ABSTRACT
Objective: To study correlation of age, gender, serum IL-6 & D-dimer value (on admission), and impact of Tocilizumab (immunomodulator)/ Remdesivir (antiviral) therapy on clinical outcome (28-day mortality), in severe COVID-19. Methodology: Confirmed cases of severe COVID-19 (ICMR/ WHO criteria), admitted in the COVID-ICU were included. Venous plasma samples were collected within 6 hours of admission on day 1 for measurement of IL-6 and Ddimer and analyzed within 2 hours. Demographic characteristics, laboratory tests and therapeutic interventions were recorded. Results: The incidence of death was significantly higher in males above fifty years. The mortality rate correlated with increasing values of IL-6 (highest at levels >70 pg/mL. D-dimer values above 0.5μg FEU/mL were associated with increased risk of poor outcome. 85.3% of patients treated with Remdesivir showed clinical improvement. When Tocilizumab and Remdisivir were administered together, 44.0% of patients survived while 56% expired. Conclusion: Men above fifty years were most vulnerable to a poor outcome. Higher levels of IL-6 and D-dimer correlated with increased mortality. Both these biomarkers may be estimated on admission, and serially thereafter, to guide clinicians in recognizing patients with severe COVID-19 early in the disease course, and monitor prognosis. Remdesivir improved clinical outcome. The mortality rate was higher when Remdesivir and Tocilizumab were administered together.
ABSTRACT
Introduction There is limited literature available regarding the prevalence and durability of immune response to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) in cancer patients. Objective The aim of this study was to analyze the seroconversion rate in cancer patients recovered from SARS-CoV-2 infection. Materials and Methods We retrospectively analyzed antibody levels and seroconversion rates in serum samples from 135 cancer patients who had recovered from SARS-CoV-2 infection. Chemiluminescent immunoassay using Roche Cobas e801 analyzer (Roche Diagnostics, Rotkreuz, Switzerland) was performed to identify Pan Ig antibody against nucleocapsid antigen. Reports of first, third, and sixth month were analyzed. Seroconversion was also compared with health-care workers (HCW) of our institute who had recovered from COVID-19 infection. Results Seroconversion rate in cancer patients was 81.2% at 1 month, 95% at 3 months, and 94.6% at 6 months post reverse transcriptase-polymerase chain reaction positivity. There was no difference in seroconversion rate among different age groups, gender, comorbidities, severity of COVID-19 symptoms, cancer disease status, and treatment with chemotherapy. Seroconversion rate in cancer patients is comparable to HCW (90.4 vs. 96%, p = 0.82) and is durable. Conclusion Humoral response to COVID-19 infection in cancer patients is comparable to general population and sustained. Such responses suggest that cancer patients are likely to benefit from COVID-19 vaccination.