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Yokoyama K, Yoshimoto N, Takayama S, Sakamoto M, Tomoda K, Ishikawa K, Yamashita M, Suzuki H, Hosogi R, Takahashi M, Fukuda M, Kani H. Impact of PEG-GCSF in Breast Cancer Patients Undergoing Chemotherapy During the COVID-19 Pandemic: Single Center Experience and Literature Review. In Vivo 2024; 38:2335-2340. [PMID: 39187320 PMCID: PMC11363791 DOI: 10.21873/invivo.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/30/2024] [Accepted: 06/11/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND/AIM The COVID-19 pandemic brought many challenges in healthcare systems globally. Pegylated granulocyte colony stimulating factor (PEG-GCSF) is recommended to reduce febrile neutropenia (FN), however there are a few reports that G-CSF might worsen COVID-19 disease, and its appropriate use during the COVID-19 pandemic remains uncertain. This retrospective study aimed to analyze the association between PEG-GCSF use and COVID-19 infection and severity. PATIENTS AND METHODS Breast cancer patients who received chemotherapy at the Nagoya Tokushukai General Hospital between October 2020 and April 2023 were included. Patients with suspected COVID-19 symptoms during each chemotherapy cycle underwent COVID-19 antigen testing. To assess the potential impact of PEG-GCSF on COVID-19 severity, we collected data on patient background, chemotherapy regimens, PEG-GCSF use, COVID-19 antigen tests, and COVID-19 infection from their medical records. RESULTS Thirty patients received chemotherapy. In total, 71 cycles were administered comprising adriamycin and cyclophosphamide (AC; 37 cycles), docetaxel (DTX; 26 cycles) and docetaxel and cyclophosphamide (TC; eight cycles). Among those patients, suspected COVID-19 symptoms were observed in only one of 62 cycles of the three regimens (1.6%) with PEG-GCSF compared to two of nine cycles (22.2%) without PEG-GCSF (p=0.0405). However, because none developed COVID-19 infection during chemotherapy, we could not assess COVID-19 severity and PEG-GCSF use. CONCLUSION A potential role of PEG-GCSF in reducing suspected COVID-19 symptoms during chemotherapy, reducing the anxiety and need for hospital visits, thus improving patients' quality of life, is suggested. These insights could contribute to optimizing the care of breast cancer patients in situations like the current pandemic.
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Affiliation(s)
- Kioto Yokoyama
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Nobuyasu Yoshimoto
- Department of Breast Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan;
- Laboratory of Genome Medicine, Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Satoru Takayama
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Masaki Sakamoto
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Keisuke Tomoda
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Ken Ishikawa
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | | | - Hiroto Suzuki
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Ryosuke Hosogi
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Masahiro Takahashi
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Mari Fukuda
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
| | - Hisanori Kani
- Department of Surgery, Nagoya Tokushukai General Hospital, Kasugai, Japan
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Bellone S, Siegel ER, Scheim DE, Santin AD. Increased von Willebrand and Factor VIII plasma levels in gynecologic patients with Post-Acute-COVID-Sequela (PASC)/Long COVID. Gynecol Oncol Rep 2024; 51:101324. [PMID: 38273933 PMCID: PMC10809113 DOI: 10.1016/j.gore.2024.101324] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/27/2024] Open
Abstract
Up to 30 % of COVID-infected patients may develop post-acute sequelae of COVID-19 (PASC), also known as Long COVID (LC), a syndrome characterized by a variety of debilitating symptoms lasting for more than 3 months after the acute infection. While the pathophysiological mechanisms behind PASC/LC are not completely understood, growing evidence suggests that an important component of this syndrome may be related to persistent microvascular inflammation causing clumping/clotting of red blood cells and platelets and thrombotic complications. We retrospectively evaluated the plasma levels of von Willebrand factor (VWF), Factor VIII and D-dimer in 10 gynecologic patients (60 % with an endometrial or ovarian cancer diagnosis) affected by PASC/LC vs 5 control patients (60 % harboring endometrial or ovarian tumors). We found elevated VWF and Factor VIII levels in all 10 PASC/LC patients (means of 254 % and 229 %, respectively) vs none of the 5 randomly selected cancer control patients (means of 108 % and 95 %, respectively), p = 0.0046 and p < 0.0001, respectively. In contrast, no significant difference was noted in the levels of D-dimer in PASC/LC. Importantly, abnormally elevated VWF and Factor VIII levels were found to persist for at least 2 years in patients with Long COVID symptoms. VWF and Factor VIII but not D-dimer levels are significantly elevated in the plasma of PASC/LC cancer patients. Abnormally and persistently elevated VWF and Factor VIII levels may represent the results of persistent microvascular damage (i.e., spike-induced endotheliosis) and may be biomarkers of persistent inflammation in gynecologic patients with PASC/LC.
