Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2
Abstract Objective To determine the impact of acute SARS-CoV-2 infection on patient with concomitant active cancer and CVD. Methods The researchers extracted and analyzed data from the National COVID Cohort Collaborative (N3C) database between January 1, 2020, and July 22, 2022. They included only p...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
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| Series: | Cardio-Oncology |
| Online Access: | https://doi.org/10.1186/s40959-023-00187-w |
| _version_ | 1827633024333774848 |
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| author | Brijesh Patel Scott A. Chapman Jake T. Neumann Aayush Visaria Oluwabunmi Ogungbe Sijin Wen Maryam Khodaverdi Priyal Makwana Jasvinder A. Singh George Sokos on behalf of the N3C Consortium |
| author_facet | Brijesh Patel Scott A. Chapman Jake T. Neumann Aayush Visaria Oluwabunmi Ogungbe Sijin Wen Maryam Khodaverdi Priyal Makwana Jasvinder A. Singh George Sokos on behalf of the N3C Consortium |
| author_sort | Brijesh Patel |
| collection | DOAJ |
| description | Abstract Objective To determine the impact of acute SARS-CoV-2 infection on patient with concomitant active cancer and CVD. Methods The researchers extracted and analyzed data from the National COVID Cohort Collaborative (N3C) database between January 1, 2020, and July 22, 2022. They included only patients with acute SARS-CoV-2 infection, defined as a positive test by PCR 21 days before and 5 days after the day of index hospitalization. Active cancers were defined as last cancer drug administered within 30 days of index admission. The “Cardioonc” group consisted of patients with CVD and active cancers. The cohort was divided into four groups: (1) CVD (-), (2) CVD ( +), (3) Cardioonc (-), and (4) Cardioonc ( +), where (-) or ( +) denotes acute SARS-CoV-2 infection status. The primary outcome of the study was major adverse cardiovascular events (MACE), including acute stroke, acute heart failure, myocardial infarction, or all-cause mortality. The researchers analyzed the outcomes by different phases of the pandemic and performed competing-risk analysis for other MACE components and death as a competing event. Results The study analyzed 418,306 patients, of which 74%, 10%, 15.7%, and 0.3% had CVD (-), CVD ( +), Cardioonc (-), and Cardioonc ( +), respectively. The Cardioonc ( +) group had the highest MACE events in all four phases of the pandemic. Compared to CVD (-), the Cardioonc ( +) group had an odds ratio of 1.66 for MACE. However, during the Omicron era, there was a statistically significant increased risk for MACE in the Cardioonc ( +) group compared to CVD (-). Competing risk analysis showed that all-cause mortality was significantly higher in the Cardioonc ( +) group and limited other MACE events from occurring. When the researchers identified specific cancer types, patients with colon cancer had higher MACE. Conclusion In conclusion, the study found that patients with both CVD and active cancer suffered relatively worse outcomes when they had acute SARS-CoV-2 infection during early and alpha surges in the United States. These findings highlight the need for improved management strategies and further research to better understand the impact of the virus on vulnerable populations during the COVID-19 pandemic. |
| first_indexed | 2024-03-09T14:52:49Z |
| format | Article |
| id | doaj.art-fbe6d71a01f94d3b8a71d0862d384884 |
| institution | Directory Open Access Journal |
| issn | 2057-3804 |
| language | English |
| last_indexed | 2024-03-09T14:52:49Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardio-Oncology |
| spelling | doaj.art-fbe6d71a01f94d3b8a71d0862d3848842023-11-26T14:22:34ZengBMCCardio-Oncology2057-38042023-10-019111310.1186/s40959-023-00187-wOutcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2Brijesh Patel0Scott A. Chapman1Jake T. Neumann2Aayush Visaria3Oluwabunmi Ogungbe4Sijin Wen5Maryam Khodaverdi6Priyal Makwana7Jasvinder A. Singh8George Sokos9on behalf of the N3C ConsortiumHeart and Vascular Institute, West Virginia UniversityDepartment of Experimental and Clinical Pharmacology, University of Minnesota College of PharmacyDepartment of Biomedical Sciences, West Virginia School of Osteopathic MedicineDepartment of Medicine, Rutgers Robert Wood Johnson Medical SchoolJohns Hopkins UniversityDepartment of Biostatistics, School of Public Health, West Virginia UniversityWest Virginia Clinical and Transitional Science InstituteWest Virginia Clinical and Transitional Science InstituteWest Virginia Clinical and Transitional Science InstituteHeart and Vascular Institute, West Virginia UniversityAbstract Objective To determine the impact of acute SARS-CoV-2 infection on patient with concomitant active cancer and CVD. Methods The researchers extracted and analyzed data from the National COVID Cohort Collaborative (N3C) database between January 1, 2020, and July 22, 2022. They included only patients with acute SARS-CoV-2 infection, defined as a positive test by PCR 21 days before and 5 days after the day of index hospitalization. Active cancers were defined as last cancer drug administered within 30 days of index admission. The “Cardioonc” group consisted of patients with CVD and active cancers. The cohort was divided into four groups: (1) CVD (-), (2) CVD ( +), (3) Cardioonc (-), and (4) Cardioonc ( +), where (-) or ( +) denotes acute SARS-CoV-2 infection status. The primary outcome of the study was major adverse cardiovascular events (MACE), including acute stroke, acute heart failure, myocardial infarction, or all-cause mortality. The researchers analyzed the outcomes by different phases of the pandemic and performed competing-risk analysis for other MACE components and death as a competing event. Results The study analyzed 418,306 patients, of which 74%, 10%, 15.7%, and 0.3% had CVD (-), CVD ( +), Cardioonc (-), and Cardioonc ( +), respectively. The Cardioonc ( +) group had the highest MACE events in all four phases of the pandemic. Compared to CVD (-), the Cardioonc ( +) group had an odds ratio of 1.66 for MACE. However, during the Omicron era, there was a statistically significant increased risk for MACE in the Cardioonc ( +) group compared to CVD (-). Competing risk analysis showed that all-cause mortality was significantly higher in the Cardioonc ( +) group and limited other MACE events from occurring. When the researchers identified specific cancer types, patients with colon cancer had higher MACE. Conclusion In conclusion, the study found that patients with both CVD and active cancer suffered relatively worse outcomes when they had acute SARS-CoV-2 infection during early and alpha surges in the United States. These findings highlight the need for improved management strategies and further research to better understand the impact of the virus on vulnerable populations during the COVID-19 pandemic.https://doi.org/10.1186/s40959-023-00187-w |
| spellingShingle | Brijesh Patel Scott A. Chapman Jake T. Neumann Aayush Visaria Oluwabunmi Ogungbe Sijin Wen Maryam Khodaverdi Priyal Makwana Jasvinder A. Singh George Sokos on behalf of the N3C Consortium Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 Cardio-Oncology |
| title | Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 |
| title_full | Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 |
| title_fullStr | Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 |
| title_full_unstemmed | Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 |
| title_short | Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2 |
| title_sort | outcomes of patients with active cancers and pre existing cardiovascular diseases infected with sars cov 2 |
| url | https://doi.org/10.1186/s40959-023-00187-w |
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