Isabel Baenas; Mikel Etxandi; Lucero Munguía; Roser Granero; Gemma Mestre-Bach; Isabel Sánchez; Emilio Ortega; Alba Andreu; Violeta L. Moize; Jose-Manuel Fernández-Real; +55 more
Isabel Baenas; Mikel Etxandi; Lucero Munguía; Roser Granero; Gemma Mestre-Bach; Isabel Sánchez; Emilio Ortega; Alba Andreu; Violeta L. Moize; Jose-Manuel Fernández-Real; Francisco J. Tinahones; Carlos Diéguez; Gema Frühbeck; Daniel Le Grange; Kate Tchanturia; Andreas Karwautz; Michael Zeiler; Hartmut Imgart; Annika Zanko; Angela Favaro; Laurence Claes; Ia Shekriladze; Eduardo Serrano-Troncoso; Raquel Cecilia-Costa; Teresa Rangil; Maria Eulalia Loran-Meler; José Soriano-Pacheco; Mar Carceller-Sindreu; Rosa Navarrete; Meritxell Lozano; Raquel Linares; Carlota Gudiol; Jordi Carratala; Maria T. Plana; Montserrat Graell; David González-Parra; José A. Gómez-del Barrio; Ana R. Sepúlveda; Jéssica Sánchez-González; Paulo P. P. Machado; Anders Håkansson; Ferenc Túry; Bea Pászthy; Daniel Stein; Hana Papezová; Jana Gricova; Brigita Bax; Mikhail F. Borisenkov; Sergey V. Popov; Denis G. Gubin; Ivan M. Petrov; Dilara Isakova; Svetlana V. Mustafina; Youl-Ri Kim; Michiko Nakazato; Nathalie Godart; Robert van Voren; Tetiana Ilnytska; Jue Chen; Katie Rowlands; Ulrich Voderholzer; Alessio M. Monteleone; Janet Treasure; Susana Jiménez-Murcia; Fernando Fernández-Aranda;
Countries: Portugal, Belgium, Belgium, France, Belgium, Italy, France, Spain, Italy, Belgium ...
Project: EC | PRIME (847879), EC | Eat2beNICE (728018), EC | PRIME (847879), EC | Eat2beNICE (728018)
Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients. We thank CERCA Programme/Generalitat de Catalunya for institutional support. This manuscript and research was supported by grants from the Department of Health of the Generalitat de Catalunya by the call Pla estratègic de recerca i innovació en salut (PERIS, SLT006/17/00077), the Ministerio de Economía y Competitividad (PSI201568701R), Fondo de Investigación Sanitario (FIS) (INT19/00046, PI17/01167, PI20/132), CIBERINFEC (CB21/13/00009) and co-funded by FEDER funds /European Regional Development Fund (ERDF), a way to build Europe (Eat2beNICE/ H2020-SFS-2016-2; Ref 728018; and PRIME/ H2020-SC1-BHC-2018-2020; Ref: 847879). CIBEROBN, CIBERSAM, CIBERINFEC and CIBERDEM are all initiatives of Instituto de Salud Carlos III (ISCIII). GMB is supported by a postdoctoral grant from FUNCIVA. PPM was supported, in part, by a Portuguese Foundation for Science and Technology grant (POCI-01-0145-FEDER-028145). IB was partially supported by a Post-Residency Grant from the Research Committee of the University Hospital of Bellvitge (HUB; Barcelona, Spain) 2020–2021. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Fondo Investigacion Sanitario-FIS, Grant/Award Numbers: FIS, INT19/00046, PI17/01167; Ministerio de Economia y Competitividad, Grant/Award Number: PSI2015-68701-R; Portuguese Foundation for Science and Technology grant, Grant/Award Number: POCI-01-0145-FEDER-028145; Consejo Nacional de Ciencia y Tecnologia; Generalitat de Catalunya; European Regional Development Fund. Data Availability Statement: Individuals may inquire with Fernández-Aranda regarding availability of the data as there is ongoing studies using the data. To avoid overlapping research efforts, Fernández-Aranda will consider a request on a case-by-case basis.
