ABSTRACT
Background. Given the limited collaborative international studies that evaluated COVID-19 in patients with cancer in comparison to patients without cancer, we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries. Methods. We retrospectively collected de-identified data on cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, at 16 centers in Asia, Australia, Europe, North America, and South America. A logistic regression model was used to identify independent predictors of all-cause mortality within 30 days after COVID-19 diagnosis. Results. Of the total 4015 COVID-19 confirmed patients entered, we analyzed 3966 patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were older than non-cancer patients (median age, 61 vs 50 years;p< 0.0001);more likely to be pancytopenic , had pulmonary disorders, hypertension, diabetes mellitus. In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms. By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46;95% CI 1.03 to 2.07;p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55;95% CI 3.34 to 6.20;p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58;CI 0.39-0.88;p=0.009). Among patients on lowflow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who were on high flow oxygen (5.9% vs 17.6%;p=0.03). Patients transfused with convalescent plasma within 1 day of diagnosis had a lower 30-day mortality rate than those transfused later (1% vs 7%, p=0.04). Conclusion. Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality, as well as convalescent plasma given early after COVID-19 diagnosis.
ABSTRACT
Background. Several studies have shown that underlying cancer is a risk factor for progression of COVID-19 to severe illness and fatal outcome but there is very little data that specifies which underlying cancer puts this patient population at the highest risk. Methods. We retrospectively collected de-identified data on 1115 cancer patients diagnosed with COVID-19 between January and November 2020, at 12 centers in Asia, Australia, Europe, North America, and South America. Patient characteristics including age, type of malignancy (hematologic malignancy [HM], lung cancer, and non-lung cancer were determined in association with severe illness as well as all-cause mortality within 30 days after COVID-19 diagnosis. Results. By multivariable logistic regression analysis, independent risk factors for 30-day mortality in cancer patients included age > 65 (OR 6.64;95% CI 3.351to 12.55;p< 0.0001), ALC < 0.5 K/microliter (OR 2.10;95% CI 1.16 to 3.79;p=0.014), and anemia at < 10g/dl (OR 2.41;95% CI 1.30 to 4.44;p=0.005). Among cancer patients, the 30-day mortality rate was significantly higher in patients with lung cancer than in patients with non-lung cancer solid tumors, including those with lung metastases (22% vs 9%;p=0.001). Patients with HM tended to have higher 30-day mortality than patients with non-lung cancer solid tumors (13% vs 9% p=0.07) and tended to have a lower mortality rate than patients with lung cancer (p=0.07). Furthermore, HM patients were more likely to be lymphopenic and anemic at diagnosis as well as progress to LRTI and be placed on ventilatory support compared to non-lung cancer solid tumor patients ( p= or < 0.01). In addition, lung cancer and HM patients were more likely to develop hypoxia and require hospital admission than non-lung cancer solid tumor patients ( p=0.01). Conclusion. Lung cancer and HM patients are associated with the highest risk of progressing to severe disease and mortality in cancer patients with COVID-19. Hence, cancer patient population should be given the highest priority as far as prevention [vaccination with boosters if needed] as well as preemptive early therapy with monoclonal antibodies right after the onset of COVID-19.
ABSTRACT
Background. Patients who are admitted to the hospital with Coronavirus Disease 2019 (COVID-19) often have protracted hospitalizations complicated by bacterial or fungal co-infections. This also raises the question whether there is some feature of COVID-19 that predisposes to development of specific co-infections. To begin answering that question, we sought to review the distribution of microorganisms identified in bacterial and respiratory cultures in patients admitted with COVID-19. Methods. In a retrospective review of all patients admitted with COVID-19 in the year 2020 at a single academic tertiary medical facility, all positive blood and respiratory cultures were reviewed. Common contaminants were removed. Duplicate growth of the same organism within the same patient was not counted as a separate event. Results. 787 patients were admitted with COVID-19 for the specified time frame. There were 131 and 147 unique events of documented bacterial or fungal growth seen in blood cultures and respiratory tract cultures, respectively. The most commonly identified organism in blood cultures was Staphylococcus aureus (3.94% of patients with COVID-19), followed closely by Enterococcus (2.41%), Klebsiella (1.65%), and Escherichia (1.27%). Staphylococcus aureus was also the most frequently isolated organism in respiratory cultures (7.24% of patients with COVID-19), followed by Pseudomonas (3.43%), Klebsiella (1.78%), Serratia (0.89%), and Stenotrophomonas (0.89%). Conclusion. This suggests that the distribution of pathogens implicated in coinfections in this patient population may not be substantially different from what might be expected in patients admitted for reasons outside of COVID-19. Further investigation with a larger patient population would provide more generalizable data, including patients admitted for reasons outside of COVID-19.
