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European Neuropsychopharmacology ; 53:S419, 2021.
Article in English | EMBASE | ID: covidwho-1592736


Background. Notwithstanding predictions of increase in suicide risk related to the current pandemic [1,2], as was the case in previous pandemics [3], so far there is no clear evidence of increased rates of suicide, self-harm, suicide attempts, or suicidal thoughts associated with the COVID-19 pandemic [4]. An increase in suicide deaths after the initial decline in the pandemic ourbreak has been described in Japan [5]. Objective. We assessed the impact of the COVID-19 outbreak on trends in suicide mortality and suicidal behavior (SB) in Cantabria (Spain). Methods. Data collection: suicide mortalities by the Institute of Forensic Medicine of Cantabria (IML) and SB (suicidal ideation, or suicide attempt defined as any self-injurious act with at least some intent to die) by Emergency Department (ED) visits using triage data from the electronic health care records of University Hospital Valdecilla (HUMV, reference hospital for all psychiatric emergencies in Cantabria, Spain). Collection period: January-2015 to December-2020. Data are analyzed in three different COVID-19 pandemic periods (outbreak and lockdown: March–June;return to quasi-normality and second wave: July-September;third wave: October-December) compared to those same quarters of the previous five years. Since we exclusively used available aggregate data in this study, formal ethical review was not required. Results. Since 2015, there has been an increasing trend of admissions to the ED of HUMV for SB, having almost tripled between 2015-2019 (88 vs 249). During 2020, visits for SB decreased by more than 30% in comparison with the previous year (173 vs 249). This decline started in March with the onset of the covid-19 pandemic. Previously in the first quarter of the year there were 35% more consultations for SB than 2019. On the contrary, during lockdown (second quarter) SB visits were one third of those in the same period of 2019. Although the third and fourth quarters of 2020 see a doubling of visits compared to the containment period, the number of visits in both quarters is between 60-65% of those in 2019. In 2020, suicides have dropped compared to 2019, both in absolute numbers (46 vs. 52) and rates per-100,000 inhabitants (7.89 vs. 8.95). In the first quarter of 2020 there were 19 suicides (7 more versus 2019), but during lockdown there were only 8 (12 less than in the same period 2019). Conclusions. In Cantabria (Spain), no increase in suicide or SB has been observed related to the pandemic. Conversely, in 2020 we found a decrease in both, consultations for SB and deaths by suicide, compared to 2019. The decrease in suicides and SB has been observed in all periods of Covid-19 pandemic (outbreak and lockdown;quasi-normality and second wave;third wave). Suicide data are difficult to collect in real time and the economic effects of the pandemic are still evolving. Preventive strategies will need to be developed to cope the possible increase in suicide and SB when current social protective measures are discontinued.No conflict of interest

Journal of Thoracic Oncology ; 16(10):S883-S884, 2021.
Article in English | EMBASE | ID: covidwho-1474794


Introduction: There are currently no predictive biomarkers for long-term survival after neoadjuvant chemoimmunotherapy. However, the identification of non-small lung cancer (NSCLC) patients who obtain long-term benefit from chemoimmunotherapy is essential to optimize therapies. Methods: Using samples from NADIM clinical trial (NCT03081689), in which resectable stage IIIA NSCLC patients were treated with neoadjuvant chemo-immunotherapy with nivolumab, we have evaluated the capacity of ctDNA levels before treatment initiation to predict overall survival (OS) and progression-free survival (PFS) by calculating Harrell’s C-statistic and we compare its predictive value with classical survival surrogates as the pathological response and clinical response assessed according to RECIST criteria v.1.1. The ctDNA was analyzed by NGS, using the Oncomine Pan-Cancer Cell-Free Assay™ (Thermo Fisher Scientific®). To explore the prognostic value of the amount of ctDNA at baseline, for each positive plasma sample, we calculated the sum of the mutant allele frequency (MAF) for all detected mutations. Patients who died from COVID19 were excluded from this analysis. Results: In our study, clinical responses based on RECIST criteria were not predictive for OS or PFS. On the contrary, in the multivariate analysis, patients with low ctDNA levels (<1% MAF), in the baseline sample, had significantly improved PFS and OS than patients in whom the opposite situation occurred (adjusted HR: 0.22;95%CI: 0.06-0.75;P=0.016 and adjusted HR: 0.04;95%CI: 0.00-0.45;P=0.008 for PFS and OS, respectively). The adjusted C-statistic (c) to predict PFS for ctDNA was 0.68 (95%CI: 0.51-0.84), which was superior to that of RECIST criteria (c=0.61;95%CI: 0.45-0.78) and similar to that of pathological response (c=0.68;95%CI: 0.52-0.84). Similarly, baseline ctDNA levels predicted OS (c=0.85;95%CI: 0.72-0.99) better than RECIST criteria (c=0.68;95%CI: 0.44-0.93). Conclusion: Pre-treatment ctDNA levels predicted more accurately long-term survival than radiological assessments in NADIM study and might be useful for the design of new clinical trials.

Bone Marrow Transplantation ; 56(SUPPL 1):362-362, 2021.
Article in English | Web of Science | ID: covidwho-1312091