ABSTRACT
Introduction: Since the emergence of the novel coronavirus SARS-CoV-2 in December 2019 in Wuhan, cases of the associated disease COVID-19 are seen worldwide. To collect clinical data of the pandemic the international, multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) registry was established. Here, we present a first description of cancer patients with COVID-19 from LEOSS. Patients and Methods: We retrospectively analyzed a cohort of 283 patients (pts) with cancer and COVID-19 from a total of 1808 pts enrolled between March 6th, 2020, and June 26th, 2020. Baseline characteristics include socio-demographics, comorbidity according to Charlson Comor-bidity Index (CCI), ECOG and outcome of COVID-19. Clinical manifestation of COVID-19 was described in four phases: uncomplicated (asymptomatic/mild symptoms), complicated (need for oxygen supplementation), critical (need for life supporting therapy) and recovery (clinical improvement/discharge). Result(s): Median observational period was 11 (range 0-48) days, median inpatients stay 12.5 (range 0-72) days. Most patients were aged 66 years or older (75.5%), 112 (39.5%) pts were female. Median CCI was 4 (0-15), 46/119 (16.5%) pts had an ECOG >2. Solid tumors were seen in 61%, lymphoma and leukemia in 14.5% and 10.5% respectively. One hundred and seven pts (38%) had an active malignant disease and 76 (27%) had received anti-cancer treatment within the last 3 months. In 181 (64%) pts COVID-19 remained in the uncomplicated phase whereas 93 (33%) pts developed a complicated or critical phase. Sixty-three (22.5%) pts required intensive care, 35 out of 63 needed mechanical ventilation. A total of 79 (28%) pts died, 67 (23.5%) from COVID-19. Median survival was 33 days and worse compared to non-cancer pts (non-cancer pts: med. survival not reached, p-value < 0.001). Conclusion(s): As expected, cancer patients hospitalized for COVID-19 frequently have severe disease and an adverse outcome. To confrm these results, age-and comorbidity adjusted analysis are needed. An update of the analysis will be presented at the DGHO Annual Meeting.
ABSTRACT
Background: Community acquired respiratory viruses (CARVs) may cause severe respiratory infections in patients (pts) with cancer. To collect epidemiological and clinical data of CARV-infections the multicentric registry OncoReVir was established. Here, we present a preliminary analysis of pts with cancer infected with CARVs. Method(s): A total of 1,142 pts with cancer and CARV-infection were enrolled between Nov2018 and Jan2022. Most cases were documented for season 17/18 and 18/19. Data on demographics, comorbidities, cancer, CARVs and infection course were collected. Pre-defined endpoints were pneumonia, admission to ICU and mortality. The relationship between cancer-specific factors and outcome was evaluated by bivariate logistic regression. Result(s): The median age was 60 (IQR 50-67) years, 42% of pts were female. Solid tumors were present in < 10%, leukemia, lymphoma and multiple myeloma in 36.5%, 27% and 23%, respectively. 50% had active cancer, 40% had received chemotherapy within the last 3 months. Targeted therapy was reported in 11.5%, high-dose steroids in 16% of pts, 56% were SCTrecipients. Commonly detected CARVs were influenza (39.5%), parainfluenza (18%), respiratory syncytial virus (15%), rhinovirus (14.5%), human metapneumovirus (hMPV, 5.5%), endemic coronavirus (5.5%) and SARSCoV- 2 (2%). Among all CARVs, frequent symptoms were cough, fever, dyspnea and rhinitis. Rates of pneumonia were highest in hMPV (33%) and SARS-CoV-2 (32%), lowest in endemic coronavirus (16%, p=0.334). 8.5% required intensive care, most of them due to COVID-19 (p=0.084). Infection-associated mortality but not rate of pneumonia showed significant differences comparing CARVs. In regression analysis, active cancer was associated with all endpoints: infection-related mortality (4.02 [1.63- 9.88], p=0.002), ICU admission (1.75 [1.07-2.88], p= 0.027) and pneumonia (1.47 [1.1-1.96], 0.009). Conclusion(s): In our cohort, all CARVs could potentially lead to severe disease. Active cancer was an independent risk factor for adverse outcome in pts with cancer and CARV-infection.
ABSTRACT
There are available by now many arguments concerning the intrinsic and endemic value of the humanities, and both from a medievalist and a modernist perspective. Similarly, there continue to be many critics who would not mind the elimination of the humanities and argue vociferously for this goal. Every critical investigation of how to defend our field thus proves to be highly valuable, but we in the humanities must also develop specific points concerning the importance of our research that will convince both students, parents, administrators, and politicians in concrete, pragmatic terms regarding the supreme relevance of college education. Fortunately, the current COVID-19 crisis has also profiled in a dramatic fashion what proves to be of fundamental importance for human life, both past and present, reminding us of the critical importance of the humanities. An existence without virtues, a completely narcissistic or egoistical concept of life, or a society entirely predicated on materialistic interests would cut us off from our own future. This article discusses several literary works and also a modern movie in which the constant quest for meaning and relevance in our lives comes to the fore and gives us direction and understanding.
ABSTRACT
INTRODUCTION: Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. PATIENTS AND METHODS: We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. RESULTS: In total, 435 cancer patients were included in our analysis. Commonest age category was 76-85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. CONCLUSION: Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.