Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 47
Filter
2.
European Journal of Nuclear Medicine and Molecular Imaging ; JOUR(SUPPL 1):S156-S156, 49.
Article in English | Web of Science | ID: covidwho-2083331
3.
Australian Journal of Primary Health ; 28(4):xlvi-xlvii, 2022.
Article in English | EMBASE | ID: covidwho-2058314

ABSTRACT

Background: Integrated health care, particularly between the broader health care system and primary care can ease the patient journey, improve outcomes and reduce healthcare costs. The rise of both Primary Health Networks and Advanced Health Research and Translation Centres in Australia expands the requirement for Australia's Practice Based Research Networks (PBRNs) to incorporate a focus on integration. However little is known about the ways in which PBRNs can help align and coordinate different parts of the health care system. Aim/Objectives: To conduct a scoping review to examine how PBRNs have been used to foster integrated care across the healthcare system. Method(s): Our scoping review used the PRISMA-ScR framework and was based on Valentijn's conceptual framework for integrated care. Two independent reviewers used CovidenceTM to search titles, s, and full texts in Ovid Medline, EMBASE, CINAHL and Scopus. We sought to identify peer-reviewed empirical studies conducted since 2000 that examined collaboration between PBRNs and the broader healthcare system. We excluded studies that solely used PBRNs for recruitment and those restricted to a single practice. Finding(s): We identified 3022 articles, of which 74 studied primary care PBRNs. Of these, 13 focussed on 'integrated care.' The studies documented collaboration between primary care and a wide range of professions and organisations. Only one explored integration at a clinical, organisational and system level, and few showed how collaborations could be established or maintained. Most prioritised population health rather than clincial care. Implications: While system integration is beginning to be explored as PBRNs evolve, there is a paucity of information on how PBRNs form and foster integration between primary care and the broader healthcare system. An improved understanding of the role of PBRNs in integration is important given the focus on system integration and sustainability within Australia's new 10 Year Plan for primary health care.

5.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009551

ABSTRACT

Background: Despite mitigation and treatment strategies, COVID-19 continues to negatively impact patients (pts) with cancer. Identifying factors that remain consistently associated with morbidity and mortality is critical for risk identification and care delivery. Methods: Using CCC19 registry data through 12/31/2021 we report clinical outcomes (30-day case fatality rate [CFR], mechanical ventilation use (MV), intensive care unit admission (ICU), and hospitalization) in adult pts with cancer and laboratory confirmed SARS-CoV-2, stratified by patient, cancer, and treatment-related factors. Results: In this cohort of 11,417 pts (with 4% reported vaccination prior to COVID-19), 55% required hospitalization, 15% ICU, 9% MV, and 12% died. Overall outcome rates remained similar for 2020 and 2021 (Table). Hydroxychloroquine was utilized in 11% and other anti-COVID-19 drugs (remdesivir, tocilizumab, convalescent plasma, and/or steroids) in 30%. Higher CFRs were observed in older age, males, Black race, smoking (14%), comorbidities (pulmonary [17%], diabetes mellitus [16%], cardiovascular [19%], renal [21%]), ECOG performance status 2+ (31%), co-infection (25%), especially fungal (35%), and initial presentation with severe COVID-19 (48%). Pts with hematologic malignancy, active/ progressing cancer status, or receiving systemic anti-cancer therapy within 1-3 months prior to COVID-19 also had worse CFRs. CFRs were similar across anti-cancer modalities. Other outcomes (ICU, MV, hospitalization) followed similar distributions by pt characteristics. Conclusions: Unfavorable outcome rates continue to remain high over 2 years, despite fewer case reports in 2021 owing to multiple factors (e.g., pandemic dynamics, respondent fatigue, overwhelmed healthcare systems). Pts with specific socio-demographics, performance status, comorbidities, type and status of cancer, immunosuppressive therapies, and COVID-19 severity at presentation experienced worse COVID-19 severity;and these factors should be further examined through multivariable modeling. Understanding epidemiological features, patient and cancer-related factors, and impact of anti-COVID-19 interventions can help inform risk stratification and interpretation of results from clinical trials.