Background Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases. EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223). Peer reviewed
AbstractBackgroundThe relationship between coronavirus disease 2019 (Covid-19) and ischemic stroke is poorly defined. We aimed to leverage genetic data to investigate reported associations.MethodsGenetic association estimates for liability to Covid-19 and cardiovascular traits were obtained from large-scale consortia. Analyses primarily focused on critical Covid-19, defined as hospitalization with Covid-19 requiring respiratory support or resulting in death. Cross-trait linkage disequilibrium score regression was used to estimate genetic correlations of critical Covid-19 with ischemic stroke, other related cardiovascular outcomes, and risk factors common to both Covid-19 and cardiovascular disease (body mass index, smoking and chronic inflammation, estimated using C-reactive protein). Mendelian randomization analysis was performed to investigate whether liability to critical Covid-19 was associated with increased risk of any of the cardiovascular outcomes for which genetic correlation was identified.ResultsThere was evidence of genetic correlation between critical Covid-19 and ischemic stroke (rg=0.29, FDR p-value=4.65×10−3), body mass index (rg=0.21, FDR-p-value=6.26×10−6) and C-reactive protein (rg=0.20, FDR-p-value=1.35×10−4), but none of the other considered traits. In Mendelian randomization analysis, liability to critical Covid-19 was associated with increased risk of ischemic stroke (odds ratio [OR] per logOR increase in genetically predicted critical Covid-19 liability 1.03, 95% confidence interval 1.00-1.06, p-value=0.03). Similar estimates were obtained when considering ischemic stroke subtypes. Consistent estimates were also obtained when performing statistical sensitivity analyses more robust to the inclusion of pleiotropic variants, including multivariable Mendelian randomization analyses adjusting for potential genetic confounding through body mass index, smoking and chronic inflammation. There was no evidence to suggest that genetic liability to ischemic stroke increased the risk of critical Covid-19.ConclusionsThese data support that liability to critical Covid-19 is associated with an increased risk of ischemic stroke. The host response predisposing to severe Covid-19 is likely to increase the risk of ischemic stroke, independent of other potentially mitigating risk factors.
Kimberley S. M. Benschop; Jan Albert; Andrés Antón; Cristina Andres; Maitane Aranzamendi; Brynja Armannsdottir; Jean-Luc Bailly; Fausto Baldanti; Guðrún Erna Baldvinsdóttir; Stuart Beard; +70 more
Kimberley S. M. Benschop; Jan Albert; Andrés Antón; Cristina Andres; Maitane Aranzamendi; Brynja Armannsdottir; Jean-Luc Bailly; Fausto Baldanti; Guðrún Erna Baldvinsdóttir; Stuart Beard; Natasa Berginc; Sindy Böttcher; Soile Blomqvist; L. Bubba; Cristina Calvo; María Cabrerizo; Annalisa Cavallero; Cristina Celma; Ferruccio Ceriotti; Inês Costa; Simon Cottrell; Margarita Del Cuerpo; Jonathan Dean; Jennifer L. Dembinski; Sabine Diedrich; Javier Díez-Domingo; DagnyHaug Dorenberg; Erwin Duizer; Robert Dyrdak; Diana Fanti; Agnes Farkas; Susan Feeney; Jacky Flipse; Cillian De Gascun; Cristina Galli; Irina Georgieva; Laura Gifford; Raquel Guiomar; Mario Hönemann; Niina Ikonen; Marion Jeannoel; Laurence Josset; Kathrin Keeren; F. Xavier López-Labrador; Melanie Maier; James McKenna; Adam Meijer; Beatriz Mengual-Chuliá; Sofie Midgley; Audrey Mirand; Milagrosa Montes; Catherine Moore; Ursula Morley; Jean-Luc Murk; Lubomira Nikolaeva-Glomb; Sanela Numanovic; Massimo Oggioni; Paula Palminha; Elena Pariani; Laura Pellegrinelli; Antonio Piralla; Corinna Pietsch; Luis Pineiro; Nuria Rabella; Petra Rainetova; Sara Colonia Uceda Renteria; María Pilar Romero; Marijke Reynders; Lieuwe Roorda; Carita Savolainen-Kopra; Isabelle Schuffenecker; Aysa Soynova; Caroline Ma Swanink; Tina Uršič; Jaco J. Verweij; Jorgina Vila; Tytti Vuorinen; Peter Simmonds; Thea Kølsen Fischer; Heli Harvala;
Countries: Norway, Germany, Denmark, France, Spain
Acute flaccid myelitis; Enterovirus D68; Surveillance Mielitis flàcida aguda; Enterovirus D68; Vigilància Mielitis flácida aguda; Enterovirus D68; Vigilancia We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.
