COVID-19 and Cancer Patients

COVID-19 has now been declared a global pandemic with evolving incidence rates and fatalities. It is important to identify vulnerable populations who will be impacted most by this pandemic leading to higher mortality rates compared to the general healthy population. Although older patients and patients with co-morbidities fall into this vulnerable group, patients with hematologic and oncologic malignancies on active cytotoxic treatments are at even greater risk as they are both myelosuppressed and immunosuppressed. In addition to following the universal guidelines recommended by the Centers for Disease Control (CDC), it is important to also institute guidelines for cancer centers to help protect this vulnerable population. We review the current data, risks, and recommendations for COVID-19 in cancer patients.

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The Biochemical Effect of Smoking on the Response to Chemotherapy

Revista de Chimie ◽

10.37358/rc.19.8.7448 ◽

2019 ◽

Vol 70 (8) ◽

pp. 2879-2882

Author(s):

Oana Miron ◽

Adina Magdalena Turcanu ◽

Bogdan Mihnea Ciuntu ◽

Vladimir Poroch ◽

Daniel Timofte

Keyword(s):

Cancer Patients ◽

Psychological Symptoms ◽

Smoking Status ◽

Symptom Burden ◽

Mortality Rates ◽

Incidence Rates ◽

Healthy Population ◽

Biochemical Effect ◽

Number Of Patients ◽

Response To Chemotherapy

Improvements in early detection of cancer have led to an important decrease in mortality rates of cancer. Given the increased incidence rates and decreased mortality rates, the number of patients surviving cancer is rapidly increasing. Although cancer patients face many physical and psychological symptoms, they also continue to engage in poor health behaviors at rates similar to those of the general-healthy population. The prime example of such unhealthy behavior is smoking. The reports show that smoking rates at the time of diagnosis of cancer vary from 10% to 95%. Our study analyzed how the smoking status influenced the outcome of chemotherapy of 249 patients suffering from various forms of cancer. Our statistical analysis showed that patients who smoked had a significant different response to chemotherapy compared to their nonsmoking peers. This meant that in our sample of 149 cancer suffering patients, individuals who did not smoke had a significant better chance of a partial positive response after chemotherapy compared to patients who smoked regularly. Therefore, tobacco smoking is an adverse prognostic factor associated with a resistance to chemotherapy. These results are important given the fact that cancer patients already face a combination of unpleasant symptoms related to their disease but also from the side effects of their treatment. Uncovering the exact mechanisms through which smoking is affecting the outcome of chemotherapy may help in increasing the quality of life, the symptom burden or the final outcome of chemotherapy.

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The Effect of COVID-19 on Hospitalized Cancer Patients and Their Healthcare

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34435 ◽

2021 ◽

pp. 699-703

Author(s):

Jahnvi Garg ◽

Ranjit S. Ambad ◽

Nandkishor Bankar

Keyword(s):

Cancer Patients ◽

Virus Disease ◽

Rt Pcr ◽

Vulnerable Group ◽

Healthcare Facilities ◽

Corona Virus ◽

Global Pandemic ◽

The World ◽

Utmost Care ◽

Staying At Home

Introduction: This article includes the effect of Corona virus disease on cancer patients and their healthcare facilities. The global pandemic mentioned around the world has impacted the most vulnerable group of patients- cancer. With the assistance of RT PCR tests and HRCT, oncologists and doctors have tried to provide treatment to Covid-19 patients. Cancer patients are more susceptible to Covid-19 than non-cancer or non-survivor patients, according to reports. To avoid the prevalence and infection of cancer victims, WHO has suggested staying at home and continuing their treatment through telemedicine unless the situation is critical for which they might require therapy and/or surgery. Covid-19 is here to stay so we should practice with utmost care and precaution.

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Research of the epidemiology on cancer of the trachea, bronchi, lungs as important components in the development of effective directions for increasing the effectiveness of pharmaceutical support for cancer patients

ScienceRise Pharmaceutical Science ◽

10.15587/2519-4852.2021.230346 ◽

2021 ◽

pp. 72-80

Author(s):

Yurii Pulnyi ◽

Hanna Panfilova ◽

Ellona Shelkova ◽

Oleksandr Kabachnyi ◽

Vitaly Chernukha

Keyword(s):