7.
Heart Lung and Circulation ; 31:S240-S241, 2022.
Article in English | EMBASE | ID: covidwho-1977314

ABSTRACT

Myocarditis has gained clinical awareness with the current COVID-19 pandemic. A recent ESC Expert Consensus document discussing management of acute myocarditis and chronic inflammatory cardiomyopathy has been published [1]. Although the document alludes to genetic predisposition, by stating that “patients with mutations responsible for arrhythmogenic cardiomyopathy may be at risk for acute myocarditis,” the growing clinical experience in this area suggests that perhaps pursuit of an inflammatory diagnosis has been at the cost of recognising an underlying genetic cause, with important implications for the patient and their family. Desmoplakin (DSP)-related arrhythmogenic cardiomyopathy (AC) is characterised by LV systolic dysfunction, subepicardial late gadolinium enhancement on cardiac magnetic resonance imaging (CMR) and frequent ventricular ectopy [2,3]. In ∼15% of DSP-related AC involving the LV, a clinical event indistinguishable from myocarditis can be the initial manifestation [4]. Myocarditis often precedes fibrosis and LV dysfunction. In this case series, we describe 3 unrelated young individuals (aged 21–28 years) diagnosed by our service with DSP pathogenic variants. In all cases the initial diagnosis was myocarditis and the diagnostic odyssey was characterised by multiple presentations with significant troponin elevations, including one in whom chronic inflammatory myocarditis was the diagnosis over many years. Since the COVID-19 pandemic, presentations for myocarditis have increased considerably [5]. This has increased the importance of the clinician considering genetic arrhythmogenic cardiomyopathy as an alternative diagnosis. Any case of myocarditis should prompt 3-generational family history, and recurrent presenters should have a CMR and be referred for consideration of genetic testing.

8.
Update in Anaesthesia ; 36:68-76, 2022.
Article in English | Scopus | ID: covidwho-1960258

ABSTRACT

Clinicians worldwide have been called to action against COVID-19, requiring development of effective systems to respond to the surge of pandemic cases. Anaesthesiologists are equipped to fulfil many roles in the operating room, critical care and retrieval settings. However, it was anticipated that the case load could overwhelm our existing referral structures, and put staff and patients at increased risk. We describe, using the “4S” components of surge capacity development, how systems, staff, space and stuff were utilised to create a COVID Anaesthesia, Intubation and Retrieval (CAIR) Team at Groote Schuur Hospital, Cape Town, South Africa. The primary aims of the team are to provide safe anaesthesia for patients with known or suspected COVID-19, and perform intubation and transfer in COVID wards or high care areas to intensive care units. Concurrently, promotion of strict infection control practices and risk mitigation through the use of a dedicated group of low-risk, highly trained individuals was achieved. Staff support systems, protocols for streamlined patient management, reallocation of spaces within the hospital, the capital and disposable equipment required for the service, and use of continual audit and iterative improvement are discussed in this article. © World Federation of Societies of Anaesthesiologists 2022.

9.
Revue Medicale Suisse ; 16(691):819-822, 2020.
Article in French | EMBASE | ID: covidwho-1870373

ABSTRACT

Medical oncologists are steering a difficult course during the COVID-19 pandemic between three opposing forces: revisiting optimal standards of cancer care, facing constantly evolving shortages as some resources are being redirected, and acknowledging the paradoxical need to keep patients away from the health care facility. This article compiles recommendations from cancer societies and expert opinions to provide guidance and practical solutions for the oncology clinic. We propose that optimal standards of care be upheld, and short-term safety concerns due to exposure to SARS-CoV-2 be weighed against a long-term compromise in cancer prognosis when deciding on adjustments in cancer care. Proper mitigation strategies in the clinic and use of less resource-heavy but equivalent treatment alternatives often allow optimal cancer care. The magnitude of benefit of cancer treatments needs to be systematically considered.

