An Insight into Association Between COVID-19 Infection and ABO Blood Group

Coronavirus disease 2019 (COVID-19), a pandemic that is triggered by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) or 2019-nCoV, causes primarily respiratory discomfort along with other mild symptoms/no symptoms, leading to severe illness and death, if proper care is not taken. At present, COVID-19 is the resilient reason for a large number of human casualties worldwide as well as a cause of crucial economic loss posturing global threat. There is a necessity of intensive research to elucidate the pathogenic mechanisms of COVID-19, which would assist in understating the susceptibility towards the infection as well as prompt development of effective prevention and treatment strategies. Over the years, clinical studies have indicated the risk of various pathogenic infections prejudiced due to preexisting chronic diseases as well as ABO blood group types to a larger extent. In line of this, current COVID-19 infection-associated clinical studies intensely endorse the relationship of blood group type of individual and risk of COVID-19 infection. In this chapter, various clinical studies from January 2020 to June 2020 have been summarized to highlight the eminence of ABO blood group and COVID-19 infection susceptibility in human population. These reports evidently support the fact that individuals with A histo blood group were found to be more vulnerable to COVID-19 infection whereas individuals with blood group O were less likely to get infected with virus. To get deeper insight in this fact, many more studies are desirable in order to further explicate the promising protective role of the blood group O and it will be supportive for designing and planning several additional countermeasures against COVID-19 infection. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

A review on current epidemiology and molecular studies of lumpy skin disease virus-an emerging worldwide threat to domestic animals

In South Asia, cattle are afflicted by the expanding virulent condition known as Lumpy Skin Disease (LSD), and sheep pox and goat pox are caused by the Capri virus. These illnesses endanger worldwide trade. Due to inadequate immunisations and poverty in rural areas, Capricorn poxviruses are spreading. This is due to the economic repercussions of the COVID-19 epidemic, debilitating sanctions in endemic countries, a growth in the legal and criminal trade of live animals and animal products, and global climate change. Skin spores are the main route of infection;however, the virus is also excreted through bodily fluids and semen. As a result, the virus is transmitted to susceptible hosts by biting flies, mosquitoes, and other insects. Insects can be transstadial and transovarial. Lumpy skin disease lesions can swell and rupture after 7 to 14 days in experimental settings, but it usually takes 2 to 5 weeks in a normal infection. Lumpy skin disease is characterised by hard, constrictive, few (mild forms) to numerous (severe forms) skin nodules that may encompass respiratory, urogenital, and other organ mucous membranes. Consequently, milk output decreases, and in countries that raise cattle, there are more abortions, cases of temporary or permanent infertility, hide damage, and mortality, all of which result in a financial loss. The best method for limiting the spread and monetary impacts of lumpy skin disease is mass immunisation and other management measures. This review provides the latest information on lumpy skin disease's viral biology, transmission, clinical, and pathological aspects. © 2023 Journal of medical pharmaceutical and allied sciences. All rights reserved.

The implication of pollution control acts & protocols and COVID-19 on air quality: A case study of Mumbai, India

This study aims to explore twin objectives. Initially, the study scrutinises the consequences of various pollution control acts and protocols signed by India to improve the air quality and then the study involves itself to investigate the aftermath of COVID-19 lockdown on the air quality of highly populated Mumbai city of India. The empirical analysis is facilitated by the application of Poirier's Spline function approach on the secondary data compiled from the Maharashtra Pollution Control Board (MPCB). The corresponding structural shifting points are identified through the CUSUM of squares (CUSUMQ) test. The empirical results disclose that Kyoto Protocol and lockdown have positively influenced the air quality. This study ends with suitable policy prescriptions. © 2023 by Shrabanti Maity, Ummey Rummana Barlaskar and Nandini Ghosh.

FRAGMENTED REALITIES OF THE PANDEMIC: The multiple marginalities of disabled people in India

The systemic exclusion of disabled people from family, social and community life is mirrored today in the social isolation and distancing that entire populations are experiencing in the wake of the COVID-19 pandemic. The pandemic has therefore brought the community into sharp focus for disabled people and their families in urban areas, either as the unrelenting and unresponsive assortment of strangers or as the empathetic responsible groups providing much-needed support. The pandemic and lockdown presented different kinds of barriers to accessibility in healthcare facilities. The pandemic, the lockdown and an economic slowdown have combined to effectively demonstrate that disabled people, especially women, dependent on and unwanted by families, are considered highly expendable. The cultural script of fear unleashed by the pandemic was something with which disabled people and their families had been somewhat acquainted in the present urban social formation. © 2022 selection and editorial matter, Niharika Banerjea, Paul Boyce and Rohit K. Dasgupta;individual chapters, the contributors

Particle Pollution, increase in Allergy and Asthma cases and application of Nanotechnology

Rationale: The aerosolized solid, liquid, mix-phased particles are the Particulate Matter or PM having serious health impacts. In the recent years with the unprecedented situation of COVID-19 pandemic, it became a necessity that the scientific world comes forward with an objective of developing more equipment for air purification with novel technology to combat airborne pathogen, aeroallergen and viruses. We have applied AFLPCO Nanotechnology to build equipment and mask. Methods: We built a fiberglass chamber to evaluate the capacity of the AFL-Mask to prevent entry of particulate matters and pathogens. To evaluate the air in the chamber, we used a LightHouse Handheld Particle Counter to sample airborne particles. We have recorded the particle concentrations at time-intervals to determine the percentage of particles entering the other chamber with the mask placed in the junction dividing the chamber. Results: This mask involves a 4-stage filtration system designed to combat all forms of airborne pathogens including bacteria, viruses, mold spores and harmful VOCs. We found that the AFL-Mask was efficient in preventing any particulate matter including PM2.5, PM10, bacterial and fungal spores and VOCs. Conclusions: The AFL-Mask and AFLPCO air purifiers built for long-term use to improve the inhaled air quality. The ergonomic design with padded lining and straps and improved filtration technology made the AFL-Mask a superior mask that provides a continuous airflow to prevent suffocation, troubled breathing and fluctuating blood pressure, especially pertaining to patients with cardiovascular or pulmonary issues. AFLPCO airpurifers were efficient in improving IAQ.