Steve Simpson-Yap; Edward De Brouwer; Tomas Kalincik; Nick Rijke; J. Hillert; Clare Walton; Gilles Edan; Yves Moreau; Tim Spelman; Lotte Geys; +37 more
Steve Simpson-Yap; Edward De Brouwer; Tomas Kalincik; Nick Rijke; J. Hillert; Clare Walton; Gilles Edan; Yves Moreau; Tim Spelman; Lotte Geys; Tina Parciak; Clément Gautrais; Nikola Lazovski; Ashkan Pirmani; Amin Ardeshirdavanai; Lars Forsberg; Anna Glaser; Robert N. McBurney; Hollie Schmidt; Arnfin Bergmann; Stefan Braune; Alexander Stahmann; Rodden M. Middleton; Amber Salter; Robert J. Fox; Anneke Van Der Walt; Helmut Butzkueven; Raed Alroughani; Serkan Ozakbas; Juan Ignacio Rojas; Ingrid van der Mei; Nupur Nag; Rumen Ivanov; Guilherme Sciascia do Olival; Alice Estavo Dias; Melinda Magyari; Doralina Guimarães Brum; Maria Fernanda Mendes; Ricardo Alonso; Richard S. Nicholas; Johana Bauer; Anibal Chertcoff; Anna Zabalza; Georgina Arrambide; Alexander Fidao; Giancarlo Comi; Liesbet M. Peeters;
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Esclerosi múltiple Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Esclerosis múltiple Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Multiple Sclerosis Background and Objectives People with multiple sclerosis (MS) are a vulnerable group for severe coronavirus disease 2019 (COVID-19), particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS. Methods Data from 12 data sources in 28 countries were aggregated (sources could include patients from 1–12 countries). Demographic (age, sex), clinical (MS phenotype, disability), and DMT (untreated, alemtuzumab, cladribine, dimethyl fumarate, glatiramer acetate, interferon, natalizumab, ocrelizumab, rituximab, siponimod, other DMTs) covariates were queried, along with COVID-19 severity outcomes, hospitalization, intensive care unit (ICU) admission, need for artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression adjusted for age, sex, MS phenotype, and Expanded Disability Status Scale (EDSS) score. Results Six hundred fifty-seven (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analyzed. Among suspected plus confirmed and confirmed-only COVID-19, 20.9% and 26.9% were hospitalized, 5.4% and 7.2% were admitted to ICU, 4.1% and 5.4% required artificial ventilation, and 3.2% and 3.9% died. Older age, progressive MS phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl fumarate, ocrelizumab and rituximab were associated with hospitalization (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.01–2.41; aOR 2.43, 95% CI 1.48–4.02) and ICU admission (aOR 2.30, 95% CI 0.98–5.39; aOR 3.93, 95% CI 1.56–9.89), although only rituximab was associated with higher risk of artificial ventilation (aOR 4.00, 95% CI 1.54–10.39). Compared to pooled other DMTs, ocrelizumab and rituximab were associated with hospitalization (aOR 1.75, 95% CI 1.29–2.38; aOR 2.76, 95% CI 1.87–4.07) and ICU admission (aOR 2.55, 95% CI 1.49–4.36; aOR 4.32, 95% CI 2.27–8.23), but only rituximab was associated with artificial ventilation (aOR 6.15, 95% CI 3.09–12.27). Compared to natalizumab, ocrelizumab and rituximab were associated with hospitalization (aOR 1.86, 95% CI 1.13–3.07; aOR 2.88, 95% CI 1.68–4.92) and ICU admission (aOR 2.13, 95% CI 0.85–5.35; aOR 3.23, 95% CI 1.17–8.91), but only rituximab was associated with ventilation (aOR 5.52, 95% CI 1.71–17.84). Associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death. Stratification by age, MS phenotype, and EDSS score found no indications that DMT associations with COVID-19 severity reflected differential DMT allocation by underlying COVID-19 severity. Discussion Using the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab with increased risk of hospitalization, ICU admission, and need for artificial ventilation and of ocrelizumab with hospitalization and ICU admission. Despite the cross-sectional design of the study, the internal and external consistency of these results with prior studies suggests that rituximab/ocrelizumab use may be a risk factor for more severe COVID-19. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. The operational costs linked to this study are funded by the Multiple Sclerosis International Federation (MSIF) and the Multiple Sclerosis Data Alliance (MSDA), acting under the umbrella of the European Charcot Foundation. The MSDA receives income from a range of corporate sponsors, recently including Biogen, Bristol-Myers Squibb (formerly Celgene), Canopy Growth Corp, Genzyme, Icometrix, Merck, Mylan, Novartis, QMENTA, Quanterix, and Roche. MSIF receives income from a range of corporate sponsors, recently including Biogen, Bristol-Myers Squibb (formerly Celgene), Genzyme, Med-Day, Merck, Mylan, Novartis, and Roche. This work was supported by the Flemish government under the Onderzoeksprogramma Artificiële Intelligentie Vlaanderen programme and the Research Foundation Fladers (FWO) for ELIXIR Belgium–Flanders (FWO) for ELIXIR Belgium. The central platform was provided by QMENTA, and the computational resources used in this work were provided by Amazon. The statistical analysis was carried out at CORe, The University of Melbourne, with support from the National Health and Medical Research Council (NHMRC; 1129189 and 1140766).
