Αρχική World News Male Patients with Cancer at Higher Risk of Severe Disease Course and...

Male Patients with Cancer at Higher Risk of Severe Disease Course and Mortality Attributable to COVID-19

The male sex appears to be a risk factor for severe disease and death due to COVID-19 in the cancer patient population according to findings from a systematic review and meta-analysis published by Anup Kasi of the Department of Medicine, Division of Medical Oncology, Kansas University Medical Center, Kansas City, Kansas, US and colleagues on 24 August 2020 in the EClinicalMedicine, published by The Lancet. The finding may help in guiding the decision making in cancer care and patient counselling in the clinics especially because societies move towards re-opening and towards a new-normal.

The authors wrote in the study background that early observational findings suggested that COVID-19 is associated with disproportionately worse outcomes in males compared to females with subsequent studies providing statistical evidence for this clinical phenomenon and indicating that morbidity and mortality are higher in males despite no difference in the proportion of infected cases between the sexes. However, the pathogenesis behind this sex bias is not yet established.

A number of theories have been proposed in that regard, for example potential role of androgenic hormones in the pathogenesis, potential sex differences in one or more of the multstep immunopathogenetic pathway including virus entry, innate immune virus recognition, and induction of adaptive immune response. Other epidemiological and clinical variables have emerged as risk factors for COVID-19 including age, comorbidities, etc. Although the reason is unclear, none of the epidemiological association of sex with adverse outcomes associated with COVID-19 appears to be established in the general community population.

Further line of reasoning suggests a potential link between certain male-specific cancers and COVID-19 pathogenesis. In particular, seminal vesicles have been found to express ACE2 and TMPRSS2 which mediate SARS-CoV-2 cellular entry and SARS-CoV-2 has been detected in semen. Although not well established, inflammation as a result of SARS-CoV-2 in the vicinity of the prostate may adversely impact patients with established prostate cancer while from the viewpoint of the infection, the male sex organs may provide a viral reservoir.

The fact that the results from several published studies examining whether there is sex bias within the adverse outcomes associated with COVID-19 in the cancer population are inconclusive and inconsistent prompted the authors to conduct a systematic review and meta-analysis to synthesize the evidence behind sex bias within COVID-19 associated disease severity and death specifically within the cancer patient population.

The authors identified the published articles which evaluated the adverse outcomes associated with COVID-19 in the cancer population from its beginning until June 2020 by searching PubMed and EMBASE, ASCO 2020 Virtual Annual Conference, AACR 2020 COVID-19 and Cancer, ESMO conferences, medRxiv and bioRxiv. The authors included in the analysis prospective or retrospective studies in English language that provide outcomes data with sex differences in the cancer population.

The primary outcomes of interest were pooled odds ratios (ORs) of severe disease, all-cause death, and the composite of severe disease and death attributable to COVID-19 in male versus female cancer patients.

Overall, 3968 patients from 17 studies were analyzed in retrospective study settings. Overall, pooled ORs of the composite of severe disease and all-cause death in the setting of COVID-19 in males versus females was 1.60 (95% confidence interval, 1.38–1.85). The risk of severe disease or death were both independently increased in males versus females.

The generalizability of the results is supported by analyzed studies that span across multiple countries from several continents. The analysis reports multiple clinical outcome associations of which are all in agreement, strongly supporting the conclusion.

However, the study has a number of limitations. The studies included were conducted in retrospective settings. Reported ORs derived from univariate analyses were used in the meta-analysis due to lack of reported multivariate adjusted ORs in included studies. However, sensitivity analysis showed that there was no significant difference between results reported from univariate and multivariate models. Pre-print databases were included in the meta-analysis despite their lack of peer review. The studies were scrutinized for quality using two separate scales prior to inclusion to control the quality of the meta-analysis. Furthermore, there was overlap in the clinical outcomes evaluated. The definition of severe disease used in the included studies consisted of both intensive care unit admission (ICU) and death. For this reason, whether male sex was associated with severe disease excluding mortality remains unclear and further studies to explain this association are warranted.

