Severity and 1-month outcome of SARS-CoV-2 infection in patients with solid cancers: a Danish nationwide cohort study.

BACKGROUND: Cancer patients are vulnerable to infections, are older and often have comorbidities in comparison to the general population, which increases the risk for severe outcomes related to COVID-19 diagnosis. METHODS: This study is a prospective, nationwide study in patients with solid cancer and SARS-CoV-2 infection included between 10 March to 15 June 2020. Patient's baseline characteristics were collected. The study's primary outcome was overall survival within 30 days of verified SARS-CoV-2 infection. Secondary outcomes were hospital admission, admission to an ICU, and need for supplemental oxygen. RESULTS: A total of 112 patients with a cancer diagnosis and verified SARS-CoV-2 infection were identified. After one month of follow up, hospitalization was required for 54% (n = 61) and 21% of the patients had died and 14 of the 23 deceased cancer patients were ≥70 years. Most patients were classified with mild COVID-19 symptoms (66%, n = 74); however, 48% (n = 23) of the ≥70-year-olds patients were classified with severe or critical COVID-19 symptoms. Among the total study population, 61% (n = 68) had comorbidities and comorbidity were more frequently observed among the deceased (91%, n = 21) and older cancer patients (≥70 years, 81%, n = 39). CONCLUSIONS: Acknowledging the low sample size in this study, our work shows that age and comorbidities, but not recent cytotoxic therapy, are associated with adverse outcomes of SARS-CoV-2 infection for patients with solid cancer. Particularly, patients with progressive disease seem to be at greater risk of a fatal outcome from COVID-19.HighlightsAge, performance status, and comorbidities are strong predictors of adverse outcome in cancer patients with SARS-CoV-2 infection.Patients with progressive cancer disease seem to be at greater risk of a fatal outcome from COVID-19.Recent cytotoxic therapy, however, did not seem to be associated with increased risk for adverse outcomes of SARS-CoV-2 infection for patients with solid cancer.

Long-term mortality in patients with type 2 diabetes undergoing coronary angiography: the impact of glucose-lowering treatment.

AIMS/HYPOTHESIS: The aim of this study was to analyse whether the increased mortality rates observed in insulin-treated patients with type 2 diabetes and coronary artery disease are explained by comorbidities and complications. METHODS: A retrospective analysis of data from two Swedish registries of type 2 diabetic patients (n = 12,515) undergoing coronary angiography between the years 2001 and 2009 was conducted. The association between glucose-lowering treatment and long-term mortality was studied after extensive adjustment for cardiovascular- and diabetes-related confounders. Patients were classified into four groups, according to glucose-lowering treatment: diet alone; oral therapy alone; insulin in combination with oral therapy; and insulin alone. RESULTS: After a mean follow-up time of 4.14 years, absolute mortality rates for patients treated with diet alone, oral therapy alone, insulin in combination with oral therapy and insulin alone were 19.2%, 17.4%, 22.9% and 28.1%, respectively. Compared with diet alone, insulin in combination with oral therapy (HR 1.27; 95% CI 1.12, 1.43) and insulin alone (HR 1.62; 95% CI 1.44, 1.83) were associated with higher mortality rates. After adjustment for baseline differences, insulin in combination with oral glucose-lowering treatment (HR 1.22; 95% CI 1.06, 1.40; p < 0.005) and treatment with insulin only (HR 1.17; 95% CI 1.02, 1.35; p < 0.01) remained independent predictors for long-term mortality. CONCLUSIONS/INTERPRETATION: Type 2 diabetes patients treated with insulin and undergoing coronary angiography have a higher long-term mortality risk after adjustment for measured confounders. Further research is needed to evaluate the optimal glucose-lowering treatment for these high-risk patients.

Increased prevalence of otitis media following respiratory syncytial virus infection.

AIM: The aim of this study was to analyse whether, during the 18 months following a respiratory syncytial virus (RSV) infection in infants, there were differences in the prevalence of common infections such as acute otitis media (AOM), compared with controls. We also wanted to see whether passive smoking could be a contributory factor. METHODS: In a longitudinal study, 33 children who attended the emergency room with an RSV infection (age < or = 7 months) were compared with 37 age-matched controls recruited from routine infant check-ups. The 18-month follow-up consisted of a questionnaire focusing on environmental factors and the child's health during the last 12 months. An allergy skin prick test (SPT) was performed and venous blood was obtained. RESULTS: The prevalence of AOM and the use of antibiotics were higher in the RSV group than in the controls (p = 0.009 and p = 0.027 respectively). The number of AOMs and the use of antibiotics correlated, r = 0.8. In the RSV group, one or both parents smoked in 52% compared with 14% in the controls (p < 0.001). There were no differences in allergy SPT results. CONCLUSION: The infants with RSV infection had AOM and were prescribed antibiotics more frequently during the follow-up period. Furthermore, smoking was far more common among the parents of the RSV group. We speculate that passive smoking could be a contributory factor to the infections noted here.

