Prognostic Value of Pro-Inflammatory Neutrophils and C-Reactive Protein in Cancer Patient With Coronavirus Disease 2019: A Multi-Center, Retrospective Study

Zhang, Bo; Yu, Yuanhang; Hubert, Shawna M.; Zhang, Yue; Lu, Jianhua; Liu, Shihua; Xie, Fang; Zhao, Liang; Lei, Xiao; Deng, Wei; Chen, Jianying; Li, Yunqiao

doi:10.3389/fphar.2020.576994

Cited by 16 publications

(23 citation statements)

References 30 publications

(28 reference statements)

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Section: Resultsmentioning

confidence: 99%

“…Biomarkers of the peripheral blood, such as the neutrophil‐to‐lymphocyte ratio (NLR) or the C‐reactive protein (CRP), have been associated with COVID‐19 disease severity in patients both with or without cancer. 11 , 20 , 21 , 22 , 23 However, as these parameters were usually obtained at the point of hospitalization for SARS‐CoV‐2 infection, they were likely influenced by the inflammatory reaction induced by the virus. We were interested if biomarkers available prior to infection were informative for the outcome of the disease and therefore analyzed laboratory values that were obtained at least 10 days (median 21 days) before the first positive SARS‐CoV‐2 PCR test was documented (Figure 3A ).…”

Section: Resultsmentioning

confidence: 99%

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Preinfection laboratory parameters may predict COVID‐19 severity in tumor patients

et al. 2021

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Background Infection with SARS‐CoV‐2 leads to COVID‐19, the course of which is highly variable and depends on numerous patient‐specific risk factors. Patients with tumor diseases are considered to be more susceptible to severe COVID‐19; however, they also represent a heterogeneous group of individuals with variable risk. Identifying specific risk factors for a severe course of COVID‐19 in patients with cancer is of great importance. Methods Patients diagnosed with solid tumors or hematological malignancies and PCR‐confirmed SARS‐CoV‐2 infection were included into the multicentric ADHOK (Arbeitsgemeinschaft der Hämatologen und Onkologen im Krankenhaus e.V.) coronavirus tumor registry. Detailed information about the patients’ cancer disease, treatment, and laboratory parameters prior to infection, was collected retrospectively. The outcome of the SARS‐CoV‐2 infection was graded according to the WHO. Results A total of 195 patients (68% with solid neoplasms and 32% with hematological malignancies) were included in the registry. Overall, the course of the SARS‐CoV‐2 infection varied greatly, as 69% of all patients were either asymptomatic or encountered a mild to moderate course, while 23% of the cohort died from COVID‐19. In multivariable analysis, preinfection laboratory parameters (determined at least 10 days and a median of 21 days before the first documentation of SARS‐CoV‐2 infection) significantly correlated with severe course of the disease. Out of these, the absolute neutrophil count prior to infection showed the strongest association with COVID‐19‐related death. Conclusion The course of COVID‐19 in patients with tumor diseases is highly variable. Preinfection laboratory parameters may aid to identify patients at risk for severe COVID‐19 at an early stage prior to infection with the virus. German Clinical Trials Register identification: DRKS00023012.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Preinfection laboratory parameters may predict COVID‐19 severity in tumor patients

et al. 2021

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“…We also observed higher neutrophil counts and C-reactive protein levels in non-survivor vs survivor cancer patients infected with COVID-19. There is a possibility that proinflammatory neutrophils and C-reactive protein induce "cytokine storm" related to endothelialitis caused by COVID-19 infected cancer patients (23,24). Serum lactate is used to assess the disease severity, therapeutic response and disease outcomes (25).…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory cytokines are involved in the severity and adverse clinical outcomes in COVID-19 infected patients ( 24 ). Zhang et al.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of COVID-19-Infected Cancer Patients in Pakistan: Differences Between Survivors and Non-Survivors