Cancer Patients ◽

Mortality Rates ◽

Epidemiological Studies ◽

Incidence Rates ◽

Morbidity And Mortality ◽

Positive Trend ◽

Female Patients ◽

Incidence And Mortality ◽

Male Cohort ◽

Epidemiological Profile

The aim: to conduct epidemiological studies on cancer of the trachea, bronchi, lungs as important components in the development of effective directions for increasing the effectiveness of pharmaceutical support for cancer patients in Ukraine. Materials and methods. The study used data from special literature, which presents the results of research on cancer in different countries of the world and data from the National Cancer Registry from 2014-2019 by indicators of morbidity and mortality of the population of Ukraine from cancer of the trachea, bronchi and lungs, including by gender. General theoretical (historical, analytical-comparative, systemic, graphic, logical, hypothetical-deductive) and applied (mathematical-statistical, epidemiological) research methods were used. Results. It was found that during 2014-2018 in terms of morbidity and mortality of the population from cancer of the trachea, bronchi and lungs in Ukraine, there was a positive dynamics of decline. So, in terms of incidence rates, which are standardized by WHO in 2018, the data decreased compared to 2014 by 8.4 %, and according to the “Ukrainian standard” – by 7.0 %. Mortality rates, which were standardized by WHO, decreased in 2018 compared to 2014 by 12.1 %, and those presented according to the “Ukrainian standard” – by 11.1 %. It was proved that the average data on morbidity and mortality of male patients were 6.2 and 7.4 times higher than in the same data for female patients. The different nature of changes in morbidity and mortality rates of patients in accordance with their gender in the dynamics of years has been established. So, for the female cohort of patients, the incidence and mortality rate from cancer of the trachea, bronchi and lungs during 2014-2018 had a complex zigzag character of changes, and in 2019, compared with the data of 2014, they increased by 22.54 % and 23.6 %, respectively. In the male cohort of patients, we observed a positive trend towards a decrease in mortality during 2014-2019. So, in 2019, these indicators reached their minimum and were equal to 57.0 and 44.0 cases per 100 thousand population. According to the data of 2019, the incidence and mortality of men from cancer of the trachea, bronchi and lungs relative to the data of 2014 decreased by 21.4 % and 25.0 %, respectively. It looks encouraging that there was relatively little fluctuation during 2014-2019 epidemiological indicators, both in general for the entire population of patients and female patients. Conclusions. The established characteristics and trends in the formation of the onco-epidemiological profile of the country's population for trachea, bronchus and lung cancer in dynamics over the years necessitate further research, taking into account changes in the main demographic indicators development of society

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COVID-19 in Immunocompromised Cancer Patients: A Case Series and Review of the Literature

Cancer Control ◽

10.1177/10732748211044361 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110443

Author(s):

Raj H. Patel ◽

Rachana Vanaparthy ◽

John N. Greene

Keyword(s):

Cancer Patients ◽

Case Series ◽

The Novel ◽

Review Of The Literature ◽

Vulnerable Group ◽

Potential Threat ◽

Healthcare Facilities ◽

Global Pandemic ◽

Cancer Care Continuum ◽

Novel Coronavirus

The global pandemic of the novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented newfound challenges to the oncology community regarding management of disease progression in immunocompromised and cancer patients. Further, the large influx of COVID-19 patients has overwhelmed healthcare facilities, limited access to intensive care unit beds and ventilators, and canceled elective surgeries causing disruptions to the cancer care continuum and re-organization of oncological care. While it is known that the potential threat of infection is greatest in elderly patients (>60 years of age) and patients with underlying comorbidities, there is still insufficient data to determine the risk of COVID-19 in cancer patients. Given the immunosuppressive status in cancer patients arising from chemotherapy and other comorbidities, management of COVID-19 in this patient population carries a unique set of challenges. We report three cases of COVID-19 in immunocompromised cancer patients and discuss the challenges in preventing, diagnosing, and treating this vulnerable group.

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Psychological Impact of Coronavirus (COVID-19) Disease on Cancer Patients

Coronaviruses ◽

10.2174/2666796701999210101151035 ◽

2021 ◽

Vol 01 ◽

Author(s):

Gaurav Dhiman

Keyword(s):

Cancer Patients ◽

Increased Hospitalization and Mortality from COVID-19 in Prostate Cancer Patients

Cancers ◽

10.3390/cancers13071630 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1630

Author(s):

Dimple Chakravarty ◽

Parita Ratnani ◽

Stanislaw Sobotka ◽

Dara Lundon ◽

Peter Wiklund ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Mortality Rates ◽

Mount Sinai Hospital ◽

Solid Cancer ◽

Continuous Variables ◽

Breast Cancer Patients ◽

Chi Square ◽

Hospital System ◽

Tumor Types

Background: Cancer patients with COVID-19 have a poor disease course. Among tumor types, prostate cancer and COVID-19 share several risk factors, and the interaction of prostate cancer and COVID-19 is purported to have an adverse outcome. Methods: This was a single-institution retrospective study on 286,609 patients who underwent the COVID-19 test at Mount Sinai Hospital system from March 2020 to December 2020. Chi-square/Fisher’s exact tests were used to summarize baseline characteristics of categorical data, and Mann–Whitney U test was used for continuous variables. Univariable logistic regression analysis to compare the hospitalization and mortality rates and the strength of association was obtained by the odds ratio and confidence interval. Results: This study aimed to compare hospitalization and mortality rates between men with COVID-19 and prostate cancer and those who were COVID-19-positive with non-prostate genitourinary malignancy or any solid cancer, and with breast cancer patients. We also compared our studies to others that reported the incidence and severity of COVID-19 in prostate cancer patients. Our studies highlight that patients with prostate cancer had higher susceptibility to COVID-19-related pathogenesis, resulting in higher mortality and hospitalization rates. Hospitalization and mortality rates were higher in prostate cancer patients with COVID-19 when compared with COVID-19 patients with non-prostate genitourinary (GU) malignancies.

