“…Although mild respiratory tract infection characterizes most COVID-19 cases, a serious and potentially fatal illness can occur, principally driven by a respiratory distress syndrome and/or vascular complications. 4 Severe outcomes are more common in older male patients with secondary comorbidities. Hypertension, chronic respiratory system diseases, diabetes and cardiac diseases were highlighted as potential risk factors for poor outcomes from COVID-19.…”
Section: Introductionmentioning
confidence: 99%
“…Serum analysis showed higher plasma levels of proinflammatory cytokines in severely ill patients. 4 Since chronic diseases may lead to low immune function, a strong correlation between the host immune status and COVID-19 prognosis has been highlighted. Therefore, immunesuppressed patients were added within the higher-risk group for severe illness from COVID-19.…”
BackgroundIn ambulatory patients with cancer with asymptomatic or pauci-symptomatic SARS-CoV-2 infection, the safety of targeted therapies (TTs), chemotherapy (CT) or immune checkpoint inhibitors (ICIs) therapy is still unknown.Material and methodsFrom the start of the first epidemic wave of SARS-CoV-2 in Bergamo, Italy, we have prospectively screened all consecutive outpatients who presented for treatment to the Oncology Division of the Papa Giovanni XXIII Hospital, Bergamo for SARS-CoV-2 antigen expression. We identified patients treated with ICIs and compared these to patients with the same cancer subtypes treated with TTs or CT.ResultsBetween March 5 and May 18, 293 consecutive patients (49% melanoma, 34% non-small cell lung cancer, 9% renal cell carcinoma, 8% other) were included in this study: 159 (54%), 50 (17%) and 84 (29%) received ICIs, CT or TTs, respectively. Overall 89 patients (30.0%) were SARS-CoV-2 positive. Mortality of SARS-CoV-2-positive patients was statistically significantly higher compared with SARS-CoV-2 negative patients (8/89 vs 3/204, respectively, Fisher’s exact test p=0.004). All deaths were due to COVID-19. Serious adverse events (SAEs) were more frequent in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative cases (Cochran-Mantel-Haenszel (CMH) test p=0.0008). The incidence of SAEs in SARS-CoV-2 positive compared with SARS-CoV-2 negative patients was similar in ICI and CT patients (17.3% and 3.7% for positive and negative patients in ICIs and 15.4% and 2.7% in CT, Breslow-Day test p=0.891). No COVID-19-related SAEs were observed in the TTs patients.ConclusionsThe incidence of SAEs was higher for SARS-CoV-2-positive patients treated with ICIs and CT, mostly in advanced disease. No SAEs were observed in patients treated with TTs. SAEs were COVID-19 related rather than treatment related. Treatment with ICIs does not appear to significantly increase risk of SAEs compared with CT. This information should be considered when determining treatment options for patients.
“…Although mild respiratory tract infection characterizes most COVID-19 cases, a serious and potentially fatal illness can occur, principally driven by a respiratory distress syndrome and/or vascular complications. 4 Severe outcomes are more common in older male patients with secondary comorbidities. Hypertension, chronic respiratory system diseases, diabetes and cardiac diseases were highlighted as potential risk factors for poor outcomes from COVID-19.…”
Section: Introductionmentioning
confidence: 99%
“…Serum analysis showed higher plasma levels of proinflammatory cytokines in severely ill patients. 4 Since chronic diseases may lead to low immune function, a strong correlation between the host immune status and COVID-19 prognosis has been highlighted. Therefore, immunesuppressed patients were added within the higher-risk group for severe illness from COVID-19.…”
BackgroundIn ambulatory patients with cancer with asymptomatic or pauci-symptomatic SARS-CoV-2 infection, the safety of targeted therapies (TTs), chemotherapy (CT) or immune checkpoint inhibitors (ICIs) therapy is still unknown.Material and methodsFrom the start of the first epidemic wave of SARS-CoV-2 in Bergamo, Italy, we have prospectively screened all consecutive outpatients who presented for treatment to the Oncology Division of the Papa Giovanni XXIII Hospital, Bergamo for SARS-CoV-2 antigen expression. We identified patients treated with ICIs and compared these to patients with the same cancer subtypes treated with TTs or CT.ResultsBetween March 5 and May 18, 293 consecutive patients (49% melanoma, 34% non-small cell lung cancer, 9% renal cell carcinoma, 8% other) were included in this study: 159 (54%), 50 (17%) and 84 (29%) received ICIs, CT or TTs, respectively. Overall 89 patients (30.0%) were SARS-CoV-2 positive. Mortality of SARS-CoV-2-positive patients was statistically significantly higher compared with SARS-CoV-2 negative patients (8/89 vs 3/204, respectively, Fisher’s exact test p=0.004). All deaths were due to COVID-19. Serious adverse events (SAEs) were more frequent in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative cases (Cochran-Mantel-Haenszel (CMH) test p=0.0008). The incidence of SAEs in SARS-CoV-2 positive compared with SARS-CoV-2 negative patients was similar in ICI and CT patients (17.3% and 3.7% for positive and negative patients in ICIs and 15.4% and 2.7% in CT, Breslow-Day test p=0.891). No COVID-19-related SAEs were observed in the TTs patients.ConclusionsThe incidence of SAEs was higher for SARS-CoV-2-positive patients treated with ICIs and CT, mostly in advanced disease. No SAEs were observed in patients treated with TTs. SAEs were COVID-19 related rather than treatment related. Treatment with ICIs does not appear to significantly increase risk of SAEs compared with CT. This information should be considered when determining treatment options for patients.