ABSTRACT
Cotton is the main cash crop in Pakistan and it contributes 0.8% shares in GDP (Gross domestic product). The area of cotton in Pakistan is increased in recent years but its production is decreasing due to unfavorable climatic conditions. COVID-19 outbreak has also an effect on cotton consumption. From August 2019 to July 2020, the COVID-19 pandemic reduced global cotton consumption by 15%. Agricultural extension and advisory activities play an important role in agricultural development and can help to improve the living conditions of farmers. Keeping in view the importance of working in agriculture field staff for cotton, the present study was designed to analyze the quality of knowledge transferred by agriculture field staff. The present study was based on primary data and conducted in the district Muzfargarh becsasue it is one of major cotton producing district of Pujnab, Pakistan. A total of 180 respondents were taken from Tehsil Alipur of Muzfargarh from different union councils through a simple random sampling technique and interviewed through a pretested structured interview schedule. The data collected was analyzed using the Statistical Package for Social Sciences (SPSS). About 58% of the respondents identified that extension meetings are good source of information and 37.7% of the respondent said that agricultural field staff visit them on monthly basis. Impact of improved cotton management practices on health rated satisfactory by 52.77% of respondents. Based on findings it is recommended that the government should work with all stakeholders to implement regular training programs for cotton farmers in all areas. Monitoring of agricultural field staff should also be done on regular basis. Modern ways of communications should be implemented in rural areas for the quality of knowledge transfer among cotton growers.
ABSTRACT
Global epidemics and illness outbreaks are the huge threats to human prosperity and sustainability. In mankind history, humans have faced many epidemics that have caused millions of deaths and destroyed the global economy, politics, etc. Under the existing era, the globe is facing another pandemic, namely the Coronavirus Disease-2019 (COVID-19). Aware of the gravity and severity of the prevailing situation, each country has taken special steps to combat this dinger epidemic, mainly through non-pharmaceutical trails including self-isolation and social distance. Moreover, most countries restrict travel and trade to limit the spread of the coronavirus. By adopting these measures, still the epidemic has greatly pretentious key economic sectors, for instance agriculture, the most significant economic sector that supports human development and food security. The review aims to explore possible drastic impacts of worldwide pandemic (COVID-19) on food and agriculture sector. It is very significant to assess the impact of COVID-19 epidemic on the food, agriculture, and economy, because it mainly concerns the sustainability of human existence and the economy. The guidelines and regulations to curb pandemic interfered with the markets supply chain, resulting halt production, distribution, and lack of labor and inputs. This has greatly affected dairy production, poultry, livestock and fisheries. During the pandemic, it was not possible to plant spring crops, such as, open field of vegetables, wheat, maize, barley, sunflower, and canola. Therefore, due to the supply chain, the pandemic has serious impacts on food, agriculture, and economy, which the governments need to quickly resolve this issue.
ABSTRACT
Background: Our objective was to describe the clinical course, risk factors and outcomes of patients infected with COVID-19 around the globe comparing cancer to non-cancer patients. Methods: We conducted a retrospective cohort study of COVID-19 confirmed cases through an international multicenter collaboration including 17 centers around the world including the United States of America, Brazil, Europe, Far East, Middle East and Australia from January to date. We evaluated the patients' clinical characteristics, clinical course of the disease, hospitalization and outcome. Death was considered to be COVID-associated if it occurred within 30 days from the time of diagnosis. Results: Preliminary data on 571 patients included 186 cancer patients and 385 non-cancer patients. Cancer patients were more likely to have COPD and received steroids but were less likely to have COVID-related symptoms compared to non-cancer patients (84% vs 97%, p< 0.0001). The rate of pneumonia with hypoxia, non-invasive ventilation and mechanical ventilation were similar in both groups. Despite the fact that hospital admissions were significantly higher in non-cancer patients (70% vs 56%, p< 0.001), promising antiviral and immune-related therapy including remdesivir, convalescent plasma and immunomodulators were more commonly used in cancer patients compared to non-cancer patients (P=0.04). Cancer patients had a higher COVIDassociated mortality rate compared to non-cancer patients (20% vs 11%, p=0.006). Conclusion: Despite the fact that cancer patients received more frequent antiviral and immune-related therapy, the mortality rate among cancer patients was significantly higher than non-cancer patients.