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Incidence, Characteristics, and Outcome of COVID-19 in Adults on Kidney Replacement Therapy: A Regionwide Registry Study

Journal of the American Society of Nephrology ◽

10.1681/asn.2020060875 ◽

2020 ◽

pp. ASN.2020060875

Author(s):

Johan De Meester ◽

Dirk De Bacquer ◽

Maarten Naesens ◽

Bjorn Meijers ◽

Marie M. Couttenye ◽

...

Keyword(s):

General Population ◽

Excess Mortality ◽

Mortality Rates ◽

Incidence Rates ◽

Registry Study ◽

Additional Risk ◽

Mortality Burden ◽

Kidney Replacement Therapy ◽

Expected Mortality ◽

Chronic Comorbidities

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disproportionally affects frail, elderly patients and those with multiple chronic comorbidities. Whether patients on RRT have an additional risk because of their specific exposure and complex immune dysregulation is controversial.MethodsTo describe the incidence, characteristics, and outcomes of SARS-CoV-2 infection, we conducted a prospective, multicenter, region-wide registry study in adult patients on RRT versus the general population from March 2 to May 25, 2020. This study comprised all patients undergoing RRT in the Flanders region of Belgium, a country that has been severely affected by coronavirus disease 2019 (COVID-19).Results At the end of the epidemic wave, crude and age-standardized cumulative incidence rates of SARS-CoV-2 infection were 5.3% versus 2.5%, respectively, among 4297 patients on hemodialysis, and 1.4% versus 1.6%, respectively, among 3293 patients with kidney transplants (compared with 0.6% in the general population). Crude and age-standardized cumulative mortality rates were 29.6% versus 19.9%, respectively, among patients on hemodialysis, and 14.0% versus 23.0%, respectively, among patients with transplants (compared with 15.3% in the general population). We found no excess mortality in the hemodialysis population when compared with mean mortality rates during the same 12-week period in 2015–2019 because COVID-19 mortality was balanced by lower than expected mortality among uninfected patients. Only 0.18% of the kidney transplant population died of SARS-CoV-2 infection.ConclusionsMortality associated with SARS-CoV-2 infection is high in patients on RRT. Nevertheless, the epidemic’s overall effect on the RRT population remained remarkably limited in Flanders. Calculation of excess mortality and age standardization provide a more reliable picture of the mortality burden of COVID-19 among patients on RRT.

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Abstract S12-02: Comprehensive meta-analysis of COVID-19 mortality rates for 22 cancer subtypes from the Reboot: COVID-Cancer Project, an interactive resource with aggregated data from 21,839 cancer patients

10.1158/1557-3265.covid-19-21-s12-02 ◽

2021 ◽

Author(s):

Emily-Claire Duffy ◽

Kelly Fan ◽

Shailesh Advani ◽

Chris Bailey ◽

James R.M. Black ◽

...

Keyword(s):

Cancer Patients ◽

Meta Analysis ◽

Mortality Rates ◽

Aggregated Data ◽

Cancer Subtypes ◽

Cancer Project

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Endovascular Aortic Repair in Patients of Advanced Age

Journal of Endovascular Therapy ◽

10.1177/15266028211049342 ◽

2021 ◽

pp. 152660282110493

Author(s):

Mitri K. Khoury ◽

Micah A. Thornton ◽

Christopher A. Heid ◽

Jacqueline Babb ◽

Bala Ramanan ◽

...

Keyword(s):

