCID: PMC10483981 DOI: 10.1177/20406207231190683] [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: 02/11/2023] [Accepted: 07/12/2023] [Indexed: 09/12/2023] Open
Abstract
Background Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking. Objectives This study aims to examine the psychological well-being of hematological patients in Italy during the initial period of the COVID-19 pandemic. Furthermore, it seeks to explore the association between modifications in the management of hematological diseases and employment status of these patients during the COVID-19 pandemic and the resulting mental health outcomes. Design and Methods A survey using the DASS-21 questionnaire was administered to 1105 hematological patients. Data analysis was conducted using the R software, and logistic regression analysis was performed to predict the association between hematological patient/general population and employment status with DASS scores. Results The hematological patient population reported significantly higher levels of depression (OR 0.947, 95% CI 0.966-0.982, p < 0.001), anxiety (OR 0.948, 95% CI 0.939-0.958, p < 0.001), and stress (OR 0.984, 95% CI 0.977-0.992, p < 0.001) compared with the general population. A significant relationship has been found in stress between employed and unemployed patients (OR 1.015, 95% CI 1.000-1.030, p = 0.044), as well as in the control group (OR 1.024, 95% CI 1.010-1.039, p = 0.001). In addition, employment status is significantly related to depression, anxiety, and stress in both the hematological patient group and the general population. Conclusion During the initial phase of the COVID-19 pandemic, hematological patients had elevated levels of depression, anxiety, and stress compared with the general population. The delay in their treatment and employment status played a role in their mental health outcomes. These findings emphasize the importance of further research to gain deeper insight into the long-term psychological effects and explore effective strategies for managing mental health in similar crises.
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Affiliation(s)
- Marianna De Muro
- Department of Hematology and Stem Cell Transplantation, Campus Bio-Medico University Hospital, Rome, Italy
| | | | | | - Paolo de Fabritiis
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - Dante Sabatino
- Institute for Research on Population and Social Policies, National Research Council (CNR), Rome, Italy
| | - Pasquale Niscola
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - Lorenza Torti
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | | | - Cristiano Tesei
- Hematology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Felice Bombaci
- Italian Association against Leukemia (AIL) Onlus, Rome, Italy
| | - Mario Tarricone
- Italian Association against Leukemia (AIL) Onlus, Rome, Italy
| | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elisabetta Abruzzese
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2. Piazzale dell’Umanesimo 10, 00144 Rome, Italy
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Cabrera-Galeana P, Reynoso-Noverón N, González-Nuñez C, Arrieta O, Torres J, Allende S, Vilar-Compte D, Díaz C, Cano C, Álvarez M, Mohar A. Mortality Prognosis Factors in Patients with Active Cancer Under Treatment, and Severe COVID-19. Arch Med Res 2023; 54:102868. [PMID: 37586114 DOI: 10.1016/j.arcmed.2023.102868] [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: 02/04/2023] [Revised: 07/07/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND COVID-19 is associated with systemic inflammation. This inflammatory response is further deregulated by oncological treatments increasing mortality in this population. However, there is conflicting information regarding the clinical factors that increase mortality in patients with severe COVID-19. OBJECTIVE The aim of this study was to identify prognostic factors associated with mortality during severe COVID-19 in patients with active cancer. In addition, the correlation between oncologic codes and mortality related to severe COVID-19 was evaluated. PATIENTS AND METHODS We analyzed a cohort of Mexican patients with active cancer and severe COVID-19 between March 2020 and February 2021. We collected information on patient demographic characteristics, COVID-19 symptoms, clinical and laboratory data, and treatments. Patients were classified according to oncologic code. We defined the oncological code based on clinical stage, treatment intention, performance status before COVID-19, and median overall survival with palliative treatment. A log-rank test was performed to determine survival. A multivariate logistic regression model was used to adjust for potential confounders. RESULTS One hundred fifty-two patients with severe COVID-19 were analyzed. The red oncologic code was associated with an increased risk of mortality OR 22.8 (CI 95% 5.0-105.1, p <0.001), low oxygen saturation OR 5.4 (CI 95% 1.7-17.4, p = 0.005), chronic corticosteriod use OR 4.3 (CI 95% 1.0-18.1, p = 0.050) and high D-dimer level OR 3.2 (CI 95% 1.2-8.2, p = 0.019). CONCLUSIONS The survival of patients with active cancer and severe COVID-19 was possible to identify, at the time of admission, specific oncological characteristics. Based on this code, decreased oxygen saturation, increased D-dimer levels, and chronic corticosteroid use were the main predictive factors related to mortality.