10.
13th International Conference on Semantic Web Applications and Tools for Health Care and Life Sciences, SWAT4HCLS 2022 ; 3127:108-117, 2022.
Article in English | Scopus | ID: covidwho-1823711

ABSTRACT

Emergence of the Coronavirus 2019 Disease has highlighted further the need for timely support for clinicians as they manage severely ill patients. We combine Semantic Web technologies with Deep Learning for Natural Language Processing with the aim of converting human-readable best evidence/ practice for COVID-19 into that which is computer-interpretable. We present the results of experiments with 1212 clinical ideas (medical terms and expressions) from two UK national healthcare services specialty guides for COVID-19 and three versions of two BMJ Best Practice documents for COVID-19. The paper seeks to recognise and categorise clinical ideas, performing a Named Entity Recognition (NER) task, with an ontology providing extra terms as context and describing the intended meaning of categories understandable by clinicians. The paper investigates: 1) the performance of classical NER using MetaMap versus NER with fine-tuned BERT models;2) the integration of both NER approaches using a lightweight ontology developed in close collaboration with senior doctors;and 3) the easy interpretation by junior doctors of the main classes from the ontology once populated with NER results. We report the NER performance and the observed agreement for human audits. Copyright © 2022 for this paper by its authors.

11.
ESMO Open ; 7(3): 100499, 2022 06.
Article in English | MEDLINE | ID: covidwho-1821235

ABSTRACT

BACKGROUND: ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). PATIENTS AND METHODS: ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection. RESULTS: This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m2, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. CONCLUSIONS: Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.


Subject(s)
COVID-19 , Hematologic Neoplasms , Neoplasms , COVID-19 Testing , Cohort Studies , Female , Humans , Male , Middle Aged , Neoplasms/epidemiology , Neoplasms/therapy , Registries , SARS-CoV-2
12.
Wirtschaftsdienst ; 102(3):162-165, 2022.
Article in German | Scopus | ID: covidwho-1782838

ABSTRACT

This article looks at over-indebtedness in Germany and its current status and trends. COVID-19 created increased attention on private debt and over-indebtedness. Various studies within the last two years show the severe financial impact of the pandemic;the situation has only eased in phases, but remains critical overall. A fundamental undersupply of efficient and effective debt counselling has become apparent. Current developments (especially with regard to energy prices) have increased the need for debt counselling. © 2022, Der/die Autor:in.

13.
Safety and Health at Work ; 13:S124, 2022.
Article in English | EMBASE | ID: covidwho-1677010

ABSTRACT

Introduction OMEGA-NET (2017-2022) is a COST Action network, funded by EU, involving about 200 occupational health researchers in 40 countries, including non-European partners. The goal is to create a network to optimize the coordination and use of occupational, industrial, and population cohorts in Europe and beyond, to inform evidence-based interventions and policy. Material and Methods A range of networking tools are available for COST Actions, such as meetings, workshops, conferences, training schools, short-term scientific missions (STSMs) and dissemination activities. Results Despite COVID-19 restrictions, the network has made great achievements, including two online searchable inventories: the Inventory of Occupational Cohorts, with more than 140 cohorts registered, and the Inventory of Occupational Exposure Tools, with about 75 tools, of which half are Job-Exposure Matrices. Working groups have discussed and written papers on harmonisation and standardisation of occupational exposure and health outcome information. So far, 15 papers are published, some as editorials or position papers, others are accepted or in progress. A webinar series, available on YouTube, present work of OMEGA-NET. The Action also includes opportunities for networking, leadership and training for early career researchers in occupational epidemiology and exposure assessment, and visits to other research institutions (STSMs), as well as stakeholder engagement. Conclusions OMEGA-NET is the largest coordination activity on occupational health globally and will substantially enhance future European and international research.

14.
41st SGAI International Conference on Innovative Techniques and Applications of Artificial Intelligence, AI 2021 ; 13101 LNAI:158-163, 2021.
Article in English | Scopus | ID: covidwho-1603584

