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Pietroluongo E, Peddio A, De Placido P, Tortora M, Ottaviano M, Gelzo M, Cernera G, Foggia M, Buonomo AR, Pinchera B, Zappulo E, Mercinelli S, Cattaneo L, Sardanelli A, Viceconte G, Scotto R, Schiano Moriello N, Servetto A, De Angelis C, Arpino G, Palmieri G, De Placido S, Bianco R, Castaldo G, Gentile I, Giuliano M. COVID-19 in patients with thymic epithelial tumors with or without Good's syndrome: a single-center retrospective study. BMC Cancer 2024; 24:748. [PMID: 38898390 PMCID: PMC11188232 DOI: 10.1186/s12885-024-12405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Thymic epithelial tumors (TETs) are rare neoplasms often associated with immune-related disorders. Patients with Good's syndrome (GS), an adult-acquired TET-related immunodeficiency, are at a high risk of mortality due to infectious diseases. This study aims to examine COVID-19 occurrence and severity in TET patients, with or without GS. METHODS Clinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations. RESULTS Overall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher's exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS. CONCLUSIONS Our data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.
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Affiliation(s)
- Erica Pietroluongo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annarita Peddio
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro De Placido
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marianna Tortora
- Regional Coordinating Center for Rare Tumors (CRCTR) of Campania Region at University Federico II, Naples, Italy
| | - Margaret Ottaviano
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, 80131, Italy
| | - Monica Gelzo
- CEINGE, Biotecnologie Avanzate, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Gustavo Cernera
- CEINGE, Biotecnologie Avanzate, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Maria Foggia
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Emanuela Zappulo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Simona Mercinelli
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Letizia Cattaneo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Alessia Sardanelli
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Giulio Viceconte
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Riccardo Scotto
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Nicola Schiano Moriello
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Alberto Servetto
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giovannella Palmieri
- Regional Coordinating Center for Rare Tumors (CRCTR) of Campania Region at University Federico II, Naples, Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, Naples, Italy.
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Regional Coordinating Center for Rare Tumors (CRCTR) of Campania Region at University Federico II, Naples, Italy
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Zhu B, Ouda R, Kasuga Y, de Figueiredo P, Kobayashi KS. NLRC5/MHC class I transactivator: A key target for immune escape by SARS-CoV-2. Bioessays 2024; 46:e2300109. [PMID: 38461519 DOI: 10.1002/bies.202300109] [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: 06/22/2023] [Revised: 09/11/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024]
Abstract
Antigen presentation to CD8+ T cells by MHC class I molecules is essential for host defense against viral infections. Various mechanisms have evolved in multiple viruses to escape immune surveillance and defense to support viral proliferation in host cells. Through in vitro SARS-CoV-2 infection studies and analysis of COVID-19 patient samples, we found that SARS-CoV-2 suppresses the induction of the MHC class I pathway by inhibiting the expression and function of NLRC5, a major transcriptional regulator of MHC class I genes. In this review, we discuss the molecular mechanisms for suppression of the MHC class I pathway and clinical implications for COVID-19.
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Affiliation(s)
- Baohui Zhu
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryota Ouda
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yusuke Kasuga
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Paul de Figueiredo
- Christopher S Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA
- Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, Missouri, USA
- Department of Veterinary Pathobiology, University of Missouri, Columbia, Missouri, USA
| | - Koichi S Kobayashi
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
- Institute for Vaccine Research and Development (IVReD), Hokkaido University, Sapporo, Hokkaido, Japan
- Department of Microbial Pathogenesis and Immunology, Texas A&M Health Science Center, Bryan, Texas, USA
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3
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Agbarya A, Sarel I, Ziv-Baran T, Schwartz O, Shechtman Y, Kozlener E, Khoury R, Sheikh-Ahmad M, Saiegh L, Swaid F, Ahmad AA, Janzic U, Brenner R. Response Rate of the Third and Fourth Doses of the BNT162b2 Vaccine Administered to Cancer Patients Undergoing Active Anti-Neoplastic Treatments. Diseases 2023; 11:128. [PMID: 37873772 PMCID: PMC10594524 DOI: 10.3390/diseases11040128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
The BNT162b2 vaccine is globally used for preventing morbidity and mortality related to COVID-19. Cancer patients have had priority for receiving the vaccine due to their diminished immunity. This study reports the response rate of administering the third and fourth vaccine doses to cancer patients receiving active anti-neoplastic treatment. A total of 142 patients received two doses of the mRNA-based BNT162b2 COVID-19 vaccine, while 76 and 25 patients received three and four doses, respectively. The efficacy of the humoral response following two vaccine doses was diminished in cancer patients, especially in the group of patients receiving chemotherapy. In a multivariate analysis, patients who received three and four BNT162b2 vaccine doses were more likely to have antibody titers in the upper tertile compared to patients who received two doses of the vaccine (odds ratio (OR) 7.62 (95% CI 1.38-42.12), p = 0.02 and 17.15 (95% CI 5.01-58.7), p < 0.01, respectively). Unlike the response after two doses, the third and fourth BNT162b2 vaccine booster doses had an increased efficacy of 95-100% in cancer patients while undergoing active treatment. This result could be explained by different mechanisms including the development of memory B cells.