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Affiliation(s)
| | | | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Juan Torres
- Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | - Silvia Allende
- Palliative Care Department, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Diana Vilar-Compte
- Department Infectious Disease, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Consuelo Díaz
- Medical Oncology Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Claudia Cano
- Medical Oncology Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Miguel Álvarez
- Medical Oncology Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Alejandro Mohar
- Cancer Epidemiology and Biomedical Research Unit, Instituto Nacional de Cancerología, Mexico City, Mexico; Biomedical Research Institute, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico.
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Avigan ZM, Paredes R, Boussi LS, Lam BD, Shea ME, Weinstock MJ, Peters MLB. Updated COVID-19 clearance time among patients with cancer in the Delta and Omicron waves. Cancer Med 2023; 12:16869-16875. [PMID: 37392171 PMCID: PMC10501268 DOI: 10.1002/cam4.6311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND COVID-19 infection delays therapy and in-person evaluation for oncology patients, but clinic clearance criteria are not clearly defined. METHODS We conducted a retrospective review of oncology patients with COVID-19 at a tertiary care center during the Delta and Omicron waves and compared clearance strategies. RESULTS Median clearance by two consecutive negative tests was 32.0 days (Interquartile Range [IQR] 22.0-42.5, n = 153) and was prolonged in hematologic malignancy versus solid tumors (35.0 days for hematologic malignancy, 27.5 days for solid tumors, p = 0.01) and in patients receiving B-cell depletion versus other therapies. Median clearance by single negative test was reduced to 23.0 days (IQR 16.0-33.0), with recurrent positive rate 25.4% in hematologic malignancy versus 10.6% in solid tumors (p = 0.02). Clearance by a predefined waiting period required 41 days until an 80% negative rate. CONCLUSIONS COVID-19 clearance remains prolonged in oncology patients. Single-negative test clearance can balance delays in care with risk of infection in patients with solid tumors.
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Affiliation(s)
- Zachary M. Avigan
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Rodrigo Paredes
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Leora S. Boussi
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Barbara D. Lam
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Meghan E. Shea
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Matthew J. Weinstock
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Mary Linton B. Peters
- Division of Hematology/Oncology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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Akbulut S, Garzali IU, Hargura AS, Aloun A, Yilmaz S. Screening, Surveillance, and Management of Hepatocellular Carcinoma During the COVID-19 Pandemic: a Narrative Review. J Gastrointest Cancer 2023; 54:408-419. [PMID: 35499649 PMCID: PMC9058753 DOI: 10.1007/s12029-022-00830-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The COVID-19 pandemic has been a burden to the global community as a whole but the healthcare community had bore the brunt of it. The pandemic resulted in policy changes that interfered with effective healthcare delivery. The healthcare community attempted to cope with the pandemic by triaging and prioritizing emergency conditions especially COVID related, ahead of elective conditions like cancer care. There was also fear that patients with cancer were at an increased risk of sever COVID-19 with increased mortality. Hepatocellular carcinoma (HCC) was also affected by these policies. METHODS We reviewed the modified measures adopted in screening, surveillance, and management of HCC during the pandemic using PubMed, Medline, Index Medicus, EMBASE, SCOPUS, and Google Scholar databases. RESULT The main modification in surveillance and screening for HCC during the pandemic includes limiting the surveillance to those with very high risk of HCC. The interval between surveillan was also delayed by few months in some cases. The adoption of teleconferencing for multidisciplinary team meetings and patient consultation is one of the highlights of this pandemic all in an effort to reduce contact and spread of the virus. The treatment of early-stage HCC was also modified as needed. The role of ablative therapy in the management of early HCC was very prominent during the pandemic as the surgical therapy was significantly affected by the lacks of ventilators and intensive care unit space resulting from the pandemic. Transplantation, especially living donor liver transplantation, was suspended in few centers because of the risk of infection to the living donors. CONCLUSION As we gradually recover from the pandemic, we should prepare for the fallout from the pandemic as we may encounter increased presentation of those patients deferred from screening during the pandemic.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Elazig Yolu 10 Km, Malatya, 44280 Turkey
- Department of Public Health, Faculty of Medicine, Inonu University, 44280 Malatya, Turkey
| | - Ibrahim Umar Garzali
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Elazig Yolu 10 Km, Malatya, 44280 Turkey
- Department of Surgery, Aminu Kano Teaching Hospital, Kano, 700101 Nigeria
| | - Abdirahman Sakulen Hargura
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Elazig Yolu 10 Km, Malatya, 44280 Turkey