ABSTRACT

Deep learning for natural language processing acquires dense vector representations for n-grams from large-scale unstructured corpora. Converting static embeddings of n-grams into a dataset of interlinked concepts with explicit contextual semantic dependencies provides the foundation to acquire reusable knowledge. However, the validation of this knowledge requires cross-checking with ground-truths that may be unavailable in an actionable or computable form. This paper presents a novel approach from the new field of explainable active learning that combines methods for learning static embeddings (word2vec models) with methods for learning dynamic contextual embeddings (transformer-based BERT models). We created a dataset for named entity recognition (NER) and relation extraction (REX) for the Coronavirus Disease 2019 (COVID-19). The COVID-19 dataset has 2,212 associations captured by 11 word2vec models with additional examples of use from the biomedical literature. We propose interpreting the NER and REX tasks for COVID-19 as Question Answering (QA) incorporating general medical knowledge within the question, e.g. “does ‘cough’ (n-gram) belong to ‘clinical presentation/symptoms’ for COVID-19?”. We evaluated biomedical-specific pre-trained language models (BioBERT, SciBERT, ClinicalBERT, BlueBERT, and PubMedBERT) versus general-domain pre-trained language models (BERT, and RoBERTa) for transfer learning with COVID-19 dataset, i.e. task-specific fine-tuning considering NER as a sequence-level task. Using 2,060 QA for training (associations from 10 word2vec models) and 152 QA for validation (associations from 1 word2vec model), BERT obtained an F-measure of 87.38%, with precision = 93.75% and recall = 81.82%. SciBERT achieved the highest F-measure of 94.34%, with precision = 98.04% and recall = 90.91%. © 2021, Springer Nature Switzerland AG.

15.
ESMO Open ; 7(1): 100339, 2022 02.
Article in English | MEDLINE | ID: covidwho-1607798

ABSTRACT

The coronavirus disease-19 (COVID-19) pandemic promises to have lasting impacts on cancer clinical trials that could lead to faster patient access to new treatments. In this article, an international panel of oncology experts discusses the lasting impacts of the pandemic on oncology clinical trials and proposes solutions for clinical trial stakeholders, with the support of recent data on worldwide clinical trials collected by IQVIA. These lasting impacts and proposed solutions encompass three topic areas. Firstly, acceleration and implementation of new operational approaches to oncology trials with patient-centric, fully decentralized virtual approaches that include remote assessments via telemedicine and remote devices. Geographical differences in the uptake of remote technology, including telemedicine, are discussed in the article, focusing on the impact of the local adoption of new operational approaches. Secondly, innovative clinical trials. The pandemic has highlighted the need for new trial designs that accelerate research and limit risks and burden for patients while driving optimization of clinical trial objectives and endpoints, while testing is being minimized. Areas of considerations for clinical trial stakeholders are discussed in detail. In addition, the COVID-19 pandemic has exposed the underrepresentation of minority groups in clinical trials; the approach for oncology clinical trials to improve generalizability of efficacy and outcomes data is discussed. Thirdly, a new problem-focused collaborative framework between oncology trial stakeholders, including decision makers, to leverage and further accelerate the innovative approaches in clinical research developed during the COVID-19 pandemic. This could shorten timelines for patient access to new treatments by addressing the cultural and technological barriers to adopting new operational approaches and innovative clinical trials. The role of the different stakeholders is described, with the aim of making COVID-19 a catalyst for positive change in oncology clinical research and eventually in cancer care.


Subject(s)
COVID-19 , Neoplasms , Telemedicine , Clinical Trials as Topic , Humans , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics , SARS-CoV-2
16.
Gastroenterology ; 160(6):S-191, 2021.
Article in English | EMBASE | ID: covidwho-1593034

ABSTRACT

Background: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been responsible for the global pandemic and disease known as COVID-19. Clinical studies have found >50% of COVID-19 patients report gastrointestinal (GI) symptoms, with some studies suggesting longer viral clearance in patients with GI symptoms. SARS-CoV-2 utilizes angiotensin-converting enzyme 2 (ACE2) as a receptor for viral attachment and intracellular entry, which is expressed in the intestine, making the GI tract a potential route of infection. Aim: To determine the effect of microbial colonization on colonic ACE2 expression using a humanized mouse model. Methods: Human stool was collected from healthy volunteers and individuals with irritable bowel syndrome, a common gastrointestinal disorder, and fecal slurries were prepared. 4-6 week old female Swiss-Webster mice (N=6/group) were gavaged with fecal slurries and maintained in sterile ex-isolator cages for 6 weeks. Posthumanization stool was collected along with proximal colonic tissue. Shotgun metagenomics was done on mouse pellets. RNAseq on tissue performed at a depth of 20 million reads/ sample using NovaSeq 6000. MAP-Rseq workflow using the mm10 genome was done to identify differentially expressed genes. Associations of ACE2 expression with α –diversity between microbiome from healthy and irritable bowel syndrome humanized mice was done using linear modeling with compositional associations assessed using PERMANOVA (BrayCurtis distance). To identify taxa associated with ACE2 expression, a permutation-based approach using the F-statistic of a linear model was used with false discovery rate (FDR) to correct for multiple testing. Results: Humanized mice demonstrated significantly lower colonic ACE2 expression compared to the germ-free mice (333.4 ± 191.1 vs. 1914 4 ± 309.9, FDR<0.001). However, ACE2 expression was similar post-humanization across all mouse groups regardless of stool used for humanization, despite decreased diversity in stool from irritable bowel syndrome patients and compositional differences from healthy volunteer stool. No associations between microbiome α-diversity (Shannon p=0.825, observed p= 0.400, InvSimpson p=0.512), β-diversity (p=0.568) or individual taxa were seen with ACE2 expression. Conclusions: Commensal microbial colonization significantly suppresses colonic ACE2 expression. However, in this pilot study, mice colonized with dysbiotic and healthy microbial communities had similar ACE2 expression. Future studies will have to explore the role of commensal microbes on gastrointestinal expression of ACE2 which may in turn reflect predisposition for infection or intestinal involvement with SARS-CoV-2. Supported by DK103911, DK120745.