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Affiliation(s)
- Stefania Bellone
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Eric R. Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - David E. Scheim
- US Public Health Service, Commissioned Corps, Inactive Reserve, Blacksburg, VA 24060-6367, USA
| | - Alessandro D. Santin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
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Bellone S, Siegel EE, Santin AD. Increased serum 1,25-dihydroxyvitamin D levels in gynecologic cancer patients with Post-Acute-Covid-Sequela (PASC)/Long COVID. Gynecol Oncol Rep 2023; 50:101301. [PMID: 38029227 PMCID: PMC10654147 DOI: 10.1016/j.gore.2023.101301] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Post-acute sequelae of COVID-19 (PASC), also known as Long-Covid (LC), may affect 10-30 % of COVID-infected patients, and is characterized by a variety of debilitating symptoms lasting over 3 months after the acute infection, including but not limited to dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. Vitamin D is an essential nutrient primarily recognized for its role in regulating calcium and bone health but also endowed with potent anti-inflammatory activity affecting a variety of immune cells. We retrospectively evaluated the plasmatic levels of both 1,25-dihydroxyvitamin-D (1,25 OH), and 25-hydroxyvitamin-D (25 OH), the active and storage forms of vitamin-D3, respectively, in the serum of gynecologic cancer patients affected by PASC/LC vs control cancer patients. We found elevated 1,25-dihydroxyvitamin-D levels in 5 out of 5 of the PASC/LC patients (mean ± SD = 97.2 ± 26.9 pg/mL) versus 0 out of 10 of randomly selected cancer control patients (44.9 ± 17.2 pg/mL, p = 0.0005). In contrast, no significant difference was noted in the levels of 25-dihydroxyvitamin-D in PASC/LC (mean ± SD = 48.2 ± 15.8 ng/mL) versus controls (43.0 ± 11.6 ng/mL, p = 0.48). Importantly, abnormal levels of vitamin D were found to persist for at least 2 years in patients with long covid symptoms. The active form (1,25OH) but not the storage form (25 OH) of vitamin-D is significantly elevated in PASC/LC cancer patients. Abnormally and persistently elevated 1,25OH levels, similarly to sarcoidosis patients, may represent the results of extrarenal conversion of vitamin D by activated macrophages, and a novel biomarker of persistent inflammation in gynecologic cancer patients with PASC/LC.
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Affiliation(s)
- Stefania Bellone
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Eric E. Siegel
- Department of Biostatistics, University of Arkansas for Medical Science, Little Rock, AR 72205, USA
| | - Alessandro D. Santin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
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Villanueva-Cotrina F, Velarde J, Rodriguez R, Bonilla A, Laura M, Saavedra T, Portillo-Alvarez D, Bustamante Y, Fernandez C, Galvez-Nino M. Active cancer as the main predictor of mortality for COVID-19 in oncology patients in a specialized center. Pathol Oncol Res 2023; 29:1611236. [PMID: 37746553 PMCID: PMC10511753 DOI: 10.3389/pore.2023.1611236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/11/2023] [Indexed: 09/26/2023]
Abstract
Introduction: The role of the type, stage and status of cancer in the outcome of COVID-19 remains unclear. Moreover, the characteristic pathological changes of severe COVID-19 reveled by laboratory and radiological findings are similar to those due to the development of cancer itself and antineoplastic therapies. Objective: To identify potential predictors of mortality of COVID-19 in cancer patients. Materials and methods: A retrospective and cross-sectional study was carried out in patients with clinical suspicion of COVID-19 who were confirmed for COVID-19 diagnosis by RT-PCR testing at the National Institute of Neoplastic Diseases between April and December 2020. Demographic, clinical, laboratory and radiological data were analyzed. Statistical analyses included area under the curve and univariate and multivariate logistic regression analyses. Results: A total of 226 patients had clinical suspicion of COVID-19, the diagnosis was confirmed in 177 (78.3%), and 70/177 (39.5%) died. Age, active cancer, leukocyte count ≥12.8 × 109/L, urea ≥7.4 mmol/L, ferritin ≥1,640, lactate ≥2.0 mmol/L, and lung involvement ≥35% were found to be independent predictors of COVID-19 mortality. Conclusion: Active cancer represents the main prognosis factor of death, while the role of cancer stage and type is unclear. Chest CT is a useful tool in the prognosis of death from COVID-19 in cancer patients. It is a challenge to establish the prognostic utility of laboratory markers as their altered values it could have either oncological or pandemic origins.