- Kenyatta University Teaching, Referral and Research Hospital, Nairobi, 00100 Kenya
| | - Ali Aloun
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Elazig Yolu 10 Km, Malatya, 44280 Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Elazig Yolu 10 Km, Malatya, 44280 Turkey
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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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Khawaja F, Srinivasan K, Spallone A, Feldman A, Cantu S, Ariza-Heredia E, Dvordak T, Alousi A, Ahmed S, George M, Frenzel E, Bhatti M, Chemaly RF. Nosocomial COVID-19 at a comprehensive cancer center during the first year of the pandemic: Lessons learned. Am J Infect Control 2023; 51:506-513. [PMID: 35901993 PMCID: PMC9310434 DOI: 10.1016/j.ajic.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The spread of coronavirus disease 2019 (COVID-19) in health care settings endangers patients with cancer. As knowledge of the transmission of COVID-19 emerged, strategies for preventing nosocomial COVID-19 were updated. We describe our early experience with nosocomial respiratory viral infections (RVIs) at a cancer center in the first year of the pandemic (March 2020-March 2021). METHODS Nosocomial RVIs were identified through our infection control prospective surveillance program, which conducted epidemiologic investigations of all microbiologically documented RVIs. Data was presented as frequencies and percentages or medians and ranges. RESULTS A total of 35 of 3944 (0.9%) documented RVIs were determined to have been nosocomial acquired. Majority of RVIs were due to SARS CoV-2 (13/35; 37%) or by rhinovirus/enterovirus (12/35; 34%). A cluster investigation of the first 3 patients with nosocomial COVID-19 determined that transmission most likely occurred from employees to patients. Five patients (38%) required mechanical ventilation and 4 (31%) died during the same hospital encounter. CONCLUSIONS Our investigation of the cluster led to enhancement of our infection control measures. The implications of COVID-19 vaccination on infection control policies is still unclear and further studies are needed to delineate its impact on the transmission of COVID-19 in a hospital setting.
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Affiliation(s)
- Fareed Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Krithika Srinivasan
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amy Spallone
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adina Feldman
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sherry Cantu
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ella Ariza-Heredia
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tanya Dvordak
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amin Alousi
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marina George
- Office of Chief Operating Officer, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth Frenzel
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Micah Bhatti
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Roy F Chemaly
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX; Office of Chief Operating Officer, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Yan J, Steiger SN, Kodama R, Fender J, Tan C, Laracy J, Cohen N, McMillen T, Jani K, Robilotti EV, Babady NE, Seo SK, Kamboj M. Predictors of Coronavirus Disease 2019 Hospitalization After Sotrovimab in Patients With Hematologic Malignancy During the BA.1 Omicron Surge. Clin Infect Dis 2023; 76:1476-1482. [PMID: 36445792 DOI: 10.1093/cid/ciac916] [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: 08/31/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sotrovimab is an anti-spike neutralization monoclonal antibody developed to reduce the risk of coronavirus disease 2019 (COVID-19) progression and advancement to hospitalization in high-risk patients. Currently, there is limited research describing the association of sotrovimab treatment in patients with hematologic malignancy and the predictive factors of hospitalization. METHODS We performed an observational study of 156 consecutive cancer patients who received sotrovimab at Memorial Sloan Kettering Cancer Center in New York City during the BA.1 Omicron surge. We evaluated the demographic, clinical, and laboratory characteristics of the patients who had subsequent COVID-19-related hospitalization(s) compared to those who did not. RESULTS Among the 156 study patients, 17 (11%) were hospitalized, of whom 4 were readmitted for COVID-19-related complications; 3 deaths were attributed to COVID-19. Results from multivariable logistic regression show that significant factors associated with hospitalization include patients on anti-CD20 therapy (adjusted odds ratio [aOR], 5.59 [95% confidence interval {CI}, 1.73-18.12]; P = .004) and with relapse/refractory disease (aOR, 5.69 [95% CI, 1.69-19.16]; P = .005). Additionally, whole genome sequencing of severe acute respiratory syndrome coronavirus 2 detected high occurrences of mutations in the spike gene associated with treatment-related resistance longitudinal samples from 11 patients treated with sotrovimab. CONCLUSIONS While sotrovimab is effective at reducing COVID-19 hospitalization and disease severity in patients with hematologic malignancy when administered early, patients who received anti-CD20 antibodies showed substantial morbidity. Due to the high potential for resistance mutation to sotrovimab and increased morbidity in patients on anti-CD20 therapy, combination treatment should be explored to determine whether it provides added benefits compared to monotherapy.