Anne M. Spanjaart; Per Ljungman; Rafael de la Cámara; Gloria Tridello; Valentín Ortiz-Maldonado; Alvaro Urbano-Ispizua; Pere Barba; Mi Kwon; Dolores Caballero; Pierre Sesques; +24 more
Anne M. Spanjaart; Per Ljungman; Rafael de la Cámara; Gloria Tridello; Valentín Ortiz-Maldonado; Alvaro Urbano-Ispizua; Pere Barba; Mi Kwon; Dolores Caballero; Pierre Sesques; Emmanuel Bachy; Roberta Di Blasi; Catherine Thieblemont; Friso Calkoen; Pim G.N.J. Mutsaers; Johan Maertens; Livia Giannoni; Emma Nicholson; Matthew Collin; Carlos Pinho Vaz; Elisabetta Metafuni; Joaquin Martinez-Lopez; Fiona L Dignan; Josep-Maria Ribera; Arnon Nagler; František Folber; Robin Sanderson; Adrian Bloor; Fabio Ciceri; Nina Knelange; Francis Ayuk; Nicolaus Kröger; Marie José Kersten; Stephan Mielke;
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Càncer hematològic; Malalties infeccioses Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Cáncer hematológico; Enfermedades infecciosas Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Haematological cancer; Infectious diseases COVID-19 is posing a significant threat to health in vulnerable patients, such as immunocompromised patients. For hematopoietic cell transplantation (HCT) recipients and patients with hematologic malignancies it is known that COVID-19 leads to severe morbidity and high mortality as compared to the general population [1–3]. For patients treated with Chimeric Antigen Receptor T-cell (CAR-T-cell) therapy for B-cell malignancies however, descriptions of the clinical course and outcome are still limited to small case series and case reports [4–8]. CAR-T-cell therapy recipients are believed to be at high risk of poor outcomes from COVID-19 due to their severely immunocompromised state, caused by prior lymphodepleting immunochemotherapy and CAR-T-cell therapy related side effects such as B-cell depletion, hypogammaglobulinemia, and cytopenias. In order to rapidly inform the medical field on the impact of COVID-19 on CAR-T-cell therapy recipients, the EBMT Infectious Diseases Working Party and the EHA Lymphoma Group joined forces and present the clinical course of COVID-19 in the largest European cohort to date.
