1
|
Kim SR, Nordlander A, Xie H, Kim YJ, Ogimi C, Thakar MS, Leisenring W, Englund JA, Boeckh M, Waghmare A. The Impact of Pretransplant Respiratory Virus Detection on Posttransplant Outcomes in Children Undergoing Hematopoietic Cell Transplantation. Clin Infect Dis 2024; 79:761-771. [PMID: 38666501 PMCID: PMC11426275 DOI: 10.1093/cid/ciae216] [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: 02/09/2024] [Indexed: 09/27/2024] Open
Abstract
BACKGROUND Pretransplant respiratory virus (RV) infections have been associated with negative transplant outcomes in adult hematopoietic cell transplantation (HCT) recipients. In the era of HCT delay because of high-risk RVs, we examined the impact of pretransplant RV detection on transplant outcomes in pediatric HCT recipients. METHODS This retrospective cohort study included pediatric myeloablative allogeneic HCT recipients from 2010 to 2019. All patients were screened for RV at least once within 90 days before HCT using reverse transcriptase polymerase chain reaction (PCR), regardless of symptoms. Posttransplant outcomes included days alive and out of hospital and progression to lower respiratory tract infection (LRTI). RESULTS Among 310 patients, 134 had an RV detected in the 90 days before HCT. In univariable analysis, transplant factors including younger age, total body irradiation, umbilical cord blood transplantation, lymphocyte count <100/mm3, HCT comorbidity index score ≥3, and viral factors including symptomatic infection, human rhinovirus as a virus type, and symptomatic pretransplant upper respiratory tract infection were associated with fewer days alive and out of hospital. In multivariable analysis, transplant factors remained significant, but not viral factors. There was a higher incidence of progression to posttransplant LRTI with the same pretransplant RV if the last positive PCR before HCT was ≤30 days compared with >30 days (P = .007). CONCLUSIONS In the setting of recommending HCT delay for high-risk RVs, symptomatic upper respiratory tract infection, including human rhinovirus infections, may lead to increased duration of hospitalization and early progression to LRTI when transplantation is performed within 30 days of the last positive PCR test.
Collapse
Affiliation(s)
- Sara Ruth Kim
- Department of Pediatric, University of Washington, Seattle, Washington, USA
- Pediatric Infectious Disease Division, Seattle Children's Hospital, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Anna Nordlander
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Hu Xie
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Yae-Jean Kim
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Chikara Ogimi
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Monica S Thakar
- Department of Pediatric, University of Washington, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Wendy Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Janet A Englund
- Department of Pediatric, University of Washington, Seattle, Washington, USA
- Pediatric Infectious Disease Division, Seattle Children's Hospital, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Michael Boeckh
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Alpana Waghmare
- Department of Pediatric, University of Washington, Seattle, Washington, USA
- Pediatric Infectious Disease Division, Seattle Children's Hospital, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| |
Collapse
|
2
|
Mourad DF, Radwan S, Hamdy R, Elkhashab DM, Kamel MM, Abdel-Moneim AS, Kadry DY. Identification of Lower Respiratory Tract Pathogens in Cancer Patients: Insights into Fatal Outcomes. Microorganisms 2024; 12:1686. [PMID: 39203528 PMCID: PMC11356771 DOI: 10.3390/microorganisms12081686] [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: 07/01/2024] [Revised: 08/06/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024] Open
Abstract
This study aimed to investigate LRTIs in cancer patients, focusing on pathogen distribution, and outcomes based on tumor types and antimicrobial treatments. The study included 110 cancer patients exhibiting symptoms of lower respiratory tract infections (LRTIs), consisting of 67 males and 43 females across a wide age range from under 1 year to over 60 years old. Exclusion of SARS-CoV-2 infection was conducted before admission. In addition to classical microbiological methods, fast-track detection using Multiplex Real-Time PCR was employed, utilizing the FTD-33 test kit. The findings revealed a diverse landscape of infections, notably Klebsiella pneumoniae, Haemophilus influenzae and Staphylococcus aureus. Parainfluenza 3 and 4 viruses, rhinovirus, influenza A subtype H1N1pdm09, influenza B and C viruses, HCoV-229, HCoV-OC43, and HCoV-HKU1 were infrequently detected. Furthermore, the existence of mixed infection highlighted the complexity of disease conditions in cancer patients. An analysis of antimicrobial treatment highlighted significant variations in fatal outcomes for carbapenem and colistimethate sodium. It was concluded that mixed infections were commonly identified as potential causes of LRTIs among cancer patients, while viral infections were less frequently detected. It underscores the complexity of antimicrobial treatment outcomes.
Collapse
Affiliation(s)
- Dalia F. Mourad
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Samah Radwan
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Rana Hamdy
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt
| | - Dina M. Elkhashab
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Mahmoud M. Kamel
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Ahmed S. Abdel-Moneim
- Department of Microbiology, College of Medicine, Taif University, Al-Taif 21944, Saudi Arabia
| | - Dalia Y. Kadry
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| |
Collapse
|
3
|
Berry GJ, Jhaveri TA, Larkin PMK, Mostafa H, Babady NE. ADLM Guidance Document on Laboratory Diagnosis of Respiratory Viruses. J Appl Lab Med 2024; 9:599-628. [PMID: 38695489 DOI: 10.1093/jalm/jfae010] [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: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 06/06/2024]
Abstract
Respiratory viral infections are among the most frequent infections experienced worldwide. The COVID-19 pandemic has highlighted the need for testing and currently several tests are available for the detection of a wide range of viruses. These tests vary widely in terms of the number of viral pathogens included, viral markers targeted, regulatory status, and turnaround time to results, as well as their analytical and clinical performance. Given these many variables, selection and interpretation of testing requires thoughtful consideration. The current guidance document is the authors' expert opinion based on the preponderance of available evidence to address key questions related to best practices for laboratory diagnosis of respiratory viral infections including who to test, when to test, and what tests to use. An algorithm is proposed to help laboratories decide on the most appropriate tests to use for the diagnosis of respiratory viral infections.
Collapse
Affiliation(s)
- Gregory J Berry
- Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian-Columbia University Irving Medical Center, New York, NY, United States
| | - Tulip A Jhaveri
- Department of Internal Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, United States
| | - Paige M K Larkin
- University of Chicago Pritzker School of Medicine, NorthShore University Health System, Chicago, IL, United States
| | - Heba Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Baltimore, MD, United States
| | - N Esther Babady
- Clinical Microbiology and Infectious Disease Services, Department of Pathology and Laboratory Medicine and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| |
Collapse
|
4
|
Zhi S, Wu W, Ding Y, Zhang Y, Pan L, Liu G, Li W. Development of rapid nucleic acid testing techniques for common respiratory infectious diseases in the Chinese population. Front Chem 2024; 12:1381738. [PMID: 38694405 PMCID: PMC11061412 DOI: 10.3389/fchem.2024.1381738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/01/2024] [Indexed: 05/04/2024] Open
Abstract
Background: Most respiratory viruses can cause serious lower respiratory diseases at any age. Therefore, timely and accurate identification of respiratory viruses has become even more important. This study focused on the development of rapid nucleic acid testing techniques for common respiratory infectious diseases in the Chinese population. Methods: Multiplex fluorescent quantitative polymerase chain reaction (PCR) assays were developed and validated for the detection of respiratory pathogens including the novel coronavirus (SARS-CoV-2), influenza A virus (FluA), parainfluenza virus (PIV), and respiratory syncytial virus (RSV). Results: The assays demonstrated high specificity and sensitivity, allowing for the simultaneous detection of multiple pathogens in a single reaction. These techniques offer a rapid and reliable method for screening, diagnosis, and monitoring of respiratory pathogens. Conclusion: The implementation of these techniques might contribute to effective control and prevention measures, leading to improved patient care and public health outcomes in China. Further research and validation are needed to optimize and expand the application of these techniques to a wider range of respiratory pathogens and to enhance their utility in clinical and public health settings.
Collapse
Affiliation(s)
- Shenshen Zhi
- Department of Blood Transfusion, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| | - Wenyan Wu
- Clinical Laboratory, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| | - Yan Ding
- Clinical Laboratory, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| | - Yuanyuan Zhang
- Clinical Laboratory, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| | - Liyan Pan
- Clinical Laboratory, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| | - Guo Liu
- Zeal Dental, Chongqing, China
| | - Wei Li
- Clinical Laboratory, Chongqing Emergency Medical Center, School of Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China
| |
Collapse
|
5
|
Kim SR, Waghmare A, Hijano DR. Approach to hematopoietic cell transplant candidates with respiratory viral detection. Front Pediatr 2024; 11:1339239. [PMID: 38304442 PMCID: PMC10830789 DOI: 10.3389/fped.2023.1339239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024] Open
Abstract
The management of respiratory viruses prior to hematopoietic cell transplant (HCT) can be controversial and requires special consideration of host factors, transplant parameters, and the specific respiratory virus (RV). In the setting of adenovirus (ADV), human metapneumovirus (HMPV), influenza, parainfluenza virus (PIV), and respiratory syncytial virus (RSV) detection prior to hematopoietic cell transplant (HCT), clinical practice guidelines recommend transplant delay when possible; however, there is much more ambiguity when other respiratory viruses, such as seasonal coronaviruses (CoVs), human rhinovirus (HRV), and SARS-CoV-2, are detected. Our aims for this review include detailing clinical practical guidelines and reviewing current literature on pre-transplant respiratory viral infections (RVIs), including antiviral therapies and prevention strategies, when available. We will center our discussion on three representative clinical scenarios, with the goal of providing practical guidance to clinicians.
Collapse
Affiliation(s)
- Sara R. Kim
- Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Alpana Waghmare
- Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Diego R. Hijano
- Departments of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, United States
| |
Collapse
|
6
|
Qin Z, Zhu F, Xie B, Zhang Y, Yuan M, Yang P, Zhang L, Wei J, Zhu Z, Qian Z, Wang Z, Fan L, Xu S, Tan Y, Qian J. Comprehensive analysis of ASB3 as a prognostic biomarker in hepatocellular carcinoma. Transl Oncol 2024; 39:101816. [PMID: 37925796 PMCID: PMC10654593 DOI: 10.1016/j.tranon.2023.101816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/15/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Some reports have indicated a high expression level of ASB3 in various cancers, but its role in hepatocellular carcinoma (HCC) remains elusive. METHODS ASB3 levels and clinical features were obtained from the TCGA database. Meanwhile, the expression levels of ASB3 in tumor and paraneoplastic tissues were further verified by qRT-PCR and Imunohistochemistry (IHC). ASB3-related downstream molecular analysis was carried out with Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Pathways linked to ASB3 expression were identified by means of gene set enrichment analysis (GSEA). Single-sample GSEA (ssGSEA) aided in conducting a correlation analysis of ASB3 with immune infiltration. Functional experiments were performed in HepG2 cells by using the small interfering RNA. RESULTS ASB3 expression was remarkably higher in HCC tissues. Its remarkable precision in forecasting cancer suggests that ASB3 might serve as an unidentified diagnostic and prognostic indicator of HCC. Higher ASB3 expression led to worse overall survival (OS), particularly in various clinical subgroups of HCC. GO/KEGG analysis indicated that critical biological activities, such as the activation of complement systems and humoral immune response, could potentially underlie the progression of HCC. Furthermore, GSEA demonstrated enrichment of certain pathways, including the MAPK, IL17, and fibrinolysis pathways, in samples with elevated ASB3 levels. ASB3 exhibited a substantial association with T helper cells, dendritic cells (DCs), and central memory T (Tcm) cell infiltration level. Cell function experiments confirmed elevated ASB3 levels in HCC cell lines as opposed to hepatic epithelial cell lines. Moreover, the ability of HCC cells to proliferate and invade was remarkably reduced by ASB3 knockdown. CONCLUSION Summarize briefly, we found that ASB3 can be a promising biomarker in HCC.