17.
Occupational and Environmental Medicine ; 78(SUPPL 1):A146, 2021.
Article in English | EMBASE | ID: covidwho-1571295

ABSTRACT

The SARS-CoV-2 virus pandemics has raised several challenges at the workplace. Within the omega-net COVID-19 taskforce, we developed standardized COVID-19 questionnaires for occupational research, a multi-country COVID-19 Job Exposure Matrix, and research on COVID-19 as an occupational disease. The compiled questionnaire resource covers all key aspects of the COVID-19 pandemic, including: COVID-19 diagnosis & prevention, Health and demographic, Use of personal protective equipment, Health effects, Work-related effects, Financial effects, Work-based risk factors, Psychosocial risk factors, Lifestyle risk factors, and Personal evaluation of the impact of COVID-19. For each of the domains additional questions are available. A second questionnaire (in a short and along version) focusses on occupational risk factors for SARS-CoV-2 infection and COVID-19 disease. The questionnaires are available online at https://omeganetcohorts.eu/news/covid19-questionnaires-omeganet/. The JEM was developed by experts from three European countries (Denmark, the Netherlands, UK), who defined the relevant exposure and workplace characteristics with regard to the possible exposure to SARS-COV 2 infection. The C19-JEM contains four determinants of transmission risk (number of people, type of people, indirect contact and location), two mitigation measures (social distance and face covering), and two social factors (income insecurity and migrant workers). Finally, we developed and piloted a questionnaire on COVID-19 as occupational disease, which provide data on 1) COVID-19 as occupational disease or injury, 2) criteria for recognition and compensation regarding exposure, disease, role of use of PPE and of competing non-occupational exposure;and 3) what can be compensated. Results are available from 36 largely European countries. Through the development and implementation of tools we not only provide instruments, but also insights on the occupational risks and diseases in relation to SARS-COV 2.

18.
Journal of NeuroInterventional Surgery ; 13(Suppl 2):A2, 2021.
Article in English | ProQuest Central | ID: covidwho-1455736