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Affiliation(s)
- Freddy Villanueva-Cotrina
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Microbiology, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Juan Velarde
- Department of Infectious Diseases, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Ricardo Rodriguez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Technologist, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Alejandra Bonilla
- Department of Radiodiagnosis, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Marco Laura
- Department of Radiodiagnosis, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Tania Saavedra
- Department of Critical Care Medicine, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Professional School of Human Medicine, Universidad Privada San Juan Bautista, Lima, Peru
| | - Diana Portillo-Alvarez
- Department of Infectious Diseases, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Professional School of Human Medicine, Universidad de Piura, Lima, Peru
| | - Yovel Bustamante
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Academic Department of Medical Microbiology, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cesar Fernandez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Marco Galvez-Nino
- Professional School of Human Medicine, Universidad Privada San Juan Bautista, Lima, Peru
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Oza PP, Kashfi K. The Triple Crown: NO, CO, and H 2S in cancer cell biology. Pharmacol Ther 2023; 249:108502. [PMID: 37517510 PMCID: PMC10529678 DOI: 10.1016/j.pharmthera.2023.108502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/16/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Nitric oxide (NO), carbon monoxide (CO), and hydrogen sulfide (H2S) are three endogenously produced gases with important functions in the vasculature, immune defense, and inflammation. It is increasingly apparent that, far from working in isolation, these three exert many effects by modulating each other's activity. Each gas is produced by three enzymes, which have some tissue specificities and can also be non-enzymatically produced by redox reactions of various substrates. Both NO and CO share similar properties, such as activating soluble guanylate cyclase (sGC) to increase cyclic guanosine monophosphate (cGMP) levels. At the same time, H2S both inhibits phosphodiesterase 5A (PDE5A), an enzyme that metabolizes sGC and exerts redox regulation on sGC. The role of NO, CO, and H2S in the setting of cancer has been quite perplexing, as there is evidence for both tumor-promoting and pro-inflammatory effects and anti-tumor and anti-inflammatory activities. Each gasotransmitter has been found to have dual effects on different aspects of cancer biology, including cancer cell proliferation and apoptosis, invasion and metastasis, angiogenesis, and immunomodulation. These seemingly contradictory actions may relate to each gas having a dual effect dependent on its local flux. In this review, we discuss the major roles of NO, CO, and H2S in the context of cancer, with an effort to highlight the dual nature of each gas in different events occurring during cancer progression.
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Affiliation(s)
- Palak P Oza
- Department of Molecular, Cellular and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, New York, NY 10031, USA
| | - Khosrow Kashfi
- Department of Molecular, Cellular and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, New York, NY 10031, USA; Graduate Program in Biology, City University of New York Graduate Center, New York 10091, USA.
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6
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Kowalska JD, Lara M, Hlebowicz M, Mularska E, Jabłonowska E, Siwak E, Wandałowicz A, Witak-Jędra M, Olczak A, Bociąga-Jasik M, Suchacz M, Stempkowska-Rejek J, Wasilewski P, Parczewski M. Non-HIV-related comorbidities and uncontrolled HIV replication are independent factors increasing the odds of hospitalization due to COVID-19 among HIV-positive patients in Poland. Infection 2023; 51:379-387. [PMID: 35882773 PMCID: PMC9325668 DOI: 10.1007/s15010-022-01887-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/08/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Immunocompromised patients are postulated to be at elevated risk of unfavorable outcomes of COVID-19. The exact effect of HIV infection on the course of COVID-19 remains to be elucidated. The aim of the study was to describe the epidemiological and clinical aspects of SARS-CoV-2 infection in HIV-infected individuals. METHODS The HIV-positive patients who were diagnosed with SARS-CoV-2 infection were identified through thirteen specialist HIV clinics routinely following them due to HIV treatment. The data were collected between November 2020 and May 2021 through an on-line electronical case report form (SurveyMonkey®). The collected information included demographics, lifestyle, comorbidities, HIV care history, COVID-19 clinical course and treatment. Logistic regression models were used to identify factors associated with the odds of death or hospitalization due to COVID-19. RESULTS One hundred and seventy-three patients with HIV-SARS-CoV-2 coinfection were included in the analysis. One hundred and sixty-one (93.1%) subjects had a symptomatic course of the disease. Thirty-nine (23.1%) of them were hospitalized, 23 (13.3%) necessitated oxygen therapy. Three (1.8%) patients required admission to the intensive care unit and 6 (3.5%) patients died. The presence of comorbidities and an HIV viral load of more than 50 copies/mL were linked to the increased odds of hospitalization (OR 3.24 [95% CI 1.27-8.28]) and OR 5.12 [95% CI 1.35-19.6], respectively). CONCLUSIONS As depicted by our analyses, HIV-positive patients with comorbidities and/or uncontrolled HIV replication who are diagnosed with SARS-CoV-2 infection should be considered of high risk of poor COVID-19 outcome and followed up carefully.