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Affiliation(s)
- Abed Agbarya
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel
| | - Ina Sarel
- Edith Wolfson Medical Center, Oncology Institute, Holon 5822012, Israel;
| | - Tomer Ziv-Baran
- School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
| | - Orna Schwartz
- Microbiology and Immunology Laboratory, Edith Wolfson Medical Center, Holon 5822012, Israel;
| | - Yelena Shechtman
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Ella Kozlener
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Rasha Khoury
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Mohammad Sheikh-Ahmad
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Leonard Saiegh
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Forat Swaid
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Asala Abu Ahmad
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Urska Janzic
- Department of Medical Oncology, University Clinic Golnik, 4202 Golnik, Slovenia;
| | - Ronen Brenner
- Edith Wolfson Medical Center, Oncology Institute, Holon 5822012, Israel;
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Cheli S, Pino MS, Goldzweig G, Scoccianti S, Fabbroni V, Giordano C, Cavalletti V, Bassetti A, Fioretto L. The Relationship Between Covid-19 Risk Perception and Vaccine Hesitancy in Cancer Patients: The Moderating Role of Externalizing Traits. CLINICAL NEUROPSYCHIATRY 2022; 19:355-364. [PMID: 36627943 PMCID: PMC9807116 DOI: 10.36131/cnfioritieditore20220602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective This mixed-methods study aimed to explore the role of externalizing traits in moderating the relationship between COVID-19 risk perception and vaccine hesitancy in patients diagnosed with cancer. A community-based participatory approach - comprising a preliminary qualitative inquiry and a subsequent cross-sectional research - was used to promote effective vaccination campaigns. Method 12 people diagnosed with cancer and 7 cancer professionals were recruited for the qualitative inquiry, 356 people either under cancer treatment or in follow-up care for the cross-sectional research.A phenomenological analysis explored the transcripts of two focus groups. The cross-sectional research tested the hypothesis emerged during the previous qualitative inquiry through self-reported questionnaires and moderated regression. Results Phenomenological analysis suggested a pivotal role of externalizing traits in vaccine hesitancy. Moderated regression revealed how the association between risk perception and vaccine hesitancy is moderated by externalizing traits, even when controlled for treatment adherence. Conclusions In the present study we found a stronger relationship between risk perception and vaccine hesitancy for patients with higher levels of externalizing traits. We suggest that vaccination campaigns should be personality-informed to offer individualized and effective solutions. Patients with externalizing traits may cope dysfunctionally with vaccination campaigns.
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Affiliation(s)
- Simone Cheli
- Center for Psychology and Health, Tages Charity, Florence, Italy, St. John’s University, Rome, Italy,Corresponding author Simone Cheli E-mail:
| | - Maria Simona Pino
- Medical Oncology Unit, Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence, Italy
| | - Gil Goldzweig
- The Academic College of Tel Aviv Yaffo – Tel Aviv, Israel
| | - Silvia Scoccianti
- Radiation Oncology Unit, Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence
| | - Valentina Fabbroni
- Medical Oncology Unit, Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence, Italy
| | - Clara Giordano
- Medical Oncology Unit, Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence, Italy
| | | | - Andrea Bassetti
- Direzione Sanitaria Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence, Italy
| | - Luisa Fioretto
- Medical Oncology Unit, Santa Maria Annunziata Hospital, Department of Oncology, Azienda USL Toscana Centro, Florence, Italy
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Aramini B, Masciale V, Samarelli AV, Tonelli R, Cerri S, Clini E, Stella F, Dominici M. Biological effects of COVID-19 on lung cancer: Can we drive our decisions. Front Oncol 2022; 12:1029830. [PMID: 36300087 PMCID: PMC9589049 DOI: 10.3389/fonc.2022.1029830] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 infection caused by SARS-CoV-2 is considered catastrophic because it affects multiple organs, particularly those of the respiratory tract. Although the consequences of this infection are not fully clear, it causes damage to the lungs, the cardiovascular and nervous systems, and other organs, subsequently inducing organ failure. In particular, the effects of SARS-CoV-2-induced inflammation on cancer cells and the tumor microenvironment need to be investigated. COVID-19 may alter the tumor microenvironment, promoting cancer cell proliferation and dormant cancer cell (DCC) reawakening. DCCs reawakened upon infection with SARS-CoV-2 can populate the premetastatic niche in the lungs and other organs, leading to tumor dissemination. DCC reawakening and consequent neutrophil and monocyte/macrophage activation with an uncontrolled cascade of pro-inflammatory cytokines are the most severe clinical effects of COVID-19. Moreover, neutrophil extracellular traps have been demonstrated to activate the dissemination of premetastatic cells into the lungs. Further studies are warranted to better define the roles of COVID-19 in inflammation as well as in tumor development and tumor cell metastasis; the results of these studies will aid in the development of further targeted therapies, both for cancer prevention and the treatment of patients with COVID-19.