Collapse
Affiliation(s)
- Zhongqiang Qin
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Fangquan Zhu
- Department of Cancer Center, Lu'an Hospital of Anhui Medical University, Lu'an, China
| | - Bo Xie
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Yang Zhang
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Mu Yuan
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Peipei Yang
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Lan Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jianzhu Wei
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Ziyi Zhu
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Zhen Qian
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Zhaoying Wang
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Longfei Fan
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Shuaishuai Xu
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Yulin Tan
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| | - Jingyu Qian
- Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, No 287 Changhuai Road, Longzihu District, Bengbu, Anhui Province 233000, China
| |
Collapse
|
7
|
Groll AH, Ebrahimi-Fakhari D. Conference Report 33rd European Congress on Clinical Microbiology and Infectious Diseases (ECCMID): New developments in pediatric oncology infectious disease supportive care. Transpl Infect Dis 2023; 25:e14146. [PMID: 37695128 DOI: 10.1111/tid.14146] [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: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023]
Abstract
Infections continue to be major causes of morbidity and mortality in immunocompromised children and adolescents with cancer or undergoing allogeneic hematopoietic cell transplantation. This report summarizes new clinical research data presented at the 33rd European Congress on Clinical Microbiology and Infectious Diseases on infections in this vulnerable population, with a focus on the epidemiology, diagnosis, and prevention of invasive fungal diseases and de-escalation strategies in neutropenic patients with fever of unknown origin.
Collapse
Affiliation(s)
- Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, University Children´s Hospital Münster, Münster, Germany
| | - Daniel Ebrahimi-Fakhari
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, University Children´s Hospital Münster, Münster, Germany
| |
Collapse
|
8
|
El Zahran T, Kalot N, Cheaito R, Khalifeh M, Estelly N, El Majzoub I. Predictors of intensive care unit admission in adult cancer patients presenting to the emergency department with COVID-19 infection: A retrospective study. PLoS One 2023; 18:e0287649. [PMID: 37643201 PMCID: PMC10464997 DOI: 10.1371/journal.pone.0287649] [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: 03/08/2023] [Accepted: 06/12/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Adult cancer patients with COVID-19 were shown to be at higher risk of Intensive Care Unit (ICU) admission. Previously published prediction models showed controversy and enforced the importance of heterogeneity among different populations studied. Therefore, this study aimed to identify predictors of ICU admission (demographic, clinical, and COVID-19 targeted medications) in cancer patients with active COVID-19 infection presenting to the Emergency Department (ED). METHODS This is a retrospective cohort study. It was conducted on adult cancer patients older than 18 years who presented to the American University of Beirut Medical Center ED from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data were extracted from electronic medical records. The association between different variables and ICU admission was tested. Logistic regression was done to adjust for confounding variables. A p-value less than 0.05 was considered significant. RESULTS Eighty-nine distinct patients were included. About 37% were admitted to the ICU (n = 33). Higher ICU admission was seen in patients who had received chemotherapy within one month, had a respiratory rate at triage above 22 breaths per minute, oxygen saturation less than 95%, and a higher c-reactive protein upon presentation to the ED. After adjusting for confounding variables, only recent chemotherapy and higher respiratory rate at triage were significantly associated with ICU admission. CONCLUSION Physicians need to be vigilant when taking care of COVID-19 infected cancer patients. Patients who are tachypneic at presentation and those who have had chemotherapy within one month are at high risk for ICU admission.
Collapse
Affiliation(s)
- Tharwat El Zahran
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Kalot
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rola Cheaito
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Malak Khalifeh
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Natalie Estelly
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Imad El Majzoub
- Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| |
Collapse
|
9
|
Smith A, Kardos P, Pfaar O, Randerath W, Estrada Riolobos G, Braido F, Sadofsky L. The treatment of mild upper respiratory tract infections - a position paper with recommendations for best practice. Drugs Context 2023; 12:2023-4-2. [PMID: 37521107 PMCID: PMC10379023 DOI: 10.7573/dic.2023-4-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/31/2023] [Indexed: 08/01/2023] Open
Abstract
Following the waning severity of COVID-19 due to vaccination and the development of immunity, the current variants of SARS-CoV-2 often lead to mild upper respiratory tract infections (MURTIs), suggesting it is an appropriate time to review the pathogenesis and treatment of such illnesses. The present article reviews the diverse causes of MURTIs and the mechanisms leading to symptomatic illness. Different symptoms of MURTIs develop in a staggered manner and require targeted symptomatic treatment. A wide variety of remedies for home treatment is available, including over-the-counter drugs and plant-derived substances. Recent pharmacological research has increased the understanding of molecular effects, and clinical studies have shown the efficacy of certain herbal remedies. However, the use of subjective endpoints in these clinical studies may suggest limited validity of the results. In this position paper, the importance of patient-centric outcomes, including a subjective perception of improved well-being, is emphasized. A best practice approach for the management of MURTIs, in which pharmacists and physicians create an improved multi-professional healthcare setting and provide healthcare education to patients, is proposed. Pharmacists act as first-line consultants and provide patients with remedies, considering the individual patient's preferences towards chemical or plant-derived drugs and providing advice for self-monitoring. Physicians act as second-line consultants if symptoms worsen and subsequently initiate appropriate therapies. In conclusion, general awareness of MURTIs should be increased amongst medical professionals and patients, thus improving their management.
Collapse
Affiliation(s)
- Andrew Smith
- School of Psychology, Cardiff University, Cardiff, UK
| | - Peter Kardos
- Centre of Allergy, Respiratory and Sleep Medicine, Maingau Clinic of the Red Cross, Frankfurt am Main, Germany
| | - Oliver Pfaar
- Department of Otorhinolaryngology, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Winfried Randerath
- Institute of Pneumology, University of Cologne, Cologne, Germany
- Bethanien Hospital, Clinic of Pneumology and Allergology, Centre for Sleep Medicine and Respiratory Care, Solingen, Germany
| | | | - Fulvio Braido
- Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy
- Università di Genova, (DIMI), Genova, Italy
| | | |
Collapse
|
10
|
Gupta A, Marzook H, Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med 2023; 23:313-331. [PMID: 35362771 PMCID: PMC8972750 DOI: 10.1007/s10238-022-00821-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes major challenges to the healthcare system. SARS-CoV-2 infection leads to millions of deaths worldwide and the mortality rate is found to be greatly associated with pre-existing clinical conditions. The existing dataset strongly suggests that cardiometabolic diseases including hypertension, coronary artery disease, diabetes and obesity serve as strong comorbidities in coronavirus disease (COVID-19). Studies have also shown the poor outcome of COVID-19 in patients associated with angiotensin-converting enzyme-2 polymorphism, cancer chemotherapy, chronic kidney disease, thyroid disorder, or coagulation dysfunction. A severe complication of COVID-19 is mostly seen in people with compromised medical history. SARS-CoV-2 appears to attack the respiratory system causing pneumonia, acute respiratory distress syndrome, which lead to induction of severe systemic inflammation, multi-organ dysfunction, and death mostly in the patients who are associated with pre-existing comorbidity factors. In this article, we highlighted the key comorbidities and a variety of clinical complications associated with COVID-19 for a better understanding of the etiopathogenesis of COVID-19.
Collapse
Affiliation(s)
- Anamika Gupta
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Hezlin Marzook
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Firdos Ahmad
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE.
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, UAE.
| |
Collapse
|
11
|
Baśkiewicz-Hałasa M, Stachowska E, Grochans E, Maciejewska-Markiewicz D, Bühner L, Skonieczna-Żydecka K, Hałasa M. Moderate Dose Bovine Colostrum Supplementation in Prevention of Upper Respiratory Tract Infections in Medical University Students: A Randomized, Triple Blind, Placebo-Controlled Trial. Nutrients 2023; 15:nu15081925. [PMID: 37111143 PMCID: PMC10146600 DOI: 10.3390/nu15081925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/14/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Colostrum supplementation has been confirmed to protect from upper respiratory tract infections (URTIs) in athletes. Our trial was designed to find out whether other young adults who have potentially been exposed to increased risk of developing URTIs can also benefit. Homogenous population of medical (MED) students (at risk) and health science (HSci) peers were supplemented with a relatively low dose (0.5-1.0 g/day) of bovine colostrum (COL) or placebo (PBO) over 45 days and then once again over 7 days starting at day 87. The trial lasted 107 days. Subjects were monitored solely by them filling out online daily questionnaires containing questions about frequency and severity of URTIs symptoms, well-being, and potential gastrointestinal side-effects. A significant level of protection from URTIs was observed as expressed by dropping frequency of symptomatic days in COL vs. PBO group among MED vs. HSci students. The same effect was also recorded for severity of symptoms, as well as general well-being perception. Overall, it can be concluded that although young healthy people seem to have sufficient defenses from URTIs, COL supplementation can provide significant support in such protection among those at higher infectious risk because of exposure to a heavy workload and increased contact with infectious agents.
Collapse
Affiliation(s)
- Magdalena Baśkiewicz-Hałasa
- Department of General Pathology, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medial University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Dominika Maciejewska-Markiewicz
- Department of Human Nutrition and Metabolomics, Pomeranian Medial University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland
| | - Leonard Bühner
- Department of General Pathology, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| | - Karolina Skonieczna-Żydecka
- Department of Biochemical Science, Pomeranian Medical University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland
| | - Maciej Hałasa
- Department of General Pathology, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
| |
Collapse
|
12
|
Yim KC, Mousa JJ, Blanco JCG, Kim S, Boukhvalova MS. Human Metapneumovirus (hMPV) Infection and MPV467 Treatment in Immunocompromised Cotton Rats Sigmodon hispidus. Viruses 2023; 15:476. [PMID: 36851691 PMCID: PMC9966515 DOI: 10.3390/v15020476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Human metapneumovirus (hMPV) is an important cause of respiratory disease in immunocompromised individuals, yet hMPV infection has not been modeled before in immunocompromised animals. In this work, cotton rats S. hispidus immunosuppressed by cyclophosphamide were infected with hMPV, and viral replication and pulmonary inflammation in these animals were compared to those in normal hMPV-infected S. hispidus. The efficacy of prophylactic and therapeutic administration of the anti-hMPV antibody MPV467 was also evaluated. Immunosuppressed animals had higher pulmonary and nasal titers of hMPV on day 5 post-infection compared to normal animals, and large amounts of hMPV were still present in the respiratory tract of immunosuppressed animals on days 7 and 9 post-infection, indicating prolonged viral replication. Immunosuppression was accompanied by reduced pulmonary histopathology in hMPV-infected cotton rats compared to normal animals; however, a delayed increase in pathology and pulmonary chemokine expression was seen in immunosuppressed cotton rats. Prophylactic and therapeutic MPV467 treatments protected both upper and lower respiratory tracts against hMPV infection. The lung pathology and pulmonary expression of IP-10 and MIP-1α mRNA were reduced by therapeutic MPV467 administration. These results indicate that immunosuppressed cotton rats represent a useful model for studying hMPV pathogenesis and for evaluating therapeutics that could alleviate hMPV-induced disease in immunocompromised subjects.