Inequities in timely cancer treatment after testing positive for COVID-19: Findings from the ASCO Survey on COVID-19 in Oncology (ASCO) Registry

Introduction: There is a disproportionately greater burden of COVID-19 among non-Hispanic Black (NHB) and Hispanic individuals, who also shoulder an inordinate burden of poor cancer outcomes. Understanding patient- and area-level factors contributing to these inequities at the intersection of COVID-19 and cancer is critical. As such, the objective of this study was to evaluate inequities in receipt of timely cancer treatment following a confirmed positive test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-the virus that causes COVID-19. Method(s): This retrospective cohort study is comprised of 2,686 non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic cancer patients from the American Society for Clinical Oncology COVID-19 Registry (ASCO Registry), for whom relatively complete data were available at entry into the registry (at the date of confirmed positive SARS-CoV-2 test) up to the end of the follow-up period (~6-9 months post confirmed positive SARS-CoV-2 test). Data were collected from April 2020 to November 2021. Relative risk (RR) estimates (generated using the generalized linear model procedure with a Poisson distribution, log link, and robust error variances) were used to examine multivariable-adjusted associations between patient-level sociodemographic and clinical factors and area-level social determinants of health (SDOH), separately, with timely (on schedule or within 14 days of schedule) and delayed (>=14-day delay) receipt of cancer treatment. Kaplan-Meier curves were plotted to investigate the time (in days) to restart cancer treatment post-COVID-19 infection. Result(s): After correction for multiple comparisons, for drug-based therapy, NHB race (RR, 0.69 [95% CI, 0.55-0.87];P=.002) and male sex (RR, 0.82 [95% CI, 0.71-0.95];P=.009) were associated with 31% and 18% reductions in timely treatment receipt. NHB race (RR, 1.41 [95% CI, 1.17-1.71];P<.001) was also associated with a 41% increased risk of >=14-day delays in treatment receipt. NHB patients further experienced longer delays, on average, in restarting drug-based therapy relative to NHW and Hispanic patients (mean days: 54.7 vs. 36.6 and 36.7, P=.001). Hispanic ethnicity was marginally associated with a lower likelihood of timely drug-based therapy receipt (RR, 0.79 [95% CI, 0.61-1.02];P=.075) and a greater risk of delayed receipt of drug-based therapy (RR, 1.31 [95% CI, 1.04-1.67];P=.024). Residents of areas with higher proportions of NHWs (>=77.4% vs. <77.4%) had a 31% higher likelihood of timely drug-based therapy receipt (RR, 1.31 [95% CI, 1.18-1.47];P<.001) and 21% significantly lower risk of delayed drug-based therapy (RR, 0.79 [95% CI, 0.69- 0.90];P=.001). Conclusion(s): NHB cancer patients, males, and residents of areas that are more racially and ethnically diverse experienced delayed drug-based cancer treatment following COVID19 infection. These delays will likely exacerbate persistent cancer survival inequities in the United States.

LISOCABTAGENE MARALEUCEL (LISO-CEL) AS SECOND-LINE THERAPY FOR R/R LARGE B-CELL LYMPHOMA (LBCL) IN PATIENTS NOT INTENDED FOR HSCT: PRIMARY ANALYSIS FROM THE PHASE 2 PILOT STUDY

Background: Patients with relapsed or refractory (R/R) LBCL after first-line treatment who are unable to undergo high-dose chemotherapy (HDCT) and hematopoietic stem cell transplantation (HSCT) hae poor outcomes and limited treatment options. Aims: PILOT (NCT03483103) ealuated liso-cel, an autologous, CD19-directed chimeric antigen receptor (CAR) T cell product, as second-line treatment in patients with R/R LBCL not intended for HSCT. Methods: Eligible patients were adults with R/R LBCL after first-line treatment who were not deemed candidates for HDCT and HSCT by their physician and met ≥ 1 frailty criteria as follows: age ≥ 70 years, Eastern Cooperatie Oncology Group performance status (ECOG PS) of 2, diffusing capacity for carbon monoxide ≤ 60%, left entricular ejection fraction < 50%, creatinine clearance < 60 mL/min, or alanine aminotransferase/aspartate aminotransferase > 2 × the upper limit of normal. Bridging therapy was allowed. Patients receied lymphodepletion with cyclophosphamide and fludarabine, followed 2-7 days later by liso-cel infusion at a target dose of 100 × 106 CAR+ T cells. Cytokine release syndrome (CRS) was graded per Lee 2014 criteria. Neurological eents (NE) were defined as inestigator-identified neurological aderse eents related to liso-cel and graded using the National Cancer Institute Common Terminology Criteria for Aderse Eents, ersion 4.03. The primary endpoint was objectie response rate (ORR) per independent reiew committee;all patients had ≥ 6 months of follow-up from first response. Results: Of 74 patients who underwent leukapheresis, 61 receied liso-cel and 1 receied nonconforming product (ie, product wherein one of the CD8 or CD4 cell components did not meet one of the requirements to be considered lisocel). Common reasons for preinfusion dropout included death and loss of eligibility (5 each). For liso-cel-treated patients, median age was 74 years (range, 53-84;79% ≥ 70 years) and 69%, 26%, and 5% met 1, 2, and 3 frailty criteria, respectiely;26% had ECOG PS of 2 and 44% had Hematopoietic Cell Transplantation-specific Comorbidity Index score ≥ 3. After first-line treatment, 54% were chemotherapy refractory, 21% relapsed within 12 months, and 25% relapsed after 12 months;51% of patients receied bridging chemotherapy. Median (range) onstudy follow-up was 12.3 months (1.2-26.5). ORR and complete response rate were 80% and 54%, respectiely (Table). Median duration of response and progression-free surial were 12.1 months and 9.0 months, respectiely. Median oerall surial has not been reached. The most frequent treatment-emergent aderse eents (TEAE) were neutropenia (51%), fatigue (39%), and CRS (38%), with grade 3 CRS in 1 patient (2%) and no grade 4/5 CRS eents. Any-grade NEs were seen in 31% (n = 19) of patients;grade 3 NEs occurred in 5% (n = 3) of patients and no grade 4/5 NEs were reported. Seen percent (n = 4) receied tocilizumab only, 3% (n = 2) receied corticosteroids only, and 20% (n = 12) receied both tocilizumab and corticosteroids for treatment of CRS and/or NEs. Oerall, grade ≥ 3 TEAEs occurred in 79% (n = 48) of patients, with grade 5 TEAEs in 2 patients (both due to COVID-19). Two patients (3%) had grade 3/4 infections and 15 (25%) had grade ≥3 neutropenia at Day 29. Summary/Conclusion: In the PILOT study, liso-cel as second-line treatment in patients with LBCL who met ≥ 1 frailty criteria and for whom HSCT was not intended demonstrated substantial and durable oerall and complete responses, with no new safety concerns. (Table Presented).

Post-covid-19 transformations for future of work and small business sustainability: Towards an inclusive economy

The COVID-19 pandemic has created shockwaves across the globe and impacted businesses and economies. Enormous disruptive transformations have happened in the work models and systems to enable businesses to flexibly operate, sustain, and remain agile in uncertain times. The future of work, which seemed uncertain post-pandemic, has reached normalcy due to the organisational resilience and strategic responses shown by organisational leaders and small businesses. Although small businesses across the world have been impacted negatively leading to closures, financial crunches, and job losses worldwide, many have shown signs of resilience and recovery. The chapter throws light on the work transformations across economies and strategic responses to deal with them. It describes the challenges faced by various small businesses and the way they have been flexible and resilient. The chapter proposes a framework for building an inclusive economy that has been asserted to be the solution to a sustainable and resilient future in times of uncertainties and crises. © 2022, IGI Global. All rights reserved.