The authors concluded that findings from their systematic review and meta-analysis show that male patients with cancer compared to female cancer patients have higher risk of severe COVID-19 as defined by disease course requiring ICU admission and intubation and higher risk of all-cause death. These findings establish sex as a risk factor in the cancer patient population and suggest that it should be taken into account in the evaluation of COVID-19 risk in the cancer setting.

Reference

Sex-bias in COVID-19-associated illness severity and mortality in cancer patients: A systematic review and meta-analysis. EClinicalMedicine; Published online 24 August 2020. DOI: https://doi.org/10.1016/j.eclinm.2020.100519

Source

NEWSLETTER

Συμπληρώστε το email σας για να λαμβάνετε τις σημαντικότερες ειδήσεις από το ogkologos.com

Βρείτε μας

2,449ΥποστηρικτέςΚάντε Like
57ΑκόλουθοιΑκολουθήστε

Διαβαστε Επίσης

ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ)

ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ) Γράφει ο Δρ Παπαδούρης Σάββας, Παθόλογος-Ογκολόγος   Ο ΜΜΚΠ βρίσκεται αναλογικά στο 80% και πλέον του συνολικού...

Διατρέχουν όντως οι καρκινοπαθείς μεγαλύτερο κίνδυνο λόγω κοροναϊού;

Σε πρακτικό επίπεδο, τα δεδομένα των σχετικών μελετών υποδηλώνουν ότι η χημειοθεραπεία ή οι άλλες αντι-νεοπλασματικές θεραπείες δεν αυξάνουν σημαντικά τον κίνδυνο θνησιμότητας από...

FDA: Η ακτινοβολία των smartphones δεν προκαλεί καρκίνο

Σε μια νέα έκθεσή της, η Υπηρεσία Τροφίμων και Φαρμάκων (FDA) των ΗΠΑ αναφέρει ότι επανεξέτασε τις σχετικές επιστημονικές έρευνες που δημοσιεύθηκαν τα τελευταία...

Νέα ανακάλυψη, νέα ελπίδα για τον καρκίνο

Ένα νεοανακαλυφθέν τμήμα του ανοσοποιητικού μας συστήματος θα μπορούσε να αξιοποιηθεί για την αντιμετώπιση όλων των ειδών καρκίνου, σύμφωνα με επιστήμονες του πανεπιστημίου Cardiff...

Καρκίνος: Ευεργετική για τους καρκινοπαθείς η άσκηση

Σημαντικά ωφέλη προσφέρει η άσκηση, ακόμη και σε ασθενείς με καρκίνο. Οι περισσότεροι ασθενείς αγνοούν τα οφέλη που μπορεί να έχει γι’ αυτούς η συχνή...

Prostate Cancer

The article is provided by Scientific Communications Officer of NIPD Genetics, Ms Marina Charitou (MSc) Prostate Cancer Awareness Prostate cancer is the second most common cancer...
- Advertisment -

Ροή Ειδήσεων

EMA Recommends Granting a Marketing Authorisation for Lenalidomide Mylan

On 15 October 2020, the European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting...

Easy Meals at Home

Our theme this week is delicious, easy to make, at home meals. These recipes minimize your cook time and maximize your food enjoyment. Ingredients 8...

This Saturday: National Prescription Drug Take-Back Day

Have you taken a look at your medicine cabinet lately? Aside from cotton swabs, mouthwash and makeup remover, are there old, outdated prescription drugs...

How People With Cancer Can Benefit From Online Therapy

Tanya J. Peterson, MS, is credentialed with the National Board of Certified Counselors. She is a regular contributor to the mental health website, Choosing...

EMA Recommends Granting a Conditional Marketing Authorisation for Autologous Anti-CD19-Transduced CD3+ Cells

On 15 October 2020, the European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting...

New Treatment Helps Survivors Regain Sensation After Breast Cancer

When NBC’s Kristen Dahlgren was diagnosed with breast cancer, she didn’t think much about the lack of sensation that her mastectomy would likely leave...