Collapse
Affiliation(s)
- Kevin C. Yim
- Sigmovir Biosystems, Inc., 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - Jarrod J. Mousa
- Center for Vaccines and Immunology, Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
- Department of Biochemistry and Molecular Biology, Franklin College of Arts and Sciences, University of Georgia, Athens, GA 30602, USA
| | - Jorge C. G. Blanco
- Sigmovir Biosystems, Inc., 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - Sonnie Kim
- NIH/NIAID, Respiratory Diseases Branch, Division of Microbiology and Infectious Diseases, Rockville, MD 20852, USA
| | - Marina S. Boukhvalova
- Sigmovir Biosystems, Inc., 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| |
Collapse
|
13
|
Santiago-Olivares C, Martínez-Alvarado E, Rivera-Toledo E. Persistence of RNA Viruses in the Respiratory Tract: An Overview. Viral Immunol 2023; 36:3-12. [PMID: 36367976 DOI: 10.1089/vim.2022.0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Respiratory RNA viruses are a major cause of acute lower respiratory tract infections and contribute substantially to hospitalization among infants, elderly, and immunocompromised. Complete viral clearance from acute infections is not always achieved, leading to persistence. Certain chronic respiratory diseases like asthma and chronic obstructive pulmonary disease have been associated with persistent infection by human respiratory syncytial virus and human rhinovirus, but it is still not clear whether RNA viruses really establish long-term infections as it has been recognized for DNA viruses as human bocavirus and adenoviruses. Herein, we summarize evidence of RNA virus persistence in the human respiratory tract, as well as in some animal models, to highlight how long-term infections might be related to development and/or maintenance of chronic respiratory symptoms.
Collapse
Affiliation(s)
- Carlos Santiago-Olivares
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Eber Martínez-Alvarado
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Evelyn Rivera-Toledo
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| |
Collapse
|
14
|
Bovine colostrum supplementation in prevention of upper respiratory tract infections – Systematic review, meta-analysis and meta-regression of randomized controlled trials. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Tanaka S, Inoue M, Yamaji T, Iwasaki M, Minami T, Tsugane S, Sawada N. Increased risk of death from pneumonia among cancer survivors: A propensity score‐matched cohort analysis. Cancer Med 2022; 12:6689-6699. [PMID: 36408891 PMCID: PMC10067036 DOI: 10.1002/cam4.5456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 10/29/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The repeated global pandemic of the new virus has led to interest in the possibility of severe pneumonia among cancer patients and survivors. Here, we aimed to assess the association between incident cancer and risk of death from pneumonia in Japanese in a large population-based cohort study. METHODS We used the data from The Japan Public Health Center-based Prospective Study (JPHC Study), which enrolled subjects aged 40 to 69 between 1990 and 1994 and followed their cancer incidence and mortality until 2013. After identifying 103,757 eligible subjects for analysis and imputing missing data on covariates by the chained equations approach, we conducted propensity score-matched analysis for 1:4 matching, leaving 14,520 cases diagnosed with cancer and 48,947 controls without cancer during the study period for final analysis. A Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and corresponding confidence interval (CI) for the risk of death from pneumonia with comparison of cancer cases and cancer-free controls. RESULTS Compared to cancer-free individuals, risk of death from pneumonia was significantly higher among those who had any diagnosed cancer (HR, 1.41; 95%CI, 1.08-1.84); those within 1 year of diagnosis (HR, 23.0; 95% CI, 2.98-177.3); within 1 to <2 years (HR, 3.66; 95% CI, 1.04-12.9); and those with regional spread or distant metastatic cancer at initial diagnosis (HR, 2.01; 95% CI, 1.26-3.21). A history of lung, oesophageal, and head and neck cancer conferred the higher risk among site-specific cancers. CONCLUSION We found a positive association between incident cancer and risk of death from pneumonia in this study. These results imply the possibility that the immunocompromised status and respiratory failure due to antitumor treatment may have resulted in a more severe outcome from pneumonia among cancer survivors than the general population.
Collapse
Affiliation(s)
- Shiori Tanaka
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | - Manami Inoue
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | - Motoki Iwasaki
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | - Tetsuji Minami
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
- National Insitute of Health and Nutrition National Institutes of Biomedical Innovation, Health and Nutrition Tokyo Japan
| | - Norie Sawada
- Epidemiology and Prevention Group Institute for Cancer Control, National Cancer Center Tokyo Japan
| | | |
Collapse
|
16
|
ÜRÜN M, BEYPINAR İ, DAVARCI SE, DEMİR H, BAYKARA M. The evaluation of vaccination status and the factors affecting vaccination in cancer patients. ACTA MEDICA ALANYA 2022. [DOI: 10.30565/medalanya.1094182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background and aim:
Coronavirus disease 2019 (COVID-19) pandemic increased the mortality of cancer patients by causing direct infection or collateral damage to the healthcare system. After the development of effective vaccines against COVID-19 infection, mortality rates declined. In this study, we try to investigate the vaccination among cancer patients.
Material and Methods:
A survey was applied to patients with cancer in order to investigate the attitudes towards vaccination and the factors effecting vaccination in two medical oncology centers in Turkey.
Results:
271 patients were included in the study. No difference was observed in the attitudes of patients towards vaccination according to cancer type. 83% of the patients were vaccinated against COVID-19. In 75% of the study population, vaccine was administered in the earliest available time. Receiving chemotherapy was the most significant reason to avoid vaccination among the study group (p=0,002). There was no significant difference in terms of treatment type for COVID-19 between patients with or without adequate vaccination. The most negative factor affecting vaccination was active chemotherapy treatment. Social relations and traditional media were the most positive factors for vaccination.
Discussion:
Vaccination is of vital importance for patients who are treated or on remission. Even if patients are to receive chemotherapy, they should be informed about vaccination and should be encouraged for vaccination.
Collapse
Affiliation(s)
| | | | | | - Hacer DEMİR
- Afyonkarahisar Sağlık Bilimleri Üniversitesi
| | | |
Collapse
|
17
|
Wu M, Liu S, Yang Y, Lin J, Liu J. Clinical characteristics and outcomes of lung cancer patients with COVID-19: A systematic review and meta-analysis protocol. PLoS One 2022; 17:e0273691. [PMID: 36044455 PMCID: PMC9432718 DOI: 10.1371/journal.pone.0273691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background COVID-19 is spreading rapidly worldwide, and the population is generally susceptible to SARS-CoV-2, especially those with cancer. Hence, our study aims to design a protocol for a systematic review and meta-analysis of the clinical characteristics and prognoses of lung cancer patients with COVID-19. Methods The protocol is prepared following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The literature will be searched in Embase, Pubmed, the Cochrane Library, LitCovid, and CNKI for potentially eligible articles. The quality of the articles will be used in the Newcastle-Ottawa Quality Assessment Scale (NOS) and Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis will be performed through RevMan 5 software. This review protocol has been registered in PROSPERO (CRD42022306866). Discussion To clarify whether COVID-19 affects the clinical symptoms and prognoses of lung cancer patients. Further study is needed to establish the best evidence-based for the management of lung cancer patients with COVID-19. Conclusion The definitive conclusion will be important to physicians effectively manage lung cancer patients with COVID-19.
Collapse
Affiliation(s)
- Mingyue Wu
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Siru Liu
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Yi Yang
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Lin
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail: (JL); (JL)
| | - Jialin Liu
- Information Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Informatics, West China Medical School, Sichuan University, Chengdu, China
- * E-mail: (JL); (JL)
| |
Collapse
|
18
|
Baier C, Huang J, Reumann K, Indenbirken D, Thol F, Koenecke C, Ebadi E, Heim A, Bange FC, Haid S, Pietschmann T, Fischer N. Target capture sequencing reveals a monoclonal outbreak of respiratory syncytial virus B infections among adult hematologic patients. Antimicrob Resist Infect Control 2022; 11:88. [PMID: 35729671 PMCID: PMC9210056 DOI: 10.1186/s13756-022-01120-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) causes community-acquired respiratory tract infections during winter. However, outbreaks in hospitals also occur repeatedly. In particular, patients with hematologic malignancies are at an increased risk for a severe and potentially fatal course of RSV infection. Here we present the investigation of an RSV outbreak in a hematology ward for adults following the ORION statement. Methods An epidemiologic and molecular outbreak analysis was performed. We developed and employed a minimal oligonucleotide probe set in target capture probe sequencing that allows cost-effective RSV-A or -B capturing to reconstruct RSV genomes from clinical samples. Results Four adult patients were involved in the outbreak caused by RSV-B in March 2019. The enforcement of the pre-existing infection control measures by effective training of hospital staff contributed to a successful containment. PCR-based RSV screening on the ward enabled early detection of new cases and rapid isolation measures. The molecular analysis demonstrated that the outbreak sequences were highly related and distinct to other RSV-B strains circulating at the same time. Conclusions A multimodal infection control concept is essential for the timely detection and control of RSV outbreaks in patients with hematological disease. Among other measures, preventive screening for respiratory viruses is recommended. Furthermore, the integration of conventional and molecular epidemiology, such as whole-genome sequencing and variant calling, significantly contributes to the understanding of transmission pathways. Based on this, appropriate conclusions can be drawn for targeted prevention measures that have prepared us for the COVID-19 pandemic beyond the RSV approach described here. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01120-z.
Collapse
|
19
|
Gueuning C, Ameye L, Loizidou A, Grigoriu B, Meert AP. PARIS score for evaluation of probability of SARS-CoV-2 infection in cancer patients. Support Care Cancer 2022; 30:7635-7643. [PMID: 35678883 PMCID: PMC9178543 DOI: 10.1007/s00520-022-07199-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/31/2022] [Indexed: 11/08/2022]
Abstract
Control of transmissible diseases as COVID-19 needs a testing and an isolation strategy. The PARIS score developed by Torjdman et al. was aimed at improving patient selection for testing and quarantining but was derived from a general population. We performed a retrospective analysis of the validity of the PARIS score in a cancer patient population. We included 164 patients counting for 181 visits at the emergency department of the Jules Bordet Institute between March 10th and May 18th which had a SARS-CoV-2 RT-PCR test at admission. Twenty-six cases (14.3%) were tested positive with a higher proportion of positive tests among hematological patients compared to those with solid tumors (26% vs 11% p = 0.02). No clinical symptoms were associated with a positive SARS-CoV-2 PCR. No association between anticancer treatment and SARS-CoV-2 infection was found. The PARIS score failed to differentiate SARS-CoV-2-positive and SARS-CoV-2-negative groups (AUC 0.61 95% CI 0.48–0.73). The negative predictive value of a low probability PARIS score was 0.89 but this concerned only 11% of the patients. A high probability PARIS score concerned 49% patients but the positive predictive value was 0.18. CT scan had a sensitivity of 0.77, specificity 0.51, a positive predictive value of 0.24, and a negative predictive value of 0.92. The performance of the PARIS score is thus very poor in this cancer population. A low-risk score can be of some utility but this concerns a minority of patients.