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Affiliation(s)
- Judy Yan
- Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Samantha N Steiger
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rich Kodama
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jerome Fender
- Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Digital Informatics and Technology Solutions, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carrie Tan
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Justin Laracy
- Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
| | - Nina Cohen
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Tracy McMillen
- Clinical Microbiology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Krupa Jani
- Clinical Microbiology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elizabeth V Robilotti
- Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
| | - N Esther Babady
- Clinical Microbiology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Susan K Seo
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
| | - Mini Kamboj
- Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
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Ishio T, Tsukamoto S, Yokoyama E, Izumiyama K, Saito M, Muraki H, Kobayashi M, Mori A, Morioka M, Kondo T. Anti-CD20 antibodies and bendamustine attenuate humoral immunity to COVID-19 vaccination in patients with B-cell non-Hodgkin lymphoma. Ann Hematol 2023; 102:1421-1431. [PMID: 37041299 PMCID: PMC10089694 DOI: 10.1007/s00277-023-05204-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
Serologic responses of COVID-19 vaccine are impaired in patients with B-cell lymphoma, especially those who had recently been treated with anti-CD20 monoclonal antibodies. However, it is still unclear whether those patients develop an immune response following vaccination. We investigated the efficacy of vaccination against SARS-CoV-2 in 171 patients with B-cell non-Hodgkin lymphoma (B-NHL) who received two doses of an mRNA-based COVID-19 vaccine and we compared the efficacy of vaccination to that in 166 healthy controls. Antibody titers were measured 3 months after administration of the second vaccine dose. Patients with B-NHL showed a significantly lower seroconversion rate and a lower median antibody titer than those in healthy controls. The antibody titers showed correlations with the period from the last anti-CD20 antibody treatment to vaccination, the period from the last bendamustine treatment to vaccination and serum IgM level. The serologic response rates and median antibody titers were significantly different between diffuse large B-cell lymphoma (DLBCL) patients in whom anti-CD20 antibody treatment was completed within 9 months before vaccination and follicular lymphoma (FL) patients in whom anti-CD20 antibody treatment was completed within 15 months before vaccination. Moreover, the serologic response rates and median antibody titers were significantly different among FL patients in whom bendamustine treatment was completed within 33 months before vaccination. We demonstrated that B-NHL patients who were recently treated with anti-CD20 antibodies and bendamustine had a diminished humoral response to COVID-19 vaccination. UMIN 000,045,267.
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Affiliation(s)
- Takashi Ishio
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan.
| | | | - Emi Yokoyama
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | - Koh Izumiyama
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | - Makoto Saito
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | - Haruna Muraki
- Division of Laboratory, Aiiku Hospital, Sapporo, Japan
| | | | - Akio Mori
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | | | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
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Vaz N, Franquet E, Heidari P, Chow DZ, Jacene HA, Ng TSC. COVID-19: Findings in nuclear medicine from head to toe. Clin Imaging 2023; 99:10-18. [PMID: 37043868 PMCID: PMC10081937 DOI: 10.1016/j.clinimag.2023.04.003] [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: 10/02/2022] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 is a multisystemic disease, and hence its potential manifestations on nuclear medicine imaging can extend beyond the lung. Therefore, it is important for the nuclear medicine physician to recognize these manifestations in the clinic. While FDG-PET/CT is not indicated routinely in COVID-19 evaluation, its unique capability to provide a functional and anatomical assessment of the entire body means that it can be a powerful tool to monitor acute, subacute, and long-term effects of COVID-19. Single-photon scintigraphy is routinely used to assess conditions such as pulmonary embolism, cardiac ischemia, and thyroiditis, and COVID-19 may present in these studies. The most common nuclear imaging finding of COVID-19 vaccination to date is hypermetabolic axillary lymphadenopathy. This may pose important diagnostic and management dilemmas in oncologic patients, particularly those with malignancies where the axilla constitutes a lymphatic drainage area. This article aims to summarize the relevant literature published since the beginning of the pandemic on the intersection between COVID-19 and nuclear medicine.
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Affiliation(s)
- Nuno Vaz
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States.