Jordi Mayneris-Perxachs; José María Moreno-Navarrete; Marta Ballanti; Giovanni Monteleone; Omero Alessandro Paoluzi; Geltrude Mingrone; Philippe Lefebvre; Bart Staels; Massimo Federici; Josep Puig; +3 more
Jordi Mayneris-Perxachs; José María Moreno-Navarrete; Marta Ballanti; Giovanni Monteleone; Omero Alessandro Paoluzi; Geltrude Mingrone; Philippe Lefebvre; Bart Staels; Massimo Federici; Josep Puig; Josep Garre; Rafael Ramos; José Manuel Fernández-Real;
Cell surface receptor-mediated viral entry plays a critical role in this infection. Well-established SARS-CoV-2 receptors such as ACE2 and TMPRSS2 are highly expressed in the gastrointestinal tract. In fact, there are evidences that SARS-CoV-2 infects epithelial cells from the digestive system. However, emerging research has identified novel mediators such as DPP9, TYK2, and CCR2, all playing a critical role in inflammation. We evaluated the expression of SARS-CoV-2 receptors in peripheral leukocytes (n=469), jejunum (n=30), and colon (n=37) of three independent cohorts by real-time PCR, RNA-sequencing, and microarray transcriptomics. We also performed HPCL-MS/MS lipidomics and metabolomics analyses to identify signatures linked to SARS-CoV-2 receptors. We found markedly higher peripheral leukocytes ACE2 expression levels in women compared to men, whereas the intestinal expression of TMPRSS2 was positively associated with BMI. Consistent lipidomics signatures associated with the expression of these mediators were found in both tissues and peripheral leukocytes involving n-3 long-chain PUFAs and arachidonic acid-derived eicosanoids, which play a key role in the regulation of inflammation and may interfere with viral entry and replication. Medium- and long-chain hydroxy acids, which have shown to interfere in viral replication, were also liked to SARS-CoV2 receptors. Gonadal steroids were also associated with the expression of some of these receptors, even after controlling for sex. The expression of SARS-CoV2 receptors was associated with several metabolic and nutritional traits in different cell types. This information may be useful in the design of potential therapies targeted at coronavirus entry. Graphical abstract
Laia Garrigós; Cristina Saura; Clara Martinez-Vila; Alberto Zambelli; Mark Bower; Barbara Pistilli; Matteo Lambertini; Diego Ottaviani; Nikolaos Diamantis; Ailsa Lumsden; +58 more
Laia Garrigós; Cristina Saura; Clara Martinez-Vila; Alberto Zambelli; Mark Bower; Barbara Pistilli; Matteo Lambertini; Diego Ottaviani; Nikolaos Diamantis; Ailsa Lumsden; Sonia Pernas; Daniele Generali; Elia Seguí; Gemma Viñas; Eudald Felip; Ana Sanchez; Gianpiero Rizzo; Armando Santoro; Alessio Cortellini; Ylenia Perone; John Chester; Maria Iglesias; Marta Betti; Bruno Vincenzi; Michela Libertini; Francesca Mazzoni; Federica Zoratto; Rossana Berardi; Annalisa Guida; Rachel Wuerstlein; Angela Loizidou; Rachel Sharkey; Juan Aguilar Company; Marta Matas; Chiara Saggia; Lorenzo Chiudinelli; Emeline Colomba-Blameble; Myria Galazi; Uma Mukherjee; Mieke Van Hemelrijck; Mar Marin; Carla Strina; Aleix Prat; Helena Pla; Eva Maria Ciruelos; Alexia Bertuzzi; Lucia del Mastro; Giampiero Porzio; Thomas Newsom-Davis; Isabel Ruiz; Maria Belen Delany; Marco Krengli; Vittoria Fotia; Alessandro Viansone; Neha Chopra; Margarita Romeo; Ramon Salazar; Ignacio Perez; Francesca d’Avanzo; Michela Franchi; Manuela Milani; Fanny Pommeret; Marco Tucci; Paolo Pedrazzoli; Nadia Harbeck; Daniela Ferrante; David J. Pinato; Alessandra Gennari;
COVID-19; SARS-CoV-2; Cáncer de mama COVID-19; SARS-CoV-2; Càncer de mama COVID-19; SARS-CoV-2; Breast cancer Background: Cancer patients are at higher risk of COVID-19 complications and mortality than the rest of the population. Breast cancer patients seem to have better prognosis when infected by SARS-CoV-2 than other cancer patients. Methods: We report a subanalysis of the OnCovid study providing more detailed information in the breast cancer population. Results: We included 495 breast cancer patients with a SARS-CoV-2 infection. Mean age was 62.6 years; 31.5% presented more than one comorbidity. The most frequent breast cancer subtype was luminal-like (n = 245, 49.5%) and 177 (35.8%) had metastatic disease. A total of 332 (67.1%) patients were receiving active treatment, with radical intent in 232 (47.6%) of them. Hospitalization rate was 58.2% and all-cause mortality rate was 20.3%. One hundred twenty-nine (26.1%) patients developed one COVID-19 complication, being acute respiratory failure the most common (n = 74, 15.0%). In the multivariable analysis, age older than 70 years, presence of COVID-19 complications, and