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Affiliation(s)
- Beatrice Aramini
- Division of Thoracic Surgery, Department of Experimental, Diagnostic and Specialty Medicine—DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni—L. Pierantoni Hospital, Forlì, Italy
- *Correspondence: Beatrice Aramini,
| | - Valentina Masciale
- Division of Oncology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Laboratory of Cell Therapy, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Valeria Samarelli
- Laboratory of Cell Therapy, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
- Respiratory Disease Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberto Tonelli
- Respiratory Disease Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Cerri
- Respiratory Disease Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Clini
- Respiratory Disease Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Franco Stella
- Division of Thoracic Surgery, Department of Experimental, Diagnostic and Specialty Medicine—DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni—L. Pierantoni Hospital, Forlì, Italy
| | - Massimo Dominici
- Division of Oncology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Laboratory of Cell Therapy, Department of Medical and Surgical Sciences, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
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Durability of Immune Response to ChAdOx1-nCoV-19 Vaccine in Solid Cancer Patients Undergoing Anticancer Treatment. Vaccines (Basel) 2022; 10:vaccines10101662. [PMID: 36298528 PMCID: PMC9609471 DOI: 10.3390/vaccines10101662] [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: 08/16/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/13/2022] Open
Abstract
There are limited data available about the durability of the immune response after administration of the widely used adenovirus-vectored ChAdOx1-nCoV-19 vaccine in cancer patients. This prospective longitudinal observational study analyzed follow-up data of immunogenic responses 12 weeks after the second dose of the ChAdOx1-nCoV-19 vaccine in 290 oncological patients compared to healthy controls. The study aimed to assess the persistence of the humoral immune response three months after the second dose, and omicron neutralization was also evaluated. Three months after completion of the second vaccine dose, the geometric mean titer of SARS-CoV-2 binding total Ig statistically decreased by 42% compared to those at 4 weeks, and was lower than that of the healthy control. Six percent of patients became seronegative for anti-RBD total Ig. Only 5% (2 of 40 samples) tested positive for surrogate neutralization against SAR-CoV-2 Omicron BA.2. Across different therapy types, a waning in immunogenicity was observed within three months after the second dose of the ChAdOx1 nCoV-19 vaccine, rendering it insufficient at that point to protect against the SAR-CoV-2 Omicron BA.2 variant.
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The Impact of SARS-CoV-2 Pandemic on Patients with Malignant Melanoma at a Romanian Academic Center: A Four-Year Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148499. [PMID: 35886351 PMCID: PMC9317187 DOI: 10.3390/ijerph19148499] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Considering cancer patients may be at an increased risk of severe COVID-19 disease, their oncologic treatment cannot be delayed without risking their oncologic outcomes. Considering this, a comprehensive evaluation is required for the management of malignant diseases such as melanoma. The current study aimed to assess the impact of the COVID-19 pandemic on the delivery of cancer care services for patients diagnosed with malignant melanoma in Romania; to document the difference in patients’ addressability and melanoma staging between the pandemic and pre-pandemic periods; as well as to determine the risk factors responsible for disease progression during the pandemic. We developed a retrospective analysis using a monocentric hospital database to compare the final 24 months of the pre-pandemic era to the first 24 months of the COVID-19 pandemic. All outpatients and inpatients with a diagnosis of malignant melanoma were screened during the study period and included in the analysis if matching the inclusion criteria. A total of 301 patients were included in the study, with 163 cases identified in the 24 months before the COVID-19 pandemic and 138 patients during the first 24 months of the pandemic. It was observed during the first two lockdown periods from March to May 2020, and, respectively, from October to December 2020, that significantly fewer patients with malignant melanoma presented for specialized medical care, while there was a statistically significantly lower proportion of outpatients due to COVID-19 restrictions (18.1% vs. 42.9%). The average Breslow depth was 1.1 mm before the pandemic, compared with 1.8 mm during the pandemic (p-value < 0.001). Third-stage patients were the most prevalent during both study periods, although with a statistically significant difference during the pandemic, with an increase from 90 (55.2%) patients to 94 (68.1%) (p-value < 0.001). The significant risk factors for disease progression were advanced AJCC stage (HR = 3.48), high Breslow index (HR = 3.19), postponed treatment (HR = 2.46), missed appointments (HR = 2.31), anemia at presentation (HR = 1.60), and patient’s age (HR = 1.57). After the pandemic limitations are brought to an end, a broad skin-cancer-screening campaign is warranted to detect the missed cases during COVID-19.
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Mafi AR, Ghanbari Motlagh A, Azadeh P. The Impact of COVID-19 on Cancer Recurrence: A Narrative Review. ARCHIVES OF IRANIAN MEDICINE 2022; 25:450-455. [PMID: 36404512 DOI: 10.34172/aim.2022.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) continues to be a worldwide healthcare problem. While our knowledge of the interaction of cancer and its management with COVID-19 mortality is gradually evolving, there are still many unanswered questions regarding the impact of COVID-19 on cancer and its prognosis. Several factors activated during COVID-19 have been implicated in tumorigenesis and the development of metastasis. Inflammation, hypoxia, reduced levels of angiotensin converting enzyme 2, elevated levels of Interleukin 6 and some other cytokines that are hallmarks of COVID-19 are capable of inducing tumor relapse and metastasis. On the other hand, there are reports that COVID-19 has been associated with cancer cure. Understanding the interaction between COVID-19 and tumor cells is essential for evaluating the potential long-term risks of COVID-19 in cancer patients, and for scheduling necessary preventive and therapeutic interventions. In this review, we briefly overview the potential impacts that COVID-19 might have on tumorigenesis and cancer relapse, as well as the role that COVID-19 might play in cancer remission and cure.
