BACKGROUND
Cancer patients are considered a priority group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination given their high risk of contracting severe coronavirus disease 2019 (COVID-19). However, limited data exists regarding the efficacy of immunization in this population. In this study we assess the immunologic response after COVID-19 vaccination of cancer versus non-cancer population.
METHODS
PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from March 01, 2020, through August 12, 2021. Primary endpoints were anti-SARS-CoV-2 spike protein (S) immunoglobulin G (IgG) seroconversion rates, T-cell response, and documented SARS-CoV-2 infection after COVID-19 immunization. Data was extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Overall effects were pooled using random effects models.
RESULTS
This systematic review and meta-analysis included 35 original studies. Overall, 51% (95% confidence interval [CI], 41-62) and 73% (95%CI, 64-81) of cancer patients developed anti-S IgG above the threshold level after partial and complete immunization, respectively. Patients with hematologic malignancies had a significantly lower seroconversion rate than those with solid tumors after complete immunization (65% vs 94%;
P
<0.0001). Compared to non-cancer controls, oncological patients were less likely to attain seroconversion after incomplete (RR 0.45 [95%CI 0.35-0.58]) and complete (RR 0.69 [95%CI 0.56-0.84]) COVID-19 immunization schemes. Cancer patients had a higher likelihood of having a documented SARS-CoV-2 infection after partial (RR 3.21; 95%CI 0.35-29.04) and complete (RR 2.04; 95%CI 0.38-11.10) immunization.
CONCLUSIONS
Cancer patients have an impaired immune response to COVID-19 vaccination compared to controls. Strategies that endorse the completion of vaccination schemes are warranted. Future studies should aim to evaluate different approaches that enhance oncological patients’ immune response.
The COVID-19 pandemic has had a substantial effect on cancer care. 1 The recent widespread availability of vaccines against SARS-CoV-2 is a promising strategy to prevent COVID-19associated mortality. However, previous reports have shown a high hesitancy rate to receive a COVID-19 vaccine among oncologic patients. 2,3 Because breast cancer is the most commonly diagnosed malignant neoplasm, 4 it is imperative to evaluate the specific concerns regarding COVID-19 vaccination among patients with this disease.Methods | From March 12 to March 26, 2021, any woman with breast cancer residing in Mexico who visited the social media channels of nongovernmental organizations dedicated to improving breast cancer care were invited to complete a webbased survey. To assess COVID-19 vaccine hesitancy rates, participants were dichotomized into a vaccine-acceptant group (ie, willing to be vaccinated immediately) and a vaccinehesitant group (ie, prefer to wait, only if vaccine is mandatory, or refuse). Respondents who previously had been vaccinated against COVID-19 were excluded from the statistical analysis.Data analyses were performed using SPSS, version 27 (IBM Inc). Significance was defined as 2-tailed P < .05. The
Background This study's objective was to conduct a multinational registry of patients with carotid body tumors (CBTs) and to analyze patients' clinical characteristics, treatments, and outcomes. Methods Retrospective study from the Carotid Paraganglioma Cooperative International Registry involving eleven medical centers in Bolivia, Ecuador, Mexico, and Spain, of all patients with a CBT who underwent resection between 2009 and 2019. Results A total of 1432 patients with a CBT surgically treated were included. Median patient age was 54 years (range: 45-63 years), and 82.9% (1184) of the study cohort were female. While at low altitude, the proportion of female-to-male cases was 2:1, at high altitude, this proportion increased to 8:1, with statistically significant differences (p = .022). Median operative time was 139 min (range: 110-180 min), while median operative blood loss was 250 ml (range: 100-500 ml), with statistically significant difference in increased blood loss (p = .001) and operative time (p = .001) with a higher Shamblin classification. Eight (0.6%) patients suffered stroke. Univariate analysis analyzing for possible factors associated with increased odds of stroke revealed intraoperative vascular lesion to present an OR of 2.37 [CI 95%;] (p = 0.001). In 245 (17.1%), a cranial nerve injury was reported. Seven (0.5%) deaths were recorded.
ConclusionThe most common CBT type on this cohort was hyperplasic, which might be partially explained by the high altitudes where these patients lived. Increased blood loss and operative time were associated with a higher Shamblin classification, and the risk of stroke was associated with patients presenting transoperative vascular lesions.
Background The increasing prevalence of venous thromboembolism (VTE) among patients with coronavirus disease 2019 (COVID-19) is a matter of concern as it contributes significantly to patients' morbidity and mortality. Data regarding the optimal anticoagulation regimen for VTE prevention and treatment remain scarce. This study describes the characteristics, treatment, and outcomes of COVID-19 patients with VTE treated in a single academic center in Mexico. Methods We conducted a retrospective study of all patients with a positive PCR test for SARS-CoV-2 hospitalized in a single academic center in Monterrey, Mexico, between March 2020 and February 2021, with a radiologically confirmed VTE, including deep venous thrombosis (DVT) and pulmonary embolism (PE). Informed consent was obtained from each patient before reviewing their medical records. Results Of the 2000 COVID-19 hospitalized patients, 36 (1.8%) developed VTE and were included in the analysis. The median age was 60 years (range 32-88 years), and up to 78% (n = 28) were males. Most patients (n = 34, 94%) had an underlying comorbidity and 47% (n = 17) had a BMI ≥ 30 kg/m2. In most cases (n=28, 78%), VTE presented as a PE, whereas the remaining 22% (n = 8) had a DVT. The median time between hospital admission and VTE was 8 days (range 0-33 days). Regarding the thromboprophylaxis regimen, 35/36 patients received low molecular weight heparin enoxaparin on admission, most commonly at a dose of 60 mg daily (n = 19, 53%). Other complications presented were superinfection (n = 19, 53%), acute kidney injury (n = 11, 31%), and septic shock (n = 5, 14%). A total of 69% of patients (n = 25) required intensive care unit admission, and patients' overall mortality was 55.6%. Conclusion VTE remains a significant cause of increased morbidity and mortality among patients with COVID-19. The strikingly high mortality among patients with VTE highlights the need for further investigation regarding the best preventive, diagnostic, and treatment approaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.