| | - Elisa Franquet
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Pedram Heidari
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - David Z Chow
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Heather A Jacene
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Thomas S C Ng
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
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Kip KE, McCreary EK, Collins K, Minnier TE, Snyder GM, Garrard W, McKibben JC, Yealy DM, Seymour CW, Huang DT, Bariola JR, Schmidhofer M, Wadas RJ, Angus DC, Kip PL, Marroquin OC. Evolving Real-World Effectiveness of Monoclonal Antibodies for Treatment of COVID-19 : A Cohort Study. Ann Intern Med 2023; 176:496-504. [PMID: 37011399 PMCID: PMC10074437 DOI: 10.7326/m22-1286] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Treatment guidelines and U.S. Food and Drug Administration emergency use authorizations (EUAs) of monoclonal antibodies (mAbs) for treatment of high-risk outpatients with mild to moderate COVID-19 changed frequently as different SARS-CoV-2 variants emerged. OBJECTIVE To evaluate whether early outpatient treatment with mAbs, overall and by mAb product, presumed SARS-CoV-2 variant, and immunocompromised status, is associated with reduced risk for hospitalization or death at 28 days. DESIGN Hypothetical pragmatic randomized trial from observational data comparing mAb-treated patients with a propensity score-matched, nontreated control group. SETTING Large U.S. health care system. PARTICIPANTS High-risk outpatients eligible for mAb treatment under any EUA with a positive SARS-CoV-2 test result from 8 December 2020 to 31 August 2022. INTERVENTION Single-dose intravenous mAb treatment with bamlanivimab, bamlanivimab-etesevimab, sotrovimab, bebtelovimab, or intravenous or subcutaneous casirivimab-imdevimab administered within 2 days of a positive SARS-CoV-2 test result. MEASUREMENTS The primary outcome was hospitalization or death at 28 days among treated patients versus a nontreated control group (no treatment or treatment ≥3 days after SARS-CoV-2 test date). RESULTS The risk for hospitalization or death at 28 days was 4.6% in 2571 treated patients and 7.6% in 5135 nontreated control patients (risk ratio [RR], 0.61 [95% CI, 0.50 to 0.74]). In sensitivity analyses, the corresponding RRs for 1- and 3-day treatment grace periods were 0.59 and 0.49, respectively. In subgroup analyses, those receiving mAbs when the Alpha and Delta variants were presumed to be predominant had estimated RRs of 0.55 and 0.53, respectively, compared with 0.71 for the Omicron variant period. Relative risk estimates for individual mAb products all suggested lower risk for hospitalization or death. Among immunocompromised patients, the RR was 0.45 (CI, 0.28 to 0.71). LIMITATIONS Observational study design, SARS-CoV-2 variant presumed by date rather than genotyping, no data on symptom severity, and partial data on vaccination status. CONCLUSION Early mAb treatment among outpatients with COVID-19 is associated with lower risk for hospitalization or death for various mAb products and SARS-CoV-2 variants. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Kevin E Kip
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (K.E.K., K.C., W.G., J.C.M., O.C.M.)
| | - Erin K McCreary
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (E.K.M., G.M.S., J.R.B.)
| | - Kevin Collins
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (K.E.K., K.C., W.G., J.C.M., O.C.M.)
| | - Tami E Minnier
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (T.E.M., P.L.K.)
| | - Graham M Snyder
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (E.K.M., G.M.S., J.R.B.)
| | - William Garrard
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (K.E.K., K.C., W.G., J.C.M., O.C.M.)
| | - Jeffrey C McKibben
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (K.E.K., K.C., W.G., J.C.M., O.C.M.)
| | - Donald M Yealy
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (D.M.Y., R.J.W.)
| | - Christopher W Seymour
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (C.W.S., D.C.A.)
| | - David T Huang
- Department of Emergency Medicine and Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (D.T.H.)
| | - J Ryan Bariola
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (E.K.M., G.M.S., J.R.B.)
| | - Mark Schmidhofer
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (M.S.)
| | - Richard J Wadas
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (D.M.Y., R.J.W.)
| | - Derek C Angus
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (C.W.S., D.C.A.)
| | - Paula L Kip
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (T.E.M., P.L.K.)
| | - Oscar C Marroquin
- Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (K.E.K., K.C., W.G., J.C.M., O.C.M.)
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Gupta S, Chauhan N, Kumari P, Bansal M, Chahar A. To study the pattern of seroconversion for SARS-CoV-2 IgG antibodies in COVID-infected cancer patients and to correlate it clinically - A cross-sectional study. J Cancer Res Ther 2023; 19:S404-S408. [PMID: 37148008 DOI: 10.4103/jcrt.jcrt_460_22] [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: 05/07/2023]
Abstract
Background Though as per literature cancer is also consider an associated risk factor for morbidity and mortality for covid infection but practically most of the cancer patients showed no symptoms with less mortality in second wave of pandemic. So this cross sectional comparative analysis study was designed to see the prevalence of sero-conversion for SARS -coV for IgG in covid infected cancer patients and to compare the IgG antibodies level between covid infected cancer patients and covid infected healthy persons. Material and Method Covid-19 antibody screening of covid recovered cancer patients as well as covid recovered healthy persons was done in department of Transfusion Medicine.IgG antibody for COVID-19 was detected using microtiter plate with whole-cell antigen coating, an in-house validated kit by NIV ICMR3. Prevalence of sero-conversion was noted down in both the groups and compared. Result There was more infectivity rate in second covid wave. Case fatality rate was much lesser as compared to 1st wave in cancer patients. In cancer patients maximum seroconversion was seen in younger group i.e. 21-30 yrs. of age, this was in contrast to finding in general population, where minimum seroconversion was seen in younger age group. It was observed that more prevalence of sero conversion was seen in general population as compared to cancer patients, but difference was non-significant. Conclusion Though cancer patients showed less rate of seroconversion as compared to normal healthy person, but none of them showed any moderate or severe symptoms inspite of being a risk factor for severity of covid. Though larger study are required to comment on statistical conclusion.
