ABSTRACT
No study has yet investigated if a severe SARS-CoV-2 infection represents a marker of an undiagnosed cancer. This population-based study, using the SNDS database, identified from 02/15/2020 to 08/31/2021, 41,302 individuals hospitalized in intensive care unit due to SARS-CoV-2 (ICU-gr) and 713,670 control individuals not hospitalized for SARS-CoV-2 (C-gr). Individuals were matched according to year of birth, sex and French department. The cancer incidence was compared in the two groups during the follow-up period (index date-12/31/2021), using Cox proportional hazards models adjusted on matching variables, socioeconomic characteristics and comorbidities. In the ICU-gr, 2.2% (n = 897) was diagnosed with a cancer in the following months, compared to 1.5% (n = 10,944) in the C-gr. The ICU-gr had a 1.31 higher risk of being diagnosed with a cancer following hospital discharge compared to the C-gr (aHR 1.31, 95% CI 1.22-1.41). A global similar trend was found when competing risk of death was taken into account (aHR 1.25, 95% CI 1.16-1.34). A significant higher risk was found concerning renal (aHR 3.16, 95% CI 2.33-4.27), hematological (aHR 2.54, 95% CI 2.07-3.12), colon (aHR 1.72, 95% CI 1.34-2.21), and lung (aHR 1.70, 95% CI 1.39-2.08) cancers. This suggests that a severe SARS-CoV-2 infection may represent a marker of an undiagnosed cancer.
Subject(s)
COVID-19 , Coleoptera , Neoplasms , Humans , Animals , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Neoplasms/diagnosis , Neoplasms/epidemiology , ResearchSubject(s)
COVID-19 , Social Media , COVID-19/epidemiology , Communication , Humans , Infodemic , Pandemics , SARS-CoV-2Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , COVID-19 Testing , Clinical Laboratory Techniques , HumansABSTRACT
Medical care of adults with disabilities, especially those with intellectual disabilities, can be ethically difficult. Several questions arise frequently. Can we administer a life-saving treatment that could impact negatively the patient's quality of life when the patient isn't able to give consent? During this Covid-19 period, can the use of chemical or physical restraints be considered as mistreatment, whereas the aim is to protect others? These are situations where the ethical question holds a central role. Although each clinical situation is unique, this article highlights, through four clinical cases, the ethical principles that should guide physicians in their decision-making process. La prise en charge medicale des adultes en situation de handicap, notamment ceux souffrant de deficience mentale, peut se reveler difficile dun point de vue ethique. Plusieurs questions se posent frequemment. Peut-on proposer un traitement vital mais qui risque dimpacter la qualite de vie du patient sans pouvoir obtenir son consentement ? En periode de Covid-19, lutilisation de moyens de contention chimique ou physique peut-elle etre consideree comme de la maltraitance alors quon cherche a proteger autrui ? Autant de situations oo la question ethique prend une place centrale. Si chaque cas est evidemment different, nous vous proposons, a travers quatre vignettes cliniques, de mettre en lumiere les principes ethiques accompagnant le medecin dans son processus decisionnel.