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Affiliation(s)
- Ahmad R Mafi
- Radiation Oncology Department, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari Motlagh
- Radiation Oncology Department, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Azadeh
- Radiation Oncology Department, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Popescu A, Pantea S, Radu D, Gluhovschi A, Dumitru C, Dahma G, Mocanu AG, Neamtu R, Dema S, Tigmeanu CV, Grigoras ML, Pescariu SA, Aabed H, Craina M. The Impact of SARS-CoV-2 Pandemic on Patients Undergoing Radiation Therapy for Advanced Cervical Cancer at a Romanian Academic Center: A Four-Year Retrospective Analysis. Diagnostics (Basel) 2022; 12:diagnostics12061488. [PMID: 35741299 PMCID: PMC9222190 DOI: 10.3390/diagnostics12061488] [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: 05/14/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives: Throughout the COVID-19 pandemic, health systems worldwide adapted to support COVID-19 patients while continuing to provide assistance to patients with other potentially fatal illnesses. While patients with cancer may be at an elevated risk of severe COVID-19-related complications, their oncologic therapies generally cannot be postponed indefinitely without a negative effect on outcomes. Taking this into account, a thorough examination of the therapy management of various cancers is necessary, such as cervical cancer. Therefore, we aimed to develop a retrospective cohort study to measure the impact of the COVID-19 pandemic on the delivery of cancer care services for women diagnosed with cervical cancer staged IB2-IVA, necessitating chemo- and radiotherapy in Romania, as well as determine the difference in cervical cancer staging between the pandemic and pre-pandemic period. Materials and Methods: Using a multicentric hospital database, we designed a retrospective study to compare the last 24 months of the pre-pandemic period to the first 24 months of the SARS-CoV-2 pandemic to evaluate the variation in the proportion of women diagnosed with cervical cancer and the percentage of inoperable cases requiring chemotherapy and radiotherapy, as well as to detail their clinical presentation and other findings. Results: We observed that the likelihood of cervical cancer patients requiring radiation therapy at a later stage than before the pandemic increased by about 20% during the COVID-19 pandemic. Patients at an advanced FIGO stage of cervical cancer had a 3.39 higher likelihood of disease progression after radiotherapy (CI [2.06−4.21], p-value < 0.001), followed by tumor size at diagnosis with a hazard ratio (HR) of 3.12 (CI [2.24−4.00], p-value < 0.001). The factors related to the COVID-19 pandemic, postponed treatment and missed appointments, were also identified as significant risk factors for cervical cancer progression (HR = 2.51 and HR = 2.24, respectively). Conclusions We predict that there will be a considerable rise in cervical cancer cases over the next several years based on existing data and that expanding screening and treatment capacity will attenuate this with a minimal increase in morbidity and fatality.
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Affiliation(s)
- Alin Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - Stelian Pantea
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.P.); (D.R.)
| | - Daniela Radu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.P.); (D.R.)
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - George Dahma
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
| | - Sorin Dema
- Discipline of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Codruta Victoria Tigmeanu
- Department of Technology of Materials and Devices in Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Mirela Loredana Grigoras
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Silvius Alexandru Pescariu
- Department VI, Cardiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Hazzaa Aabed
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.P.); (A.G.); (C.D.); (G.D.); (A.G.M.); (R.N.); (M.C.)
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10
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Li Z, Wei Y, Zhu G, Wang M, Zhang L. Cancers and COVID-19 Risk: A Mendelian Randomization Study. Cancers (Basel) 2022; 14:cancers14092086. [PMID: 35565215 PMCID: PMC9099868 DOI: 10.3390/cancers14092086] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary During the COVID-19 pandemic, cancer patients are regarded as a highly vulnerable population. Given the unavoidable bias and unmeasured confounders in observational studies, the causal effects of cancers on COVID-19 outcomes are largely unknown. In the study, we tried to evaluate the causal effects of cancers on COVID-19 outcomes using the Mendelian randomization (MR) approach. No strong evidence was observed to support a causal role of cancer in COVID-19 development. Previous observational correlations between cancers and COVID-19 outcomes were likely confounded. Large and well-conducted epidemiological studies are required to determine whether cancers causally contribute to increased risk of COVID-19. Abstract Observational studies have shown increased COVID-19 risk among cancer patients, but the causality has not been proven yet. Mendelian randomization analysis can use the genetic variants, independently of confounders, to obtain causal estimates which are considerably less confounded. We aimed to investigate the causal associations of cancers with COVID-19 outcomes using the MR analysis. The inverse-variance weighted (IVW) method was employed as the primary analysis. Sensitivity analyses and multivariable MR analyses were conducted. Notably, IVW analysis of univariable MR revealed that overall cancer and twelve site-specific cancers had no causal association with COVID-19 severity, hospitalization or susceptibility. The corresponding p-values for the casual associations were all statistically insignificant: overall cancer (p = 0.34; p = 0.42; p = 0.69), lung cancer (p = 0.60; p = 0.37; p = 0.96), breast cancer (p = 0.43; p = 0.74; p = 0.43), endometrial cancer (p = 0.79; p = 0.24; p = 0.83), prostate cancer (p = 0.54; p = 0.17; p = 0.58), thyroid cancer (p = 0.70; p = 0.80; p = 0.28), ovarian cancer (p = 0.62; p = 0.96; p = 0.93), melanoma (p = 0.79; p = 0.45; p = 0.82), small bowel cancer (p = 0.09; p = 0.08; p = 0.19), colorectal cancer (p = 0.85; p = 0.79; p = 0.30), oropharyngeal cancer (p = 0.31; not applicable, NA; p = 0.80), lymphoma (p = 0.51; NA; p = 0.37) and cervical cancer (p = 0.25; p = 0.32; p = 0.68). Sensitivity analyses and multivariable MR analyses yielded similar results. In conclusion, cancers might have no causal effect on increasing COVID-19 risk. Further large-scale population studies are needed to validate our findings.