et al. 2021

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BackgroundCancer patients are considered as highly vulnerable individuals in the current COVID-19 pandemic. We studied the clinical characteristics of survivor and non-survivor COVID-19-infected cancer patients in Pakistan.Patients and MethodsWe did a retrospective study of 70 cancer patients with PCR-confirmed COVID-19 infection from Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore and Peshawar, Pakistan between April 13 and July 09, 2020. These patients were discharged from the hospital or had died by July 09, 2020. Clinical, pathological and radiological characteristics were compared between survivors and non-survivors by fisher’s exact test and chi-square test. Univariable and multivariable logistic regression models were performed to explore the risk factors of mortality.ResultsSeventy cancer patients with SARS-CoV-2 infection were enrolled and the majority were males 38 (54.3%). 57 (81.4%) had solid tumors and 13 (18.6%) had hematological malignancies. Dyspnea (44 cases) was the most common symptom (62.9%). Complications were reported in 51 (72.9%) patients during the course of disease. 19 (27.1%) patients were admitted to an intensive care unit (ICU). A significant increase in the C-reactive protein level and neutrophil count was observed in the deceased patients as compared to the surviving patients. D-dimer values of ≥0.2 mg/L were significantly associated with mortality (P=0.01). We identified two independent risk factors associated with death, ICU admission (P=0.007) and D-dimer (P=0.003).ConclusionPakistani cancer patients with COVID-19 infection reported poor prognosis. Intensive surveillance of clinicopathological characteristics of cancer patients infected with COVID-19 especially D-dimer values may play a pivotal role in the outcome of the disease.

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Effect of SARS-CoV-2 infection on outcome of cancer patients: A systematic review and meta-analysis of studies of unvaccinated patients

Felice

Visci

Teglia

et al. 2021

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<underline>Background</underline>. Since the beginning of the SARS-Cov-2 pandemic, cancer patients affected by COVID-19 have been reported to experience poor prognosis; however, a detailed quantification of the effect of SARS-CoV-2 infection on outcome of unvaccinated cancer patients has not been performed.<br /><underline>Methods</underline>. To carry out a systematic review of the studies on outcome of unvaccinated cancer patients infected by Sars-Cov-2, a search string was devised which was used to identify relevant publications in PubMed up to December 31, 2020. We selected three outcomes: mortality, access to ICU, and COVID-19 severity or hospitalization. We considered results for all cancers combined as well as for specific cancers. We conducted random-effects meta-analyses of the results, overall and after stratification by region. We also performed sensitivity analyses according to quality score and assessed publication bias.<br /><underline>Results</underline>. For all cancer combined, the pooled odds ratio (OR) for mortality was 2.32 (95% confidence interval [CI] 1.82-2.94, I2 for heterogeneity 90.1%, 24 studies), that for ICU admission was 2.39 (95% CI 1.90-3.02, I2 0.0%, 5 studies), that for disease severity or hospitalization was 2.08 (95% CI 1.60-2.72, I2 92.1%, 15 studies). The pooled mortality OR for hematologic neoplasms was 2.14 (95% CI 1.87-2.44, I2 20.8%, 8 studies). Data were insufficient to perform a meta-analysis for other cancers. In the mortality meta-analysis for all cancers, the pooled OR was higher for studies conducted in Asia than studies conducted in Europe or North America. There was no evidence of publication bias.<br /><underline>Conclusions</underline>. Our meta-analysis indicate a two-fold increased risk of adverse outcomes (mortality, ICU admission and severity of COVID-19) in unvaccinated cancer patients infected with SARS-CoV-2 compared to uninfected patients. These results should be compared with studies conducted in vaccinated patients; nonetheless, they argue for special effort to prevent SARS-CoV-2 infection in patients with cancer.<br />Funding. No external funding was obtained.

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Prognostic Value of Pro-Inflammatory Neutrophils and C-Reactive Protein in Cancer Patient With Coronavirus Disease 2019: A Multi-Center, Retrospective Study

Cited by 16 publications

References 30 publications

Preinfection laboratory parameters may predict COVID‐19 severity in tumor patients

Preinfection laboratory parameters may predict COVID‐19 severity in tumor patients

Clinical Characteristics of COVID-19-Infected Cancer Patients in Pakistan: Differences Between Survivors and Non-Survivors

Effect of SARS-CoV-2 infection on outcome of cancer patients: A systematic review and meta-analysis of studies of unvaccinated patients

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