Lisocabtagene maraleucel (liso-cel) as second-line (2L) therapy for R/R large B-cell lymphoma (LBCL) in patients (pt) not intended for hematopoietic stem cell transplantation (HSCT): Primary analysis from the phase 2 PILOT study

Background: Pts with R/R LBCL after first-line (1L) treatment (tx) who are unable to undergo high-dose chemotherapy (HDCT) and HSCT have poor outcomes and limited tx options. PILOT (NCT03483103) evaluated liso-cel, an autologous, CD19-directed chimeric antigen receptor (CAR) T cell product, as 2L tx in pts with R/R LBCL not intended for HSCT. Methods: Eligible pts were adults with R/R LBCL after 1L tx who were not deemed candidates for HDCT and HSCT by their physician and met ≥ 1 frailty criteria: age ≥ 70 yr, ECOG PS = 2, DLCO ≤ 60%, LVEF < 50%, CrCl < 60 mL/min, or ALT/AST > 2 × ULN. Bridging tx was allowed. Pts received lymphodepletion with cyclophosphamide and fludarabine, followed 2-7 days later by liso-cel at a target dose of 100 × 106 CAR+ T cells. Cytokine release syndrome (CRS) was graded per Lee 2014 criteria and neurological events (NE) per NCI CTCAE, version 4.03. Primary endpoint was ORR per independent review committee (IRC);all pts had ≥ 6 mo followup (f/u) from first response. Results: Of 74 pts leukapheresed, 61 received liso-cel and 1 received nonconforming product. Common reasons for pre-infusion dropout included death and loss of eligibility (5 each). For liso-cel-treated pts, median age was 74 yr (range, 53-84;79% ≥ 70 yr) and 69%, 26%, and 5% met 1, 2, and 3 frailty criteria, respectively;26% had ECOG PS = 2 and 44% had HCT-CI score ≥ 3. After 1L tx, 54% were chemotherapy refractory, 21% relapsed ≤ 12 mo, and 25% relapsed > 12 mo;51% of pts received bridging chemotherapy. Median (range) on-study f/u was 12.3 mo (1.2-26.5). ORR and CR rate was 80% and 54%, respectively. Median DOR and PFS was 12.1 mo and 9.0 mo, respectively. Median OS has not been reached (Table). Most frequent tx-emergent AEs (TEAE) were neutropenia (51%), fatigue (39%), and CRS (38%), with grade (gr) 3 CRS in 1 pt (2%) and no gr 4/5 CRS. Any-grade NEs were seen in 31%, gr 3 in 5% (n = 3), and no gr 4/5 NEs;7% received tocilizumab, 3% corticosteroids, and 20% both for tx of CRS/NEs. Overall, gr ≥ 3 TEAEs occurred in 79%, with gr 5 in 2 pts (both due to COVID-19). Two pts (3%) had gr 3/4 infections and 15 (25%) had gr ≥3 neutropenia at Day 29. Conclusions: In the PILOT study, liso-cel as 2L tx in pts with LBCL who met ≥ 1 frailty criteria and for whom HSCT was not intended demonstrated substantial and durable overall and complete responses, with no new safety concerns.

Need of the Hour: Sustainable Business Models in Higher Education Sector in Post Covid Regime

Purpose: The onset of covid 19 has introduced a paradigm shift in the modus operandi of the organizations across the globe. The rapidity of transformation had adversely impacted the lives and livelihood of and continued its strain in covid saturated regime. The pandemic has upended the business in Higher Education Institutions too, diluted the employee engagement, brought a transition in the organizational factors and resultantly aggravated the all-pervasive sufferings of the academicians. While each of the educational segment faced its unique challenges, prominently the Higher Educational Institutions underwent tremendous learning revolution. In the light of unearthing the intensity of disruption among the academicians, the present study is taken up to critically analyse the need for new business models due to the transition in the organizational factors. For the convenience of the study only the Bangalore based Private Higher Educational Institutions are considered. Design/Methodology/Approach: A strategically constructed 5-point Likert scale questionnaire in Goggle form was designed to obtain and evaluate the responses from the academicians of the Private Higher Educational Institutions in Bangalore. The population consists of 819 Private Colleges catering to the needs of the discipline of Arts, Science, Management and Commerce. Stratified random sampling technique is considered to collect the responses from each of the every10 faculties in each single mentioned department. With continued follow ups, the sizeable sample reached up to 389, slightly higher than the calculated samplesize for known population. The analysis was made by using the statistical tool: Wilcoxon Signed Ranks Test to check the sensitivity of transition in the organizational factors due to the pandemic. Findings: The chosen tool for the study does not demand the testing of the relation between the dependent and independent variables, hence no hypothesis being constructed. However, the Wilcoxon Signed Ranks Test showed that covid did make a statistically significant effect on the Organizational Factors, most predominantly the "Supportive of change" (Z=-14.821, p=0.000). 315 responses revealed the negative ranking which prompted a non-willingness of the organization to support the change in post covid scenario, 23 respondents on the contrary felt a negligible positive transition in the same organizational factors whereas the responses of the remaining 51 participants found to be neutral. The overall organizational effectiveness reported a diminishing trend in the post covid scenario. Research implications:The study is confined to Private Higher Educational Institutions in Bangalore. The study has used ranking test to identify the weightage of responses towards transition in organizational factors which invariably creates awareness among the academicians and the service providers too. In deep contrast with the pre covid scenario, the shift in organizational parameters would pave the way for future restructuring. The set of strategic suggestions provided in the present study could bring substantial change if implemented with care and caution. Originality/value: The originality of the study is checked through the available online plagiarism software and found to be within 10%. Paper type: Research paper

Genome-wide Analysis to Identify Palindromes, Mirror and Inverted Repeats in SARS-CoV-2, MERS-CoV and SARS-CoV-1

Research pertaining to SARS-CoV-2 is in full swing to understand the origin and evolution of this deadly virus that can lead to its rapid detection. To achieve this, atypical genomic sequences which may be unique to SARS-CoV-2 or Coronaviridae family in general may be investigated. Such sequences in virus genomes may be responsible for target prediction, replication, defence mechanisms and viral packaging. This fact has motivated us to explore the different types of repeats such as palindromes, mirror repeats and inverted repeats in SARS-CoV-2, MERS-CoV and SARS-CoV-1. For this purpose, the respective reference sequence of SARS-CoV-2, MERS-CoV and SARS-CoV-1 is divided into descriptors of sequences of length k using k-mer technique. Thereafter, these descriptors are represented as a collection of tokens which are subsequently used for the identification of palindrome, mirror repeat and inverted repeat in the respective reference sequence. The highest number of palindromes, mirror repeats and inverted repeats are identified for descriptor length 10. As a result, for palindromes such values are 38, 42 and 33 and for mirror repeats they are 52, 38 and 33 for SARS-CoV-2, MERS-CoV and SARS-CoV-1 respectively. For inverted repeats, with a descriptor length 10 and intervening length 5, the values are 59, 56 and 70 respectively. Moreover, the identified repeats are then searched for in 108246, 291 and 340 SARS-CoV-2, MERS-CoV and SARS-CoV-1 virus sequences respectively to find the population coverage of such repeats. It surpasses 99% in most cases and even 100% for some. Furthermore, GC contents which mostly lie between 20%-50% are evaluated for these repeats as well in order to understand their binding efficacy. Author

