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Journal of Clinical Oncology ; JOUR(16):E18647-E18647, 40.
Article in English | Web of Science | ID: covidwho-2092897
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009601


Background: Patients with comorbidities especially those with oncological diseases could have severe COVID-19 outcomes. OBJECTIVE: The aim of this study was to evaluate the role of prolonged positivity of SARS-Cov2 in evolution of patients with various neoplasia. Methods: We analysed clinical and laboratory (hematological parameters and inflammatory markers: interleukin-6 and ferritin) data of COVID-19 patients admitted in intensive care unit (ICU) Department of our hospital, during 2020-2021 and presented in medical history solid tumors or haematological neoplasia . The cohort of patients included 78 patients with severe and critical form of COVID-19, 31 patients with solid tumors and 47 patients with hematologic malignancies. We consider long COVID-19 all cases with SARS Cov2 positivity more than 14 days. Results: The frequency of long COVID-19 was quite equal between patients groups with solid tumors and hematologic malignancies, incidence rate 1:2, the incidence rate differences was 1:18, p = 0.75. Long COVID-19 was observed in 60% cases with favourable evolution, Chi-squared 5.35%, p = 0.02, these patients had moderate form and was admitted in hospital in 1 or more days after the onset, median value 3 (min 1, max 55) compared with patients with normal duration of positivity of SARS-Cov2 test-median value 2 (min 1, max 8), p = 0.01. The Kaplan Meyer survival analyses indicated long COVID-19 as predictive factor for unfavourable evolution, Chi-squared 17.97, p < 0.0001. Although we have not obtain significant differences, we observed more severe lymphopenia in patient without long COVID-19, probably because a part of these patients group died in the first 14 days of COVID-19 (0.765 (min 0.04, max 297.64) vs. 1.01 (min 0.09, max 254.35), p = 0.09). The rest of hematological and biochemistry parameters was not significant different between groups. Infectious and thrombotic complication was most frequent in patients with long COVID-19, Chi squared 8.6, p = 0.003. Conclusions: Long Covid-19 is predictable for unfavourable evolution and is associated with sepsis and thrombotic complication. This diagnosis is frequent in patients who was admitted in hospital after the onset of COVID-19 symptoms, early treatment of COVID-19 in oncological patients being very important for favourable evolution.

Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509096


Background : COVID-19 frequently associated thrombotic complication that could determine severe evolution. Inflammation was proved as important pathogenic mechanism of thrombosis. Aims : The main objective was to evaluate the role of inflammation in increased risk of thrombosis in COVID 19 patients. Methods : Our study was prospective and included all patients diagnosed with COVID 19 between April-September 2020 in Hematology, Pneumology and Intensive Care Unit from Colentina Clinical Hospital (285 patients). The diagnosis was established using molecular test for SARS-Cov2. Results : Thrombotic complication was presented in 56 COVID-19 patients (19, 65%), The higher incidence of thrombosis was observed in severe form of COVID-19: stage 3 (66%) and stage 2 (26.3%), Comorbidities: diabetes mellitus, obesity and arterial hypertension were presented in majority of COVID 19 patients with thrombosis. Acute thrombosis (stroke, myocardial infarction or pulmonary embolism) was diagnosed in 14 patients;all of them were admitted in Intensive care unit due severe form of COVID-19. Inflammatory markers including C reactive protein (CRP), procalcitonin, ferritin are significantly increased in COVID-19 group with acute thrombosis compared with COVID -19 patients with thrombosis in medical history CRP 148.86 mg/L (2.96-386.5) vs. 58.24 mg/L (min 0.25, max 212.98) P = 0.005;procalcitonin 0.93 ng/ml (0.04-784) vs 0.18 (min 0.02, max 14.1) P = 0.02;ferritin 702 ng/ml (min 102, max 4070) vs. 1195 ng/ml (min 358, max 12800) P = 0.03. There is no significant difference between haematological parameters in COVID-19 patients with acute thrombosis or in their medical history. D Dimers are significant increased in patients with acute thrombosis 4.79 ug/ml (0.51-20) vs patients with medical history of thrombosis 2.12 (0.31-20), P = 0.02. The level of protein C, protein S and antitrombine III, antiphospholipid antibodies are not significant modified in the both groups. Conclusions : The assessment of inflammation parameters are very important in COVID-19 patients especially those with a history of thrombosis or who have significant comorbidities (diabetes mellitus, arterial hypertension or obesity).

HemaSphere ; 5(SUPPL 2):383, 2021.
Article in English | EMBASE | ID: covidwho-1393444


Background: The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was first reported in Wuhan, China in December2019 and represented the pathogen agent that induced COVID-19. The onset and evolution of COVID -19 is severe when is associated with another comorbidities. Patients with acute leukemia present high risk for severe form of COVID-19 Aims: The main objective was to evaluate the particularities of COVID-19 in patients with acute leukemia. Methods: Our study was prospective and included 49 patients with acute leukemia (27 male median age 64 and22 female median age 54,5) who also were SARS CoV2 positive between April2020- February2021 admitted in Hematology and Intensive Care Unit Departments of Colentina Clinical Hospital Bucharest. The diagnosis was established using molecular test for SARS-Cov2 Results: In the group was included 32 patients diagnosed with acute myeloid leukemia (AML), 9 patients with acute lymphoid leukemia (ALL), 6 patients with acut promyelocytic leukemia and2 patients with acute bifenotypic leukemia. Severe form of COVID-19 with ICU addmission was diagnosed in16 patients (32,17%), almost all of them (15 patients) had unfavourable evolution compared with non-ICU patients group with only1 deceased patient, p<0.0001. The recent chemotherapy followed by severe aplasia was the main negative factor that impacted patient evolution (rho=0.508, p=0.0002),13 patients admitted in ICU Department and12 patients in non-ICU. Severe pneumonia (more than 30% lung field) was diagnosed in17 patients with recent chemotherapy and 4 untreated patients. The type of leukemia or refractory status have not any impact of patient evolution. Antiviral therapy - Remdesivir rapidly introduced in patient's therapy was followed by favourable evolution. Summary/Conclusion: Patients with acute leukemia are negatively impacted by intensive chemotherapy during COVID-19 evolution. The key for good prognosis of these patients during COVID-19 are rapid diagnosis and antiviral therapy at the onset of the disease.