Mortality Rate ◽

Survival Benefit ◽

Elective Surgery ◽

Endovascular Aneurysm Repair ◽

The Elderly ◽

Mortality Rates ◽

Current Data ◽

Aortic Aneurysms ◽

Advanced Age ◽

The Impact

Purpose: Treatment decisions for the elderly with abdominal aortic aneurysms (AAAs) are challenging. With advancing age, the risk of endovascular aneurysm repair (EVAR) increases while life expectancy decreases, which may nullify the benefit of EVAR. The purpose of this study was to quantify the impact of EVAR on 1-year mortality in patients of advanced age. Materials and Methods: The 2003–2020 Vascular Quality Initiative Database was utilized to identify patients who underwent EVAR for AAAs. Patients were included if they were 80 years of age or older. Exclusions included non-elective surgery or missing aortic diameter data. Predicted 1-year mortality of untreated AAAs was calculated based on a validated comorbidity score that predicts 1-year mortality (Gagne Index, excluding the component associated with AAAs) plus the 1-year aneurysm-related mortality without repair. The primary outcome for the study was 1-year mortality. Results: A total of 11 829 patients met study criteria. The median age was 84 years [81, 86] with 9014 (76.2%) being male. Maximal AAA diameters were apportioned as follows: 39.6% were <5.5 cm, 28.6% were 5.5–5.9 cm, 21.3% were 6.0–6.9 cm, and 10.6% were ≥7.0 cm. The predicted 1-year mortality rate without EVAR was 11.9%, which was significantly higher than the actual 1-year mortality rate with EVAR (8.2%; p<0.001). The overall rate of perioperative MACE was 4.4% (n = 516). Patients with an aneurysm diameter <5.5cm had worse actual 1-year mortality rates with EVAR compared to predicted 1-year mortality rates without EVAR. In contrast, those with larger aneurysms (≥5.5cm) had better actual 1-year mortality rates with EVAR. The benefit from EVAR for those with Gagne Indices 2–5 was largely restricted to those with AAAs ≥ 7.0cm; whereas those with Gagne Indices 0–1 experience a survival benefit for AAAs larger than 5.5 cm. Conclusion: The current data suggest that EVAR decreases 1-year mortality rates for patients of advanced age compared to non-operative management in the elderly. However, the survival benefit is largely limited to those with Gagne Indices 0–1 with AAAs ≥ 5.5 cm and Gagne Indices 2–5 with AAAs ≥ 7.0 cm. Those of advanced age may benefit from EVAR, but realizing this benefit requires careful patient selection.

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ANTICOAGULANT THERAPY IN CANCER PATIENTS WITH ATRIAL FIBRILLATION. CONSIDERING AGE FACTOR

Успехи геронтологии ◽

10.34922/ae.2020.33.1.013 ◽

2020 ◽

pp. 99-106

Author(s):

В. И. Потиевская ◽

А. А. Ахобеков ◽

М. Ф. Баллюзек

Keyword(s):

Atrial Fibrillation ◽

Cancer Patients ◽

Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Current Data ◽

Related Factors ◽

Age Related ◽

Liver And Kidney ◽

After Cancer

Рассматривается современное состояние вопроса выбора антикоагулянтной терапии при фибрилляции предсердий (ФП) у онкологических больных. Отмечается, что сложность выбора антикоагулянта при злокачественных новообразованиях (ЗНО) определяется такими факторами, как коморбидные сердечно-сосудистые заболевания, нарушения функции печени и почек, метаболические дисфункции, свойственные, прежде всего, пациентам старшей возрастной группы. Приводятся актуальные данные по оценке риска геморрагических и тромбоэмболических осложнений ФП при ЗНО в аспекте возраста. Обсуждаются возможные причины увеличения риска развития ФП во время и после лечения ЗНО, в том числе и в связи с возраст-ассоциированностью этих патологий. Рассмотрены вопросы выбора антикоагулянтов у пациентов, находящихся на активной противоопухолевой терапии, особенно на препаратах из группы прямых оральных антикоагулянтов (ПОАК). Согласно данным обсервационных исследований, именно ПОАК являются перспективным, относительно безопасным и эффективным выбором для онкологических пациентов с ФП, в связи с чем их применение должно активно изучаться в рандомизированных клинических исследованиях с учетом фактора возраста. Подчеркивается, что подбор схемы антикоагулянтной терапии у пациентов с ФП и ЗНО требует междисциплинарного участия кардиологов и онкологов, а часто и гериатров, чтобы индивидуализировать лечение и предложить наиболее эффективную терапию. The current issue of the choice of anticoagulant therapy of atrial ﬁbrillation (AF) in cancer patients is considered. It is noted that the difﬁculty of choosing an anticoagulant in malignancies is largely determined by age-related factors, such as comorbid cardiovascular diseases, liver and kidney dysfunction, metabolic disorders common for in elderly patients. Current data on the risk assessment of hemorrhagic and thromboembolic complications of AF in cancer patients in the aspect of age presented. During and after cancer treatment, the risk of developing AF can increase, also in connection with the age-associated pathology. Possible reasons of it are discussed. The choice of different anticoagulants groups in patients treated with anticancer therapy, including direct oral anticoagulants (DOAC) is considered. According to available data from observational studies, it is the DOAC that is a promising, relatively safe and effective choice for cancer patients with AF, and therefore their use should be actively studied in randomized trials, considering the factor of age. It is particularly noted that solving this problem requires the interdisciplinary involvement of cardiologists, oncologists, and sometimes, geriatrics, to individualize treatment for each case and to offer the most effective therapy.

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