Glofitamab Plus R-CHOP Induces High Response Rates with Minimal Cytokine Release Syndrome (CRS) in Patients (pts) with Relapsed/Refractory (R/R) Non-Hodgkin Lymphoma (NHL) and Previously Untreated (1L) Diffuse Large B-Cell Lymphoma (DLBCL): Preliminary Results from a Dose-Escalation and Safety Run-in Phase Ib Study

Background: Over a third of pts with 1L DLBCL do not respond to, or relapse after, rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP;[Sarkozy and Sehn. Ann Lymphoma 2019]). Despite recent advances, pts with R/R NHL have limited curative options. Glofitamab (Glofit) is a novel, T-cell-engaging bispecific antibody with a 2:1 molecular configuration that allows bivalent binding to CD20 on B cells and monovalent binding to CD3 on T cells. Unlike other CD20xCD3 bispecific antibodies, this format uniquely enables combination with anti-CD20 antibodies, including rituximab. Glofit monotherapy induces high response rates in R/R B-cell NHL (Hutchings et al. J Clin Oncol 2021). We present results of the ongoing NP40126 study (NCT03467373), designed to assess the feasibility and safety of Glofit + R-CHOP in R/R NHL (dose-escalation phase) and 1L DLBCL (safety run-in phase). Methods: R/R NHL dose-escalation: Pts (Eastern Cooperative Oncology Group performance status [ECOG PS] 0-2) received increasing Glofit doses in separate cohorts (70µg, 1800µg, 10mg and 30mg) plus standard R-CHOP for 6-8 cycles (each 21-day). To mitigate CRS risk, R- or obinutuzumab (G)-CHOP was given in Cycle (C)1, with the aim of tumor debulking. Glofit was given from C2 onwards. For 70µg and 1800µg cohorts, fixed-dose Glofit was given on C2 Day (D)8 and onwards. For 10mg and 30mg cohorts, step-up dosing was used to further mitigate CRS risk (2.5mg C2D8, 10mg C2D15, target dose C3D8 and onwards). Optional Glofit maintenance was permitted (every 2 months for <2 years;dose-escalation phase only). 1L DLBCL safety run-in: Pts (ECOG PS 0-3) received Glofit 30mg plus standard R-CHOP for 6-8 cycles (each 21-day). Pts received R-CHOP in C1;Glofit step-up dosing began in C2 (2.5mg C2D8, 10mg C2D15, 30mg C3D8 and onwards). Response rates were assessed by PET-CT (Lugano criteria;[Cheson et al. J Clin Oncol 2014]). CRS events were graded by ASTCT criteria [Lee et al. Biol Blood Marrow Transplant 2019]. Results: R/R NHL dose-escalation: At data cut-off (June 10, 2021), 31 pts (23 follicular lymphoma [FL];6 transformed FL;1 marginal-zone lymphoma;1 mantle-cell lymphoma) had received Glofit with R/G-CHOP. Median age was 62 years, median prior lines of therapy was 2 (range: 1-5). In efficacy-evaluable pts (n=31), after a median 9.0 months' (range: 0-29) follow-up, the overall response rate (ORR) was 90% (n=28) and complete response rate (CRR) was 77% (n=24). Median duration of response was not reached. The Figure shows change in tumor size. Grade (Gr) ≥3 adverse events (AEs) occurred in 28 (90%) pts, serious AEs in 21 (68%) pts and CRS in 17 (55%) pts (mostly low grade;majority after the first 2.5mg Glofit dose;Table). One (3%) pt had a Gr 5 AE (COVID-19 pneumonia not related to study treatment). AEs led to Glofit dose modification/interruption in 2 (6%) pts and Glofit withdrawal in 1 (3%) pt. Neurologic AEs (NAEs) occurred in 20 (65%) pts: Gr 1-2 (16 pts, 52%);Gr 3 (4 pts, 13%). Immune effector cell-associated neurotoxicity syndrome (ICANS)-like AEs were uncommon;a serious AE was reported in 1 pt only (Gr 3 epilepsy during the maintenance phase;resolved in 3 days). Neutropenia occurred in 24 (77%) pts. Median dose intensity was 100% for all R-CHOP components. 1L DLBCL safety run-in: At data cut-off, 13 pts were enrolled (safety population);of these, 4 pts received Glofit 30mg with R-CHOP and were efficacy-evaluable. Median age was 68 years, all pts had Ann Arbor Stage 3/4 disease. At interim assessment (C3), CRR was 100% (4/4). Of 13 pts, 1 (8%) had a CRS event (Gr 1 with fever only) after the first 2.5mg Glofit dose;no other CRS events observed. Gr ≥3 AEs occurred in 8 (62%) pts and Gr ≥3 AEs related to Glofit in 1 (8%) pt only. One (8%) pt had a serious AE and 1 (8%) pt had a Gr 5 AE (infusion-related reaction related to rituximab on C1D1). No AEs led to Glofit or R-CHOP dose interruptions. NAEs occurred in 3 (23%) pts (all Gr 1-2;none were ICANS-like). Neutropenia occurred in 6 (46%) pts. Median dose intensity was 10 % for all R-CHOP components. Conclusions: Initial data show that Glofit + R-CHOP has tolerable safety in R/R NHL and 1L DLBCL. R-CHOP dose intensity was maintained in all pts. The very low CRS rate and no neurotoxicity in 1L DLBCL may render Glofit particularly suitable for the outpatient setting without the need for hospitalization. Updated data, including end-of-treatment responses from the 1L DLBCL safety run-in phase, will be presented. [Formula presented] Disclosures: Ghosh: Seattle Genetics: Consultancy, Honoraria, Speakers Bureau;Gilead: Consultancy, Honoraria, Research Funding, Speakers Bureau;Pharmacyclics LLC, an AbbVie Company: Consultancy, Honoraria, Research Funding, Speakers Bureau;AbbVie: Honoraria, Speakers Bureau;Karyopharma: Consultancy, Honoraria;AstraZeneca: Consultancy, Honoraria, Speakers Bureau;ADC Therapeutics: Consultancy, Honoraria;Adaptive Biotech: Consultancy, Honoraria;TG