ABSTRACT

IntroductionCerebral vasospasms are an important cause of considerable morbidity and mortality after subarachnoid hemorrhage (SAH). In addition to conservative therapy, endovascular spasmolysis can play an important role in the management of this disease. Still, optimal management remains controversial. Stent-retrievers may provide an alternative and additional technique for the treatment of cerebral vasospasms.1Aim of StudyTo investigate the feasibility and safety of mechanical spasmolysis with different stent-retrievers.MethodsWe retrospectively analyzed all patients with vasospasms after SAH that were treated with percutaneous spasmolysis using self-expanding and adjustable stent-retrievers and remodeling devices in addition to conventional vasospasm therapy.Results21 vessel-segments with vasospasms in 12 patients were included. Spasmolysis with stent-retrievers was conducted in proximal and distal vessel segments without complications. In 42.9% a good effect, in 52.4% a medium effect and in only one case (4.8%) a poor angiographic effect was achieved, respectively. Spasmolysis was more effective in distal vessel segments compared to proximal (reduction of stenosis 56.6% vs. 26.7%, p<0.05) and more effective with 3 mm compared to 4 mm stent-retrievers (43.6% vs. 25.8%, p=0.059). 71.4% of patients had a favorable outcome (mRS 0–1) at long-term FU (77–226d).ConclusionStent-retrievers are frequently used in interventional stroke therapy and may represent a safe and effective treatment option for intracranial spasmolysis after SAH, especially for the more distal vessel-segments. Compared to conventional balloon-PTA, this method seems promising by its ease of use, low risk of rupture and retained blood flow during dilatation, however further improvement of the radial force is recommended.ReferenceBhogal P, Loh Y, Brouwer P, et al. Treatment of cerebral vasospasm with self-expandable retrievable stents: proof of concept. J Neurointerv Surg 2017;9:52–59. doi:10.1136/neurintsurg-2016–012546DisclosureFundingNo funding was received for this research. Johannes Hensler: Personal fees from consultant activity for Balt, outside the submitted work. Wodarg F: Personal fees from consultant activity for Microvention, personal fees from consultant activity for Acandis, personal fees from consultant activity for Cerus Endovascular, personal fees from consultant activity for Cerenovus, personal fees from consultant activity for Balt, outside the submitted work. Jawid Madjidyar: none Sönke Peters: none Gesa Cohrs: none Olav Jansen: Personal fees from consultant activity for STRYKER, personal fees from consultant activity for Medtronic, personal fees from consultant activity for Covidien, outside the submitted work. Naomi Larsen: none

