ABSTRACT
Background: Oncology patients, with active, lung, metastatic (m) disease, 1st y after diagnosis, have higher risk of SARS-COV2 infection, 26% severity/mortality vs 2-3% overall. Individual risk depends from age, comorbidity, PS. Infection impaired diagnosis/surveillance. Population includes patients with active early (E) or m disease on treatment (OT), untreated m and long survivors. mRNAbased vaccines demonstrated >90% efficacy to prevent disease. Immunization level depends from tumors/sites, therapy, administration timing, immune dysfunction and fitness. Adverse events were local reaction, systemic reactivity, asthenia, headache and pyrexia. Methods: We reported prevalence of infection/disease, ongoing vaccine administrations among patients followed at Oncology Territorial Care, S. Salvatore Hospital L'Aquila. Results: 18 patients reported infection, 8 asymptomatic, 2 mild symptoms (pyrexia), 8 severe (bilateral pneumonia, fever, respiratory failure, 6 hospitalized): 9 OT, 2 m colorectal, 1 m pancreatic, 1 m ovarian, 1 m neuroendocrine, 1 m renal cell, 1 pancreatic with previous m colorectal, 2 E colorectal (3 chemotherapy/target agents, 1 chemotherapy, 2 biological agent, 2 surgery, 1 locoregional therapy);8 survivor, 3 with history of m;1 with active disease before treatment beginning. 5 thereafter received 1 vaccine dose. From 4thJan to 20thMay 2021, 194 patients (87 M, 107 F) underwent vaccine administration, 24 affected by E disease OT, 64 m OT, 1 m out of treatment, 105 survivors. Tumors: 18 lung (11 m, 2 E OT), 64 gastrointestinal (19 m, 6 E OT), 33 breast (9 m, 2 E OT), 20 genitourinary (8 m, 2 E OT), 5 cutaneous/melanoma (3 m OT), 20 gynecological (6 m, 2 E OT), 6 HN (3 m, 1 E OT), 5 CNS, 17 multiple (1 m, 6 E OT), 6 rare (3 m, 1 E OT). Administered vaccines: 106 Pfizer-BioNTech, 17 Moderna, 4 Astra Zeneca. All grade adverse events: pain at injection site, 37, fever 9, asthenia 8, myalgia/articolar pain 7, headache 3, diarrhea 1, erythema 1, vomiting 1, hypertension 1, conjunctival hemorrhage1, hemolitic syndrome, 1. Conclusion: Open questions are long-term efficacy, protection again mild/ severe infection, immunity in aged, contagiousness of vaccinated patients, intervals between administrations. Vaccination in oncology population prevents frail patients from infection and severe disease, monitoring in clinical practice safety/effectiveness, not included in trials. Mature data will be presented.
ABSTRACT
COVID-19 disease has spread around the world since December 2019. Neurological symptoms are part of its clinical spectrum. Objective: To know the neurological manifestations in patients infected by COVID-19 in Argentina. Methods: Multicenter study conducted in adults, from May 2020 to January 2021, with confirmed COVID-19 and neurological symptoms. Demographic variables, existence of systemic or neurological comorbidities, the form of onset of the infection, alteration in complementary studies and the degree of severity of neurological symptoms were recorded. Results: 817 patients from all over the country were included, 52% male, mean age 38 years, most of them without comorbidities or previous neurological pathology. The first symptom of the infection was neurological in 56.2% of the cases, predominantly headache (69%), then anosmia/ageusia (66%). Myalgias (52%), allodynia/hyperalgesia (18%), and asthenia (6%) were also reported. 3.2% showed diffuse CNS involvement such as encephalopathy or seizures. 1.7% had cerebrovascular complications. Sleep disorders were observed in 3.2%. 6 patients were reported with Guillain Barré (GBS), peripheral neuropathy (3.4%), tongue paresthesia (0.6%), hearing loss (0.4%), plexopathy (0.3%). The severity of neurological symptoms was correlated with age and the existence of comorbidities. Conclusions: Our results, similar to those of other countries, show two types of neurological symptoms associated with COVID-19: some potentially disabling or fatal such as GBS or encephalitis, and others less devastating, but more frequent such as headache or anosmia that demand increasingly long-term care.