Therapeutics: Consultancy, Honoraria, Research Funding;Genmab: Consultancy, Honoraria;Bristol Myers Squibb: Consultancy, Honoraria, Research Funding, Speakers Bureau;Epizyme: Honoraria, Speakers Bureau;Incyte: Consultancy, Honoraria;Janssen: Consultancy, Honoraria, Speakers Bureau;Genentech: Research Funding. Townsend: Celgene (Bristol-Myers Squibb): Consultancy, Honoraria;F. Hoffmann-La Roche Ltd: Consultancy, Honoraria. Dickinson: Amgen: Honoraria;Celgene: Research Funding;Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau;Takeda: Research Funding;Gilead Sciences: Consultancy, Honoraria, Speakers Bureau;MSD: Consultancy, Honoraria, Research Funding, Speakers Bureau;Janssen: Consultancy, Honoraria;Bristol-Myers Squibb: Consultancy, Honoraria;Roche: Consultancy, Honoraria, Other: travel, accommodation, expenses, Research Funding, Speakers Bureau. Topp: Celgene: Consultancy, Research Funding;Janssen: Consultancy;Universitatklinikum Wurzburg: Current Employment;Kite, a Gilead Company: Consultancy, Research Funding;Novartis: Consultancy;Roche: Consultancy, Research Funding;Gilead: Research Funding;Regeneron: Consultancy, Research Funding;Macrogeniecs: Research Funding;Amgen: Consultancy, Research Funding. Santoro: Sandoz: Speakers Bureau;Eli-Lilly: Speakers Bureau;Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;AstraZeneca: Speakers Bureau;Gilead: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Servier: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Celgene: Speakers Bureau;Amgen: Speakers Bureau;AbbVie: Speakers Bureau;Roche: Speakers Bureau;BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Eisai: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Takeda: Speakers Bureau;Sanofi: Consultancy;Arqule: Consultancy, Speakers Bureau;Novartis: Speakers Bureau;Bayer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;MSD: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Crump: Novartis: Membership on an entity's Board of Directors or advisory committees;Kyte/Gilead: Membership on an entity's Board of Directors or advisory committees;Epizyme: Research Funding;Roche: Research Funding. Morschhauser: Epizyme: Consultancy, Membership on an entity's Board of Directors or advisory committees;Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees;Genentech, Inc.: Consultancy;Genmab: Membership on an entity's Board of Directors or advisory committees;Roche: Consultancy, Speakers Bureau;BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees;Chugai: Honoraria;Incyte: Membership on an entity's Board of Directors or advisory committees;Servier: Consultancy;AstraZenenca: Membership on an entity's Board of Directors or advisory committees;Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees;F. Hoffmann-La Roch Ltd: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Celgene: Membership on an entity's Board of Directors or advisory committees;AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees;Janssen: Honoraria. Mehta: Kite/Gilead;Roche-Genetech;Celgene/BMS;Oncotartis;Innate Pharmaceuticals;Seattle Genetics;Incyte;Takeda;Fortyseven Inc/Gilead;TG Therapeutics;Merck;Juno Pharmaceuticals/BMS: Research Funding;Seattle Genetics;Incyte;TG Therapeutics: Consultancy;Seattle Genetics;Incyte;TG Therapeutics: Membership on an entity's Board of Directors or advisory committees. Panchal: F. Hoffmann-La Roche Ltd: Current Employment. Wu: F. Hoffmann-La Roche Ltd: Current Employment, Current equity holder in publicly-traded company. Barrett: Roche Products Ltd: Current Employment;F. Hoffmann-La Roche Ltd: Current equity holder in publicly-traded company. Humphrey: Roche: Current Employment, Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company. Qayum: F. Hoffmann-La Roche Ltd: Current Employment, Current equity holder in publicly-traded company. Hutchings: Novartis: Research Funding;Janssen: Honoraria, Research Funding;Incyte: Research Funding;Genentech: Honoraria, Research Funding;Celgene: Research Funding;Takeda: Consultancy, Honoraria, Research Funding;Roche: Consultancy, Honoraria, Research Funding;Genmab: Consultancy, Honoraria, Research Funding. OffLabel Disclosure: Glofitamab is a full-length, humanized immunoglobulin G1 bispecific antibody with a 2:1 molecular format that facilitates bivalent binding to CD20 on B-cells, and monovalent binding to CD3 on T-cells. Glofitamab redirects T cells to engage and eliminate malignant B cells. Glofitamab is an investigational agent. Rituximab (Rituxan) is aCD20-directed cytolytic antibody indicated for the treatment of adult pts with: relapsed or refractory, low grade or follicular, CD20-positive, B-cell NHL as a single agent;previously untreated follicular, CD20-positive, B-cell NHL in combination with first-line chemotherapy (chemo) and, in pts achieving a CR or PR to a rituximab product in combination with chemo, as single-agent maintenance therapy;non-progressing (including stable disease), low-grade, CD20 positive, B-cell NHL as a single agent after first-line CVP chemo;previously untreated diffuse large B-cell, CD20-positive, NHL in combination with CHOP or other anthracycline-based chemo regimens;previously untreated and previously treated CD20-positive CLL in combination with fludarabine and cyclophosphamide.