Collapse
Affiliation(s)
- Candice Gueuning
- Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Lieveke Ameye
- Data Center, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Angela Loizidou
- Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Bogdan Grigoriu
- Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anne-Pascale Meert
- Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.
| |
Collapse
|
20
|
Azhdari Tehrani H, Ramezaninejad S, Mardani M, Shokouhi S, Darnahal M, Hakamifard A. Hematologic malignancies and COVID‐19 infection: A monocenter retrospective study. Health Sci Rep 2022; 5:e638. [PMID: 35620550 PMCID: PMC9124951 DOI: 10.1002/hsr2.638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hamed Azhdari Tehrani
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Soodeh Ramezaninejad
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Shervin Shokouhi
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Maryam Darnahal
- Department of Hematology and Medical Oncology Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| |
Collapse
|
21
|
Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc07. [PMID: 35707229 PMCID: PMC9174886 DOI: 10.3205/dgkh000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Germany, guidelines for hygiene in hospitals are given in form of recommendations by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, "KRINKO"). The KRINKO and its voluntary work are legitimized by the mandate according to § 23 of the Infection Protection Act (Infektionsschutzgesetz, "IfSG"). The original German version of this document was published in February 2021 and has now been made available to the international professional public in English. The guideline provides recommendations on infection prevention and control for immunocompromised individuals in health care facilities. This recommendation addresses not only measures related to direct medical care of immunocompromised patients, but also management aspects such as surveillance, screening, antibiotic stewardship, and technical/structural aspects such as patient rooms, air quality, and special measures during renovations.
Collapse
|
22
|
AYGÜNEŞ U, KARAGÜN B, ŞAŞMAZ Hİ, AKBAŞ T, ANTMEN AB. Clinical and radiological features of COVID-19 infection in pediatric hematology-oncology and transplant patients. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1036774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
23
|
Varkoly K, Tan S, Beladi R, Fonseca D, Zanetti IR, Kraberger S, Shah C, Yaron JR, Zhang L, Juby M, Fath A, Ambadapadi S, House M, Maranian P, Pepine CJ, Varsani A, Moreb J, Schultz-Cherry S, Lucas AR. RNA Virus Gene Signatures Detected in Patients With Cardiomyopathy After Chemotherapy; A Pilot Study. Front Cardiovasc Med 2022; 9:821162. [PMID: 35360008 PMCID: PMC8962958 DOI: 10.3389/fcvm.2022.821162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Viral infections are pervasive and leading causes of myocarditis. Immune-suppression after chemotherapy increases opportunistic infections, but the incidence of virus-induced myocarditis is unknown. Objective An unbiased, blinded screening for RNA viruses was performed after chemotherapy with correlation to cardiac function. Methods High-throughput sequencing of RNA isolated from blood samples was analyzed following chemotherapy for hematological malignancies (N = 28) and compared with left ventricular ejection fraction (LVEF). Results On initial rigorous analysis, low levels of influenza orthomyxovirus and avian paramyxovirus sequences were detectable, but without significant correlation to LVEF (r = 0.208). A secondary broad data mining analysis for virus sequences, without filtering human sequences, detected significant correlations for paramyxovirus with LVEF after chemotherapy (r = 0.592, P < 0.0096). Correlations were similar for LVEF pre- and post- chemotherapy for orthomyxovirus (R = 0.483, P < 0.0421). Retrovirus detection also correlated with LVEF post (r = 0.453, p < 0.0591), but not pre-chemotherapy, but is suspect due to potential host contamination. Detectable phage and anellovirus had no correlation. Combined sequence reads (all viruses) demonstrated significant correlation (r = 0.621, P < 0.0078). Reduced LVEF was not associated with chemotherapy (P = NS). Conclusions This is the first report of RNA virus screening in circulating blood and association with changes in cardiac function among patients post chemotherapy, using unbiased, blinded, high-throughput sequencing. Influenza orthomyxovirus, avian paramyxovirus and retrovirus sequences were detectable in patients with reduced LVEF. Further analysis for RNA virus infections in patients with cardiomyopathy after chemotherapy is warranted.
Collapse
Affiliation(s)
- Kyle Varkoly
- Department of Internal Medicine, McLaren Macomb Hospital- Michigan State University College of Human Medicine, Mt Clemens, MI, United States
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Shaoyuan Tan
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Roxana Beladi
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
- Department of Neurological Surgery, Ascension Providence Hospital- Michigan State University College of Human Medicine, Southfield, MI, United States
| | - David Fonseca
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Isabela Rivabem Zanetti
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Simona Kraberger
- The Biodesign Center of Fundamental and Applied Microbiomics, Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Chintan Shah
- Division of Hematology/Oncology, Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Jordan R. Yaron
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
- School for Engineering of Matter, Transport and Energy, Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ, United States
| | - Liqiang Zhang
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Michael Juby
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Ayman Fath
- Department of Internal Medicine, Dignity Health, Creighton University, Phoenix, AZ, United States
| | - Sriram Ambadapadi
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Melanie House
- Department of Internal Medicine, Dignity Health, Creighton University, Phoenix, AZ, United States
| | - Paul Maranian
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Carl J. Pepine
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Arvind Varsani
- The Biodesign Center of Fundamental and Applied Microbiomics, Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, United States
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Jan Moreb
- Hematologic Malignancies, Transplantation and Cellular Therapy Program, Forsyth Medical Center, Derrick L Davis Cancer Center, Winston-Salem, NC, United States
| | - Stacey Schultz-Cherry
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Alexandra R. Lucas
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, United States
- Center for Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
- *Correspondence: Alexandra R. Lucas
| |
Collapse
|
24
|
Latif MB, Shukla S, Del Rio Estrada PM, Ribeiro SP, Sekaly RP, Sharma AA. Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection. Transl Res 2022; 241:83-95. [PMID: 34871809 PMCID: PMC8641406 DOI: 10.1016/j.trsl.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/09/2023]
Abstract
Patients with cancers have been severely affected by the COVID-19 pandemic. This is highlighted by the adverse outcomes in cancer patients with COVID-19 as well as by the impact of the COVID-19 pandemic on cancer care. Patients with cancer constitute a heterogeneous population that exhibits distinct mechanisms of immune dysfunction, associated with distinct systemic features of hot (T-cell-inflamed/infiltrated) and cold (Non-T-cell-inflamed and/or infiltrated) tumors. The former show hyper immune activated cells and a highly inflammatory environment while, contrastingly, the latter show the profile of a senescent and/or quiescent immune system. Thus, the evolution of SARS-CoV-2 infection in different types of cancers can show distinct trajectories which could lead to a variety of clinical and pathophysiological outcomes. The altered immunological environment including cytokines that characterizes hot and cold tumors will lead to different mechanisms of immune dysfunction, which will result in downstream effects on the course of SARS-CoV-2 infection. This review will focus on defining the known contributions of soluble pro- and anti-inflammatory mediators on immune function including altered T-cells and B-cells responses and as well on how these factors modulate the expression of SARS-CoV-2 receptor ACE2, TMPRSS2 expression, and lymph node fibrosis in cancer patients. We will propose immune mechanisms that underlie the distinct courses of SARS-CoV-2 infection in cancer patients and impact on the success of immune based therapies that have significantly improved cancer outcomes. Better understanding of the immune mechanisms prevalent in cancer patients that are associated to the outcomes of SARS-CoV-2 infection will help to identify the high-risk cancer patients and develop immune-based approaches to prevent significant adverse outcomes by targeting these pathways.
Collapse
Affiliation(s)
- Muhammad Bilal Latif
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Sudhanshu Shukla
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Perla Mariana Del Rio Estrada
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Susan Pereira Ribeiro
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Rafick Pierre Sekaly
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia.
| | - Ashish Arunkumar Sharma
- Pathology Advanced Translational Research Unit, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| |
Collapse
|
25
|
Ghasemzadeh M, Ghasemzadeh A, Hosseini E. Exhausted NK cells and cytokine storms in COVID-19: Whether NK cell therapy could be a therapeutic choice. Hum Immunol 2022; 83:86-98. [PMID: 34583856 PMCID: PMC8423992 DOI: 10.1016/j.humimm.2021.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/17/2021] [Accepted: 09/04/2021] [Indexed: 02/08/2023]
Abstract
The global outbreak of coronavirus-2019 (COVID-19) still claims more lives daily around the world due to the lack of a definitive treatment and the rapid tendency of virus to mutate, which even jeopardizes vaccination efficacy. At the forefront battle against SARS-CoV-2, an effective innate response to the infection has a pivotal role in the initial control and treatment of disease. However, SARS-CoV-2 subtly interrupts the equations of immune responses, disrupting the cytolytic antiviral effects of NK cells, while seriously activating infected macrophages and other immune cells to induce an unleashed "cytokine storm", a dangerous and uncontrollable inflammatory response causing life-threatening symptoms in patients. Notably, the NK cell exhaustion with ineffective cytolytic function against the sources of exaggerated cytokine release, acts as an Achilles' heel which exacerbates the severity of COVID-19. Given this, approaches that improve NK cell cytotoxicity may benefit treatment protocols. As a suggestion, adoptive transfer of NK or CAR-NK cells with proper cytotolytic potentials and the lowest capacity of cytokine-release (for example CD56dim NK cells brightly express activating receptors), to severe COVID-19 patients may provide an effective cure especially in cases suffering from cytokine storms. More intriguingly, the ongoing evidence for persistent clonal expansion of NK memory cells characterized by an activating phenotype in response to viral infections, can benefit the future studies on vaccine development and adoptive NK cell therapy in COVID-19. Whether vaccinated volunteers or recovered patients can also be considered as suitable candidates for cell donation could be the subject of future research.
Collapse
Affiliation(s)
- Mehran Ghasemzadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | | | - Ehteramolsadat Hosseini
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Department of Immunology, Alfred Medical Research and Education Precinct, Monash University, Melbourne, Victoria, Australia; Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria, Australia.
| |
Collapse
|
26
|
Sakleshpur S, Steed AL. Influenza: Toward understanding the immune response in the young. Front Pediatr 2022; 10:953150. [PMID: 36061377 PMCID: PMC9437304 DOI: 10.3389/fped.2022.953150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/28/2022] [Indexed: 12/12/2022] Open
Abstract
Annually influenza causes a global epidemic resulting in 290,000 to 650,000 deaths and extracts a massive toll on healthcare and the economy. Infants and children are more susceptible to infection and have more severe symptoms than adults likely mitigated by differences in their innate and adaptive immune responses. While it is unclear the exact mechanisms with which the young combat influenza, it is increasingly understood that their immune responses differ from adults. Specifically, underproduction of IFN-γ and IL-12 by the innate immune system likely hampers viral clearance while upregulation of IL-6 may create excessive damaging inflammation. The infant's adaptive immune system preferentially utilizes the Th-2 response that has been tied to γδ T cells and their production of IL-17, which may be less advantageous than the adult Th-1 response for antiviral immunity. This differential immune response of the young is considered to serve as a unique evolutionary adaptation such that they preferentially respond to infection broadly rather than a pathogen-specific one generated by adults. This unique function of the young immune system is temporally, and possibly mechanistically, tied to the microbiota, as they both develop in coordination early in life. Additional research into the relationship between the developing microbiota and the immune system is needed to develop therapies effective at combating influenza in the youngest and most vulnerable of our population.