19.
Annals of Oncology ; 32:S1133, 2021.
Article in English | EMBASE | ID: covidwho-1432861

ABSTRACT

Background: At the height of the first wave of the SARS-COV-2 pandemic, ESMO mobilized to accelerate research for the understanding of COVID-19 in cancer patients (pts). ESMO CoCARE is an international collaborative registry-based, cohort study, gathering real-world data and information from healthcare professionals about the natural history, treatment and outcomes of COVID-19 in cancer pts. Methods: ESMO CoCARE captures information on pts with any solid or hematologic malignancy (including cancer survivors free of disease for ≥5 years) presenting with a COVID-19 diagnosis in any of the participating centers. Data collected since 06/2020 include demographics, cancer characteristics and status, co-morbidities, COVID-19 clinical features, course, management and outcome. Factors influencing COVID-19 severity (hospitalization +/- ICU support needed) and recovery are investigated using multivariable logistic regression with backward elimination method. The study is ongoing. Results: The current analysis includes 1551 registered pts (19 countries;87% pts from 23 European centers, 7% and 6% pts from 5 Northern African and 7 Asian centers), with COVID-19 diagnosis as of 11/03/2021. Median age was 64 years, with the majority female (52%), cancer stage III/IV (58%), and on active cancer treatment (60%). 65% had severe COVID-19 requiring hospitalization, with 11% receiving intensive care. In multivariable analysis, in addition to demographics (male gender, older age, other ethnicity than Caucasian, lower BMI), co-morbidities and symptomatic COVID-19, severe disease was associated to higher ECOG PS (Odds Ratio (OR)2 vs 0=5.9, OR1 vs 0=2.1), hematological malignancies (OR hemvs solid =2.0), and active/progressive cancer status (OR progressivevs no evidence of disease =1.6). 98% of pts with mild disease recovered, as opposed to only 70% of those with severe disease. Cancer stage was an additional prognostic factor for recovery (ORI/II vs IV =3.4). Conclusions: Demographic characteristics, type and status of cancer, and symptomatology of COVID-19 increase the probability of severe disease, while advanced cancer stage is also associated with the risk of death. Legal entity responsible for the study: Institut Curie, Paris, France. Funding: ESMO - European Society for Medical Oncology. Disclosure: E. Romano: Financial Interests, Institutional, Funding, Investigator-initiated trial: AstraZeneca;Financial Interests, Institutional, Funding, Investigator-initiated trial: BMS;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Merck;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Pierre Fabre. R. Lee: Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Institutional, Funding: BMS. A. Croitoru: Financial Interests, Personal, Advisory Role: Ipsen;Financial Interests, Personal, Advisory Role: Astellas;Financial Interests, Personal and Institutional, Funding: Bristol-Myers Squibb;Financial Interests, Personal and Institutional, Funding: Merck;Financial Interests, Personal and Institutional, Funding: Astellas;Financial Interests, Personal and Institutional, Funding: Servier;Financial Interests, Personal and Institutional, Funding: Five Prime Therapeutics;Financial Interests, Personal and Institutional, Funding: Amgen;Financial Interests, Personal, Other, Travel funding: Merck;Financial Interests, Personal, Other, travel funding: Servier;Financial Interests, Personal, Other, travel funding: Roche. S. Susnjar: Financial Interests, Personal, Other, Honoraria and/or advisory fees: Roche;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Pfizer;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Novartis;Financial Interests, Personal, Other, Honoraria and/or advisory fees: AstraZeneca;Financial Interests, Personal, Other, Honoraria and/or advisory fees: Amicus. M. Rossi: Financial Interests, Personal, Other, travel and personal fees: Novartis;Financial terests, Personal, Other, travel and personal fees: Ipsen. O.A. Michielin: Financial Interests, Personal, Other, personal fees: Bristol-Myers Squibb;Financial Interests, Personal, Other, personal fees: MSD;Financial Interests, Personal, Other, personal fees: Novartis;Financial Interests, Personal, Other, personal fees: Roche;Financial Interests, Personal, Other, personal fees: Amgen;Financial Interests, Personal, Other, personal fees: NeraCare GmbH. G. Pentheroudakis: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Lilly;Financial Interests, Personal, Advisory Board: Merck;Financial Interests, Personal, Advisory Board: MSD;Financial Interests, Personal, Advisory Board: Roche;Financial Interests, Institutional, Principal Investigator: AbbVie;Financial Interests, Institutional, Research Grant: Amgen;Financial Interests, Institutional, Principal Investigator, Coordinating PI: Amgen;Financial Interests, Institutional, Research Grant: AstraZeneca;Financial Interests, Institutional, Principal Investigator: AstraZeneca;Financial Interests, Institutional, Research Grant: Boehringer Ingelheim;Financial Interests, Institutional, Funding: Boehringer Ingelheim;Financial Interests, Institutional, Funding: Bristol Myers Squibb;Financial Interests, Institutional, Principal Investigator: Bristol Myers Squibb;Financial Interests, Institutional, Principal Investigator: Debbiopharm;Financial Interests, Institutional, Funding: Enorasis;Financial Interests, Institutional, Funding: Genekor;Financial Interests, Institutional, Funding: Ipsen;Financial Interests, Institutional, Principal Investigator: Ipsen;Financial Interests, Institutional, Funding: Janssen;Financial Interests, Institutional, Principal Investigator: Lilly;Financial Interests, Institutional, Funding: Merck;Financial Interests, Institutional, Principal Investigator: Merck;Financial Interests, Institutional, Funding: MSD;Financial Interests, Institutional, Principal Investigator: MSD;Financial Interests, Institutional, Funding: Pfizer;Financial Interests, Institutional, Principal Investigator: Roche;Financial Interests, Institutional, Research Grant: Roche;Financial Interests, Institutional, Funding: Sanofi;Financial Interests, Institutional, Principal Investigator, Coodinating Pi: Servier;Financial Interests, Institutional, Funding: Servier. S. Peters: Consultation / Advisory role: AbbVie, Amgen, AstraZeneca, Bayer, Beigene, Biocartis, Bio Invent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, Elsevier, F. Hoffmann-La Roche/Genentech, Foundation Medicine, Illumina, Incyte, IQVIA, Janssen, Medscape, Merck Sharp and Dohme, Merck Serono, Merrimack, Mirati, Novartis, PharmaMar, Phosplatin Therapeutics, Pfizer, Regeneron, Sanofi, Seattle Genetics, Takeda, Vaccibody. Talk in a company’s organized public event: AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, e-cancer, Eli Lilly, F. Hoffmann-La Roche/Genentech, Illumina, Medscape, Merck Sharp and Dohme, Novartis, PER, Pfizer, Prime, RTP, Sanofi, Takeda. Receipt of grants/research supports: (Sub)investigator in trials (institutional financial support for clinical trials) sponsored by Amgen, AstraZeneca, Biodesix, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, F. Hoffmann-La Roche/Genentech, GSK, Illumina, Lilly, Merck Sharp and Dohme, Merck Serono, Mirati, Novartis, and Pfizer, Phosplatin Therapeutics. All other authors have declared no conflicts of interest.

