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Objective: To identify and describe the risk factors that increase susceptibility in older adults to infection by SARS-CoV-2 (Covid-19). Material(s) and Method(s): Descriptive, cross-sectional study in adults over 60 years, patients with a positive result (RT-PCR) were analysed to detect SARS-CoV-2. The study was carried out from May 17 to July 21, 2020. A multiple logistic regression model was used to analyse the risk factors of the study population. Result(s): 102 older adults were included with a mean age of 82.5 +/- 8.8 years, 55 (54%) were positive and 47 (46%) were negative. When analysing the risk factors related to higher mortality coupled with Covid-19 infection, the statistically significant variable was frailty, with an OR of 11.6 in frail adults compared to robust individuals (p-value = 0.024.) Conclusion(s): In the vulnerable population, risk factors must be identified and treated, but above all, such factors must be prevented in advance;early detection, isolation, effective treatment must be carried out as well as follow-up of contacts and prevention of the spread of the new virus to reduce mortality in vulnerable groups.Copyright © 2022 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
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Purpose/Background: Perioperative COVID-19 infection is associated with an increase in morbidity and mortality, in addition to the consequences on surgical pathologies due to delays in diagnosis and treatment. Hypothesis/Aim: The aim of this study it is to describe and evaluate the effects of the pandemic on patients undergoing colorectal cancer surgery in the UC-Christus Healthcare Network. Methods/Interventions: A retrospective observational cross-sectional cohort study was made. It was based on the review of the admissions and surgical protocols of patients operated due to colon and rectal cancer diagnosis between 03/18/2019 - 03/17/2021 in the UC-Christus Healthcare Network. Patients with incomplete records and follow-ups, recurrences, or endoscopic treatments were excluded. The results of patients who were operated before the sanitary restrictions were compared with those who were operated afterwards (03/18/2020). The variables of sex, age, date of surgery, procedure, approach, tumor location, TNM, biopsy, pathological stage, presence of neoadjuvant and/or adjuvant, cause of mortality, emergency admission, and ostomy requirement were recorded in a database. The descriptive and analytic statistics of the results were analyzed using the Microsoft SPSS-Statistics21 program. Proportions were compared with the Chi2 test and Fisher's exact test in variables whose frequency was less than 5. Results/Outcome(s): One hundred seven records were included in the first period (79 colon and 28 rectal tumors) and 134 in the second (100 colon and 34 rectal tumors), with no significant differences between the number of patients nor the distribution by sex in both periods. In the colon tumors group, there were no significant differences between the groups of patients with early-stage (17), locally advanced (118), and metastatic (44) tumors between both periods. Nineteen patients (10.6%) underwent emergency surgery, 36 patients (20.1%) required an ostomy to be performed without significant differences in both periods. At the rectum tumor group, there were no significant differences concerning sex, nor pathological stage, where 17 (26.9%) were in the initial stages, 29 (46%) locally advanced, and 17 (26.9%) were metastatic. The laparoscopic approach was preferred in all tumor groups, requiring conversion in 6 (4.65%) colon tumor and 1 (2.17%) rectal tumor cases. No mortalities were recorded 30, 60, nor 90 days after Limitations: Among the limitations of our study is a selection bias, since it was carried out only in one institution, so the results obtained here are not necessarily extrapolated to the general population. Conclusions/Discussion: In patients operated in the oncology program of the Healthcare Network, there were no significant differences regarding the number of operated patients, their pathological stage, mortality, or approach in the compared periods.
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INTRODUCTION AND OBJECTIVE: Androgen deprivation therapy (ADT) can help maintain remission in advanced prostate cancer (PCa) patients with bone metastases, however, growth and metastatic spread often recur. To address the need for more predictive pre-clinical research platforms and to identify new targets and therapies for bone metastatic castration-resistant prostate cancer (CRPC). METHODS: We used patient-derived xenograft (PDX) tumors from bone metastatic prostate cancer patients to establish threedimensional (3D) organoids and investigated their response to ADT by either withholding di-hydro-testosterone (no DHT) or treating with enzalutamide. Cyst/spheroid quantitation, immunohistopathology, cell viability assay, qRT-PCR, RNA sequencing, gene set enrichment analysis (GSEA) and live cell cycle tracking using Fucci2BL were performed in PDXs: PCSD1, PCSD13 and PCSD25 and compared to PCa Cell lines: P, DU145 and LNCaP. RESULTS: ADT resulted in CRPC spheroids with CK5D CK8D cells, up-regulated stem-cell transcription factors, steroidogenic and neurogenic pathways and down-regulated AR-target genes, interferon, cell cycle, cell division and circadian pacemaker pathways. Enzalutamide-treated spheroids transitioned to G0 and AR protein was decreased but not AR mRNA. Moreover, ADT decreased both ACE2 and TMPRSS2, host cell viral entry factors for the severe acute respiratory syndrome (SARS) SARS-CoV-2. CONCLUSIONS: In organoids, or mini-tumors, established from prostate cancer bone metastasis PDXs, a novel type of dormant ADT-resistant cell with specific gene changes emerged which may be targeted in order to eradicate dormant metastases before they can progress. This study identified a new dormant CRPC basal-luminal hybrid prostate cancer cell and gene signature which may be therapeutically targeted to eradicate dormant CRPC bone metastases in order to prevent disease recurrence. ADT also reduced the cell factors required for SARS-CoV-2 or its variants to infect its host cells and thus may reduce COVID-19 disease severity. The PDX organoid models can be used to screen for therapies that target the dormant CRPC cells and that reduce ACE2 and TMPRSS2 expression to suppress viral load of SARS-CoV-2 and its variants.
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Background: Although severe acute respiratory syndrome coronavirus (SARSCoV- 2) infection is primarily a respiratory disease, other organs are also affected. Several pathological studies confirm that SARS-CoV-2 invades kidney tissue causing endothelial damage, glomerular and vascular changes, extensive acute tubular injury and podocyte viral infection. AKI in COVID-19 appears to be frequent, with an AKI incidence of up to 46%, and a 20% requirement for renal replacement therapy (RRT). Patients with AKI show a trend towards worse outcomes and increased mortality. Information on Latin- American population is scarce. Methods: We created a cohort to describe the incidence, risk factors, and outcomes associated with AKI in hospitalized patients with COVID-19 in Mexico City, excluding patients with a known chronic kidney disease. AKI was defined and classified according to KDIGO guidelines. Results: We included 127 patients. 11 patients (8.66%) met the criteria for severe COVID-19, and were more likely to have AKI (81.82% vs. 54.31%, p=0.078). Of the 72 (56.69%) patients that had AKI, 48% were diagnosed at the time of admission. Patients with AKI were more likely to be men (61.7% vs. 42.42%, p=0.043) and older (55.68 years vs. 48.89 years, 0.018). With regards disease severity, 72% of them had a grade 1 AKI. 7 patients (9.72%) had grade 3 AKI, 4 of which needed renal replacement therapy. Overall length of stay was longer in patients with AKI (12 days vs. 7 days, p=0.003). A nonsignificant trend towards stay in critical care units was observed. 3 out of 127 patients died, all 3 had AKI. Conclusions: Amongst our studied population, AKI was associated with a longer length of stay and with a trend towards a more use of critical care services. The lack of association of AKI with mortality could be due to the low overall in-hospital mortality of COVID-19 patients (2.40%).