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Coinfections in Patients With Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Study.
Satyanarayana, Gowri; Enriquez, Kyle T; Sun, Tianyi; Klein, Elizabeth J; Abidi, Maheen; Advani, Shailesh M; Awosika, Joy; Bakouny, Ziad; Bashir, Babar; Berg, Stephanie; Bernardes, Marilia; Egan, Pamela C; Elkrief, Arielle; Feldman, Lawrence E; Friese, Christopher R; Goel, Shipra; Gomez, Cyndi Gonzalez; Grant, Keith L; Griffiths, Elizabeth A; Gulati, Shuchi; Gupta, Shilpa; Hwang, Clara; Jain, Jayanshu; Jani, Chinmay; Kaltsas, Anna; Kasi, Anup; Khan, Hina; Knox, Natalie; Koshkin, Vadim S; Kwon, Daniel H; Labaki, Chris; Lyman, Gary H; McKay, Rana R; McNair, Christopher; Nagaraj, Gayathri; Nakasone, Elizabeth S; Nguyen, Ryan; Nonato, Taylor K; Olszewski, Adam J; Panagiotou, Orestis A; Puc, Matthew; Razavi, Pedram; Robilotti, Elizabeth V; Santos-Dutra, Miriam; Schmidt, Andrew L; Shah, Dimpy P; Shah, Sumit A; Vieira, Kendra; Weissmann, Lisa B; Wise-Draper, Trisha M.
  • Satyanarayana G; Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Enriquez KT; Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Sun T; Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Klein EJ; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Abidi M; University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Advani SM; Cancer Prevention and Control, Department of Oncology, Georgetown University School of Medicine, Georgetown University, Washington DC, USA.
  • Awosika J; University of Cincinnati Cancer Center, Cincinnati, Ohio, USA.
  • Bakouny Z; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Bashir B; Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Berg S; Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, Illinois, USA.
  • Bernardes M; Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
  • Egan PC; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Elkrief A; McGill University Health Centre, Montreal, Quebec, Canada.
  • Feldman LE; University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA.
  • Friese CR; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.
  • Goel S; Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
  • Gomez CG; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.
  • Grant KL; Hartford HealthCare Cancer Institute, Hartford, Connecticut, USA.
  • Griffiths EA; Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
  • Gulati S; University of Cincinnati Cancer Center, Cincinnati, Ohio, USA.
  • Gupta S; Cleveland Clinic, Cleveland, Ohio, USA.
  • Hwang C; Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, Michigan, USA.
  • Jain J; The University of Kansas Cancer Center, Overland Park, Kansas, USA.
  • Jani C; Mount Auburn Hospital, Cambridge, Massachusetts, USA.
  • Kaltsas A; Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
  • Kasi A; The University of Kansas Cancer Center, Overland Park, Kansas, USA.
  • Khan H; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Knox N; Stritch School of Medicine at Loyola University, Maywood, Illinois, USA.
  • Koshkin VS; Helen Diller Family Comprehensive Cancer Center at the University of California at San Francisco, San Francisco, California, USA.
  • Kwon DH; Helen Diller Family Comprehensive Cancer Center at the University of California at San Francisco, San Francisco, California, USA.
  • Labaki C; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Lyman GH; Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • McKay RR; University of Washington, Seattle, Washington, USA.
  • McNair C; Moores Cancer Center, University of California San Diego, La Jolla, California, USA.
  • Nagaraj G; Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Nakasone ES; Loma Linda University Cancer Center, Loma Linda, California, USA.
  • Nguyen R; Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
  • Nonato TK; University of Washington, Seattle, Washington, USA.
  • Olszewski AJ; University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA.
  • Panagiotou OA; Moores Cancer Center, University of California San Diego, La Jolla, California, USA.
  • Puc M; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Razavi P; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Robilotti EV; Virtua Health, Mt. Holly, New Jersey, USA.
  • Santos-Dutra M; Moores Cancer Center, University of California San Diego, La Jolla, California, USA.
  • Schmidt AL; Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
  • Shah DP; McGill University Health Centre, Montreal, Quebec, Canada.
  • Shah SA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Vieira K; Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, Texas, USA.
  • Weissmann LB; Stanford Cancer Institute at Stanford University, Stanford, California, USA.
  • Wise-Draper TM; The Warren Alpert Medical School of Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
Open Forum Infect Dis ; 9(3): ofac037, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1701403
ABSTRACT

BACKGROUND:

The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection.

METHODS:

We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality.

RESULTS:

Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age >50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections.

CONCLUSIONS:

Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid