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Future Oncol ; 18(6): 719-725, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1674207


Aim: To delineate clinical correlates of COVID-19 infection severity in hospitalized patients with malignancy. Methods: The authors conducted a retrospective review of all hospitalized patients with a hematologic and/or solid tumor malignancy presenting to the authors' institution between 1 March 2020 and 5 January 2021, with a laboratory confirmed diagnosis of COVID-19. Univariate and multivariate logistic regression analyses were used to determine associations between specific severity outcomes and clinical characteristics. Results: Among 2771 hospitalized patients with COVID-19, 246 (8.88%) met inclusion criteria. Patients who were actively receiving treatment had an increased rate of death following admission (odds ratio [OR]: 2.7). After adjusting for significant covariates, the odds ratio increased to 4.4. Patients with cancer involvement of the lungs had a trend toward increased odds of death after adjusting for covariates (OR: 2.3). Conclusions: Among COVID-19 positive hospitalized cancer patients, systemic anti-cancer therapy was associated with significantly increased odds of mortality.

Plain language summary Though cancer is a biologically heterogenous disease with a wide spectrum of clinical features and behavior, accumulating evidence suggests that cancer patients are at greater susceptibility to COVID-19 infection and more likely to experience morbidity and mortality from COVID-19 infection than non-cancer patients. In this study, the authors reviewed the clinical characteristics of patients with a diagnosis of cancer hospitalized with COVID-19 to assess potential correlates of COVID-19 severity in this population. Notably, analysis of the hospital data revealed a statistically significant increased incidence of mortality in cancer patients who were receiving systemic anti-cancer treatment, including chemotherapy, immunotherapy or targeted therapy, than in those not on therapy. Likewise, there was a trend toward increased mortality in those with either primary or metastatic tumor involvement of the lung compared with those without lung involvement.

COVID-19/complications , COVID-19/mortality , Neoplasms/complications , Neoplasms/drug therapy , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , California/epidemiology , Female , Hospitalization , Humans , Immune Checkpoint Inhibitors/therapeutic use , Immunologic Factors/therapeutic use , Lung Neoplasms/complications , Male , Middle Aged , Molecular Targeted Therapy , Patient Acuity , Retrospective Studies , SARS-CoV-2
Blood ; 136(Supplement 1):20-21, 2020.
Article in English | PMC | ID: covidwho-1339044


Introduction:Early epidemiological studies of U.S. patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have suggested a possible association between ABO/Rh blood group phenotype and both susceptibility and severity of COVID-19 infection. Given the remarkable heterogeneity of the host inflammatory response in this viral syndrome and the widespread expression of ABO/Rh antigens on vascular and alveolar endothelial cells, it is biologically plausible that certain blood group phenotypes, with their unique repertoire of anti-A and/or anti-B antibodies, may differentially augment the host-pathogen response. We conducted a retrospective review of patients hospitalized for COVID-19 within our regional healthcare network in San Diego County to identify an association between ABO/Rh blood group type and the severity of infection.Methods:All patients hospitalized at one of five Scripps Health hospitals in San Diego County from March 1, 2020 to July 30, 2020 with a PCR confirmed diagnosis of COVID-19 and blood type on record were included in the initial analysis (n = 316). Demographic, laboratory and clinical data were extracted from the electronic medical record and included age, ethnicity, BMI, sex, medications, co-morbidities and admission white blood cell and lymphocyte count, hemoglobin, platelets, ESR, CRP and D-dimer. Outcomes of interest included length of hospitalization, intensive care unit (ICU) admission, mechanical ventilation need, and mortality. Significant associations between each parameter of interest and blood group type were determined using either linear or logistic regression analysis. To address potential confounding variables, an adjusted multivariate model accounting for potential significant (p<0.1) predictors of each outcome on univariate analysis, in addition to blood type groups, was conducted to further refine any associations. The study was approved by the Scripps Health Institutional Review Board.Results:316 patients met inclusion criteria for analysis. Hospitalized COVID patients were predominantly male, obese (BMI 30.6) and were an average age of 63 years. Almost 70% of patients hospitalized were Hispanic. 57.0% of patients were blood type O, 30.4% were type A, 3.8% were type B and 8.9% were type AB. 7% were Rh negative. Median length of hospital stay was 16.5±14.7 days, 59% were admitted to the ICU, 37% were intubated, and 27% died. Further relevant laboratory values on admission, co-morbidities, and medications administered during hospitalization are summarized in Table 1. Blood type, with or without adjusting for other clinical variables, was not predictive of length of hospital stay, ICU admission, or intubation during the hospitalization. Type B blood alone was associated with decreased odds of death (OR: 0.27, 95% CI: 0.06-0.85, p<0.05), though this effect was not seen after adjusting for significant confounding variables (OR: 0.39, 95% CI: 0.08-1.43, p>0.18).Conclusion:In this large, multi-hospital, retrospective analysis of patients hospitalized for COVID-19 in San Diego County, there was a low relative percentage of Rh negative blood type and type B blood compared to historical population averages. Blood type was not determined to be independently associated with hospital length of stay, mechanical ventilation, ICU admission or death. ABO/Rh blood typing appears to have a limited prognostic role in COVID-19 severity of hospitalized patients, though further analysis of the protective effects of type B and/or Rh negative blood type may be warranted in a larger sample.

Future Sci OA ; 7(8): FSO735, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1270970


AIM: This study investigates the association between ABO blood phenotype and COVID-19 severity, measured by intensive care unit admission, need for intubation, hospitalization length and death. It further explores clinical predictors of COVID-19 severity within a primarily Hispanic demographic in San Diego County. MATERIALS & METHODS: We retrospectively reviewed 942 total patients, 473 with available blood type, hospitalized at five Scripps Health hospitals with COVID-19. RESULTS: No significant association was found between ABO phenotype and COVID-19 severity on multivariate analysis, while a diagnosis of anemia and male sex was associated with all severity outcomes on exploratory analysis. CONCLUSION: Our results provide relevant clinical correlates of COVID-19 severity and help better elucidate the association between ABO phenotype and COVID-19.

Leukemia ; 35(7): 1864-1872, 2021 07.
Article in English | MEDLINE | ID: covidwho-1216445


Standard treatment options in classic HCL (cHCL) result in high response rates and near normal life expectancy. However, the disease itself and the recommended standard treatment are associated with profound and prolonged immunosuppression, increasing susceptibility to infections and the risk for a severe course of COVID-19. The Hairy Cell Leukemia Foundation (HCLF) has recently convened experts and discussed different clinical strategies for the management of these patients. The new recommendations adapt the 2017 consensus for the diagnosis and management with cHCL to the current COVID-19 pandemic. They underline the option of active surveillance in patients with low but stable blood counts, consider the use of targeted and non-immunosuppressive agents as first-line treatment for cHCL, and give recommendations on preventive measures against COVID-19.

COVID-19/complications , Leukemia, Hairy Cell/therapy , COVID-19/epidemiology , COVID-19/pathology , COVID-19/virology , Consensus , Humans , Leukemia, Hairy Cell/complications , Pandemics , Practice Guidelines as Topic , SARS-CoV-2/isolation & purification , Severity of Illness Index