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Affiliation(s)
- Justyna D. Kowalska
- Department of Adults’ Infectious Diseases, Medical University in Warsaw, Warsaw, Poland
- HIV Out-Patient Clinic, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
| | - Martyna Lara
- 3rd Department, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
- Present Address: Department of Infectious Diseases, University Hospital in Cracow, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Maria Hlebowicz
- Department of Infectious Diseases, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Elżbieta Mularska
- Outpatient Clinic for AIDS Diagnostics and Therapy Specialistic Hospital, Chorzow, Poland
| | - Elżbieta Jabłonowska
- Department of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland
| | - Ewa Siwak
- HIV Out-Patient Clinic, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland
| | - Alicja Wandałowicz
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Białystok, Poland
| | - Magdalena Witak-Jędra
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anita Olczak
- Department of Infectious Diseases and Hepatology, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Monika Bociąga-Jasik
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 30-688, Kraków, Poland
| | - Magdalena Suchacz
- Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Piotr Wasilewski
- 4Th Department, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
| | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Khiyali Z, Naderi Z, Vakil M, Ghasemi H, Dehghan A, Bijani M. A study of COVID anxiety, spiritual well-being and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic: a cross-sectional study in the south of Iran. BMC Psychol 2023; 11:75. [PMID: 36935528 PMCID: PMC10025065 DOI: 10.1186/s40359-023-01126-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/15/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Patients with cancer are at higher risk of contracting COVID-19 with poor prognosis. Therefore, the present study was conducted to investigate anxiety, spiritual well-being, and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic in the south of Fars Province, Iran. METHODS This is a descriptive study with a cross-sectional design conducted on the patients undergoing chemotherapy at Dr. Ali Shariati Hospital in Fasa from November 2021 to February 2022. Cancer patients undergoing chemotherapy were included in the study by census method. Out of 210 patients, 155 participated in the study. Data were collected electronically using the standard instruments of Ellison's Spiritual Well-being Scale, COVID-19 anxiety questionnaire, and Connor-Davidson resilience scale. The collected data were analyzed in SPSS 22 using descriptive statistics, Pearson correlation tests, T-test, ANOVA and multivariate linear regression at a level of significance of P < 0.05. RESULTS The participants' resilience mean score was 46.35 ± 26.51 and their spiritual well-being mean score was 69.58 ± 9.32. In addition, their COVID anxiety mean, score was found to be 16.85 ± 10.51. The results showed a significant direct correlation between the patients' spiritual well-being and resilience (r = 0.47, P < 0.001) and a significant inverse correlation between the patients' spiritual well-being and COVID-19-related anxiety (r = - 0.275, P < 0.001). In addition, there was a significant inverse correlation between the variables of resilience and COVID-19-related anxiety (r = - 0.637, P < 0.001). Based on multivariate linear regression, the most common predictors in resilience were age and history of infection with COVID-19, and in spiritual health and anxiety, was a history of infection with COVID-19. CONCLUSION Enhancement of spiritual well-being and resilience in patients should be an integral part of care as these qualities are valuable resources in fighting cancer and lowering patients' anxiety, especially during the COVID-19 pandemic.
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Affiliation(s)
- Zahra Khiyali
- Department of Gerontology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Zeinab Naderi
- Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Mohammadkazem Vakil
- Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
| | - Hajar Ghasemi
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, 81936-13119, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, 81936-13119, Iran.
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Bencze D, Fekete T, Pázmándi K. Correlation between Type I Interferon Associated Factors and COVID-19 Severity. Int J Mol Sci 2022; 23:ijms231810968. [PMID: 36142877 PMCID: PMC9506204 DOI: 10.3390/ijms231810968] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
Antiviral type I interferons (IFN) produced in the early phase of viral infections effectively inhibit viral replication, prevent virus-mediated tissue damages and promote innate and adaptive immune responses that are all essential to the successful elimination of viruses. As professional type I IFN producing cells, plasmacytoid dendritic cells (pDC) have the ability to rapidly produce waste amounts of type I IFNs. Therefore, their low frequency, dysfunction or decreased capacity to produce type I IFNs might increase the risk of severe viral infections. In accordance with that, declined pDC numbers and delayed or inadequate type I IFN responses could be observed in patients with severe coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as compared to individuals with mild or no symptoms. Thus, besides chronic diseases, all those conditions, which negatively affect the antiviral IFN responses lengthen the list of risk factors for severe COVID-19. In the current review, we would like to briefly discuss the role and dysregulation of pDC/type I IFN axis in COVID-19, and introduce those type I IFN-dependent factors, which account for an increased risk of COVID-19 severity and thus are responsible for the different magnitude of individual immune responses to SARS-CoV-2.
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Affiliation(s)
- Dóra Bencze
- Department of Immunology, Faculty of Medicine, University of Debrecen, 1 Egyetem Square, H-4032 Debrecen, Hungary
- Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, 1 Egyetem Square, H-4032 Debrecen, Hungary
| | - Tünde Fekete
- Department of Immunology, Faculty of Medicine, University of Debrecen, 1 Egyetem Square, H-4032 Debrecen, Hungary
| | - Kitti Pázmándi
- Department of Immunology, Faculty of Medicine, University of Debrecen, 1 Egyetem Square, H-4032 Debrecen, Hungary
- Correspondence: ; Tel./Fax: +36-52-417-159
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Cox RE, Parish M, Oxencis C, Mckenna E, Thapa B, Chakrabarti S. Short term safety of coronavirus disease 2019 vaccines in patients with solid tumors receiving systemic therapy. World J Clin Oncol 2022; 13:599-608. [PMID: 36157156 PMCID: PMC9346427 DOI: 10.5306/wjco.v13.i7.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/27/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are currently three coronavirus disease 2019 (COVID-19) vaccines approved by the United States Food and Drug Administration to prevent coronavirus infection. However, robust data are unavailable on the adverse events of the vaccines in patients with solid tumor malignancies undergoing systemic therapies.
