Cancer patients affected by COVID-19: Experience from Milan, Lombardy

Bogani, Giorgio; Ditto, Antonino; Bosio, Sara; Brusadelli, Claudia; Raspagliesi, Francesco

doi:10.1016/j.ygyno.2020.06.161

Cited by 39 publications

(83 citation statements)

References 8 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 51 ] Peer reviewed 22 11 25 Feb to 24 Mar 2020 San Raffaele Hospital, Lombardy, Italy Any 45 Bogani et al. [ 52 ] Peer reviewed 19 3 Feb and Mar 2020 Lombardy, Italy Any 46 Guan et al. [ 53 ] Peer reviewed 18 3 11 Dec 2019 to 31 Jan 2020 Wuhan, China Any 47 Tagliamento et al.…”

Section: Resultsmentioning

confidence: 99%

Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

Saini

Tagliamento

Lambertini

et al. 2020

European Journal of Cancer

298

275

View full text Add to dashboard Cite

Background Patients with coronavirus disease 2019 (COVID-19) who have underlying malignancy have a higher mortality rate compared with those without cancer, although the magnitude of such excess risk is not clearly defined. We performed a systematic review and pooled analysis to provide precise estimates of the mortality rate among patients with both cancer and COVID-19. Methods A systematic literature search involving peer-reviewed publications, preprints and conference proceedings up to July 16, 2020, was performed. The primary end-point was the case fatality rate (CFR), defined as the rate of death among patients with cancer and COVID-19. The CFR was assessed with a random effects model, which was used to derive a pooled CFR and its 95% confidence interval (CI). Results Fifty-two studies, involving a total of 18,650 patients with both COVID-19 and cancer, were selected for the pooled analysis. A total of 4243 deaths were recorded in this population. The probability of death was 25.6% (95% CI: 22.0%–29.5%; I 2 = 48.9%) in this patient population. Conclusions Patients with cancer who develop COVID-19 have high probability of mortality. Appropriate and aggressive preventive measures must be taken to reduce the risk of COVID-19 in patients with cancer and to optimally manage those who do contract the infection.

show abstract

Section: Resultsmentioning

confidence: 99%

Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

Saini

Tagliamento

Lambertini

et al. 2020

European Journal of Cancer

298

275

View full text Add to dashboard Cite

show abstract

“…A multicenter retrospective cohort study also reported that patients with malignant tumors have a higher risk of developing severe COVID-19 disease (Tian et al, 2020). Moreover, another retrospective study reported that women who received an active treatment for gynecological cancer are at higher risk of severe COVID-19 (Bogani et al, 2020). Yet another study demonstrated that the risk of COVID-19 might outweigh the urgency for cancer treatment (Indini et al, 2020).…”

Section: Discussionmentioning

confidence: 97%

Systematic Analysis of Coronavirus Disease 2019 (COVID-19) Receptor ACE2 in Malignant Tumors: Pan-Cancer Analysis

Song

Han

Liu

et al. 2020

Front. Mol. Biosci.

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 (COVID-19) was first detected in patients with pneumonia in December 2019 in China and it spread rapidly to the rest of the world becoming a global pandemic. Several observational studies have reported that cancer is a risk factor for COVID-19. On the other hand, ACE2, a receptor for the SARS-CoV-2 virus, was found to be aberrantly expressed in many tumors. However, the characterization of aberrant ACE2 expression in malignant tumors has not been elucidated. Here, we conducted a systematic analysis of the ACE2 expression profile across 31 types of tumors. Methods: Distribution of ACE2 expression was analyzed using the GTEx, CCLE, TCGA pan-cancer databases. We evaluated the effect of ACE2 on clinical prognosis using the Kaplan-Meier survival plot and COX regression analysis. Correlation between ACE2 and immune infiltration levels was investigated in various cancer types. Additionally, the correlation between ACE2 and immune neoantigen, TMB, microsatellite instability, Mismatch Repair Genes (MMRs), HLA gene members, and DNA Methyltransferase (DNMT) was investigated. The frequency of ACE2 gene mutation in various tumors was analyzed. Functional enrichment analysis was conducted in various cancer types using the GSEA method. Results: In normal tissues, ACE2 was highly expressed in almost all 31 organs tested. In cancer cell lines, the expression level of ACE2 was low to medium. Although aberrant expression was observed in most cancer types, high expression of ACE2 was not linked to OS, DFS, RFS, and DFI in most tumors in TCGA pan-cancer data. We found that ACE2 expression was significantly correlated with the infiltrating levels of macrophages and dendritic cells, CD4+ T cells, CD8+ T cells, and B cells in multiple tumors. A positive correlation between ACE2 expression and immune neoantigen, TMB, and microsatellite instability was found in multiple cancers. GSEA analysis which was

show abstract

“…Drastic measures should be implemented to maintain an adequate standard of care for oncologic patients and to reduce the risk of contamination for health care providers and other patients. Recent guidelines suggested to minimize the number of clinical examinations and follow-up visits and to reduce surgical procedures that may be associated with prolonged operative time, risk of significant complications and admission to intensive care units [ 11 12 ]. Postponing surgery in women with low-risk cancers has also been recommended, favoring medical treatment whenever possible [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The lack of medical sources/equipment (including the intensive care unit) and the possible risk of developing severe consequences for patients for patients harboring asymptomatic COVID-19 are the main reason to avoid extensive surgical procedure. Recently, the Fondazione IRCCS Istituto Nazionale dei Tumori, reported data of 5 cancer patients affected by COVID-19 undergoing surgery at the beginning of the outbreak [ 11 ]. Among those 5 patients, 2 died in the early postoperative period; while other 2 patients needed prolonged hospitalization and intensive care unit admission [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the Fondazione IRCCS Istituto Nazionale dei Tumori, reported data of 5 cancer patients affected by COVID-19 undergoing surgery at the beginning of the outbreak [ 11 ]. Among those 5 patients, 2 died in the early postoperative period; while other 2 patients needed prolonged hospitalization and intensive care unit admission [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of COVID-19 in gynecologic oncology: a Nationwide Italian Survey of the SIGO and MITO groups

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. Methods The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. Results Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%–15%), and to perform less radical surgical procedures (20%–25%) during COVID-19 pandemic. Conclusions National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.

show abstract

Cancer patients affected by COVID-19: Experience from Milan, Lombardy

Abstract: There are growing concerns on the impact of COVID-19 in cancer patients. • COVID-19 is impacting oncologic practice directly and indirectly. • Prioritizing patients journey during COVID-19 is of paramount importance.

Cited by 39 publications

References 8 publications

Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

Systematic Analysis of Coronavirus Disease 2019 (COVID-19) Receptor ACE2 in Malignant Tumors: Pan-Cancer Analysis

Impact of COVID-19 in gynecologic oncology: a Nationwide Italian Survey of the SIGO and MITO groups

Contact Info

Product

Resources

About