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Santarelli IM, Sierra M, Fernández SI. Screening for SARS-COV-2 Using RT-qPCR in Patients with Hematologic Neoplasms Receiving Chemotherapy. Prague Med Rep 2023; 124:33-39. [PMID: 36763829 DOI: 10.14712/23362936.2023.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
It has been recommended that patients with leukaemias and lymphomas undergo universal screening for SARS-COV-2 using RT-qPCR before each treatment on the grounds of their high risk of experiencing severe forms of COVID-19. This raises a conflict with different recommendations which prioritise testing symptomatic patients. We found that among 56 RT-qPCR obtained in asymptomatic patients with hematologic neoplasms before chemotherapy administration, 2 (3.5%) were positive. A negative result did not exclude SARS-COV-2 infection in 1 patient (1.8%). It is unclear what the benefit of screening for SARS-COV-2 using RT-qPCR in patients with hematologic neoplasms who receive chemotherapy is.
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Affiliation(s)
- Ignacio Martín Santarelli
- Departamento de Medicina, Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina. .,Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Mariela Sierra
- División de Infectología, Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina.,Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Sofía Isabel Fernández
- Departamento de Medicina, Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina.,Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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Cortellini A, Aguilar-Company J, Salazar R, Bower M, Sita-Lumsden A, Plaja A, Lee AJX, Bertuzzi A, Tondini C, Diamantis N, Martinez-Vila C, Prat A, Apthorp E, Gennari A, Pinato DJ. Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer. Br J Cancer 2022; 127:1787-1792. [PMID: 35995934 PMCID: PMC9395853 DOI: 10.1038/s41416-022-01952-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Consolidated evidence suggests spontaneous immunity from SARS-CoV-2 is not durable, leading to the risk of reinfection, especially in the context of newly emerging viral strains. In patients with cancer who survive COVID-19 prevalence and severity of SARS-CoV-2 reinfections are unknown. METHODS We aimed to document natural history and outcome from SARS-CoV-2 reinfection in patients recruited to OnCovid (NCT04393974), an active European registry enrolling consecutive patients with a history of solid or haematologic malignancy diagnosed with COVID-19. RESULTS As of December 2021, out of 3108 eligible participants, 1806 COVID-19 survivors were subsequently followed at participating institutions. Among them, 34 reinfections (1.9%) were reported after a median time of 152 days (range: 40-620) from the first COVID-19 diagnosis, and with a median observation period from the second infection of 115 days (95% CI: 27-196). Most of the first infections were diagnosed in 2020 (27, 79.4%), while most of reinfections in 2021 (25, 73.5%). Haematological malignancies were the most frequent primary tumour (12, 35%). Compared to first infections, second infections had lower prevalence of COVID-19 symptoms (52.9% vs 91.2%, P = 0.0008) and required less COVID-19-specific therapy (11.8% vs 50%, P = 0.0013). Overall, 11 patients (32.4%) and 3 (8.8%) were fully and partially vaccinated against SARS-CoV-2 before the second infection, respectively. The 14-day case fatality rate was 11.8%, with four death events, none of which among fully vaccinated patients. CONCLUSION This study shows that reinfections in COVID-19 survivors with cancer are possible and more common in patients with haematological malignancies. Reinfections carry a 11% risk of mortality, which rises to 15% among unvaccinated patients, highlighting the importance of universal vaccination of patients with cancer.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Badalona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Aleix Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | | | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Gatineau J, Nidercorne C, Dupont A, Puiffe ML, Cohen JL, Molinier-Frenkel V, Niedergang F, Castellano F. IL4I1 binds to TMPRSS13 and competes with SARS-CoV-2 spike. Front Immunol 2022; 13:982839. [PMID: 36131918 PMCID: PMC9483092 DOI: 10.3389/fimmu.2022.982839] [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: 06/30/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022] Open
Abstract
The secreted enzyme interleukin four-induced gene 1 (IL4I1) is involved in the negative control of the adaptive immune response. IL4I1 expression in human cancer is frequent and correlates with poor survival and resistance to immunotherapy. Nevertheless, its mechanism of action remains partially unknown. Here, we identified transmembrane serine protease 13 (TMPRSS13) as an immune cell-expressed surface protein that binds IL4I1. TMPRSS13 is a paralog of TMPRSS2, of which the protease activity participates in the cleavage of SARS-CoV-2 spike protein and facilitates virus induced-membrane fusion. We show that TMPRSS13 is expressed by human lymphocytes, monocytes and monocyte-derived macrophages, can cleave the spike protein and allow SARS-CoV-2 spike pseudotyped virus entry into cells. We identify regions of homology between IL4I1 and spike and demonstrate competition between the two proteins for TMPRSS13 binding. These findings may be relevant for both interfering with SARS-CoV-2 infection and limiting IL4I1-dependent immunosuppressive activity in cancer.