Analysis of Outcomes and Predictors of Response in Patients with Relapsed Mantle Cell Lymphoma Treated with Brexucabtagene Autoleucel

Background: Brexucabtagene autoleucel (brexu-cel) is the first CD19 chimeric antigen receptor T-cell (CAR T) therapy approved for use in patients (pts) with relapsed mantle cell lymphoma (MCL). The ZUMA-2 trial demonstrated that brexu-cel induces durable remissions in these pts with an ORR of 85% (59% CR), estimated 12-month PFS rate of 61%, and similar toxicity profile to other CAR T therapies (Wang et al, NEJM 2020). We conducted a multicenter, retrospective study of pts treated with commercial brexu-cel to evaluate its safety and efficacy in the non-trial setting. Methods: We reviewed records of pts with relapsed MCL across 12 US academic medical centers. Pts who underwent leukapheresis between July 2020 and June 2021 with the intent to proceed to commercial brexu-cel were included. Baseline demographic and clinical characteristics were summarized using descriptive statistics. Survival curves were generated using the Kaplan-Meier method, and univariate models were fit to identify predictors of post-CAR T outcomes. Results: Fifty-five pts underwent leukapheresis. There were 3 manufacturing failures. Baseline characteristics of the 52 pts who received brexu-cel are summarized in Table 1. Median age was 66 yrs (range: 47-79 yrs) and 82% were male. Twenty of 29 (69%) pts with known baseline MIPI were intermediate or high risk. Seven pts had a history of CNS involvement. The median number of prior therapies was 3 (range: 2-8), including prior autologous stem cell transplant (ASCT) in 21 (40%) and prior allogeneic transplant in 2 pts (1 with prior ASCT and 1 without). Fifty percent had relapsed within 24 months of their initial therapy. All pts had previously received a Bruton's tyrosine kinase inhibitor (BTKi), including 29 (56%) with disease progression on a BTKi. Forty (77%) pts received bridging therapy (17 BTKi, 10 BTKi + venetoclax, 6 chemo, 3 venetoclax, 2 XRT only, 1 steroids only, 1 lenalidomide + rituximab). The ORR was 88% (CR 69%) among patients who received brexu-cel. Two pts had PD on initial restaging and 3 died prior to first response assessment (without evidence of relapse). Seven pts have not completed restaging due to limited follow-up (< 3 months) and were not included in the response assessment. Five pts have progressed, including 2 with CR and 1 with PR on initial restaging. With a median follow-up of 4.2 months, the estimated 6-month PFS and OS rates were 82.7% and 89.0%, respectively. All 7 pts with prior CNS involvement were alive without relapse at last follow-up. The incidence of cytokine release syndrome (CRS) was 84% (10% grade ≥ 3) with a median time to max grade of 5 days (range: 0-10 days). There were no cases of grade 5 CRS. The incidence of neurotoxicity (NT) was 57% (31% grade ≥ 3) with a median time to onset of 7 days (range: 4-15 days). NT occurred in 4/7 pts with prior CNS involvement (3 grade 3, 1 grade 4). Grade 5 NT occurred in 1 pt who developed cerebral edema and died 8 days after infusion. Thirty-five pts received tocilizumab, 33 received steroids, 7 received anakinra, and 1 received siltuximab for management of CRS and/or NT. Post-CAR T infections occurred in 8 pts, including two grade 5 infectious AEs (covid19 on day +80 and septic shock on day +40 after infusion). Rates of grade ≥ 3 neutropenia and thrombocytopenia were 38% and 37%, respectively. Among pts with at least 100 days of follow-up and lab data available, 5/34 (15%) had persistent grade ≥ 3 neutropenia and 4/34 (12%) had persistent grade ≥ 3 thrombocytopenia at day +100. Five pts have died, with causes of death being disease progression (2), septic shock (1), NT (1), and covid19 (1). Univariate analysis did not reveal any significant associations between survival and baseline/pre-CAR T MIPI, tumor pathologic or cytogenetic features, prior therapies, receipt of steroids/tocilizumab, or pre-CAR T tumor bulk. Conclusions: This analysis of relapsed MCL pts treated with commercial brexu-cel reveals nearly identical response and toxicity rates compared to those reported on ZUMA-2. Longer follow-up is require to confirm durability of response, but these results corroborate the efficacy of brexu-cel in a population of older adults with high-risk disease features. While all 7 pts with prior CNS involvement are alive and in remission, strategies to mitigate the risk of NT in this setting need to be evaluated. Further studies to define the optimal timing of CAR T, bridging strategies, and salvage therapies for post-CAR T relapse in MCL are warranted. [Formula presented] Disclosures: Gerson: TG Therapeutics: Consultancy;Kite: Consultancy;Abbvie: Consultancy;Pharmacyclics: Consultancy. Sawalha: TG Therapeutics: Consultancy, Research Funding;Celgene/BMS: Research Funding;BeiGene: Research Funding;Epizyme: Consultancy. Bond: Kite/Gilead: Honoraria. Karmali: Janssen/Pharmacyclics: Consultancy;BeiGene: Consultancy, Speakers Bureau;Morphosys: Consultancy, Speakers Bureau;Takeda: Research Funding;Genentech: Consultancy;AstraZeneca: Speakers Bureau;Roche: Consultancy;Karyopharm: Consultancy;Epizyme: Consultancy;Kite, a Gilead Company: Consultancy, Research Funding, Speakers Bureau;BMS/Celgene/Juno: Consultancy, Research Funding;EUSA: Consultancy. Torka: TG Therapeutics: Membership on an entity's Board of Directors or advisory committees. Chow: ADC Therapeutics: Current holder of individual stocks in a privately-held company, Research Funding;AstraZeneca: Research Funding. Shadman: Abbvie, Genentech, AstraZeneca, Sound Biologics, Pharmacyclics, Beigene, Bristol Myers Squibb, Morphosys, TG Therapeutics, Innate Pharma, Kite Pharma, Adaptive Biotechnologies, Epizyme, Eli Lilly, Adaptimmune, Mustang Bio and Atara Biotherapeutics: Consultancy;Mustang Bio, Celgene, Bristol Myers Squibb, Pharmacyclics, Gilead, Genentech, Abbvie, TG Therapeutics, Beigene, AstraZeneca, Sunesis, Atara Biotherapeutics, GenMab: Research Funding. Ghosh: Genentech: Research Funding;Pharmacyclics LLC, an AbbVie Company: Consultancy, Honoraria, Research Funding, Speakers Bureau;Karyopharma: Consultancy, Honoraria;Seattle Genetics: Consultancy, Honoraria, Speakers Bureau;Janssen: Consultancy, Honoraria, Speakers Bureau;TG Therapeutics: Consultancy, Honoraria, Research Funding;Incyte: Consultancy, Honoraria;Gilead: Consultancy, Honoraria, Research Funding, Speakers Bureau;Genmab: Consultancy, Honoraria;Epizyme: Honoraria, Speakers Bureau;Bristol Myers Squibb: Consultancy, Honoraria, Research Funding, Speakers Bureau;AstraZeneca: Consultancy, Honoraria, Speakers Bureau;ADC Therapeutics: Consultancy, Honoraria;Adaptive Biotech: Consultancy, Honoraria;AbbVie: Honoraria, Speakers Bureau. Moyo: Seattle Genetics: Consultancy. Fenske: TG Therapeutics: Consultancy, Speakers Bureau;Servier Pharmaceuticals: Consultancy;Seattle Genetics: Speakers Bureau;Sanofi: Speakers Bureau;Pharmacyclics: Consultancy;MorphoSys: Consultancy;Kite (Gilead): Speakers Bureau;KaryoPharm: Consultancy;CSL Therapeutics: Consultancy;Bristol-Myers Squibb: Speakers Bureau;Biogen: Consultancy;Beigene: Consultancy;AstraZeneca: Speakers Bureau;ADC Therapeutics: Consultancy;Adaptive Biotechnologies: Consultancy;AbbVie: Consultancy. Grover: Genentech: Research Funding;Novartis: Consultancy;ADC: Other: Advisory Board;Kite: Other: Advisory Board;Tessa: Consultancy. Maddocks: Seattle Genetics: Divested equity in a private or publicly-traded company in the past 24 months;BMS: Divested equity in a private or publicly-traded company in the past 24 months;Pharmacyclics: Divested equity in a private or publicly-traded company in the past 24 months;Novatis: Divested equity in a private or publicly-traded company in the past 24 months;Janssen: Divested equity in a private or publicly-traded company in the past 24 months;Morphosys: Divested equity in a private or publicly-traded company in the past 24 months;ADC Therapeutics: Divested equity in a private or publicly-traded company in the past 24 months;Karyopharm: Divested equity in a private or publicly-traded company in the past 24 months;Beigene: Divested equity in a private or publicly-traded company in the past 24 months;Merck: Divested equity in a private or publicly-traded company in the past 24 months;KITE: Divested equity in a private or publicly-traded company in the past 24 months;Celgene: Divested equity in a private or publicly-traded company in the past 24 months. Jacobson: Kite, a Gilead Company: Consultancy, Honoraria, Other: Travel support;Humanigen: Consultancy, Honoraria, Other: Travel support;Celgene: Consultancy, Honoraria, Other: Travel support;Pfizer: Consultancy, Honoraria, Other: Travel support, Research Funding;Lonza: Consultancy, Honoraria, Other: Travel support;AbbVie: Consultancy, Honoraria;Precision Biosciences: Consultancy, Honoraria, Other: Travel support;Novartis Pharmaceuticals Corporation: Consultancy, Honoraria, Other: Travel support;Nkarta: Consultancy, Honoraria;Axis: Speakers Bureau;Clinical Care Options: Speakers Bureau. Cohen: Janssen, Adaptive, Aptitude Health, BeiGene, Cellectar, Adicet, Loxo/Lilly, AStra ZenecaKite/Gilead: Consultancy;Genentech, Takeda, BMS/Celgene, BioInvent, LAM, Astra Zeneca, Novartis, Loxo/Lilly: Research Funding.

