PURPOSE This study aims to describe the clinical manifestations, laboratory findings, treatment, and outcomes of patients with cancer with COVID-19 infection in Syria. The primary objective was to identify the overall survival (OS) time, and the secondary objectives were to identify factors associated with severe COVID-19 infection. METHODS This multicenter retrospective study was undertaken at four hospitals in Damascus, Syria, between March 28, 2020, and March 29, 2021. Data extracted from medical records included clinical manifestations, radiologic findings, laboratory results, treatment, and outcomes. Survival analysis was done by using the Kaplan-Meier method and Cox regression model for follow-up and anticancer treatment patients to study the effect on OS time. The effects of potential risk factors of developing severe COVID-19 were studied by multivariable logistic regression. RESULTS Of 114 patients included, 61 (53.51%) were male. Smokers represented 29 (25.44%), and 63 (55.26%) patients had a history of coexisting chronic diseases. The most common cancer type was breast cancer 17 (14.91%). Sixty-eight (59.65%) patients were receiving anticancer treatment within 1 month of being diagnosed with COVID-19 infection and 46 (40.35%) were outpatient follow-ups. Multiple logistic regression analysis showed that comorbidities (odds ratio: 2.814, P = .044) and anticancer treatment (odds ratio: 8.790, P < .05) were risk factors linked to severe to critical COVID-19 infection. OS time was 245 (95% CI, 217.96 to 272.47) days, lower among patients with cancer with COVID-19 infection receiving anticancer treatment compared with follow-up patients ( P value < .05). CONCLUSION Patients with cancer with COVID-19 infection receiving anticancer treatment had a lower OS time. It may be worth considering stopping anticancer treatment in patients with cancer with COVID-19 when possible in search of better outcomes.
ObjectivesThis study aims to compare the clinical manifestations, laboratory findings, outcomes and overall survival time of patients with COVID-19 with and without comorbidities.DesignRetrospective design.SettingThis study was undertaken at two hospitals in Damascus.ParticipantsA total of 515 Syrian patients met the inclusion criterion, laboratory-confirmed COVID-19 infection following the Centers for Disease Control and Prevention. Exclusion criteria were suspected and probable cases that were not confirmed with a positive reverse transcription-PCR assay, and patients who self-discharged from the hospital against medical advice.Primary and secondary outcome measuresFirst, assess the impacts of comorbidities on COVID-19 infection in four areas (clinical manifestations, laboratory findings, severity and outcomes). Second, calculate the overall survival time for patients with COVID-19 with comorbidities.ResultsOf 515 patients included, 316 (61.4%) were male and 347 (67.4%) had at least one coexisting chronic disease. Patients with comorbidities compared with no comorbidities were more vulnerable to poor outcomes such as severe infection (32.0% vs 9.5%, p<0.001), severe complications (34.6% vs 9.5%, p<0.001), the need for mechanical ventilation (28.8% vs 7.7%, p<0.001) and death (32.0% vs 8.3%, p<0.001). Multiple logistic regression showed that age ≥65 years old, positive smoking history, having ≥2 comorbidities and chronic obstructive pulmonary disease were risk factors linked to severe COVID-19 infection in patients with comorbidities. Overall survival time was lower among patients with comorbidities (vs no comorbidities), patients with ≥2 comorbidities (vs one comorbidity), and patients with hypertension, chronic obstructive pulmonary disease, malignancy or obesity (vs other comorbidities) (p<0.05).ConclusionThis study revealed that COVID-19 infection had poor outcomes among those with comorbidities. Severe complications, mechanical ventilation usage and death were more prevalent among patients with comorbidities compared with those with no comorbidities.
Purpose Our study aims to describe post-vaccination side effects, evaluate the effectiveness of Covid-19 vaccines and determine the reasons for vaccine hesitancy among Syrians. Methods This cross-sectional study was conducted between April 13 and May 28, 2022. The survey was distributed through social media platforms and face-to-face interviews. Data from vaccinated and unvaccinated participants were collected and analyzed using the chi-square test, multivariable logistic regression to detect factors associated with side effects and severe side effects, and Kaplan-Meier plot to evaluate vaccine efficacy. Results Of the 3509 participants included, 1672 (47.6%) were vaccinated. The most common reasons for not taking the vaccine were concerns about the vaccine’s side effects 815 (44.4%) and not being convinced with the vaccine benefits 762 (41.5%). The majority of symptoms were mild 788 (47.1%), followed by moderate 374 (22.3%), and severe 144 (8.6%). The most common symptoms were tiredness 1028 (61.5%), pain at the injection site 933 (55.8%), and low-grade fever 684 (40.9%). Multivariable logistic regression analysis revealed that < 40 years (vs. ≥40; OR: 2.113, p-value = 0.008), females (vs. males; OR: 2.245, p-value < .001), did not receive influenza shot last year (vs. did receive Influenza shot last year OR: 1.697, p-value = 0.041), AstraZeneca (vs. other vaccine brands; OR: 2.799, p-value < .001), co-morbidities (vs. no co-morbidities; OR: 1.993, p-value = 0.008), and diabetes mellitus (vs. no diabetes mellitus; OR: 2.788, p-value = 0.007) were associated with severe post-vaccine side effects. Serious side effects reported were blood clots 5 (0.3%), thrombocytopenia 2 (0.1%), anaphylaxis 1 (0.1%), seizures 1 (0.1%), and cardiac infarction 1 (0.1%). Fully vaccinated participants had higher free of infection time compared with partially vaccinated and previously infected unvaccinated participants (p-value < .001). Conclusion Our study revealed that most side effects reported were mild in severity and self-limiting. Increasing the public’s awareness of the nature of the vaccine’s side effects would reduce the misinformation and improve the public’s trust in vaccines. Larger studies to evaluate rare and serious adverse events and long-term side effects are needed to overcome vaccine hesitancy among people.