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Affiliation(s)
- Surabhi Gupta
- Department of Radiation Oncology, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Nitu Chauhan
- Department of Transfusion Medicine, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Pratibha Kumari
- Department of Radiation Oncology, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Manish Bansal
- Department of Medicine, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Ajeet Chahar
- Department of Medicine, S. N. Medical College, Agra, Uttar Pradesh, India
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Humoral response to mRNA-based COVID-19 vaccine and booster effect of a third dose in patients with mature T cell and NK-cell neoplasms. Ann Hematol 2023; 102:819-827. [PMID: 36862167 PMCID: PMC9978274 DOI: 10.1007/s00277-023-05142-4] [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: 01/04/2023] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
Patients with lymphoid malignancies have impaired humoral immunity caused by the disease itself and its treatment, placing them at risk for severe coronavirus disease-19 (COVID-19) and reduced response to vaccination. However, data for COVID-19 vaccine responses in patients with mature T cell and NK-cell neoplasms are very limited. In this study of 19 patients with mature T/NK-cell neoplasms, anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike antibodies were measured at 3 months, 6 months, and 9 months after the second mRNA-based vaccination. At the time of the second and third vaccinations, 31.6% and 15.4% of the patients were receiving active treatment. All patients received the primary vaccine dose and the third vaccination rate was 68.4%. In patients with mature T/NK-cell neoplasms, both seroconversion rate (p < 0.01) and antibody titers (p < 0.01) after the second vaccination were significantly lower than those in healthy controls (HC). In individuals who received the booster dose, patients had significantly lower antibody titers than those in HC (p < 0.01); however, the seroconversion rate in patients was 100%, which was the same as that in HC. The booster vaccine resulted in a significant increase of antibodies in elderly patients who had shown a response that was inferior to that in younger patients after two doses of vaccination. Since higher antibody titers and higher seroconversion rate reduced the incidence of infection and mortality, vaccination more than three times may have the advantage for patients with mature T/NK-cell neoplasms, especially in elderly patients. Clinical trial registration number: UMIN 000,045,267 (August 26th, 2021), 000,048,764 (August 26th, 2022).
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Madamombe K, Shambira G, Masoja G, Dhliwayo T, Juru TP, Gombe NT, Chadambuka A, Karakadzai M, Tshimanga M. Factors associated with COVID-19 fatality among patients admitted in Mashonaland West Province, Zimbabwe 2020-2022: a secondary data analysis. Pan Afr Med J 2023; 44:142. [PMID: 37396695 PMCID: PMC10311223 DOI: 10.11604/pamj.2023.44.142.37858] [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: 10/17/2022] [Accepted: 01/18/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction approximately 15% of COVID-19 patients develop symptoms necessitating admission. From 2020 to 2022, Mashonaland West Province had an institutional case fatality rate of 23% against a national rate of 7%. Therefore, we evaluated the COVID-19 admissions in the province to determine the factors associated with COVID-19 mortality. Methods we conducted an analytical cross-sectional study based on secondary data from isolation centers across the province using all 672 death audit forms and patient records. We obtained data on patient demographics, signs and symptoms, clinical management and oxygen therapy administered, among other things. Data were entered into an electronic form and imported into Epi-info 7 for analysis bivariate and multivariate conducted. Results: we found that being an older man, aOR 1.04 (1.03-1.05), who had diabetes aOR 6.0 (95% CI: 3.8-9.2) and hypertension aOR 4.5 (95% CI: 2.8-6.5) were independent risk factors. Patients put on dexamethasone aOR 2.4 (95% CI: 1.6-3.4) and heparin/clexane aOR 1.6 (95% CI: 1.1-2.2) had a higher mortality risk. However, vitamin C aOR 0.48 (95% CI: 0.31-0.71) and oxygen therapy aOR 0.14 (95% CI: 0.10-0.19) and being pregnant aOR 0.06 (95% CI: 0.02-0.14) were protective. Conclusion: mortality risk increased in older male patients with comorbidities and with those on dexamethasone and heparin therapy. Oxygen therapy and vitamin C were protective. There is a need to conduct further study of the source of these variations in risk across patients to establish the true impact of differences in individuals' mortality.