AIM To evaluate the safety of COVID-19 vaccines in patients with solid tumors undergoing systemic therapies.
METHODS The study included patients with solid tumors treated in an academic tertiary care center who received COVID-19 vaccination between January 1, 2021 and August 15, 2021, while undergoing systemic therapy. Electronic medical records were accessed to collect information on patient characteristics, systemic therapies, type of vaccine received, and adverse effects associated with the vaccine administration. Adverse events (AEs) were graded according to Common Terminology Criteria for Adverse Events, version 5.0.
RESULTS The analysis included 210 patients; the median age was 70 years, and 51% of patients were female. The most common chemotherapy, immunotherapy, and targeted therapy administered were taxane-based regimens 14.2% (30/210), anti-programmed death 1 (PD-1) agents 22.8% (48/210), and antiangiogenic agents 7.1% (15/210), respectively. The most common cancers were gastrointestinal 43.8% (92/210), thoracic 30.4% (64/210), and genitourinary 17.6% (37/210). Patients received the following vaccines: 2 doses of BNT162b2 by Pfizer 52% (110/210), 2 doses of mRNA-1273 by Moderna 42% (89/210), and 1 dose of JNJ-78436735 by Johnson & Johnson 5% (11/210). At least 1 AE attributable to the vaccine was observed in 37 patients 17.6% (37/210). The total number of AEs attributable to vaccines was 62: Fifty-three grade 1 and nine grade 2. Most adverse events occurred after the second dose 59.7% (37/62). The most frequent grade 1 AEs included fatigue 17% (9/53), fever 15% (8/53), injection site reaction 13.2% (7/53), and chills 9.4% (5/53). The most frequent grade 2 AEs were fatigue 33.3% (3/9) and generalized weakness 22.2% (2/9). Therapy was delayed by 2 wk because of the AEs possibly related to vaccine administration in 3 patients 1.4% (3/210).
CONCLUSION The present study demonstrates that the adverse events associated with COVID-19 vaccination are infrequent, mild, and rarely delay treatment in patients with solid tumors receiving systemic therapies.
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Affiliation(s)
- Ronald E Cox
- Student, Medical College of Wisconsin, Wauwatosa, WI 53222, United States
| | - Marie Parish
- Pharmacy, Froedtert & the Medical College of Wisconsin, Wauwatosa, WI 53222, United States
| | - Carolyn Oxencis
- Pharmacy, Froedtert & the Medical College of Wisconsin, Wauwatosa, WI 53222, United States
| | - Edward Mckenna
- Department of Hematology and Oncology, Medical College of Wisconsin, Wauwatosa, WI 53222, United States
| | - Bicky Thapa
- Department of Hematology and Oncology, Medical College of Wisconsin, Wauwatosa, WI 53222, United States
| | - Sakti Chakrabarti
- Department of Hematology and Oncology, Medical College of Wisconsin, Wauwatosa, WI 53222, United States
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The Impact of SARS-CoV-2 Pandemic on Patients with Malignant Melanoma at a Romanian Academic Center: A Four-Year Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148499. [PMID: 35886351 PMCID: PMC9317187 DOI: 10.3390/ijerph19148499] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Considering cancer patients may be at an increased risk of severe COVID-19 disease, their oncologic treatment cannot be delayed without risking their oncologic outcomes. Considering this, a comprehensive evaluation is required for the management of malignant diseases such as melanoma. The current study aimed to assess the impact of the COVID-19 pandemic on the delivery of cancer care services for patients diagnosed with malignant melanoma in Romania; to document the difference in patients’ addressability and melanoma staging between the pandemic and pre-pandemic periods; as well as to determine the risk factors responsible for disease progression during the pandemic. We developed a retrospective analysis using a monocentric hospital database to compare the final 24 months of the pre-pandemic era to the first 24 months of the COVID-19 pandemic. All outpatients and inpatients with a diagnosis of malignant melanoma were screened during the study period and included in the analysis if matching the inclusion criteria. A total of 301 patients were included in the study, with 163 cases identified in the 24 months before the COVID-19 pandemic and 138 patients during the first 24 months of the pandemic. It was observed during the first two lockdown periods from March to May 2020, and, respectively, from October to December 2020, that significantly fewer patients with malignant melanoma presented for specialized medical care, while there was a statistically significantly lower proportion of outpatients due to COVID-19 restrictions (18.1% vs. 42.9%). The average Breslow depth was 1.1 mm before the pandemic, compared with 1.8 mm during the pandemic (p-value < 0.001). Third-stage patients were the most prevalent during both study periods, although with a statistically significant difference during the pandemic, with an increase from 90 (55.2%) patients to 94 (68.1%) (p-value < 0.001). The significant risk factors for disease progression were advanced AJCC stage (HR = 3.48), high Breslow index (HR = 3.19), postponed treatment (HR = 2.46), missed appointments (HR = 2.31), anemia at presentation (HR = 1.60), and patient’s age (HR = 1.57). After the pandemic limitations are brought to an end, a broad skin-cancer-screening campaign is warranted to detect the missed cases during COVID-19.