Background :Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death and the second deadliest infectious disease after COVID-19. ¹ Extrapulmonary tuberculosis (EPTB) cases accounted for 16% of the 7.5 million cases of TB worldwide in 2019. ² global statistics indicate that Tuberculosis kills about 4,500 patient every day¹.Aims :1. To know the epidemiology of extrapulmonary tuberculosis in Syria.2. To know the effect of pulmonary tuberculosis risk factors on extrapulmonary tuberculosis.3. To know the percentage of TB recurrence .4. To know the percentage of non-adherence to tuberculosis treatment.5. The comparison of the incidence of extrapulmonary tuberculosis over an 18-year period.Methods :A retrospective study conducted at the National Center for Tuberculosis Control in Damascus and its countryside for the year of 2020 to analyze the patients with extrapulmonary tuberculosis .Results :205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year of 2020 and the sites of extrapulmonary tuberculosis were distributed as follows :Lymph Nodes TB (102) 49.75% , peritoneal TB (28) 13.66% , pleural TB (26) 12.68% , spine TB (Pott's disease) (11) 5.36% , meningeal TB (8) 3.90% , skeletal TB (7) 3.41% , skin and soft tissue TB (5) 2.44% , genitourinary TB (5) 2.44% , gastrointestinal tuberculosis (5) 2.44% , pericardial TB (3) 1.46% , eye Tb (3) 1.46% , ENT Tb (1) 0.49% , breast TB (1) 0.49%In diagnosing tuberculosis of the lymph nodes by biopsy the affected nodes were distributed as follows :Cervical lymph nodes 80.40% , Axillary lymph nodes 6.86%. , Supraclavicular lymph nodes 4.90% , Submandibular lymph nodes 2.94% , Mesenteric nodes 2.94% , Mediastinal nodes 1.96%.Most incidence rate was in patients between 25 and 34 years old , while the least incidence rate was in patients older than 65 years old . The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34% . The majority of infected patients were residents in the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidities among patients with extrapulmonary tuberculosis were:Hypertension: 23.41% of cases , Diabetes Mellitus : 15.12% cases , Chronic obstructive pulmonary disease: 2.4% , Covid-19: 9.75% were diagnosed with COVID-19, 9 of which were confirmed by PCR testing, and 11 cases were diagnosed clinically . 17 of those infected with Covid-19 had lymph nodes tuberculosis, two had urogenital tuberculosis, and one case was with pleural tuberculosis . Possible risk factors were : Smoking: (cigarettes and hookah) 38.53% of extrapulmonary tuberculosis patients were smokers of cigarettes and waterpipes in addition to passive smokers, while 61.46% were non-smokers , Unhealthy housing: 23.41% of patients live in an unventilated or unsunny houses , Forced displacement: 20.97% of all patients which forced them to live in crowded and unhealthy places , cases of relapse: 12 cases of recurrence (5.85%) , cases of non-adherence to tuberculosis treatment: 9 cases (4.39%) , Prisoners : 6 cases (2.92%). The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats was the least common symptom 14.63% .Conclusion :Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but still is a preventable and treatable disease that’s why disease prevention , early diagnosis and early treatment are vital.
Background: Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death, and the second deadliest infectious disease after COVID-19 worldwide1. Extrapulmonary tuberculosis (EPTB) cases accounted for 15% of the 7.2 million cases of TB worldwide in 2019. ² global statistics indicate that Tuberculosis causes 4,500 deaths every day¹. We aim to study the epidemiology of EPTB and its risk factors. Methods: A multicenter retrospective study was conducted at the National Center for Tuberculosis Control in Damascus in the year 2020 to analyze the patients with extrapulmonary tuberculosis. Results: 205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year 2020, and the most common site of extrapulmonary tuberculosis was Lymph Nodes (102) 49.75%, while ear and breast were the least common (1 case of each). Cervical nodes were the most affected with EPTB (80.40%), while Mediastinal nodes were the least affected (1.96%). The most incidence rate was in patients between 25 and 34 years old, while the least incidence rate was in patients older than 65 years old. The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34%. The majority of infected patients were residents in the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidity was Hypertension: 23.41% of cases, while kidney diseases were the least common. Smoking was the most common risk factor. The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats were the least common symptom 14.63%. Conclusion: Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but still can be prevented by vaccination and avoiding the possible risk factors that were studied in this study.
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