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Affiliation(s)
- Kudzai Madamombe
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Gerald Shambira
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Gift Masoja
- Zimbabwe Ministry of Health and Child Care, Mashonaland West, Zimbabwe
| | - Tapiwa Dhliwayo
- Zimbabwe Ministry of Health and Child Care, Mashonaland West, Zimbabwe
| | - Tsitsi Patience Juru
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | - Addmore Chadambuka
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | - Mufuta Tshimanga
- Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe
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Fedorchenko Y, Zimba O. Comorbidities in the COVID-19 Pandemic: Scopus-Based Bibliometric Analysis. J Korean Med Sci 2023; 38:e93. [PMID: 36942396 PMCID: PMC10027540 DOI: 10.3346/jkms.2023.38.e93] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Comorbidities attract enormous attention amid the coronavirus disease 2019 (COVID-19) pandemic. Mapping knowledge based on these clinical conditions is increasingly important since the pandemic is still raging and primarily affecting subjects with chronic diseases and comorbidities. Clinical presentation and complications of COVID-19 are still hot topics which are explored in numerous evidence-based publications. The aim of this study was to analyze Scopus-indexed COVID-19 papers covering comorbidities. METHODS Searches through the Scopus database were performed on September 19, 2022 using the following keywords: "Diabetes mellitus" OR "Cardiovascular Diseases" OR "Rheumatic Diseases" OR "Obesity" OR "Malignancies" AND "COVID-19." All retrieved articles were analyzed using the following categories: document type, authorship, keywords, journal, citation score, country of origin, and language. Using the software tool VOSviewer version 1.6.18, we visualized the network of authors and keywords co-occurrence of the most prevalent comorbidities reported in connection with COVID-19. RESULTS Reports on COVID-19 and diabetes mellitus (DM) were most frequently published (n = 12,282). The US was the most productive country (n = 3,005) in the field of COVID-19 and comorbidities. There were 1,314 documents on COVID-19 and rheumatic diseases which is the least number in comparison with other comorbidities (COVID-19 and DM: 12,282, COVID-19 and cardiovascular disease: 9,911, COVID-19 and obesity: 7,070, and COVID-19 and malignancies: 1,758). CONCLUSION This mapping of COVID-19-related documents in connection with comorbidities may prioritize future research directions.
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Affiliation(s)
- Yuliya Fedorchenko
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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Chatterjee S, Nalla LV, Sharma M, Sharma N, Singh AA, Malim FM, Ghatage M, Mukarram M, Pawar A, Parihar N, Arya N, Khairnar A. Association of COVID-19 with Comorbidities: An Update. ACS Pharmacol Transl Sci 2023; 6:334-354. [PMID: 36923110 PMCID: PMC10000013 DOI: 10.1021/acsptsci.2c00181] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Indexed: 03/03/2023]
Abstract
Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) which was identified in Wuhan, China in December 2019 and jeopardized human lives. It spreads at an unprecedented rate worldwide, with serious and still-unfolding health conditions and economic ramifications. Based on the clinical investigations, the severity of COVID-19 appears to be highly variable, ranging from mild to severe infections including the death of an infected individual. To add to this, patients with comorbid conditions such as age or concomitant illnesses are significant predictors of the disease's severity and progression. SARS-CoV-2 enters inside the host cells through ACE2 (angiotensin converting enzyme2) receptor expression; therefore, comorbidities associated with higher ACE2 expression may enhance the virus entry and the severity of COVID-19 infection. It has already been recognized that age-related comorbidities such as Parkinson's disease, cancer, diabetes, and cardiovascular diseases may lead to life-threatening illnesses in COVID-19-infected patients. COVID-19 infection results in the excessive release of cytokines, called "cytokine storm", which causes the worsening of comorbid disease conditions. Different mechanisms of COVID-19 infections leading to intensive care unit (ICU) admissions or deaths have been hypothesized. This review provides insights into the relationship between various comorbidities and COVID-19 infection. We further discuss the potential pathophysiological correlation between COVID-19 disease and comorbidities with the medical interventions for comorbid patients. Toward the end, different therapeutic options have been discussed for COVID-19-infected comorbid patients.
