1713P Active smoking and severity of COVID-19 infection in cancer patients
Autor: | J.N. Minatta, Oriol Mirallas, Cristino Cruz, F. M. Laia, C. Urbano Centella, X. Mielgo Rubio, M. Rodriguez Castells, R. López-Castro, Laura Mezquita, Estela Pineda, Aleix Prat, Edouard Auclin, M.V. Bluthgen, D. Casadevall Aguilar, N. Epaillard, L. Masfarré, M. Tagliamento, Sara Pilotto, N. Saoudi Gonzalez, G. D. H. Marta |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) business.industry Mortality rate Cancer Retrospective cohort study Hematology medicine.disease Systemic therapy Intensive care unit Article law.invention Oncology law Internal medicine behavior and behavior mechanisms medicine Absolute neutrophil count Median body business |
Zdroj: | Annals of Oncology |
ISSN: | 0923-7534 |
DOI: | 10.1016/j.annonc.2020.08.1777 |
Popis: | Background: Smoking is the leading cause of cancer worldwide Active smoking alters the inflammatory environment of the respiratory epithelium, increasing the production of potent pro-inflammatory cytokines that promote the recruitment of macrophages and neutrophils, leading to lung damage We hypothesize that smoking-induced inflammation can impact on COVID-19 infection severity and mortality related to the proinflammatory cascade Methods: Multicenter retrospective cohort of cancer patients (pts) with COVID-19 infection diagnosed by PCR/Ag detection (n=274) and CT-scan (N=13) in Mar-Apr/20r in 12 centers Clinical and biological data were collected Smoker was defined as active tobacco consumption and heavy smoker as >30 pack-year (PY) Primary endpoints were 30-day mortality rate and the rate of severe acute respiratory failure (SARF), defined by oxygen requirements >15 L/min Results: A total of 287 pts were enrolled: 25 (9%) were active smokers, 127 (47%) were former and 116 (43%) never smoker Among active smokers: 73% were heavy smokers, median age was 62y, 60% were male and median body mass index was 22 Regarding their comorbidities: 25% had hypertension, 8% cardiovascular disease, 28% chronic obstructive pulmonary disease and 24% diabetes Thoracic tumors were the most common (52%), 72% had advanced disease and 56% were under systemic therapy 92% of active smokers required hospitalization, 68% developed pneumonia and 58% required oxygen Only 4% were escalated to the intensive care unit Active smokers received treatment with hydroxychloroquine (91%), azithromycin (61%), antiviral therapy (33%) and steroids (29%) Only 4% received immunomodulatory drugs SARF was the most common complication (25%) and no thromboembolic events were observed A pro-inflammatory status was observed at COVID-19 diagnosis in active smokers, e g median of absolute neutrophil count was 6 35 (vs 5 4), mean ferritin was 1269 (vs 991) and D-Dimer was 2422 (vs 1816);but with no significant differences Overall mortality rate was 27% Mortality rate was higher in active smokers (40% vs 24% in non-smokers;p=0 08) Conclusions: Active smoking might be associated with severe COVID-19 infection and early death in cancer patients Smoking induced-inflammation should be further explored Legal entity responsible for the study: Aleix Prat Funding: Has not received any funding Disclosure: E Auclin: Travel/Accommodation/Expenses: Mundifarma;Speaker Bureau/Expert testimony: Sanofi Genzime S Pilotto: Speaker Bureau/Expert testimony: Astra-Zeneca;Speaker Bureau/Expert testimony: Boehringer Ingelheim;Speaker Bureau/Expert testimony: Eli-Lilly;Speaker Bureau/Expert testimony: BMS A Prat: Honoraria (institution), Speaker Bureau/Expert testimony: Roche;Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer;Honoraria (institution), Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis;Amgen;Speaker Bureau/Expert testimony: BMS;Honoraria (institution), Speaker Bureau/Expert testimony: Daiichi Sankyo;Nanostring;Advisory/Consultancy: Puma;Oncolytics Biotech;MSD;Honoraria (institution), Advisory/Consultancy: Lilly;Boehringer;Sysmex Europa GmbH;Medican Scientia inno Research;Celgene;Astellas;Officer/Board of Directors: Breast International Group;Solti's Foundation;Actitud frente al cancer foundation L Mezquita: Speaker Bureau/Expert testimony, Research grant/Funding (self), Travel/Accommodation/Expenses: Bristol-Meyers Squibb;Speaker Bureau/Expert testimony: Tecnofarma;Honoraria (institution), Speaker Bureau/Expert testimony: Astrazeneca;Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche;Research grant/Funding (self): Boehringer Intelligence All other authors have declared no conflicts of interest |
Databáze: | OpenAIRE |
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