metastatic disease were factors correlated with worse outcomes, while ongoing anticancer therapy at time of COVID-19 diagnosis appeared to be a protective factor. No particular oncological treatment was related to higher risk of complications. In the context of SARS-CoV-2 infection, 73 (18.3%) patients had some kind of modification on their oncologic treatment. At the first oncological reassessment (median time: 46.9 days ± 36.7), 255 (51.6%) patients reported to be fully recovered from the infection. There were 39 patients (7.9%) with long-term SARS-CoV-2-related complications. Conclusion: In the context of COVID-19, our data confirm that breast cancer patients appear to have lower complications and mortality rate than expected in other cancer populations. Most breast cancer patients can be safely treated for their neoplasm during SARS-CoV-2 pandemic. Oncological treatment has no impact on the risk of SARS-CoV-2 complications, and, especially in the curative setting, the treatment should be modified as little as possible. D.J. Pinato is supported by grant funding from the Wellcome Trust Strategic Fund (PS3416) and acknowledges grant support from the Cancer Treatment and Research Trust (CTRT), infrastructural and grant support by the Cancer Research UK Imperial Centre and the NIHR Imperial Biomedical Research Centre. A. Gennari is supported by the AIRC IG Grant, No. 14230, Associazione Italiana per la Ricerca sul Cancro Foundation, Milan, Italy and acknowledge also support from the UPO Aging Project.
Juan Gómez Rivas; Bhaskar Somani; Moises Rodriguez Socarrás; Giancarlo Marra; Ian Pearce; Lars Henningsohn; Patricia Zondervan; Henk van der Poel; Hendrik Van Poppel; James N’Dow; +15 more
Juan Gómez Rivas; Bhaskar Somani; Moises Rodriguez Socarrás; Giancarlo Marra; Ian Pearce; Lars Henningsohn; Patricia Zondervan; Henk van der Poel; Hendrik Van Poppel; James N’Dow; Evangelos Liatsikos; Joan Palou; Rade Stanisavljevic; Bojanic Nebojsa; Pavel Banov; Leonid Spivak; Stilianos Giannakopoulos; Mario Álvarez-Maestro; Jan Svihra; Tobias Page; Emrah Yuruk; Miguel Silva-Ramos; Saban Sarikaya; Francesco Porpiglia; Attila Szendroi;
Background The burden of urological diseases is rising as the worldwide population ages. Although specialist urological provision is needed, a large proportion of these conditions will be managed in primary care. The importance of including urology in medical education currently remains unclear. Objective To provide recommendations on undergraduate medical education for urology in Europe. Design, setting, and participants A three-round Delphi process to reach consensus on standardising the undergraduate urology curriculum in Europe was endorsed by the European School of Urology. Outcome measurements and statistical analysis The levels of agreement were set using a nine-point scale according to the GRADE grid: 1–3, disagree; 4–6, uncertain; and 7–9, agree. Consensus was defined as at least 70% of the participants scoring within the same 3-point grouping. Results and limitations Overall, consensus was reached for 20 of 34 statements (70.5%) across the three Delphi rounds, with agreement for 75% (n = 15) and disagreement for 25% (n = 5). The following main points were agreed. Urological teaching should be introduced before year 5 of medical school, with at least 20 h of theoretical activities and at least 30 h of practical activities. Urology should be taught as a stand-alone subject rather than combined with another surgical specialty or a nephrology programme. The participants agreed that urology should be taught according to symptoms. A urology programme should include the anatomy and physiology of the urinary tract, and students should know how to clinically assess a urological patient. Conclusions Our recommended urology pathway will allow European medical schools to provide a more comprehensive undergraduate urology curriculum. It will also help to improve and maintain standards of urology undergraduate teaching across Europe. Patient summary Our survey showed that urology in universities should have, at minimum, time for theoretical and practical activities and should be taught as a stand-alone subject on the basis of symptoms. Students should give feedback to facilitate constant improvement and evolution of the teaching programme. Take Home Message Our survey shows that urology teaching in universities should have, at minimum, time for theoretical and practical activities and should be taught as a stand-alone subject on the basis of symptomatology. Students should give feedback to facilitate constant improvement and evolution of the teaching programme.