Collapse
Affiliation(s)
- Sonia Sakleshpur
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Ashley L Steed
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| |
Collapse
|
27
|
Sawyers A, Chou M, Johannet P, Gulati N, Qian Y, Zhong J, Osman I. Clinical outcomes in cancer patients with COVID-19. Cancer Rep (Hoboken) 2021; 4:e1413. [PMID: 34409775 PMCID: PMC8420395 DOI: 10.1002/cnr2.1413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early reports on cancer patients with coronavirus disease 2019 (COVID-19) corroborated speculation that cancer patients are at increased risk for becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and developing severe COVID-19. However, cancer patients are a heterogeneous population and their corresponding risk may be different. AIM To compare COVID-19 presentation in patients with active malignancy to those with a history of cancer to determine the impact of cancer status on COVID-19 outcomes in the two groups. METHODS AND RESULTS Of the 6724 patients who were hospitalized at NYU Langone Health (3/16/20-7/31/20) and tested positive for SARS-CoV-2, 580 had either active cancer (n = 221) or a history of cancer (n = 359). We compared the baseline clinicodemographic characteristics and hospital courses of the two groups. We studied the relationship between cancer status and the rate of admission to the intensive care unit (ICU), use of invasive mechanical ventilation (IMV), and all-cause mortality. The two groups had similar laboratory results associated with COVID-19 infection, incidence of venous thromboembolism, and incidence of severe COVID-19. Active cancer status was not associated with the rate of ICU admission (p = .307) or use of IMV (p = .236), but was significantly associated with worse all-cause mortality in both univariate and multivariate analysis with odds ratios of 1.48 (95% confidence interval [CI]: 1.04-2.09; p = .028) and 1.71 (95% CI: 1.12-2.63; p = .014), respectively. CONCLUSION Active cancer patients had worse survival outcomes compared to patients with a history of cancer despite similar COVID-19 disease characteristics in the two groups. Our data suggest that cancer care should continue with minimal interruptions during the pandemic to bring about response and remission as soon as possible.
Collapse
Affiliation(s)
- Amelia Sawyers
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Margaret Chou
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Paul Johannet
- Department of MedicineNYU Grossman School of MedicineNew YorkUSA
| | - Nicholas Gulati
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| | - Yingzhi Qian
- Department of Population HealthNYU Grossman School of MedicineNew YorkUSA
| | - Judy Zhong
- Department of Population HealthNYU Grossman School of MedicineNew YorkUSA
| | - Iman Osman
- Ronald O. Perelman Department of DermatologyNYU Grossman School of MedicineNew YorkUSA
| |
Collapse
|
28
|
New C, Lee ZY, Tan KS, Wong AHP, Wang DY, Tran T. Tetraspanins: Host Factors in Viral Infections. Int J Mol Sci 2021; 22:11609. [PMID: 34769038 PMCID: PMC8583825 DOI: 10.3390/ijms222111609] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/17/2022] Open
Abstract
Tetraspanins are transmembrane glycoproteins that have been shown increasing interest as host factors in infectious diseases. In particular, they were implicated in the pathogenesis of both non-enveloped (human papillomavirus (HPV)) and enveloped (human immunodeficiency virus (HIV), Zika, influenza A virus, (IAV), and coronavirus) viruses through multiple stages of infection, from the initial cell membrane attachment to the syncytium formation and viral particle release. However, the mechanisms by which different tetraspanins mediate their effects vary. This review aimed to compare and contrast the role of tetraspanins in the life cycles of HPV, HIV, Zika, IAV, and coronavirus viruses, which cause the most significant health and economic burdens to society. In doing so, a better understanding of the relative contribution of tetraspanins in virus infection will allow for a more targeted approach in the treatment of these diseases.
Collapse
Affiliation(s)
- ChihSheng New
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - Zhao-Yong Lee
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - Kai Sen Tan
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore 119228, Singapore
| | - Amanda Huee-Ping Wong
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - De Yun Wang
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Thai Tran
- Infectious Disease Translational Research Program, National University of Singapore, Singapore 119228, Singapore; (C.N.); (Z.-Y.L.); (K.S.T.); (A.H.-P.W.)
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| |
Collapse
|
29
|
Mandal A, Singh P, Samaddar A, Singh D, Verma M, Rakesh A, Ranjan R. Vaccination of cancer patients against COVID-19: towards the end of a dilemma. Med Oncol 2021; 38:92. [PMID: 34235592 PMCID: PMC8263320 DOI: 10.1007/s12032-021-01540-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022]
Abstract
With the emergence of second wave of COVID-19 infection globally, particularly in India in March-April 2021, protection by massive vaccination drive has become the need of the hour. Vaccines have been proved to reduce the risk of developing severe illness and are emerging as vital tools in the battle against COVID-19. As per the GLOBOCAN database, nearly 19.3 million new cancer cases have been reported in 2020 globally, which posed a significant challenge to health care providers to protect such large number of 'vulnerable' patients from COVID-19. Nevertheless, a considerable degree of doubt, hesitancy and misconceptions are noted regarding the administration of vaccines particularly during active immuno-suppressant treatment. This review article highlights the added vulnerability of cancer patients to the COVID-19 infection and has explored the immunological challenges associated with malignancy, anticancer treatment and COVID-19 vaccination.
Collapse
Affiliation(s)
- Avik Mandal
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India.
| | - Pritanjali Singh
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India
| | - Arghadip Samaddar
- Depratment of Neuromicrobiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Dharmendra Singh
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India
| | - Manika Verma
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India
| | - Amrita Rakesh
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India
| | - Rakesh Ranjan
- Department of Radiation Oncology, All India Institute of Medical Sciences, Aurangabad Road, Phulwari Sharif, Patna, Bihar, 801507, India
| |
Collapse
|
30
|
Galsky MD, Balar AV, Black PC, Campbell MT, Dykstra GS, Grivas P, Gupta S, Hoimes CJ, Lopez LP, Meeks JJ, Plimack ER, Rosenberg JE, Shore N, Steinberg GD, Kamat AM. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of urothelial cancer. J Immunother Cancer 2021; 9:e002552. [PMID: 34266883 PMCID: PMC8286774 DOI: 10.1136/jitc-2021-002552] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
A number of immunotherapies have been developed and adopted for the treatment of urothelial cancer (encompassing cancers arising from the bladder, urethra, or renal pelvis). For these immunotherapies to positively impact patient outcomes, optimal selection of agents and treatment scheduling, especially in conjunction with existing treatment paradigms, is paramount. Immunotherapies also warrant specific and unique considerations regarding patient management, emphasizing both the prompt identification and treatment of potential toxicities. In order to address these issues, the Society for Immunotherapy of Cancer (SITC) convened a panel of experts in the field of immunotherapy for urothelial cancer. The expert panel developed this clinical practice guideline (CPG) to inform healthcare professionals on important aspects of immunotherapeutic treatment for urothelial cancer, including diagnostic testing, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence- and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with urothelial cancer.
Collapse
Affiliation(s)
- Matthew D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Arjun V Balar
- Perlmutter Cancer Center, New York University Langone Medical Center, New York, New York, USA
| | - Peter C Black
- Department of Urologic Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew T Campbell
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gail S Dykstra
- Bladder Cancer Advocacy Network (BCAN), Bethesda, Maryland, USA
- Dykstra Research, Seattle, Washington, USA
| | - Petros Grivas
- Department of Medicine, Division of Oncology, University of Washington, Seattle, Washington, USA
- Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Shilpa Gupta
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Christoper J Hoimes
- Department of Medicine, Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Lidia P Lopez
- Division of Hematology-Oncology, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Joshua J Meeks
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- The Jesse Brown VA Medical Center, Chicago, Illinois, USA
| | - Elizabeth R Plimack
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Jonathan E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Deparment of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, South Carolina, USA
| | - Gary D Steinberg
- Department of Urology and Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York, USA
| | - Ashish M Kamat
- Department of Urology under Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
31
|
COVID-19 in Patients with Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:315-331. [PMID: 33973186 DOI: 10.1007/978-3-030-63761-3_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With more than 5 million cases and 333,212 deaths, COVID-19 (or SARS-CoV-2) continues to spread. General symptoms of this disease are similar to that of many other viral respiratory diseases, including fever, cough, dyspnea, and fatigue, with a chance of progression to more severe complications. However, the virus does not affect all people equally, and cases with comorbidities such as malignancies, cardiovascular diseases, respiratory diseases, and kidney diseases are at higher risk of developing severe events, including requiring intensive ventilation, intensive care unit (ICU) admission, and death. Patients with cancer are more likely to be infected with COVID-19, which is possibly due to their immunological dysfunction or frequent clinic visits. Also, there is a higher chance that these patients experience severe events because of the medication they receive. In this chapter, we will review the main clinical manifestations of COVID-19 in patients with cancer. Recommendations and challenges for managing resources, organizing cancer centers, treatment of COVID-19-infected cancer patients, and performing cancer research during this pandemic will also be discussed.
Collapse
|
32
|
Goudsmit A, Cubilier E, Meert AP, Aftimos P, Stathopoulos K, Spilleboudt C, Loizidou A. Factors associated with SARS-CoV-2 infection and outcome in patients with solid tumors or hematological malignancies: a single-center study. Support Care Cancer 2021; 29:6271-6278. [PMID: 33851236 PMCID: PMC8043836 DOI: 10.1007/s00520-021-06175-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Immunocompromised cancer patients are presumed to be at high risk of developing COVID-19 infection. Predisposing factors to contracting COVID-19 and to severe outcomes have been described in registries but were not compared between solid tumors and hematological malignancies. METHOD This retrospective single oncologic center study included adults with solid tumors or hematological malignancies referred to testing by naso-pharyngeal swab for a SARS-CoV-2 RT-PCR from March 10 to May 18, 2020. RESULTS A total of 212 patients were included in the study. Forty-five (21%) were tested positive with SARS-CoV-2. The univariate analysis with positive SARS-CoV-2 PCR as a dependent variable reveals significant odds ratios (ORs) for age-with a mean of 62.5 years-(OR: 1.05, 95% CI: 1.02-1.08), performance status ≥2 (OR: 2.38, 95% CI: 1.22-4.70), inpatient status (OR: 2.36, 95%CI: 1.11-4.91), and hematological malignancies (OR: 2.48, 95% CI: 1.23-4.96). In contrast, OR for solid tumors reveals a negative association (OR: 0.40, 95% CI: 0.20-0.81). When integrating severe outcome (ICU admission or COVID-19-related death) as a dependent variable, the univariate logistic regression model shows significant ORs for pre-existing lymphopenia (OR: 4.0, 95% CI: 1.17-15.04), hematological malignancies (OR: 3.73, 95% CI: 1.09-13.80), and a negative association for solid tumors (OR: 0.27; 95% CI: 0.07-0.92). CONCLUSION In patients referred for SARS-CoV-2 testing, hematological malignancies were associated with a higher risk of COVID-19 infection and severe outcomes. Other factors were age and inpatient status.