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Affiliation(s)
- Sayan Chatterjee
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Lakshmi Vineela Nalla
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India.,Department of Pharmacy, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh 522302, India
| | - Monika Sharma
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Nishant Sharma
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Aditya A Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Fehmina Mushtaque Malim
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Manasi Ghatage
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Mohd Mukarram
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Abhijeet Pawar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Nidhi Parihar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India
| | - Neha Arya
- Department of Translational Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Bhopal 462020, India
| | - Amit Khairnar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gujarat 382355, India.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno 602 00, Czech Republic.,ICRC-FNUSA Brno 656 91, Czech Republic.,Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 62500 Brno, Czechia
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COVID-19 Adverse Outcomes in Immunocompromised Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2023. [DOI: 10.5812/ijcm-131077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a devastating viral pandemic infecting millions of people with a wide range of symptoms from fever to death. It has been suggested that immunocompromised patients are at a higher risk of severe disease, poor clinical outcomes, and mortality. However, these patients’ risk factors and COVID-19-related outcomes are not well characterized. Objectives: We evaluated the COVID-19-related outcomes among immunocompromised patients ranging from solid tumors, hematological malignancies, and HIV to autoimmune disease and transplant recipients who received immunosuppressive agents. We also aimed at finding risk factors related to mortality among immunocompromised patients with COVID-19. Methods: This cross-sectional study was conducted in Khansari Hospital, Iran between March and November 2021. We included immunocompromised patients with nasal swab positive SARS-CoV-2 polymerase chain reaction (PCR) results in the study. Patient outcomes, including hospitalization ward and the mortality rate, were assessed till three months after COVID-19 infection were evaluated in all patients. Moreover, the relation between risk factors and the rate of the mortality rate was analyzed in immunocompromised patients with COVID-19. Results: A total number of 74 immunocompromised patients with solid tumors, hematologic malignancies, autoimmune diseases, acquired immunodeficiencies, and solid-organ transplant recipients were included in the study. Results indicated that the male gender and ICU hospitalization significantly increase the mortality risk. Surprisingly, chemotherapy is associated with a lower risk of mortality. Conclusions: Identifying the risk factors can improve the decision-making on cancer patients’ management during the COVID-19 infection. A further large cohort of patients would be required to identify risk factors relating to poor clinical outcomes and mortality rates in immunocompromised patients with COVID-19.
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Identification of Clinical Features Associated with Mortality in COVID-19 Patients. OPERATIONS RESEARCH FORUM 2023. [PMCID: PMC9984757 DOI: 10.1007/s43069-022-00191-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractUnderstanding clinical features and risk factors associated with COVID-19 mortality is needed to early identify critically ill patients, initiate treatments and prevent mortality. A retrospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020 was conducted. COVID-19-related mortality and its association with clinical features including headache, chest pain, symptoms on computerized tomography (CT), hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia were investigated. Based on the investigation outcome, decision tree and dimension reduction algorithms were used to identify the aforementioned risk factors. Of the 3008 patients (mean age 59.3 ± 18.7 years, 44% women) with COVID-19, 373 died. There was a significant association between COVID-19 mortality and old age, headache, chest pain, low respiratory rate, oxygen saturation < 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Our results might help identify early symptoms related to COVID-19 and better manage patients according to the extracted decision tree. The proposed ML models identified a number of clinical features and risk factors associated with mortality in COVID-19 patients. These models if implemented in a clinical setting might help to early identify patients needing medical attention and care. However, more studies are needed to confirm these findings.
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Risk factors of SARS-CoV-2 infection and complications from COVID-19 in lung cancer patients. Int J Clin Oncol 2023; 28:531-542. [PMID: 36859565 PMCID: PMC9977088 DOI: 10.1007/s10147-023-02311-3] [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: 08/05/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Identifying lung cancer patients at an increased risk of getting SARS-CoV-2-related complications will facilitate tailored therapy to maximize the benefit of anti-cancer therapy, while decreasing the likelihood of COVID-19 complications. This analysis aimed to identify the characteristics of lung cancer patients that predict for increased risk of death or serious SARS-CoV-2 infection. PATIENTS AND METHODS This was a retrospective cohort study of patients with lung cancer diagnosed October 1, 2015, and December 1, 2020, and a diagnosis of COVID-19 between February 2, 2020, and December 1, 2020, within the Veterans Health Administration. Serious SARS-CoV-2 infection was defined as hospitalization, ICU admission, or mechanical ventilation or intubation within 2 weeks of COVID-19 diagnosis. For categorical variables, differences were assessed using Χ2 tests, while Kruskal-Wallis rank-sum test was used for continuous variables. Multivariable logistic regression models were fit relative to onset of serious SARS-CoV-2 infection and death from SARS-CoV-2 infection. RESULTS COVID-19 infection was diagnosed in 352 lung cancer patients. Of these, 61 patients (17.3%) died within four weeks of diagnosis with COVID-19, and 42 others (11.9%) experienced a severe infection. Patients who had fatal or severe infection were older and had lower hemoglobin levels than those with mild or moderate infection. Factors associated with death from SARS-CoV-2 infection included increasing age, immune checkpoint inhibitor therapy and low hemoglobin level. CONCLUSIONS The mortality of lung cancer patients from COVID-19 disease in the present cohort was less than previously reported in the literature. The identification of risk factors associated with severe or fatal outcomes informs management of patients with lung cancer who develop COVID-19 disease.
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