[Screening for lung cancer. Promising results with low-dose CT]. / Screening for lungecancer. Lovende resultater med lavdosis-CT.

Low-radiation-dose computed tomography (low-dose CT) is a new, promising technology presently used in screening for lung cancer in some medical centres in the USA and Japan. The three population-based studies of the efficacy of screening with low-dose CT published to date all show that more than 85% of the lung cancers detected by low-dose CT are in stage I, offering improved possibility for curative treatment. The number of false positive scans, was up to 20%. The radiation dose per low-dose CT scan was approximately the dose of a mammography (1 mSv). In two studies, low-dose CT failed to detect some centrally located tumours. None of the studies are capable of evaluating changes in lung cancer mortality in a screened population compared to those of a control population. There is, therefore, a need for further assessments of positive as well as negative effects of population-based screening with low-dose CT.

Incidence of lung cancer in Denmark: historical and actual status.

This is a registry-based analysis of 97,281 lung cancer patients diagnosed in Denmark during the period 1943-1994. The development of lung cancer incidence in Denmark in the study period is described and this information is used to predict the future trends in lung cancer in Denmark. Since 1960, lung cancer has been the most frequent type of cancer in Danish men, excluding skin cancer. The incidence in men reached its maximum in 1985, when it was 100 new cases per 100,000 inhabitants, whereafter the incidence began to level off and was 83 per 100,000 inhabitants in 1994. During the study period, the incidence of lung cancer in Danish women was somewhat lower than in men. The incidence in women has been steadily increasing since 1960 by approximately 20% per each 5-year period, and was 46 per 100,000 inhabitants in 1994. Adenocarcinoma is the most frequent histological subtype in women and the only subtype increasing in incidence in men. Taking the actual development into account, the incidence of lung cancer will continue to fall among men and rise among women, leading to a reversal of the classical gender ratio in about 15 years.

[Primary lung cancer in Denmark. Historical and current developmental tendencies]. / Primaer lungekraeft i Danmark. Historiske og aktuelle udviklingstendenser.

This study describes the development of lung cancer incidence in Denmark based on analysis of the Danish Cancer Registry database containing files on 97,281 lung cancer patients diagnosed in 1943-1994 in Denmark. Since 1960, lung cancer has been the most frequent type of cancer in Danish men, excluding skin cancer, the incidence reached its maximum in 1985, being 100 new cases per 100,000 inhabitants, but thereafter the incidence began to level off. During the study period, the incidence of lung cancer in Danish women was somewhat lower than in men, but increasing and was in 1994 46 per 100,000 inhabitants. Adenocarcinoma is the most frequent histological subtype in women and is the only histological subtype in men that is increasing in incidence. In conclusion, a decrease has been observed in the incidence of lung cancer among Danish males while the incidence of lung cancer in Danish women is increasing. Taking the actual development in incidence into account, the incidence of lung cancer will continue to fall among men and rise among women, leading to a reversal of the classical gender ratio in about 15 years.

[Allergic and pseudo-allergic reactions to drugs in an Icelandic urban population 20-44 years of age.].

OBJECTIVE: Allergic or pseudo-allergic reactions to drugs are common complaints. The symptoms vary from mild to life threatening. Although the mechanisms for most drug reactions are unknown or uncertain such reactions are believed to be more common among atopic individuals. Our goal was: 1) To estimate the prevalence of allergic and pseudo-allergic drug reactions in a random urban Icelandic population 20-44 years of age. 2) To search for the characteristics of symptoms and which drugs were involved in such reactions, 3) their association to atopy and atopic diseases and 4) to find possible risk factors. MATERIAL AND METHODS: In the second stage of the European Community Respiratory Health Survey an urban population 20-44 years of age was invited to participate. In Iceland altogether 545 answered an additional question: Have you at any time had allergic reaction to drugs? Those who answered yes to this question were contacted later by telephone and asked further about drug allergy. RESULTS: Altogether 77 (14%) replied yes to the question, more females (19%) than males (9%) (p<0.001). Atopic individuals (with one or more positive prick tests) and those with nasal allergies, eczema, urticaria and illness caused by eating a particular food or foods reported allergic drug reactions more often (p<0.05). IgE geometric mean value was 17.5 kU/L for those who reported allergic drug reaction compared to 12.6 kU/L among the others (p=0.08). The most common symptoms associated with drugs were skin symptoms (urticaria, angioneurotic edema), symptoms from respiratory organs and fever. With further inquiries by telephone 13/64 denied drug allergy. Thus 51/64 (80%) withheld their questionnaire answers. Antibiotics were most often blamed for drug reactions, followed by anaesthetics, NSAID and opiates. CONCLUSION: There was a correlation between reported drug reactions and atopy and/or atopic diseases. The drug reactions were more than twice as common in women as in men. The only comparable study we know of, shows the prevalence of drug reactions on the same level as in Iceland.