20.
Annals of Oncology ; 31:S1201-S1202, 2020.
Article in English | PMC | ID: covidwho-1384954

ABSTRACT

Background: SARS-CoV-2 is associated with diverse clinical presentations ranging from asymptomatic infection to lethal complications. Small studies have suggested inferior outcomes in patients (pts) on active cancer treatment. This finding was not independently validated in our prior report on 928 pts, which included treatments administered within 4 weeks of COVID-19 diagnosis. Here, we examine outcomes related to systemic cancer treatment within one year of lab-confirmed SARS-CoV-2 infection in an expanded cohort. Method(s): The COVID-19 and Cancer Consortium (CCC19) registry (NCT04354701) was queried for pts ever receiving systemic treatment. Treatment type, cancer type, stage, and COVID-19 outcomes were examined. Pts were stratified by time from last treatment administration: <2 wk, 2-4 wk, 1-3 mo, or 3-12 mo. Standardized incidence ratios (SIR) of mortality by treatment type and timing were calculated. Result(s): As of 31 July 2020, we analyzed 3920 pts;42% received systemic anti-cancer treatment within 12 mo (Table). 159 distinct medications were administered. The highest rate of COVID-19-associated complications were observed in pts treated within 1-3 months prior to COVID-19;all-cause mortality in this group was 26%. 30-day mortality by most recent treatment type was 20% for chemotherapy, 18% for immunotherapy, 17% for chemoradiotherapy, 29% for chemoimmunotherapy, 20% for targeted therapy, and 11% for endocrine therapy. SIR of mortality was highest for chemoimmunotherapy or chemotherapy <2 wks, and lowest for endocrine treatments. A high SIR was also found for targeted agents within 3-12 mo. Pts untreated in the year prior to COVID-19 diagnosis had a mortality of 14%. [Formula presented] Conclusion(s): 30-day mortality was highest amongst cancer pts treated 1-3 months prior to COVID-19 diagnosis and those treated with chemoimmunotherapy. Except for endocrine therapy, mortality for subgroups was numerically higher than in pts untreated within a year prior to COVID-19 diagnosis. Clinical trial identification: NCT04354701. Legal entity responsible for the study: The COVID-19 and Cancer Consortium (CCC19). Funding(s): National Cancer Institute (P30 CA068485). Disclosure: T.M. Wise-Draper: Research grant/Funding (self), Travel/Accommodation/Expenses: AstraZeneca;Research grant/Funding (self): BMS;Research grant/Funding (self): Tesaro/GSK;Advisory/Consultancy: Shattuck Labs;Leadership role, Travel/Accommodation/Expenses, HNC POA Lead: Caris Life Sciences;Research grant/Funding (self), Travel/Accommodation/Expenses: Merck;Travel/Accommodation/Expenses: Eli Lilly;Travel/Accommodation/Expenses: Bexion. A. Elkrief: Research grant/Funding (self): AstraZeneca. B.I. Rini: Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Merck;Advisory/Consultancy, Research grant/Funding (self): Roche;Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Pfizer;Advisory/Consultancy, Research grant/Funding (self): AVEO;Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: BMS;Advisory/Consultancy: arravive;Advisory/Consultancy: 3D medicines;Advisory/Consultancy: Synthorx;Advisory/Consultancy: Surface Oncology;Shareholder/Stockholder/Stock options: PTC Therapeutics;Research grant/Funding (self): AstraZeneca. D.B. Johnson: Advisory/Consultancy: Array Biopharma;Advisory/Consultancy, Research grant/Funding (self): BMS;Advisory/Consultancy: Janssen;Advisory/Consultancy: Merck;Advisory/Consultancy: Novartis;Research grant/Funding (self): Incyte;Leadership role: ASCO melanoma scientific committee chair;Leadership role: NCCN Melanoma committee. G. Lopes: Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim;Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer;Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution): AstraZeneca;Research grant/Funding (institution): Merck;Research grant/Funding (institution): EMD Serono;Research gr

SELECTION OF CITATIONS
SEARCH DETAIL