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Affiliation(s)
- Zengbin Li
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China; (Z.L.); (Y.W.); (G.Z.); (M.W.)
| | - Yudong Wei
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China; (Z.L.); (Y.W.); (G.Z.); (M.W.)
| | - Guixian Zhu
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China; (Z.L.); (Y.W.); (G.Z.); (M.W.)
| | - Mengjie Wang
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China; (Z.L.); (Y.W.); (G.Z.); (M.W.)
| | - Lei Zhang
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China; (Z.L.); (Y.W.); (G.Z.); (M.W.)
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: ; Tel.: +86-29-8265-5135
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11
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COVID-19 Pandemic Impact on Surgical Treatment Methods for Early-Stage Cervical Cancer: A Population-Based Study in Romania. Healthcare (Basel) 2022; 10:healthcare10040639. [PMID: 35455816 PMCID: PMC9024750 DOI: 10.3390/healthcare10040639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 12/30/2022] Open
Abstract
Being one of the most common malignancies in young women, cervical cancer is frequently successfully screened around the world. Early detection enables for an important number of curative options that allow for more than 90% of patients to survive more than three years without cancer relapse. Unfortunately, the COVID-19 pandemic put tremendous pressure on healthcare systems and access to cancer care, determining us to develop a study on the influence the pandemic had on surgical care of cervical cancer, and to assess changes in its management and outcomes. A retrospective study design allowed us to compare cervical cancer trends of the last 48 months of the pre-pandemic period with the first 24 months during the COVID-19 pandemic, using the database from the Timis County Emergency Clinical Hospital. New cases of cervical cancer presented to our clinic in more advanced stages (34.6% cases of FIGO stage III during the pandemic vs. 22.4% before the pandemic, p-value = 0.047). These patients faced significantly more changes in treatment plans, postponed surgeries, and postponed radio-chemotherapy treatment. From the full cohort of cervical cancer patients, 160 were early stages eligible for curative intervention who completed a three-year follow-up period. The disease-free survival and overall survival were not influenced by the surgical treatment of choice, or by the SARS-CoV-2 infection (log-rank p-value = 0.449, respectively log-rank p-value = 0.608). The individual risk factors identified for the three-year mortality risk were independent of the SARS-CoV-2 infection and treatment changes during the COVID-19 pandemic. We observed significantly fewer cases of cervical cancer diagnosed per year during the first 24 months of the COVID-19 pandemic, blaming the changes in healthcare system regulations that failed to offer the same conditions as before the pandemic. Even though we did not observe significant changes in disease-free survival of early-stage cervical cancers, we expect the excess of cases diagnosed in later stages to have lower survival rates, imposing the healthcare systems to consider different strategies for these patients while the pandemic is still ongoing.
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12
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Liang X, Chen Y, Fan Y. Bioinformatics approach to identify common gene signatures of patients with coronavirus 2019 and lung adenocarcinoma. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:22012-22030. [PMID: 34775559 PMCID: PMC8590527 DOI: 10.1007/s11356-021-17321-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/28/2021] [Indexed: 02/05/2023]
Abstract
Coronavirus disease 2019 (COVID-19) continues as a global pandemic. Patients with lung cancer infected with COVID-19 may develop severe disease or die. Treating such patients severely burdens overwhelmed healthcare systems. Here, we identified potential pathological mechanisms shared between patients with COVID-19 and lung adenocarcinoma (LUAD). Co-expressed, differentially expressed genes (DEGs) in patients with COVID-19 and LUAD were identified and used to construct a protein-protein interaction (PPI) network and to perform enrichment analysis. We used the NetworkAnalyst platform to establish a co-regulatory of the co-expressed DEGs, and we used Spearman's correlation to evaluate the significance of associations of hub genes with immune infiltration and immune checkpoints. Analysis of three datasets identified 112 shared DEGs, which were used to construct a protein-PPI network. Subsequent enrichment analysis revealed co-expressed genes related to biological process (BP), molecular function (MF), and cellular component (CC) as well as to pathways, specific organs, cells, and diseases. Ten co-expressed hub genes were employed to construct a gene-miRNA, transcription factor (TF)-gene, and TF-miRNA network. Hub genes were significantly associated with immune infiltration and immune checkpoints. Finally, methylation level of hub genes in LUAD was obtained via UALCAN database. The present multi-dimensional study reveals commonality in specific gene expression by patients with COVID-19 and LUAD. These findings provide insights into developing strategies for optimising the management and treatment of patients with LUAD with COVID-19.
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Affiliation(s)
- Xiao Liang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yali Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yuchao Fan
- Department of Anesthesiology, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, No.55, Section 4, Renmin South Road, Chengdu, 610041, Sichuan Province, China.