“…Accordingly, our data suggest that at the early stages of the outbreak, COVID-19 affected more males than females, similar to MERS, but younger age groups like SARS. According to several studies, age is considered a major risk factor for severe diseases (9,14). Hence, the relatively young population (Mean of 44) of travelers could have been asymptomatic carriers who spread the virus across the globe.…”
Section: Comorbidities Hospitalization Severity and Outcome Of Tramentioning
confidence: 99%
“…Out of seven coronaviruses known to infect humans, four are seasonal (229E, NL63, OC43, and HKU1) and cause common respiratory infections similar to influenza (1). Additionally, three novel coronaviruses of animal origin (zoonotic) have emerged in the last two decades and caused unprecedented outbreaks in human: the Severe Acute Respiratory Syndrome (SARS-CoV) that emerged in 2003 (2)(3)(4), the Middle East Respiratory Syndrome (MERS-CoV) that emerged in 2012 (5,6), and the SARS-CoV-2 that emerged at the end of 2019 (7)(8)(9)(10). All of the zoonotic viruses were associated with server respiratory illnesses.…”
Background: SARS-CoV-2 continues to claim hundreds of thousands of people's lives. It mostly affects the elderly and those with chronic illness but can also be fatal in younger age groups. This article is the first comprehensive analysis of the epidemiological and clinical outcomes of the travel-associated SARS-CoV-2 cases until April 19, 2020.Methods: Demographic and clinical data of travel-associated SARS-CoV-2 cases were collected for the period between January 16, 2020 and April 19, 2020. More than one hundred and eighty databases were searched, including the World Health Organization (WHO) database, countries' ministries websites, and official media sites. Demographic and clinical data were extracted and analyzed.Results: A total of 1,186 cases from 144 countries meeting the inclusion criteria were reported and included in the analysis. The mean age of the cases was 44 years, with a male to female ratio of 1.6:1. Travel-associated cases originated from more than 40 countries, with China, Italy, and Iran reporting the highest numbers at 208, 225, and 155, respectively. Clinical symptoms varied between patients, with some reporting symptoms during the flights (117 cases; 9.87%). A total of 312 (26.31%) cases were hospitalized, of which 50 cases (4.22%) were fatal.Conclusion: Major gaps exist in the epidemiology and clinical spectrum of the COVID-19 travel-associated cases due to a lack of reporting and sharing data of many counties. The identification and implementation of methodologies for measuring traveler's risk to coronavirus would help in minimizing the spread of the virus, especially in the next waves.
“…However, on the remaining third of the genome it diverges quite strongly, especially at the level of the S1 protein and ORF 8 (Fig. 2 ) (Zhou et al 2020c ). Fig.…”
Section: Sars-cov-2: From Yunnan To Wuhan?mentioning
SARS-CoV-2 is a new human coronavirus (CoV), which emerged in China in late 2019 and is responsible for the global COVID-19 pandemic that caused more than 97 million infections and 2 million deaths in 12 months. Understanding the origin of this virus is an important issue, and it is necessary to determine the mechanisms of viral dissemination in order to contain future epidemics. Based on phylogenetic inferences, sequence analysis and structure–function relationships of coronavirus proteins, informed by the knowledge currently available on the virus, we discuss the different scenarios on the origin—natural or synthetic—of the virus. The data currently available are not sufficient to firmly assert whether SARS-CoV2 results from a zoonotic emergence or from an accidental escape of a laboratory strain. This question needs to be solved because it has important consequences on the risk/benefit balance of our interactions with ecosystems, on intensive breeding of wild and domestic animals, on some laboratory practices and on scientific policy and biosafety regulations. Regardless of COVID-19 origin, studying the evolution of the molecular mechanisms involved in the emergence of pandemic viruses is essential to develop therapeutic and vaccine strategies and to prevent future zoonoses. This article is a translation and update of a French article published in Médecine/Sciences, August/September 2020 (10.1051/medsci/2020123).
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