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11
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Mosaed R, Fasihi H, Norouzi A, Anjomanian V, Ardalan MA, Alazmani Noodeh F, Khoshdel AR. Influenza Vaccine and COVID-19 Pandemic: Could This Vaccine Help Limit the Potential Adverse Consequences of SARS-CoV-2? IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2022; 21:e127032. [PMID: 36710988 PMCID: PMC9872545 DOI: 10.5812/ijpr-127032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/04/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has prompted researchers to find treatments and vaccines to control SARS-CoV-2. There are some hypotheses about the benefit of respiratory virus vaccines, like MMR, for COVID-19 pneumonia severity, morbidity, and mortality. The influenza vaccine is one of the most frequently used respiratory virus vaccines covered by one of the Iranian insurance institutes. We have a symmetrical group of participants that have received this vaccine that could be compared with each other. We compared 3,379 persons aged 20 - 75 years for the effect of the influenza vaccine on COVID-19 mortality. We ultimately found that it does not affect mortality caused by COVID-19 pneumonia, but it can decrease the hospitalization cost in people over 65 years with a history of chronic disease.
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Affiliation(s)
- Reza Mosaed
- Department of Clinical Pharmacy, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Hossein Fasihi
- Biomaterial and Medicinal Chemistry Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Amir Norouzi
- Iran Armed Forces Health Insurance Organization, Tehran, Iran
| | | | - Mohammad Afshar Ardalan
- Internal Medicine Department, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Farshid Alazmani Noodeh
- Critical Care Nursing Department, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Reza Khoshdel
- Department of Public Health, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Corresponding Author: Department of Public Health, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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12
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Sharma V, Rai H, Gautam DNS, Prajapati PK, Sharma R. Emerging evidence on Omicron (B.1.1.529) SARS-CoV-2 variant. J Med Virol 2022; 94:1876-1885. [PMID: 35083761 PMCID: PMC9015596 DOI: 10.1002/jmv.27626] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/24/2022]
Abstract
COVID's Omicron variant has sparked a slew of concerns across the globe. This review aims to provide a brief overview of what we know about the Omicron variant right now. The new variant has been discovered in 149 countries across all six World Health Organization (WHO) regions since its discovery in South Africa on November 24, 2021 and became the dominant variant in the country in less than 3 weeks. The WHO has warned that the B.1.1.529 variant is spreading at an unprecedented rate, and has urged countries to prepare for the worst. Over the course of this time, researchers from Africa and around the world have uncovered a wealth of information about the virus's epidemiology and biological properties. Case numbers are increasing exponentially in hard-hit areas such as South Africa, United Kingdom, and USA (overtaking the delta variant), implying that the variant is highly transmissible. Initial research has provided some insights into the efficacy of vaccines against the Omicron variant and whether it produces major illness, however, much remains unknown, and additional work is needed to investigate what the initial reports represent in real-world situations.
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Affiliation(s)
- Vineet Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical SciencesBanaras Hindu UniversityVaranasiIndia
| | - Himanshu Rai
- DST‐Centre for Interdisciplinary Mathematical Sciences, Institute of ScienceBanaras Hindu UniversityVaranasiIndia
| | - Dev N. S. Gautam
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical SciencesBanaras Hindu UniversityVaranasiIndia
| | - Pradeep K. Prajapati
- Department of Rasa Shastra and Bhaishajya KalpanaAll India Institute of AyurvedaNew DelhiIndia
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical SciencesBanaras Hindu UniversityVaranasiIndia
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13
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Mohseni Afshar Z, Hosseinzadeh R, Barary M, Ebrahimpour S, Alijanpour A, Sayad B, Hosseinzadeh D, Miri SR, Sio TT, Sullman MJM, Carson‐Chahhoud K, Babazadeh A. Challenges posed by COVID-19 in cancer patients: A narrative review. Cancer Med 2022; 11:1119-1135. [PMID: 34951152 PMCID: PMC8855916 DOI: 10.1002/cam4.4519] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 01/09/2023] Open
Abstract
A novel coronavirus, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the causative agent of coronavirus disease 2019 (COVID-19). In early 2020, the World Health Organization declared COVID-19 the sixth public health emergency of international concern. The COVID-19 pandemic has substantially affected many groups within the general population, but particularly those with extant clinical conditions, such as having or being treated for cancer. Cancer patients are at a higher risk of developing severe COVID-19 since the malignancy and chemotherapy may negatively affect the immune system, and their immunocompromised condition also increases the risk of infection. Substantial international efforts are currently underway to develop specific methods for diagnosing and treating COVID-19. However, cancer patients' risk profiles, management, and outcomes are not well understood. Thus, the main objective of this review is to discuss the relevant evidence to understand the prognosis of COVID-19 infections in cancer patients more clearly, as well as helping to improve the clinical management of these patients.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
- Students’ Scientific Research Center (SSRC)Tehran University of Medical SciencesTehranIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Babak Sayad