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13
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Roel E, Pistillo A, Recalde M, Fernández-Bertolín S, Aragón M, Soerjomataram I, Jenab M, Puente D, Prieto-Alhambra D, Burn E, Duarte-Salles T. Cancer and the risk of coronavirus disease 2019 diagnosis, hospitalisation and death: A population-based multistate cohort study including 4 618 377 adults in Catalonia, Spain. Int J Cancer 2022; 150:782-794. [PMID: 34655476 PMCID: PMC8652827 DOI: 10.1002/ijc.33846] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
The relationship between cancer and coronavirus disease 2019 (COVID-19) infection and severity remains poorly understood. We conducted a population-based cohort study between 1 March and 6 May 2020 describing the associations between cancer and risk of COVID-19 diagnosis, hospitalisation and COVID-19-related death. Data were obtained from the Information System for Research in Primary Care (SIDIAP) database, including primary care electronic health records from ~80% of the population in Catalonia, Spain. Cancer was defined as any primary invasive malignancy excluding non-melanoma skin cancer. We estimated adjusted hazard ratios (aHRs) for the risk of COVID-19 (outpatient) clinical diagnosis, hospitalisation (with or without a prior COVID-19 diagnosis) and COVID-19-related death using Cox proportional hazard regressions. Models were estimated for the overall cancer population and by years since cancer diagnosis (<1 year, 1-5 years and ≥5 years), sex, age and cancer type; and adjusted for age, sex, smoking status, deprivation and comorbidities. We included 4 618 377 adults, of which 260 667 (5.6%) had a history of cancer. A total of 98 951 individuals (5.5% with cancer) were diagnosed, and 6355 (16.4% with cancer) were directly hospitalised with COVID-19. Of those diagnosed, 6851 were subsequently hospitalised (10.7% with cancer), and 3227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% confidence interval [1.05-1.11]), direct COVID-19 hospitalisation (1.33 [1.24-1.43]) and death following hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions.
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Affiliation(s)
- Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - María Aragón
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - Mazda Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Edward Burn
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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14
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Mortality of covid-19 pneumonia during anticancer treatment in lung cancer patients. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp211120018b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim: The COVID-19 pandemic has multiple impacts on the management
of cancer patients. Treatment of malignancies, including chemotherapy,
targeted therapy, immunotherapy and radiotherapy, can suppress the immune
system and lead to the development of severe complications of COVID-19
infection. The aim of this study was to determine the mortality of lung
cancer (LC) patients, in whom the COVID-19 infection was confirmed during
active antitumor treatment. Methods: This retrospective study was conducted
at the Institute for Pulmonary Diseases of Vojvodina. All patients included
in the study underwent active anticancer treatment at the time of diagnosis
of COVID-19. SARS-CoV-2 infection was determined with polymerase chain
reaction test (PCR). Patient data were collected using the institutional
database and observed period was from November 20, 2020 to June 5, 2021.
Statistical analysis of the derived patient?s data using the multivariate
and univariate testing. Results: Out of total 828 observed COVID-19
hospitalized patients 81 were LC patient on active antitumor treatment.
Patients were predominantly male (67.9%), smokers (55.6%), 66.47 years old
(range 43-83). Majority of patients (50.6%) were Eastern Cooperative
Oncology Group performance status (ECOG PS) 1 and 83.9% had at least one
comorbidity. The most common comorbidities were arterial hypertension
(66.7%), chronic obstructive pulmonary disease (COPD) (28.4%) and diabetes
(21%). Obesity, congestive heart failure and other cardiovascular diseases
were present in 11%, 6.2% and 7.4% of patients. The most common was
adenocarcinoma (33.3%), followed by squamous (30.9%) and small-cell lung
cancer (24.7%). Predominantly 63% of the patients were in stage III of
disease and 33.3% were in stage IV. Metastases were most commonly present in
the contralateral lung/pleura (14.8%), brain (6.2%), bone (3.7%) and liver
(3.7%). Systemic anticancer therapy was applied in 37/81 patients (45.6%),
chest radiotherapy in 35/81 (43.2%), concurrent chemoradiotherapy in 1/81
(1.2%) and other types of radiotherapy in 8/81 patients (9.87%). The most
common forms of systemic therapy were chemotherapy (35.8%), immunotherapy
(7.4%) and targeted therapy (2.4%) patients. Most common chemotherapy was
cisplatin-based regiment applied in 34.6% of patients. The mortality from
COVID-19 was 19.8%. The statistically significance in relation to the type
of treatment was not observed (p = 0.973). Statistical significance was
observed between mortality and ECOG PS (p = 0.011). Conclusions: LC patients
are dependent on antitumor treatment and at the same time highly susceptible
to potential infection. In this study we did not find statistically
significant differences in mortality related to the type of antitumor
treatment in COVID-19 positive LC patients. Further detailed research on
larger scale is needed to be performed in order to explore the effects of
SARS-CoV-2 on cancer patients. All possible methods of protection against
SARS-CoV-2 virus should be performed in order to minimize the risk of
infection in all but especially in immunocompromised cancer patients.
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15
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Special aspects of medical care for cancer patients during COVID-19 pandemic. ARCHIVE OF ONCOLOGY 2022. [DOI: 10.2298/aoo210205002p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The biggest challenge for the World Health Organization today is the fight against the COVID-19 pandemic. The current situation prompted major adjustments in the system of cancer care. In this review, we investigate the aspects of cancer treatment and care during the pandemic, since in this setting oncological services face challenges in determining the feasibility of anticancer treatments while minimizing the risk of infection. Cancer patients are at a higher risk from COVID-19 disease. Therefore, oncological community is discussing on the priorities for providing cancer therapies and care and at the same time minimizing the risk of infection.