Imgs 'the glue of paediatric rotas', but who are they?

Background International Medical Graduates (IMG) form a significant part of the paediatric workforce in the UK. IMGs come from diverse cultural and ethnic backgrounds, and some have many years of postgraduate training in their country of origin (COO). The composition of this workforce includes: Speciality Trainees (ST1-ST8), Trust grade (Clinical Fellows), SAS (Speciality and Associate Specialty), and Locums. Due to the heterogeneity of this group, it is hard to find data to characterise this vital part of the workforce. We hope to fill a gap by starting to understand this group and the particular challenges they face, related to adopting to the new environment in their personal, social and work life. During Covid many of these doctors have faced additional challenges of isolation, being separated for long periods from family overseas, and not having the usual opportunities to make connections outside work. Our project, 'Soft Landing' aims to understand and help address these challenges. Objectives To explore the challenges faced by an IMGs in personal, social and working lives and how they progress through their careers in UK. Methods The survey was distributed via email to Training Programme Directors, as well as via social media. It was open to all paediatric IMGs in UK. Results 108 IMGs participated in the survey. 44% of them had worked in the UK for <12 months. Almost half planned to apply for training posts. The doctor's roles: Trainees: 15%, Non-Trainees (Level 1 and 2): 65%, Locum SHO: 20%. For most (80%), induction at start of post was not IMG tailored. 75% of participants had more than 5 years postgraduate experience. Despite most having many years of clinical experience, only 14% of IMGs felt confident during their first on call. Communication was a challenge for 50% of the cohort, and safeguarding was another concern with only 9% reporting feeling confident. Career-wise, 33% of participants mentioned their educational supervisor was aware of their career goals. 90% of the cohort reported opportunity to participate in audits and QIPs. However, only 30% of participants had an opportunity to present at national/international conference. Of concern, and reflecting WRES (Workforce Race Equality Standard) data on the experience of the medical BAME workforce, 60% of the cohort, mentioned that they had to take time off from work due to stress. The stress was related to 'work load', 'racism', 'non-supportive supervisors', 'difficult colleagues' and 'challenging patients'. 56% of the cohort mentioned that they were bullied and harassed in the work place. 40% of the cohort had received negative feed back at work. A large number, 46%, of the cohort had considered leaving UK. Conclusions Our survey highlights areas of challenge, data which reflects our own experiences as IMGs. This allows us to identify key areas for improvement. With a better understanding of the issues, and gaps identified we have established the Soft Landing project. We hope to work with key stakeholders to address these identified areas for improved support in order to continue to recruit and retain this valuable part of the workforce.

Precautionary behaviour for COVID-19 among general population in Hills, West Bengal, India: A pilot study

Background: Precautionary behaviour is important for prevention of disease spread. Preparedness for pandemic requires understanding and monitoring of disease-related perceptions and psychological responses in the general public and can be assessed by Health Behavioural Model (HBM). Objectives: This study aims to assess the COVID-19 related precautionary behaviour among population in hills of West Bengal, India conforming to the health belief models. Methods: A descriptive cross-sectional study was conducted among 351 participants with purposive sampling. The questions were formed in simple way to make it easier for the general population to understand and answer respectively. Based on Health Belief Model with its 6 constructs answers were rated on 5-point Likert scale with 5 being highest score and 1 the lowest. Data was analysed using principles of descriptive and inferential statistics. Result: Majority of subjects were educated and males. Risk perception and vaccination intent was high. Majority study subjects agreed that perceived severity and susceptibility was high and disagree that perceived benefits were high. Majority stated that they were not sure how they will respond to others in times of need. Interpretation and Conclusion: Study concludes that risk perception is high and perceived preventive behaviours were higher among majority of subjects. However, a larger study is recommended.

Upper respiratory tract SARS-CoV2 viral shedding in cancer patients

Background: SARS-CoV-2 virus has been shown to persist in respiratory tract in immunocompromised patients. However, such data are lacking for both asymptomatic and symptomatic SARS-CoV-2 infection in cancer patients. We share our single center experience on duration of SARS-CoV-2 viral presence in the upper respiratory tract of cancer patients with SARS-CoV-2 infection (asymptomatic and symptomatic) detected by viral PCR. Methods: This is retrospective review of cancer patients with documented SARS-CoV-2 infection and measurement of viral shedding at Levine Cancer Institute. Testing indications were COVID-19 symptomatic illness, pre-procedural and pre-chemo testing. Prolonged shedding was defined as presence of viral RNA beyond 30 days after first positive test. To document viral clearance, patients required 2 negative SARSCoV-2 PCR test separated by at least 24 hours and maximum 3 weeks apart either by nasopharyngeal or nasal PCR swab. Differences in distributions were identified between patients shedding virus more than 30 days and less than 30 days using uni- and multivariable logistic regression models. Statistical significance was set at p < 0.10 to enter the multivariable model, and p < 0.05 to remain. Results: Demographic data: median age 62 (range 20-93);58.5% females;70% White, 21% Black, and 7.4% Hispanics. Comorbidities included hypertension 43.2%, diabetes 16.7% and chronic lung disease 3.7%. Underlying malignancies were breast cancer 25%, hematologic cancer 22%, lung cancer 16% and genitourinary 11%. Chemotherapy was received by 26.5% patients within 4 weeks prior to testing. 162 patients were identified median duration of 18 days (range 4-90 days). Of these, 76% patients were tested for non-symptomatic indication with median duration of shedding 17 days (range 6-80) and 23% were tested for clinical symptoms with median duration of shedding 29 days (range 4-90) (p = < 0.001);50% of patients never developed symptoms, whereas 35% patients with non-symptomatic testing indication, subsequently developed symptoms. Viral clearance by day 30, day 45, day 60 and day 90 was 78%, 93%, 97% and 100% respectively. Univariate analysis did not show difference between patients with prolonged shedding vs those shedding less than 30 days for age, gender, race, ethnicity, underlying malignancy, co-morbidities including body mass index, diabetes, chronic lung conditions, hypertension, or receipt of cytotoxic chemo. Multivariable analysis showed that presence of symptoms at any point during SARS-CoV-2 infection (OR 5.9, 95% CI 2.4-14.5, p < 0.001) was associated with prolonged shedding. Conclusions: Symptomatic SARS-CoV-2 infection is associated with prolonged viral shedding in cancer patients. Cancer patients can have asymptomatic SARS-CoV-2 infection. More studies are warranted to understand viral kinetics and its clinical implications in cancer patients.