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | | | - Seyed Rouhollah Miri
- Cancer Research CenterCancer Institute of IranTehran University of Medical ScienceTehranIran
| | - Terence T. Sio
- Department of Radiation OncologyMayo ClinicPhoenixArizonaUSA
| | - Mark J. M. Sullman
- Department of Social SciencesUniversity of NicosiaNicosiaCyprus
- Department of Life and Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
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14
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Bosch-Barrera J, Roqué A, Teixidor E, Carmona-Garcia MC, Arbusà A, Brunet J, Martin-Castillo B, Cuyàs E, Verdura S, Menendez JA. Clinical Management of COVID-19 in Cancer Patients with the STAT3 Inhibitor Silibinin. Pharmaceuticals (Basel) 2021; 15:19. [PMID: 35056076 PMCID: PMC8778965 DOI: 10.3390/ph15010019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
COVID-19 pathophysiology is caused by a cascade of respiratory and multiorgan failures arising, at least in part, from the SARS-CoV-2-driven dysregulation of the master transcriptional factor STAT3. Pharmacological correction of STAT3 over-stimulation, which is at the root of acute respiratory distress syndrome (ARDS) and coagulopathy/thrombosis events, should be considered for treatment of severe COVID-19. In this perspective, we first review the current body of knowledge on the role of STAT3 in the pathogenesis of severe COVID-19. We then exemplify the potential clinical value of treating COVID-19 disease with STAT3 inhibitors by presenting the outcomes of two hospitalized patients with active cancer and COVID-19 receiving oral Legalon®-a nutraceutical containing the naturally occurring STAT3 inhibitor silibinin. Both patients, which were recruited to the clinical trial SIL-COVID19 (EudraCT number: 2020-001794-77) had SARS-CoV-2 bilateral interstitial pneumonia and a high COVID-GRAM score, and showed systemic proinflammatory responses in terms of lymphocytopenia and hypoalbuminemia. Both patients were predicted to be at high risk of critical COVID-19 illness in terms of intensive care unit admission, invasive ventilation, or death. In addition to physician's choice of best available therapy or supportive care, patients received 1050 mg/day Legalon® for 10 days without side-effects. Silibinin-treated cancer/COVID-19+ patients required only minimal oxygen support (2-4 L/min) during the episode, exhibited a sharp decline of the STAT3-regulated C-reactive protein, and demonstrated complete resolution of the pulmonary lesions. These findings might inspire future research to advance our knowledge and improve silibinin-based clinical interventions aimed to target STAT3-driven COVID-19 pathophysiology.
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Affiliation(s)
- Joaquim Bosch-Barrera
- Medical Oncology, Catalan Institute of Oncology, Dr. Josep Trueta Hospital of Girona, 17007 Girona, Spain
- Department of Medical Sciences, Medical School, University of Girona, 17003 Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
| | - Ariadna Roqué
- Medical Oncology, Catalan Institute of Oncology, Dr. Josep Trueta Hospital of Girona, 17007 Girona, Spain
| | - Eduard Teixidor
- Medical Oncology, Catalan Institute of Oncology, Dr. Josep Trueta Hospital of Girona, 17007 Girona, Spain
| | | | - Aina Arbusà
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, 17007 Girona, Spain
| | - Joan Brunet
- Medical Oncology, Catalan Institute of Oncology, Dr. Josep Trueta Hospital of Girona, 17007 Girona, Spain
- Department of Medical Sciences, Medical School, University of Girona, 17003 Girona, Spain
- Catalan Institute of Oncology, IDIBELL, 08908 L'Hospitalet de Llobregat, Spain
| | - Begoña Martin-Castillo
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
- Unit of Clinical Research, Catalan Institute of Oncology, 17007 Girona, Spain
| | - Elisabet Cuyàs
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, 17007 Girona, Spain
| | - Sara Verdura
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, 17007 Girona, Spain
| | - Javier A Menendez
- Girona Biomedical Research Institute (IDIBGI), 17190 Salt, Spain
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, 17007 Girona, Spain
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15
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Izadmehr S, Lundon DJ, Mohamed N, Katims A, Patel V, Eilender B, Mehrazin R, Badani KK, Sfakianos JP, Tsao CK, Wiklund P, Oh WK, Cordon-Cardo C, Tewari AK, Galsky MD, Kyprianou N. The Evolving Clinical Management of Genitourinary Cancers Amid the COVID-19 Pandemic. Front Oncol 2021; 11:734963. [PMID: 34646777 PMCID: PMC8504458 DOI: 10.3389/fonc.2021.734963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/31/2021] [Indexed: 12/24/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19), a disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, has become an unprecedented global health emergency, with fatal outcomes among adults of all ages throughout the world. There is a high incidence of infection and mortality among cancer patients with evidence to support that patients diagnosed with cancer and SARS-CoV-2 have an increased likelihood of a poor outcome. Clinically relevant changes imposed as a result of the pandemic, are either primary, due to changes in timing or therapeutic modality; or secondary, due to altered cooperative effects on disease progression or therapeutic outcomes. However, studies on the clinical management of patients with genitourinary cancers during the COVID-19 pandemic are limited and do little to differentiate primary or secondary impacts of COVID-19. Here, we provide a review of the epidemiology and biological consequences of SARS-CoV-2 infection in GU cancer patients as well as the impact of COVID-19 on the diagnosis and management of these patients, and the use and development of novel and innovative diagnostic tests, therapies, and technology. This article also discusses the biomedical advances to control the virus and evolving challenges in the management of prostate, bladder, kidney, testicular, and penile cancers at all stages of the patient journey during the first year of the COVID-19 pandemic.