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16
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Schoonbeek RC, de Jel DVC, van Dijk BAC, Willems SM, Bloemena E, Hoebers FJP, van Meerten E, Verbist BM, Smeele LE, Halmos GB, Merkx MAW, Siesling S, De Bree R, Takes RP. Fewer head and neck cancer diagnoses and faster treatment initiation during COVID-19 in 2020: A nationwide population-based analysis. Radiother Oncol 2021; 167:42-48. [PMID: 34915063 PMCID: PMC8667560 DOI: 10.1016/j.radonc.2021.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
Background Inevitably, the emergence of COVID-19 has impacted non-COVID care. Because timely diagnosis and treatment are essential, especially for patients with head and neck cancer (HNC) with fast-growing tumours in a functionally and aesthetically important area, we wished to quantify the impact of the COVID-19 pandemic on HNC care in the Netherlands. Material and Methods This population-based study covered all, in total 8468, newly diagnosed primary HNC cases in the Netherlands in 2018, 2019 and 2020. We compared incidence, patient and tumour characteristics, primary treatment characteristics, and time-to-treatment in the first COVID-19 year 2020 with corresponding periods in 2018 and 2019 (i.e. pre-COVID). Results The incidence of HNC was nearly 25% less during the first wave (n = 433) than in 2019 (n = 595) and 2018 (n = 598). In April and May 2020, the incidence of oral cavity and laryngeal carcinomas was significantly lower than in pre-COVID years. There were no shifts in tumour stage or alterations in initial treatment modalities. Regardless of the first treatment modality and specific period, the median number of days between first visit to a HNC centre and start of treatment was significantly shorter during the COVID-19 year (26–28 days) than pre-COVID (31–32 days, p < 0.001). Conclusion The incidence of HNC during the Netherlands’ first COVID-19 wave was significantly lower than expected. The expected increase in incidence during the remainder of 2020 was not observed. Despite the overloaded healthcare system, the standard treatment for HNC patients could be delivered within a shorter time interval.
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Affiliation(s)
- Rosanne C Schoonbeek
- University of Groningen, University Medical Center Groningen, Department of Otorhinolaryngology and Head and Neck Surgery, Groningen, The Netherlands.
| | - Dominique V C de Jel
- Dutch Institute for Clinical Auditing, Scientific Bureau, Leiden, The Netherlands; Netherlands Cancer Institute/Antoni van Leeuwenhoek, Department of Head and Neck Oncology and Surgery, Amsterdam, The Netherlands
| | - Boukje A C van Dijk
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Stefan M Willems
- University of Groningen, University Medical Center Groningen, Department of Pathology, Groningen, The Netherlands
| | - Elisabeth Bloemena
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Pathology, The Netherlands
| | - Frank J P Hoebers
- Maastricht University Medical Centre Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, The Netherlands
| | - Esther van Meerten
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, The Netherlands
| | - Berit M Verbist
- Leiden University Medical Center, Department of Radiology, The Netherlands
| | - Ludi E Smeele
- Netherlands Cancer Institute/Antoni van Leeuwenhoek, Department of Head and Neck Oncology and Surgery, Amsterdam, The Netherlands; Amsterdam University Medical Center, University of Amsterdam, Department of Oral and Maxillofacial Surgery, The Netherlands
| | - György B Halmos
- University of Groningen, University Medical Center Groningen, Department of Otorhinolaryngology and Head and Neck Surgery, Groningen, The Netherlands
| | - Matthias A W Merkx
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Utrecht, The Netherlands; Radboud University Medical Center, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Utrecht, The Netherlands; University of Twente, Department of Health Technology and Services Research, Technical Medical Centre, Enschede, The Netherlands
| | - Remco De Bree
- University Medical Center Utrecht, Department of Head and Neck Surgical Oncology, The Netherlands
| | - Robert P Takes
- Radboud University Medical Center, Department of Otolaryngology/Head and Neck Surgery, Nijmegen, the Netherlands
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17
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Meiners J, Jansen K, Gorbokon N, Büscheck F, Luebke AM, Kluth M, Hube-Magg C, Höflmayer D, Weidemann S, Fraune C, Möller K, Bernreuther C, Lebok P, Menz A, Jacobsen F, Clauditz T, Sauter G, Uhlig R, Wilczak W, Izbicki J, Perez D, Minner S, Burandt E, Krech T, Marx A, Simon R, Steurer S. Angiotensin-Converting Enzyme 2 Protein Is Overexpressed in a Wide Range of Human Tumour Types: A Systematic Tissue Microarray Study on >15,000 Tumours. Biomedicines 2021; 9:biomedicines9121831. [PMID: 34944647 PMCID: PMC8698714 DOI: 10.3390/biomedicines9121831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023] Open
Abstract
Angiotensin-converting enzyme 2 (ACE2) is a regulator in the renin-angiotensin system. ACE2 expression was analysed immunohistochemically in 15,306 samples from 119 tumour types and in 608 samples of 76 normal tissue types. In normal tissue, ACE2 was most abundant in testis and corpus luteum, kidney, small intestine and capillaries of selected organs. At least an occasional weak ACE2 positivity of tumour cells was seen in 83 of 119 (70%) tumour types. ACE2 tumour cell positivity was particularly frequent in papillary (94%) and clear cell (86%) renal cell carcinoma, colorectal adenocarcinoma (81%), mucinous ovarian cancer (61%), cholangiocarcinoma (58%), hepatocellular carcinoma (56%), and in adenocarcinomas of the stomach (47%), pancreas (42%), and the lung (35%). ACE2-positive capillaries were found in 409/12,644 (3%) of analysable tumours, most frequently in tumours with endocrine/neuroendocrine activity. Presence of ACE2-positive capillaries was linked to low stage in papillary thyroid cancer and low grade in neuroendocrine neoplasms. In conclusion, ACE2 expression can occur both in tumour cells and tumour-associated capillaries in a broad variety of different tumour types at highly variable frequencies.