Risk factors for hospitalization for cancer patients with SARS-CoV-2 infection

Background: Cancer patients are more susceptible to developing severe disease associated with SARS-CoV-2 infection. Herein, data from a high-volume cancer center is presented highlighting risk factors associated with hospitalization with COVID-19 disease. Methods: Cancer patients in the Levine Cancer Institute COVID19 database who were tested for SARS-CoV-2 due to clinical illness from March 1, 2020 to October 29, 2020 with 90 days follow-up are described here. Patients' demographic and clinical information were retrospectively entered into a REDCap database from chart reviews. Differences in distributions were identified between hospitalized and nonhospitalized patients using the chi-squared test with uni- and multivariable logistic regression models. Statistical significance was set at p<0.05. Results: 228 patients with SARS-CoV-2 infection were identified, of whom 103 (45%) were hospitalized. Median age was 63 years (range 28-95). Race distribution for infection showed White 65%, followed by Black 26.8% and Hispanic ethnicity 16.7% , with a similar distribution for hospital admission. Median length of stay was 10 days (range 1-91) with no readmissions within 90 days. The most common underlying malignancies were breast (29.8%), hematologic (21.1%) and genitourinary (12.3%). The most common preexisting conditions included hypertension (55.7%), diabetes (27.2%) and cardiac disease (3.9%). The most common presenting symptoms were cough (50.2%), fever (38.4%), fatigue (37.8%) and shortness of breath (36.4%). Maximum oxygen requirements for hospitalized patients were ambient air (34%), nasal canula (34%), high/medium flow nasal canula (10%), non-invasive ventilation (13%) and mechanical ventilation (10%). Case fatality rate was 10% with diagnosis of COVID-19, including 21.4% of those admitted to the hospital and 51.7% of those admitted to the ICU. Univariable logistic regression analysis showed that age, sex, prior chemotherapy, upper gastrointestinal cancers, hematologic cancers, number of medical conditions, cardiac disease, chronic lung diseases, hypertension, and diabetes increased risk of hospitalization. Table shows results of multivariate analysis. Conclusions: The COVID-19 pandemic has caused high case fatality rates in our cancer patients. We identified age, cardiac disease, hematologic malignancy and receipt of chemotherapy within 4 weeks of diagnosis as risk factors for hospitalization. These data may help in prioritizing early intervention in vulnerable subgroups to improve survival outcomes.

Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine: a national cohort study.

OBJECTIVE: To compare outcomes before and after implementation of medical abortion (termination of pregnancy) without ultrasound via telemedicine. DESIGN: Cohort analysis. SETTING: The three main abortion providers. POPULATION OR SAMPLE: Medical abortions at home at ≤69 days' gestation in two cohorts: traditional model (in-person with ultrasound, n = 22 158) from January to March 2020 versus telemedicine-hybrid model (either in person or via telemedicine without ultrasound, n = 29 984, of whom 18 435 had no-test telemedicine) between April and June 2020. Sample (n = 52 142) comprises 85% of all medical abortions provided nationally. METHODS: Data from electronic records and incident databases were used to compare outcomes between cohorts, adjusted for baseline differences. MAIN OUTCOME MEASURES: Treatment success, serious adverse events, waiting times, gestation at treatment, acceptability. RESULTS: Mean waiting time from referral to treatment was 4.2 days shorter in the telemedicine-hybrid model and more abortions were provided at ≤6 weeks' gestation (40% versus 25%, P < 0.001). Treatment success (98.8% versus 98.2%, P > 0.999), serious adverse events (0.02% versus 0.04%, P = 0.557) and incidence of ectopic pregnancy (0.2% versus 0.2%, P = 0.796) were not different between models. In the telemedicine-hybrid model, 0.04% were estimated to be over 10 weeks' gestation at the time of the abortion; all were completed safely at home. Within the telemedicine-hybrid model, effectiveness was higher with telemedicine than in-person care (99.2% versus 98.1%, P < 0.001). Acceptability of telemedicine was high (96% satisfied) and 80% reported a future preference for telemedicine. CONCLUSIONS: A telemedicine-hybrid model for medical abortion that includes no-test telemedicine and treatment without an ultrasound is effective, safe, acceptable and improves access to care. TWEETABLE ABSTRACT: Compelling evidence from 52 142 women shows no-test telemedicine abortion is safe, effective and improves care.

Self-isolation of healthcare workers during covid-19 pandemic in a tertiary care center – association between their sleep quality, anxiety status and social capital

With the rapid spread of COVID-19 since its inception a year back, the frontline healthcare workers, who underwent isolation and quarantine following possible exposure, faced multiple psychiatric problems like deterioration of sleep quality and anxiety manifestations. Different demographic variables were found to be associated with their occurrence, as well as inter-relation between them were found to be common. We tried to examine the role of social support system as well to the appearance of such problems in the present study. After getting the ethical clearance, willing healthcare workers during their isolation and quarantine were presented questionnaires consisting of Socio-demographic proforma, Self-rating Anxiety Scale (SAS), Personal Social Capital Scale 16 (PSCS) and Pittsburgh Sleep Quality Index (PSQI). Data taken were analysed with independent t test and Fishers exact chi square test, Pearson’s correlation analysis and linear regression analysis. Majority of the subjects were married Hindu female from urban background, mostly doctor and nurse by profession. Independent T test revealed significant association between gender and anxiety status as well as between marital status and sleep quality. Positive correlation between the PSCS scores and the SAS scores (r=0.652, P<0.01) and negative correlations between the PSCS and PSQI scores and between the SAS and PSQI score were found albeit being statistically insignificant. Significant association was found between the SAS score and social bridging component of PSCS (Fishers exact chi sq. value 0.54 and p = 0.003). Anxiety score was significantly affected when the socio-demographic factors like gender, religion, marital status and scores of sleep quality (PSQI) and social capital (PSCS) were considered together as seen in the linear regression analysis.

Neonate with rare clinical presentation of COVID-19: a report of two clinically distinct cases

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread across the world. We describe two cases of neonate, presenting with features like multisystem inflammatory syndrome (MIS-C), who presented to our neonatal unit of Dr. M R Khan Shishu Hospital, Bangladesh on August, 2020. Case 1 was a 7-day-old male infant presented at 14 hours of life with fever, poor feeding, per rectal bleeding and shock. Detailed examination revealed Down's fancies and pallor. Case 2 was 15-day old neonate presenting with fever, rash and convulsion and his laboratory values were remarkable for high levels of C-reactive protein, D-dimer, ferritin and his Cerebrospinal fluid (CSF) findings were consistent with aseptic meningitis. Both babies were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First case was very critical and referred to tertiary care hospital after stabilization. 2nd case recovered completely and was discharged to home in 15 days. Though till date COVID 19 in neonate is not very well-known to us, it is essential to disseminate information among the medical community regarding severe and atypical presentations of COVID-19 in neonate as prior knowledge can help to quickly identify and treat these patients as they present in the neonatal department.