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Affiliation(s)
| | | | | | | | - José L. Cohen
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France
- AP-HP, Hopital H Mondor, CIC Biotherapies, Créteil, France
| | - Valérie Molinier-Frenkel
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France
- AP-HP, Hopital Henri Mondor, Departement d’Hematologie-Immunologie, Créteil, France
- *Correspondence: Flavia Castellano, ; Florence Niedergang, ; Valérie Molinier-Frenkel,
| | - Florence Niedergang
- Université Paris Cité, CNRS, INSERM, Institut Cochin, CNRS, Paris, France
- *Correspondence: Flavia Castellano, ; Florence Niedergang, ; Valérie Molinier-Frenkel,
| | - Flavia Castellano
- Univ Paris Est Creteil, INSERM, IMRB, Creteil, France
- AP-HP, Hopital Henri Mondor, Plateforme des Ressources Biologiques, Créteil, France
- *Correspondence: Flavia Castellano, ; Florence Niedergang, ; Valérie Molinier-Frenkel,
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Risk stratification by anamnesis increases SARS-CoV-2 test efficiency in cancer patients. Strahlenther Onkol 2021; 198:354-360. [PMID: 34618171 PMCID: PMC8494759 DOI: 10.1007/s00066-021-01853-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To evaluate the impact of testing asymptomatic cancer patients, we analyzed all tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) before and during radiotherapy at a tertiary cancer center throughout the second wave of the pandemic in Germany. Methods Results of all real-time polymerase chain reaction (RT-PCR) tests for SARS-CoV‑2 performed at our radio-oncology department between 13 October 2020 and 11 March 2021 were included. Clinical data and anamnestic information at the time of testing were documented and examined for (i) the presence of COVID-19-related symptoms and (ii) virus-related anamnesis (high-risk [prior positive test or contact to a positive tested person within the last 14 days] or low-risk [inconspicuous anamnesis within the last 14 days]). Results A total of 1056 SARS-CoV‑2 tests in 543 patients were analyzed. Of those, 1015 tests were performed in asymptomatic patients and 41 tests in patients with COVID-19-associated symptoms. Two of 940 (0.2%) tests in asymptomatic patients with low-risk anamnesis and three of 75 (4.0%) tests in asymptomatic patients with high-risk anamnesis showed a positive result. For symptomatic patients, SARS-CoV‑2 was detected in three of 36 (8.3%) low-risk and three of five (60.0%) high-risk tests. Conclusion To the best of our knowledge, this is the first study evaluating the correlation between individual risk factors and positivity rates of SARS-CoV‑2 tests in cancer patients. The data demonstrate that clinical and anamnestic assessment is a simple and effective measure to distinctly increase SARS-CoV‑2 test efficiency. This might enable cancer centers to adjust test strategies in asymptomatic patients, especially when test resources are scarce. Supplementary Information The online version of this article (10.1007/s00066-021-01853-7) contains supplementary material, which is available to authorized users.
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Fares AF, Fadul LA, Benetton B, Nogueira ML, Lanza M, Araújo DV. Systematic SARS-CoV-2-testing for asymptomatic cancer patients treated at a public healthcare tertiary centre in Brazil. Ecancermedicalscience 2021; 15:1269. [PMID: 34567254 PMCID: PMC8426015 DOI: 10.3332/ecancer.2021.1269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has had enormous consequences in Brazil and worldwide. Patients with cancer affected by COVID-19 are at a higher risk of developing complications and worse outcomes compared to the non-cancer population, particularly the ones on active systemic treatment. Considering the COVID-19’s high transmissibility in asymptomatic and pre-symptomatic patients, we sought to determine the prevalence of COVID-19 infection in patients with solid cancers receiving systemic therapy in a Brazilian public health hospital. Furthermore, we studied whether socio-economic status was associated with prevalence. Methods Consecutive asymptomatic patients undergoing treatment for solid tumours at the chemotherapy and infusion centre of Hospital de Base were enrolled. Patients were prospectively tested for severe acute respiratory syndrome coronavirus 2 RNA real-time polymerase chain reaction with nasal and oropharyngeal swabs immediately prior to treatment. A socio-economic survey was carried out prior to testing. Demographic and socio-economic characteristics were summarised in means, medians and proportions. Results From 6 to 13 October 2020, 148 asymptomatic patients were identified. Of those, 41 were excluded, leaving 107 eligible patients. The mean age of the population was 58 years (SD ± 12.6); 54% were female and 90% were self-identified as White. The most common cancer sites were gastrointestinal tract (36%) and breast (25%). Most patients had a metastatic disease (59%) and were on anticancer treatment involving chemotherapy (95%). Regarding socio-economic status, 46% of our population had either primary school or illiterate as their highest educational level. In terms of monthly income, 92% had a personal income inferior to U$380 and 88% a household income inferior to U$585. Of the 107 patients tested, only 1 (0.9%) was positive for COVID-19. This is a 48-year-old man living in an urban area, with primary school educational level and a monthly personal income inferior to U$390. Conclusion Despite a high prevalence of COVID-19 in Brazil, our cohort demonstrated a low prevalence of COVID-19 (0.9%) amongst asymptomatic patients with cancer. We hypothesise that patients with cancer, independent of their socio-economic status, are aware of the increased risk of developing a severe disease and are adherent to physical distancing, masking and hygiene measures.
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Affiliation(s)
- Aline F Fares
- Department of Medical Oncology, Hospital de Base-HB Onco, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
| | - Luiza A Fadul
- Department of Medical Oncology, Hospital de Base-HB Onco, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
| | - Barbara Benetton
- Department of Medical Oncology, Hospital de Base-HB Onco, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
| | - Mauricio L Nogueira
- Department Infectious Diseases, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
| | - Marcia Lanza
- Department of Medical Oncology, Hospital de Base-HB Onco, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
| | - Daniel V Araújo
- Department of Medical Oncology, Hospital de Base-HB Onco, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, 15090-000, Brazil
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