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Affiliation(s)
- Jan Meiners
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Kristina Jansen
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Franziska Büscheck
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Andreas M. Luebke
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Martina Kluth
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Doris Höflmayer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Sören Weidemann
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Christoph Fraune
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Katharina Möller
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Christian Bernreuther
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Patrick Lebok
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Anne Menz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Frank Jacobsen
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Till Clauditz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Guido Sauter
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Ria Uhlig
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Jakob Izbicki
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Daniel Perez
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Sarah Minner
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Eike Burandt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Till Krech
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Clinical Centre Osnabrueck, Institute of Pathology, 49074 Osnabrueck, Germany
| | - Andreas Marx
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Correspondence: ; Tel.: +49-40-7410-57214
| | - Stefan Steurer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
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Cioffi R, Sabetta G, Rabaiotti E, Bergamini A, Bocciolone L, Candotti G, Candiani M, Valabrega G, Mangili G, Pignata S. Impact of COVID-19 on medical treatment patterns in gynecologic oncology: a MITO group survey. Int J Gynecol Cancer 2021; 31:1363-1368. [PMID: 34426526 PMCID: PMC8384495 DOI: 10.1136/ijgc-2021-002784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/05/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE COVID-19 is a global public health emergency. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological tumors. The Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) performed a survey to evaluate the impact of the COVID-19 pandemic on medical treatment of gynecological cancer, with a focus on chemotherapy and oral treatment with poly(ADP)-ribose polymerase inhibitors (PARP-i). METHODS The survey consisted of a self-administered online questionnaire, sent via email between November 2020 and January 2021 to all members of MITO group. RESULTS Forty-nine centers completed the questionnaire. The majority of respondents (83%) use screening tests to determine COVID-19 status in patients who were to undergo chemotherapy or oral medications. All respondents to our survey continued cancer therapy in patients who tested negative for COVID-19 during the pandemic. Seventy-three percent of respondents declared they stopped treatment with chemotherapy or PARP-i only after a positive swab and resumed therapy when negative tests were confirmed. CONCLUSIONS COVID-19 positivity impacted patterns of treatment in patients diagnosed with ovarian cancer within the MITO group. Further investigations are needed to evaluate whether these modifications influence oncological clinical outcomes.
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Affiliation(s)
- Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Sabetta
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Bocciolone
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgio Candotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Pignata
- Department of Uro-Gynecological Oncology, Istituto Nazionale Tumori "Fondazione G Pascale" IRCCS, Naples, Italy
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19
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General practice attendances among patients attending a post-COVID-19 clinic: a pilot study. BJGP Open 2021; 5:BJGPO.2021.0016. [PMID: 33757962 PMCID: PMC8278502 DOI: 10.3399/bjgpo.2021.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background About 10–35% of people with COVID-19 need medical care within 3 weeks of infection. However, the prevalence of ongoing care needs among those experiencing severe COVID-19 illness is unclear. Aim This pilot study aimed to address this knowledge gap by examining GP attendance trends among patients attending a post-COVID-19 hospital follow-up clinic, 3–6 months after an initial clinic visit. Design & setting Data were collected from adult patients attending a post-COVID-19 follow-up clinic at the Mater Misericordiae University Hospital (MMUH), Dublin, Ireland. Method Participants completed questionnaires outlining their demographics; medical histories; emergency hospital admissions and readmissions where applicable; and, where relevant, GP attendances following hospital discharge. Analyses were conducted using descriptive and inferential statistics. Results Participants’ (n = 153) median age was 43.5 years (interquartile range [IQR] = 30.9–52.1 years). There were 105 females (68.6%, 95% confidence interval [CI] = 61.3% to 75.9%). Various medical histories were reported among participants. Sixty-seven (43.2%, 95% CI = 35.9% to 51.6%) received emergency COVID-19 hospital care. Older adults, males, intensive care unit [ICU] admissions, and readmissions were common among hospital attendees. Of the hospital attendees, 16 (24%, 95% CI = 13.7% to 34.2%) attended GPs within 7 days of hospital discharge, and 26 (39%, 95% CI = 27.3% to 50.7%) within 30 days. Older adults, people with pre-existing medical conditions, and individuals admitted to ICU and/or readmitted to hospital were common among general practice attendees. Conclusion Persistent health issues appear to be common among patients with severe COVID-19, particularly those who are older adults, have pre-existing health problems, and who had been in ICU and/or readmission care. Larger scale studies of ongoing COVID-19 care needs in primary care and general practice are required.
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