Collapse
Affiliation(s)
- Anouk Goudsmit
- Internal Medicine, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium.
| | - Edouard Cubilier
- Internal Medicine, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium
| | - Anne-Pascale Meert
- Internal Medicine, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium
| | - Philippe Aftimos
- Clinical Trials Conduct Unit, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium
| | | | - Chloe Spilleboudt
- Hematology Department, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium
| | - Angela Loizidou
- Internal Medicine, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium
| |
Collapse
|
33
|
Gasmi A, Peana M, Pivina L, Srinath S, Gasmi Benahmed A, Semenova Y, Menzel A, Dadar M, Bjørklund G. Interrelations between COVID-19 and other disorders. Clin Immunol 2021; 224:108651. [PMID: 33333255 PMCID: PMC7833539 DOI: 10.1016/j.clim.2020.108651] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory tract virus that causes Coronavirus disease (COVID-19). The virus originated in Wuhan, China, in December 2019 and has spread across the globe to-date. The disease ranges from asymptomatic carriers to symptoms such as fever, sore throat, cough, lung infections, and in severe cases, acute respiratory distress syndrome, sepsis, and death. As many as 50% of patients reported having at least one comorbidities with COVID-19 upon hospital admission. Hypertension, diabetes, chronic obstructive pulmonary disease, obesity, and cardiovascular diseases are among the most commonly reported. Comorbidities are contributing to acute disease prognosis and increased risk of severe symptoms. Around 70% of patients who require ICU care have been observed to have comorbidities. This review intends to understand how some of these comorbidities affect the disease's prognosis and how severe the outcome can be expected.
Collapse
Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy.
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan; CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Shvetha Srinath
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | | | - Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan; CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | | | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway.
| |
Collapse
|
34
|
Anforderungen an die Infektionsprävention bei der medizinischen Versorgung von immunsupprimierten Patienten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:232-264. [PMID: 33394069 PMCID: PMC7780910 DOI: 10.1007/s00103-020-03265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
35
|
The Pivotal Role of Viruses in the Pathogeny of Chronic Lymphocytic Leukemia: Monoclonal (Type 1) IgG K Cryoglobulinemia and Chronic Lymphocytic Leukemia Diagnosis in the Course of a Human Metapneumovirus Infection. Viruses 2021; 13:v13010115. [PMID: 33466993 PMCID: PMC7830454 DOI: 10.3390/v13010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Type-1 cryoglobulinemia (CG) is a rare disease associated with B-cell lymphoproliferative disorder. Some viral infections, such as Epstein–Barr Virus infections, are known to cause malignant lymphoproliferation, like certain B-cell lymphomas. However, their role in the pathogenesis of chronic lymphocytic leukemia (CLL) is still debatable. Here, we report a unique case of Type-1 CG associated to a CLL transformation diagnosed in the course of a human metapneumovirus (hMPV) infection. Case presentation: A 91-year-old man was initially hospitalized for delirium. In a context of febrile rhinorrhea, the diagnosis of hMPV infection was made by molecular assay (RT-PCR) on nasopharyngeal swab. Owing to hyperlymphocytosis that developed during the course of the infection and unexplained peripheral neuropathy, a type-1 IgG Kappa CG secondary to a CLL was diagnosed. The patient was not treated for the CLL because of Binet A stage classification and his poor physical condition. Conclusions: We report the unique observation in the literature of CLL transformation and hMPV infection. We provide a mini review on the pivotal role of viruses in CLL pathophysiology.
Collapse
|
36
|
Ardon O, Reuter VE, Hameed M, Corsale L, Manzo A, Sirintrapun SJ, Ntiamoah P, Stamelos E, Schueffler PJ, England C, Klimstra DS, Hanna MG. Digital Pathology Operations at an NYC Tertiary Cancer Center During the First 4 Months of COVID-19 Pandemic Response. Acad Pathol 2021; 8:23742895211010276. [PMID: 35155745 PMCID: PMC8819741 DOI: 10.1177/23742895211010276] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/18/2021] [Accepted: 03/21/2021] [Indexed: 11/21/2022] Open
Abstract
Implementation of an infrastructure to support digital pathology began in 2006 at
Memorial Sloan Kettering Cancer Center. The public health emergency and COVID-19
pandemic regulations in New York City required a novel workflow to sustain
existing operations. While regulatory enforcement discretions offered faculty
workspace flexibility, a substantial portion of laboratory and digital pathology
workflows require on-site presence of staff. Maintaining social distancing and
offering staggered work schedules. Due to a decrease in patients seeking health
care at the onset of the pandemic, a temporary decrease in patient specimens was
observed. Hospital and travel regulations impacted onsite vendor technical
support. Digital glass slide scanning activities onsite proceeded without
interruption throughout the pandemic, with challenges including staff who
required quarantine due to virus exposure, unrelated illness, family support, or
lack of public transportation. During the public health emergency, we validated
digital pathology systems for a remote pathology operation. Since March 2020,
the departmental digital pathology staff were able to maintain scanning volumes
of over 100 000 slides per month. The digital scanning team reprioritized
archival slide scanning and participated in a remote sign-out validation and
successful submission of New York State approval for a laboratory developed
test. Digital pathology offers a health care delivery model where pathologists
can perform their sign out duties at remote location and prevent disruptions to
critical pathology services for patients seeking care at our institution during
emergencies. Development of standard operating procedures to support digital
workflows will maintain turnaround times and enable clinical operations during
emergency or otherwise unanticipated events.
Collapse
Affiliation(s)
- Orly Ardon
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,The Warren Alpert Center for Digital and Computational Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Meera Hameed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,The Warren Alpert Center for Digital and Computational Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lorraine Corsale
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Allyne Manzo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sahussapont J Sirintrapun
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,The Warren Alpert Center for Digital and Computational Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Ntiamoah
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Evangelos Stamelos
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter J Schueffler
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,The Warren Alpert Center for Digital and Computational Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine England
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David S Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,The Warren Alpert Center for Digital and Computational Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew G Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
37
|
Abstract
Critically ill patients with cancer are vulnerable to infections because of the underlying malignancy, tumor-directed therapy, immunosuppression, breaches in mucosa or skin, malnutrition, and other factors. Neutropenia remains the most important risk factor for infection. Infectious complications occurring in critically ill patients with cancer can affect the bloodstream, lungs, gastrointestinal tract, central nervous system, urinary tract, and the skin. Pneumonias are the leading cause of infection in patients with cancer admitted to the intensive care unit. Consideration of opportunistic pathogens in the differential diagnosis is important in patients with impaired cellular and/or humoral immunity or compromised splenic function.
Collapse
Affiliation(s)
- Susan K Seo
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Catherine Liu
- Vaccine and Infectious Disease Division, Fred Hutchison Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sanjeet S Dadwal
- Division of Infectious Diseases, Department of Medicine, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| |
Collapse
|
38
|
Montenegro P, Pinillos L, Young F, Aguilar A, Tirado-Hurtado I, Pinto JA, Vallejos C. Telemedicine and the current opportunities for the management of oncological patients in Peru in the context of COVID-19 pandemic. Crit Rev Oncol Hematol 2021; 157:103129. [PMID: 33227573 PMCID: PMC7581359 DOI: 10.1016/j.critrevonc.2020.103129] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022] Open
Abstract
COVID-19 pandemic is the more challenging public health emergency of the century, producing the collapse of health systems and unprecedented levels of morbidity and mortality around the world, especially in low resource settings. Patients with chronic diseases are the most affected, not only due to the high susceptibility to SARS-CoV-2 infection but also due to the decrease in opportunities for timely care. In this dark landscape, telemedicine, before limited to very specific scenarios, has become one of our main tools to manage cancer patients, particularly in Latin America where COVID-19 has had a strong impact on the public health. Telemedicine can provide rapid access to specialized cancer care in a scenario complicated, reducing the exposure of patients and healthcare personnel to the SARS-CoV-2. In this review, we would like to share our experience and our workflow using telemedicine at Oncosalud-AUNA, a private clinic in Peru.
Collapse
Affiliation(s)
| | | | | | | | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, AUNA, Lima41, Peru
| | | |
Collapse
|
39
|
Perret C, Le Corre N, Castro-Rodriguez JA. Emergent Pneumonia in Children. Front Pediatr 2021; 9:676296. [PMID: 34222146 PMCID: PMC8247473 DOI: 10.3389/fped.2021.676296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
In recent decades there have been multiple pathogens, viruses and bacteria, which have emerged as causal agents of pneumonia affecting adults, albeit less frequently, to children. For the purposes of this article we have classified emerging pathogens as follows: True emerging, to pathogens identified for the very first time affecting human population (SARS-CoV-1, SARS-CoV-2, MERS-CoV, avian influenza, and hantavirus); Re-emerging, to known pathogens which circulation was controlled once, but they have reappeared (measles, tuberculosis, antimicrobial resistant bacteria such as CA-MRSA, Mycoplasma pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and new serotypes of post-vaccine pneumococcal); and finally, those that we have called old known with new presentations, including common pathogens that, in particular condition, have changed their form of presentation (rhinovirus, and non-SARS coronavirus). We will review for each of them their epidemiology, forms of presentation, therapy, and prognosis in children compared to the adult with the aim of being able to recognize them to establish appropriate therapy, prognostics, and effective control measures.
Collapse
Affiliation(s)
- Cecilia Perret
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicole Le Corre
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose A Castro-Rodriguez
- Department of Pediatric Pulmonology and Cardiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
40
|
Han HJ, Nwagwu C, Anyim O, Ekweremadu C, Kim S. COVID-19 and cancer: From basic mechanisms to vaccine development using nanotechnology. Int Immunopharmacol 2020; 90:107247. [PMID: 33307513 PMCID: PMC7709613 DOI: 10.1016/j.intimp.2020.107247] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/17/2022]
Abstract
Shows updated understanding of SARS-CoV-2, including the interaction between ACE 2 and the viral spike protein. More effective vaccines are required for immunocompromised cancer patients. Cancer alters the immune system through different levels of D-Dimer, albumin, prothrombin, and neutrophils. Nanomaterials assist vaccine delivery, including viral vector and mRNA vaccines with lipid nanoparticles.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global pandemic which has induced unprecedented ramifications, severely affecting our society due to the long incubation time, unpredictably high prevalence and lack of effective vaccines. One of the interesting notions is that there is an association between COVID-19 and cancer. Cancer patients seem to exhibit exacerbated conditions and a higher mortality rate when exposed to the virus. Therefore, vaccines are the promising solution to minimise the problem amongst cancer patients threatened by the new viral strains. However, there are still limitations to be considered, including the efficacy of COVID vaccines for immunocompromised individuals, possible interactions between the vaccine and cancer, and personalised medicine. Not only to eradicate the pandemic, but also to make it more effective for immunocompromised patients who are suffering from cancer, a successful vaccine platform is required through the implementation of nanotechnology which can also enable scalable manufacturing and worldwide distribution along with its faster and precise delivery. In this review, we summarise the current understanding of COVID-19 with clinical perspectives, highlighting the association between COVID-19 and cancer, followed by a vaccine development for this association using nanotechnology. We suggest different administration methods for the COVID-19 vaccine formulation options. This study will contribute to paving the way towards the prevention and treatment of COVID-19, especially for the immunocompromised individuals.