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Affiliation(s)
- Sudeh Izadmehr
- Department of Medicine, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Dara J. Lundon
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nihal Mohamed
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andrew Katims
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Vaibhav Patel
- Department of Medicine, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Benjamin Eilender
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Reza Mehrazin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ketan K. Badani
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - John P. Sfakianos
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Che-Kai Tsao
- Department of Medicine, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - William K. Oh
- Department of Medicine, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carlos Cordon-Cardo
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashutosh K. Tewari
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Matthew D. Galsky
- Department of Medicine, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Natasha Kyprianou
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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16
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Wu L, Zheng Y, Liu J, Luo R, Wu D, Xu P, Wu D, Li X. Comprehensive evaluation of the efficacy and safety of LPV/r drugs in the treatment of SARS and MERS to provide potential treatment options for COVID-19. Aging (Albany NY) 2021; 13:10833-10852. [PMID: 33879634 PMCID: PMC8109137 DOI: 10.18632/aging.202860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) experienced an outbreak that expanded worldwide. Lopinavir/ritonavir (LPV/r), which is used effectively for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections, was applied for COVID-19 treatment given similarities in the molecular structures of these viruses. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of lopinavir/ritonavir antiviral treatment in patients with SARS, MERS, and COVID-19. After registration with INPLASY, a search was conducted in PubMed, Embase, China National Knowledge Infrastructure (CNKI), Cochrane Library, WanFang Data, China Biomedical Literature Database (CBM) and other databases for all relevant literature on lopinavir/ritonavir treatment of SARS, MERS and COVID-19. The Cochrane Collaboration's bias risk assessment tool and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the literature, and RevMan 5.3 software was used to evaluate the relevant outcome indicators of the efficacy and safety of lopinavir/ritonavir in the treatment of COVID-19. A total of 18 eligible studies (including randomized controlled studies, cohort studies, and case-control studies) were retrieved and included with a total of 2273 patients. The lopinavir/ritonavir group exhibited an increased nucleic acid conversion rate (P=0.004), higher virus clearance rate (P<0.0001), lower mortality rate (P=0.002), and reduced incidence of acute respiratory distress syndrome (ARDS) (P=0.02) compared with the control group. No significant benefit in the improvement rate of chest CT (P=0.08) or incidence of adverse events (P=0.45) was noted. The lopinavir/ritonavir group had a lower incidence of acute respiratory distress syndrome (P=0.02). According to the clinical prognostic results, the incidence of adverse events between the two groups was not statistically significant (P<0.0001). The efficacy of lopinavir/ritonavir in the treatment of patients with SARS, MERS and COVID-19 was significantly better than that of the control. Furthermore, the incidence of adverse events did not significantly increase. Lopinavir/ritonavir is effective in the treatment of COVID-19, and this combination should be further assessed in RCT studies. In addition, when we analyzed the differences in age and sex, we found that the differences were statistically significant in the safety and effectiveness of lopinavir/ritonavir in patients with COVID-19, and both of these factors played a significant role in the trial.
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Affiliation(s)
- Liusheng Wu
- Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen 518036, Guangdong, China
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
- Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuzhen Zheng
- Department of Thoracic Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510655, Guangdong, China
| | - Jixian Liu
- Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen 518036, Guangdong, China
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
| | - Ruixing Luo
- Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen 518036, Guangdong, China
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
- Anhui Medical University, Hefei 230032, Anhui, China
| | - Dingwang Wu
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
| | - Pengcheng Xu
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
| | - Da Wu
- Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen 518036, Guangdong, China
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
| | - Xiaoqiang Li
- Peking University Shenzhen Hospital, Clinical College of Anhui Medical University, Shenzhen 518036, Guangdong, China
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
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