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Clinical and Virologic Characteristics and Outcomes of Coronavirus Disease 2019 at a Cancer Center.
Yoke, Leah H; Lee, Juhye M; Krantz, Elizabeth M; Morris, Jessica; Marquis, Sara; Bhattacharyya, Pooja; So, Lisa; Riedo, Francis X; Simmons, Jason; Khaki, Ali Raza; Cheng, Guang-Shing; Greninger, Alexander L; Pergam, Steven A; Waghmare, Alpana; Ogimi, Chikara; Liu, Catherine.
  • Yoke LH; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Lee JM; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
  • Krantz EM; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Morris J; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Marquis S; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Bhattacharyya P; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • So L; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Riedo FX; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
  • Simmons J; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Khaki AR; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
  • Cheng GS; EvergreenHealth, Kirkland, Washington, USA.
  • Greninger AL; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
  • Pergam SA; Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
  • Waghmare A; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Ogimi C; Division of Oncology, University of Washington, Seattle, Washington, USA.
  • Liu C; Division of Oncology, Department of Medicine, Stanford University, Palo Alto, California, USA.
Open Forum Infect Dis ; 8(6): ofab193, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1286576
ABSTRACT

BACKGROUND:

High morbidity and mortality have been observed in patients with cancer and coronavirus disease 2019 (COVID-19); however, there are limited data on antimicrobial use, coinfections, and viral shedding.

METHODS:

We conducted a retrospective cohort study of adult patients at the Seattle Cancer Care Alliance diagnosed with COVID-19 between February 28, 2020 and June 15, 2020 to characterize antimicrobial use, coinfections, viral shedding, and outcomes within 30 days after diagnosis. Cycle threshold values were used as a proxy for viral load. We determined viral clearance, defined as 2 consecutive negative results using severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction results through July 30, 2020.

RESULTS:

Seventy-one patients were included with a median age of 61 years; 59% had a solid tumor. Only 3 patients had documented respiratory bacterial coinfection. Empiric antibiotics for pneumonia were prescribed more frequently early in the study period (February 29-March 28, 2020; 12/34) compared to the later period (March 29-June 15, 2020; 2/36) (P = .002). The median number of days from symptom onset to viral clearance was 37 days with viral load rapidly declining in the first 7-10 days after symptom onset. Within 30 days of diagnosis, 29 (41%) patients were hospitalized and 12 (17%) died. Each additional comorbidity was associated with 45% lower odds of days alive and out of hospital in the month following diagnosis in adjusted models.

CONCLUSIONS:

Patients at a cancer center, particularly those with multiple comorbidities, are at increased risk of poor outcomes from COVID-19. Prolonged viral shedding is frequently observed among cancer patients, and its implications on transmission and treatment strategies warrant further study.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid