Corpus overview


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MeSH Disease

Human Phenotype

Transmission

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Seroprevalence
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    Oncologic Immunomodulatory Agents in Patients with Cancer MESHD and COVID-19

    Authors: Justin Jee; Aaron J Stonestrom; Sean Devlin; Teresa Nguyentran; Beatriz Wills; Varun Narendra; Michael B Foote; Melissa Lumish; Santosha Vardhana; Stephen Pastores; Neha Korde; Dhwani Patel; Steven Horwitz; Michael Scordo; Anthony Daniyan

    doi:10.1101/2020.08.11.20145458 Date: 2020-08-12 Source: medRxiv

    Background Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer MESHD. How these agents impact patients with cancer MESHD who are infected with SARS-CoV-2 remains unclear. Methods We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure HP respiratory failure MESHD or death MESHD with receipt of the aforementioned medications and with pre-COVID-19 neutropenia HP neutropenia MESHD. The study included all cancer MESHD patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N=820). We controlled for cancer MESHD-related characteristics known to predispose to worse COVID-19. To address that more acutely ill patients receive therapeutic corticosteroids, we examined patient subsets based on different levels of respiratory support: <=2 L/min supplemental oxygen, >2L/min supplemental oxygen, and advanced respiratory support prior to death. Results Corticosteroid administration was associated with worse outcomes in the pre-2L supplemental oxygen cohort; no statistically significant difference was observed in the >2L/min supplemental oxygen and post-critical cohorts. Interleukin-6 (IL-6) and C-reactive protein (CRP) levels were lower, and ferritin levels were higher, after corticosteroid administration. In patients with metastatic thoracic cancer MESHD, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure HP respiratory failure MESHD or death MESHD among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer MESHD had respiratory failure HP respiratory failure MESHD or death MESHD among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia HP neutropenia MESHD was associated with worse COVID-19 course. Relative prevalence SERO of chemotherapy-associated neutropenia HP neutropenia MESHD in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer MESHD patients in the COVID-19 era.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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