International multicenter study comparing COVID-19 in patients with cancer to patients without cancer: Impact of risk factors and treatment modalities on survivorship.

Background: In this international multicenter study, we aimed to determine the independent risk factors associated with increased 30 day mortality and the impact of cancer and novel treatment modalities in a large group of patients with and without cancer with COVID-19 from multiple countries. Methods: We retrospectively collected de-identified data on a cohort of patients with and without cancer diagnosed with COVID-19 between January and November 2020 from 16 international centers. Results: We analyzed 3966 COVID-19 confirmed patients, 1115 with cancer and 2851 without cancer patients. Patients with cancer were more likely to be pancytopenic and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding 2 wk (p≤0.01). 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 (p≤0.01). By country-adjusted multivariable logistic regression analyses, cancer was not found to be an independent risk factor for 30 day mortality (p=0.18), whereas lymphopenia was independently associated with increased mortality in all patients and in patients with cancer. Older age (≥65y) was the strongest predictor of 30 day mortality in all patients (OR = 4.47, p<0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30 day mortality (OR = 0.64, p=0.036). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30 day mortality rate than those who did not (5.9 vs 17.6%; p=0.03). Conclusions: Increased 30 day all-cause mortality from COVID-19 was not independently associated with cancer but was independently associated with lymphopenia often observed in hematolgic malignancy. Remdesivir, particularly in patients with cancer receiving low-flow oxygen, can reduce 30 day all-cause mortality. Funding: National Cancer Institute and National Institutes of Health.

International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship

BackgroundIn this international multicenter study 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. MethodsWe retrospectively collected de-identified data on a cohort of cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, from 16 international centers. ResultsWe analyzed 3966 COVID-19 confirmed patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were more likely to be pancytopenic, and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding two weeks (p[≤]0.01). 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 (p[≤]0.01). 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 to6.20; 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 low-flow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who did not (5.9% vs 17.6%; p=0.03). ConclusionsCancer 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. Condensed AbstractIn this large multicenter worldwide study of 4015 patients with COVID-19 that included 1115 patients with cancer, we found that cancer is an independent risk factor for increased 30-day all-cause mortality. Remdesivir is a promising treatment modality to reduce 30-day all-cause mortality.

In vivo evaluation of the virucidal efficacy of Chlorhexidine and Povidone-iodine mouthwashes against salivary SARS-CoV-2.

BackgroundThe oral cavity is potentially high-risk transmitter of COVID-19. Antimicrobial mouthrinses are used in many clinical pre procedural situations for prophylactic purposes. An evident-based investigation for an effective mouthwash solution against salivary SARS-CoV-2 is urgently required for the exposure reduction during dental procedures. AimsThis study aimed to evaluate in vivo virucidal efficacy of 2 mouthwashes: 1% Povidoneiodine and 0.2% Chlorhexidine as a dental preprocedural oral disinfection against salivary SARS-CoV-2. Materials and MethodsIn this randomized-controlled clinical trial, studied group comprised laboratory-confirmed COVID-19 positive patients through nasopharyngeal swabs. Participants were divided into 3 groups. For 30 seconds, group A gargled with 1% Povidone-iodine, group B mouthrinsed with 0.2% Chlorhexidine and control group C mouthrinsed with distilled water. Saliva samples were collected before and 5 minutes after mouthwash. SARS-CoV-2 rRT-PCR was then performed for each sample. Evaluation of the efficacy was based on difference in Ct value. The analysis of data was carried out using GraphPad Prism version 5 for Windows. Paired t test and unpaired t test were used. A probability value of less than 0.05 was regarded as statistically significant. ResultsSixty-one compliant participants (36 female and 25 male) with a mean age 45.3 {+/-} 16.7 years-old were enrolled. A significant mean Ct value difference (p < 0.0001) between the paired samples in group A (n = 25) and also in group B (n = 27) (p < 0.0001) was found. In contrast, no significant difference (p = 0.566) existed before and after the experiment in the control group C (n = 9). Moreover, a significant difference was noted between the delta Ct of distilled water wash and each of the 2 solutions 1 % Povidone-iodine (p = 0.012) and Chlorhexidine 0.2% (p = 0.0024). No significant difference was found between the delta Ct of patients using 1% Povidone-iodine and Chlorhexidine 0.2% solutions (p = 0.24). ConclusionChlorhexidine 0.2% and 1% Povidone-iodine oral solutions are effective preprocedural mouthwashes against salivary SARS-COV-2 in dental treatments. Their use as a preventive strategy to reduce the spread of COVID-19 during dental practice should be systematically implemented.

Prevalence of hepatitis B and anti-hepatitis C virus antibody among people who inject drugs in the Lebanese population

Background: People who inject drugs (PWIDs) are prone to a number of blood-borne viral infections. Hepatitis B virus (HBV) and hepatitis C virus (HCV) constitute an important public health concern in this high risk group.Aims: We aimed to determine the prevalence of HBV and HCV antibody among PWIDs in Lebanon.Methods: We conducted a prospective cross-sectional study between June 2015 and June 2016 on PWIDs recruited through Lebanese nongovernmental organizations in collaboration with the Lebanese Ministry of Public Health. The participants were tested for HBs antigen and HCV antibody using rapid test kits. The prevalence of each virus was then calculated. The correlation between both infections and other possible risk factors was also analysed.Results: A total of 250 people were included in our study, of whom 98% were males. Mean age was 31.9 (standard devia-tion 8.7) years. The prevalence of HBsAg and anti-HCV among PWIDs was 1.2% and 15.6%, respectively. Older age, longer duration of drug use and lack of awareness were significantly correlated with a higher rate of HCV infection (P < 0.01). The high rate of needle sharing among our PWIDs significantly affected the prevalence of anti-HCVAb. Conclusion: PWIDs remain the subpopulation most affected with chronic HCV in Lebanon.

Contexte : Les consommateurs de drogues injectables sont exposés à un certain nombre d’infections virales transmises par le sang. Les virus de l’hépatite B (HBV) et de l’hépatite C (HCV) constituent une préoccupation de santé publique majeure dans ce groupe à risque élevé.Objectif : La présente étude avait pour objectif de déterminer la prévalence du HBV et du HCV chez les consommateurs de drogues injectables au Liban.Méthodes : Entre juin 2015 et juin 2016, nous avons mené une étude transversale prospective sur des consommateurs de drogues injectables recrutés par l’intermédiaire d’organisations non gouvernementales libanaises, en collaboration avec le ministère de la Santé publique libanais. Les participants ont été soumis à des tests de dépistage des antigènes de surface de l’hépatite B et des anticorps anti-HCV à l’aide de kits de dépistage rapide. La prévalence de chaque virus a ensuite été calculée. La corrélation entre les deux infections et d’autres facteurs de risque possibles a également été examinée.Résultats : Au total, 250 personnes ont été incluses dans l’étude, dont 98 % d’hommes. L’âge moyen était de 31,9 ans (écart type 8,7). La prévalence des antigènes de surface du virus de l’hépatite B et des anticorps anti-HCV, parmi les consommateurs de drogues injectables, était respectivement de 1,2 % et de 15,6 %. On a observé une corrélation significative entre l’âge, une durée plus longue de consommation de drogue, le manque de sensibilisation et le taux plus élevé d’infection à HCV (p < 0,01). Le taux élevé de partage de seringues chez les consommateurs de drogues injectables avait une incidence significative sur la prévalence des anticorps anti-HCV. Conclusion : Les consommateurs de drogues injectables restent la sous-population la plus touchée par l’hépatite C chronique au Liban.