Collapse
Affiliation(s)
- Hyun Jee Han
- University College London, Department of Neonatology, United Kingdom.
| | - Chinekwu Nwagwu
- Department of Pharmaceutics, University of Nigeria Nsukka, Nigeria.
| | - Obumneme Anyim
- Department of Internal Medicine, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria
| | - Chinedu Ekweremadu
- Department of Pharmaceutics and Pharmaceutical Technology Enugu State University of Science and Technology, Nigeria.
| | - San Kim
- Basildon and Thurrock University Hospital, United Kingdom.
| |
Collapse
|
41
|
de Sandes‐Freitas TV, Canito Brasil IR, Oliveira Sales MLDMB, Studart e Neves Lunguinho MS, Pimentel ÍRS, Josino da Costa LAT, Esmeraldo RDM. Lessons from SARS-CoV-2 screening in a Brazilian organ transplant unit. Transpl Infect Dis 2020; 22:e13376. [PMID: 32573894 PMCID: PMC7361162 DOI: 10.1111/tid.13376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023]
Abstract
Protecting immunosuppressed patients during infectious disease outbreaks is crucial. During this novel coronavirus disease 2019 pandemic, preserving "clean areas" in hospitals assisting organ transplant recipients is key to protect them and to preserve transplantation activity. Evidence suggests that asymptomatic carriers might transmit the SARS-CoV-2, challenging the implementation of transmission preventive strategies. We report a single-center experience using universal SARS-CoV-2 screening for all inpatients and newly admitted patients to an Organ Transplant Unit located in a region with significantly high community-based transmission.
Collapse
Affiliation(s)
- Tainá Veras de Sandes‐Freitas
- Transplant DivisionHospital Geral de FortalezaFortalezaBrazil
- Department of Clinical MedicineFederal University of CearaFortalezaBrazil
- State University of CearáProfessional Master's Degree in Organ TransplantationFortalezaBrazil
| | - Ivelise Regina Canito Brasil
- Transplant DivisionHospital Geral de FortalezaFortalezaBrazil
- State University of CearáProfessional Master's Degree in Organ TransplantationFortalezaBrazil
| | | | | | | | | | | |
Collapse
|
42
|
Dallas RH, Rains JK, Wilder K, Humphrey W, Cross SJ, Ghafoor S, Brazelton de Cardenas JN, Hayden RT, Hijano DR. The Aerogen ® Solo Is an Alternative to the Small Particle Aerosol Generator (SPAG-2) for Administration of Inhaled Ribavirin. Pharmaceutics 2020; 12:pharmaceutics12121163. [PMID: 33260359 PMCID: PMC7760766 DOI: 10.3390/pharmaceutics12121163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022] Open
Abstract
Respiratory syncytial virus (RSV) is associated with adverse outcomes among immunocompromised patients. Inhaled ribavirin has been shown to improve mortality rates. The Small-Particle Aerosol Generator delivery system (SPAG-2) is the only FDA-cleared device to deliver inhaled ribavirin. However, it is difficult to set up and maintain. We developed a method for delivery of this medication using the vibrating mesh nebulizer (Aerogen®). We did not observe any adverse events with this method.
Collapse
Affiliation(s)
- Ronald H. Dallas
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN 38105, USA;
| | - Jason K. Rains
- Department of Critical Care and Pulmonary Medicine, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (J.K.R.); (K.W.); (S.G.)
| | - Keith Wilder
- Department of Critical Care and Pulmonary Medicine, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (J.K.R.); (K.W.); (S.G.)
| | - William Humphrey
- Department of Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (W.H.); (S.J.C.)
| | - Shane J. Cross
- Department of Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (W.H.); (S.J.C.)
| | - Saad Ghafoor
- Department of Critical Care and Pulmonary Medicine, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (J.K.R.); (K.W.); (S.G.)
| | | | - Randall T. Hayden
- Department of Pathology, St. Jude Children Research Hospital, Memphis, TN 38105, USA; (J.N.B.d.C.); (R.T.H.)
| | - Diego R. Hijano
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN 38105, USA;
- Correspondence: ; Tel.: +1-901-595-0448
| |
Collapse
|
43
|
Quagliariello V, Bonelli A, Caronna A, Conforti G, Iovine M, Carbone A, Berretta M, Botti G, Maurea N. SARS-CoV-2 Infection and Cardioncology: From Cardiometabolic Risk Factors to Outcomes in Cancer Patients. Cancers (Basel) 2020; 12:E3316. [PMID: 33182653 PMCID: PMC7697868 DOI: 10.3390/cancers12113316] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease-2019 (COVID-19) is a highly transmissible viral illness caused by SARS-CoV-2, which has been defined by the World Health Organization as a pandemic, considering its remarkable transmission speed worldwide. SARS-CoV-2 interacts with angiotensin-converting enzyme 2 and TMPRSS2, which is a serine protease both expressed in lungs, the gastro-intestinal tract, and cardiac myocytes. Patients with COVID-19 experienced adverse cardiac events (hypertension, venous thromboembolism, arrhythmia, myocardial injury, fulminant myocarditis), and patients with previous cardiovascular disease have a higher risk of death. Cancer patients are extremely vulnerable with a high risk of viral infection and more negative prognosis than healthy people, and the magnitude of effects depends on the type of cancer, recent chemotherapy, radiotherapy, or surgery and other concomitant comorbidities (diabetes, cardiovascular diseases, metabolic syndrome). Patients with active cancer or those treated with cardiotoxic therapies may have heart damages exacerbated by SARS-CoV-2 infection than non-cancer patients. We highlight the cardiovascular side effects of COVID-19 focusing on the main outcomes in cancer patients in updated perspective and retrospective studies. We focus on the main cardio-metabolic risk factors in non-cancer and cancer patients and provide recommendations aimed to reduce cardiovascular events, morbidity, and mortality.
Collapse
Affiliation(s)
- Vincenzo Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Annamaria Bonelli
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Antonietta Caronna
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Gabriele Conforti
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Martina Iovine
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Andreina Carbone
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| | - Massimiliano Berretta
- Department of Medical Oncology-Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy;
| | - Gerardo Botti
- Scientific Direction, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Nicola Maurea
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy; (A.B.); (A.C.); (G.C.); (M.I.); (A.C.)
| |
Collapse
|
44
|
Greenberg A, Barish P, Hoffman A. Overuse of Respiratory Viral Panels: A Teachable Moment. JAMA Intern Med 2020; 180:1373-1374. [PMID: 32865562 DOI: 10.1001/jamainternmed.2020.3535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Anya Greenberg
- University of California, San Francisco, School of Medicine, San Francisco
| | - Peter Barish
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco
| | - Ari Hoffman
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco.,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco
| |
Collapse
|
45
|
Chamseddine S, Chmaisse A, Akel I, Zein ZE, Khalil S, Raad SA, Khati A, Ghandour H, Khafaja S, Haj M, Abboud M, Mahfouz R, Araj G, Zaraket H, Hanna-Wakim R, Muwakkit S, Dbaibo G. Epidemiology and clinical characteristics of viral infections in hospitalized children and adolescents with cancer in Lebanon. PLoS One 2020; 15:e0239258. [PMID: 32961548 PMCID: PMC7508634 DOI: 10.1371/journal.pone.0239258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 09/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background Viral infections in children and adolescents with malignancy are commonly encountered and have a significant impact on morbidity and mortality. Studies and epidemiological data regarding viral infections in children with cancer in developing countries are lacking. This retrospective cohort study aims to assess the burden of viral infections in children and adolescents with cancer, by assessing prevalence, risk factors, as well as morbidity and mortality of common viruses over a period of 8 years. Methods and findings Medical records of cancer patients treated at the Children Cancer Center of Lebanon were reviewed and 155 participants under the age of 21 were identified with at least one documented viral infection during the period from July 2009 to November 2017. This subset included 136 participants with active malignancy and 19 participants with a history of cancer who underwent hematopoietic stem cell transplantation [HSCT] and were in remission; the latter group was analyzed separately. Information regarding participant characteristics, hospital course, and complications were obtained. Associations between viral infections and certain factors were assessed. In the cohort, 64% were male, 81% were Lebanese. In participants with active malignancy, 90% received chemotherapy in the 6 months preceding the viral infection episode, 11% received radiotherapy. 51% of participants were neutropenic at the time of viral detection, and 77% were lymphopenic. 17% experienced a bacterial co-infection, and 3 experienced a viral co-infection. Among 162 viral infection episodes, clinically diagnosed skin infections, mainly herpes simplex virus type 1 and varicella-zoster virus, were the most common [44% of cases]. These were followed by laboratory-proven systemic herpes infections: cytomegalovirus [14%] and Epstein-Barr virus [6%]. Respiratory viruses: influenza and respiratory syncytial virus, accounted for 9% and 4%, respectively, whereas rotavirus represented 11% and BK virus represented 3% of cases. Acute lymphocytic leukemia was the most prevalent neoplasia [57%]. Fever was the most common presenting symptom [55%] and febrile neutropenia was the reason for admission in 24% of cases. The mean length of stay was significantly longer in participants with cytomegalovirus infections and significantly lower in rotavirus infection. Admission to the ICU occurred in 9%, complications in 8%, and mortality in 5%. Participants with viral infections post-HSCT were noted to have a significantly longer length of hospital stay compared to non-HSCT participants, with no other significant differences in clinical course and outcome. The study was limited by its retrospective nature and by the late introduction and underuse of multiplex PCR panels, which may have led to underdiagnosis of viral infections. Conclusions Viral infections were prevalent in our sample of cancer patients and may have contributed to morbidity and mortality. Newly available viral diagnostics are likely to vastly increase the number and scope of detectable viral infections in this population. Prospective studies using multiplex PCR technology with systematic testing of patients will be more helpful in defining the burden of viral infections. Furthermore, efforts at antimicrobial stewardship would benefit from the identification of viral causes of infection and limit the unnecessary use of antibiotics in the pediatric cancer population.
Collapse
Affiliation(s)
- Sarah Chamseddine
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ahmad Chmaisse
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Imad Akel
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Zeinab El Zein
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Suzan Khalil
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sarah Abi Raad
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Antoine Khati
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Hiba Ghandour
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sarah Khafaja
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Magda Haj
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Miguel Abboud
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, Children’s Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rami Mahfouz
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Araj
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hassan Zaraket
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, Beirut, Lebanon
| | - Rima Hanna-Wakim
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samar Muwakkit
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, Children’s Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
| |
Collapse
|
46
|
Arrieta O, Cardona AF, Lara-Mejía L, Heredia D, Barrón F, Zatarain-Barrón ZL, Lozano F, de Lima VC, Maldonado F, Corona-Cruz F, Ramos M, Cabrera L, Martin C, Corrales L, Cuello M, Arroyo-Hernández M, Aman E, Bacon L, Baez R, Benitez S, Botero A, Burotto M, Caglevic C, Ferraris G, Freitas H, Kaen DL, Lamot S, Lyons G, Mas L, Mata A, Mathias C, Muñoz A, Patane AK, Oblitas G, Pino L, Raez LE, Remon J, Rojas L, Rolfo C, Ruiz-Patiño A, Samtani S, Viola L, Viteri S, Rosell R. Recommendations for detection, prioritization, and treatment of thoracic oncology patients during the COVID-19 pandemic: the THOCOoP cooperative group. Crit Rev Oncol Hematol 2020; 153:103033. [PMID: 32650215 PMCID: PMC7305738 DOI: 10.1016/j.critrevonc.2020.103033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/13/2020] [Indexed: 12/16/2022] Open
Abstract
The world currently faces a pandemic due to SARS-CoV-2. Relevant information has emerged regarding the higher risk of poor outcomes in lung cancer patients. As such, lung cancer patients must be prioritized in terms of prevention, detection and treatment. On May 7th, 45 experts in thoracic cancers from 11 different countries were invited to participate. A core panel of experts regarding thoracic oncology care amidst the pandemic gathered virtually, and a total of 60 initial recommendations were drafted based on available evidence, 2 questions were deleted due to conflicting evidence. By May 16th, 44 experts had agreed to participate, and voted on each of the 58 recommendation using a Delphi panel on a live voting event. Consensus was reached regarding the recommendations (>66 % strongly agree/agree) for 56 questions. Strong consensus (>80 % strongly agree/agree) was reached for 44 questions. Patients with lung cancer represent a particularly vulnerable population during this time. Special care must be taken to maintain treatment while avoiding exposure.
Collapse
Affiliation(s)
- Oscar Arrieta
- Instituto Nacional de Cancerología, Mexico City, Mexico.
| | - Andrés F Cardona
- Thoracic Oncology Clinic, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - David Heredia
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | | | | | | | | | - Maritza Ramos
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis Cabrera
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Claudio Martin
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina; Hospital Maria Ferrer, Buenos Aires, Argentina
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica; Oncología Médica, Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Mauricio Cuello
- Department of Oncology, Hospital de Clínicas, Universidad de la República - UDELAR, Montevideo, Uruguay
| | | | - Enrique Aman
- Clinical Oncology Unit, Swiss Medical Group, Buenos Aires, Argentina
| | - Ludwing Bacon
- Centro de Oncología, Hospital Vivián Pellas, Nicaragua
| | - Renata Baez
- National Institute for Respiratory Diseases, Mexico City, Mexico
| | - Sergio Benitez
- Coordinador de la sección Oncología, asociación Argentina de Medicina Respiratoria, Argentina
| | | | - Mauricio Burotto
- Clínica Universidad de los Andes, Centro de Estudios Clínicos Bradford Hill, Chile
| | - Christian Caglevic
- Departamento de Investigación del Cáncer- Fundación Arturo López Pérez, Santiago, Chile
| | - Gustavo Ferraris
- Centro Médico Dean Funes, Radioterapia Oncológica, Córdoba, Argentina
| | - Helano Freitas
- Departamento de Oncologia Clínica - A C Camargo Cancer Center, São Paulo, Brazil
| | | | - Sebastián Lamot
- CONCIENCIA, Instituto Oncohematológico de la Patagonia, Chile
| | - Gustavo Lyons
- Department of Thoracic Surgery, Hospital Británico, Buenos Aires, Argentina
| | - Luis Mas
- Medical Oncology Department, National Institute for Neoplastic Diseases - INEN, Lima, Peru
| | - Andrea Mata
- Hospital La Católica Goicoechea, San José, Costa Rica
| | | | | | - Ana Karina Patane
- Hospital de Rehabilitacion Respiratoria María Ferrer, Buenos Aires, Argentina
| | | | - Luis Pino
- Medical Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Luis E Raez
- Thoracic Oncology Program Memorial Cancer Institute, Memorial Healthcare System, Pembroke Pines, FL, United States
| | - Jordi Remon
- Medical Oncology Department, Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Barcelona, Spain
| | - Leonardo Rojas
- Medical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | | | - Suraj Samtani
- Medical Oncology Department, Clínica Bradford Hill, Santiago, Chile
| | - Lucia Viola
- Fundación neumológica colombiana, Bogotá, Colombia
| | - Santiago Viteri
- Instituto Oncológico Dr. Rosell. Centro Médico Teknon. Grupo QuironSalud. Barcelona, España
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| |
Collapse
|
47
|
Gabutti G, De Motoli F, Sandri F, Toffoletto MV, Stefanati A. Viral Respiratory Infections in Hematological Patients. Infect Dis Ther 2020; 9:495-510. [PMID: 32638228 PMCID: PMC7339094 DOI: 10.1007/s40121-020-00313-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Viral infections of the respiratory system represent one of the most important complications in hematological patients in terms of both the severity of the clinical picture and its related impact on the duration of hospitalization, and of mortality. The most implicated viruses are those that commonly cause community-based respiratory diseases: respiratory syncytial virus, Influenza virus and rhinovirus. However, in some cases the clinical picture may be triggered by first infection with or reactivation of pathogens normally not responsible for clinically relevant diseases in immunocompetent subjects. This issue is currently being taken into greater consideration within the scientific community. However, the strong heterogeneity in the epidemiology and clinical expression of these infections and the lack of adequate therapeutic options imply that there is currently no uniform consensus on the best management of these patients. The main purpose of this review is to highlight which viruses are currently most implicated in the onset of these infections, what is their incidence in so heterogeneous and fragile patients and the factors that lead to disease's onset and evolution. Possible or available clinical management options, diagnostic and therapeutic tools, and preventive and prophylaxis measures are also discussed.
Collapse
Affiliation(s)
- Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
| | - Francesco De Motoli
- Post-Graduate School of Hygiene and Preventive Medicine, University of Ferrara, Ferrara, Italy
| | - Federica Sandri
- Post-Graduate School of Hygiene and Preventive Medicine, University of Ferrara, Ferrara, Italy
| | | | - Armando Stefanati
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| |
Collapse
|
48
|
Cancer Patients Have a Higher Risk Regarding COVID-19 - and Vice Versa? Pharmaceuticals (Basel) 2020; 13:ph13070143. [PMID: 32640723 PMCID: PMC7408191 DOI: 10.3390/ph13070143] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 07/03/2020] [Indexed: 02/06/2023] Open
Abstract
The world is currently suffering from a pandemic which has claimed the lives of over 230,000 people to date. The responsible virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and causes the coronavirus disease 2019 (COVID-19), which is mainly characterized by fever, cough and shortness of breath. In severe cases, the disease can lead to respiratory distress syndrome and septic shock, which are mostly fatal for the patient. The severity of disease progression was hypothesized to be related to an overshooting immune response and was correlated with age and comorbidities, including cancer. A lot of research has lately been focused on the pathogenesis and acute consequences of COVID-19. However, the possibility of long-term consequences caused by viral infections which has been shown for other viruses are not to be neglected. In this regard, this opinion discusses the interplay of SARS-CoV-2 infection and cancer with special focus on the inflammatory immune response and tissue damage caused by infection. We summarize the available literature on COVID-19 suggesting an increased risk for severe disease progression in cancer patients, and we discuss the possibility that SARS-CoV-2 could contribute to cancer development. We offer lines of thought to provide ideas for urgently needed studies on the potential long-term effects of SARS-CoV-2 infection.
Collapse
|
49
|
Yeoh CB, Lee KJ, Rieth EF, Mapes R, Tchoudovskaia AV, Fischer GW, Tollinche LE. COVID-19 in the Cancer Patient. Anesth Analg 2020; 131:16-23. [PMID: 32543802 PMCID: PMC7179051 DOI: 10.1213/ane.0000000000004884] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 12/15/2022]
Abstract
The novel coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. Since then, it has spread across the world to become one of the most serious life-threatening pandemics since the influenza pandemic of 1918. This review article will focus on the specific risks and nuanced considerations of COVID-19 in the cancer patient. Important perioperative management recommendations during this outbreak are emphasized, in addition to discussion of current treatment techniques and strategies available in the battle against COVID-19.
Collapse
Affiliation(s)
- Cindy B. Yeoh
- From the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kathleen J. Lee
- Department of Anesthesiology and Pain Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth F. Rieth
- From the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Renee Mapes
- Department of Anesthesiology and Pain Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Anna V. Tchoudovskaia
- From the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gregory W. Fischer
- From the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Luis E. Tollinche
- From the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
50
|
Robilotti EV, Babady NE, Mead PA, Rolling T, Perez-Johnston R, Bernardes M, Bogler Y, Caldararo M, Figueroa CJ, Glickman MS, Joanow A, Kaltsas A, Lee YJ, Lucca A, Mariano A, Morjaria S, Nawar T, Papanicolaou GA, Predmore J, Redelman-Sidi G, Schmidt E, Seo SK, Sepkowitz K, Shah MK, Wolchok JD, Hohl TM, Taur Y, Kamboj M. Determinants of COVID-19 disease severity in patients with cancer. Nat Med 2020; 26:1218-1223. [PMID: 32581323 DOI: 10.1038/s41591-020-0979-0] [Citation(s) in RCA: 433] [Impact Index Per Article: 108.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/11/2020] [Indexed: 12/23/2022]
Abstract
As of 10 April 2020, New York State had 180,458 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 9,385 reported deaths. Patients with cancer comprised 8.4% of deceased individuals1. Population-based studies from China and Italy suggested a higher coronavirus disease 2019 (COVID-19) death rate in patients with cancer2,3, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-194. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. From 10 March to 7 April 2020, 423 cases of symptomatic COVID-19 were diagnosed at Memorial Sloan Kettering Cancer Center (from a total of 2,035 patients with cancer tested). Of these, 40% were hospitalized for COVID-19, 20% developed severe respiratory illness (including 9% who required mechanical ventilation) and 12% died within 30 d. Age older than 65 years and treatment with immune checkpoint inhibitors (ICIs) were predictors for hospitalization and severe disease, whereas receipt of chemotherapy and major surgery were not. Overall, COVID-19 in patients with cancer is marked by substantial rates of hospitalization and severe outcomes. The association observed between ICI and COVID-19 outcomes in our study will need further interrogation in tumor-specific cohorts.
Collapse
Affiliation(s)
- Elizabeth V Robilotti
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - N Esther Babady
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter A Mead
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Thierry Rolling
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rocio Perez-Johnston
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marilia Bernardes
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yael Bogler
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario Caldararo
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cesar J Figueroa
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Michael S Glickman
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Alexa Joanow
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anna Kaltsas
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Yeon Joo Lee
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Anabella Lucca
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Employee Health and Wellness Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amanda Mariano
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sejal Morjaria
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Tamara Nawar
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Genovefa A Papanicolaou
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Jacqueline Predmore
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gil Redelman-Sidi
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Elizabeth Schmidt
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susan K Seo
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Kent Sepkowitz
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Monika K Shah
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Jedd D Wolchok
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA.,Human Oncology and Pathogenesis Program, Department of Medicine, Ludwig Center and Parker Institute for Cancer Immunotherapy at Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tobias M Hohl
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Ying Taur
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Mini Kamboj
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA.
| |
Collapse
|