Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study

Results Sixty-one cancer survivors and 183 matched non-cancer patients were screened from 2,828 COVID-19 infected patients admitted to 4 hospitals in Wuhan,China.The median ages of the cancer survivor cohort and non-cancer patient cohort were 64.0(55.0–73.0)and 64.0(54.0–73.5),respectively(P=0.909).Cancer survivors reported a higher incidence of symptom onset than non-cancer patients.Fever(80.3%vs.65.0%;P=0.026)was the most prevalent symptom,followed by cough(65.6%vs.37.7%;P<0.001),myalgia,and fatigue(45.9%vs.13.6%;P<0.001).The risks of the development of severe events(adjusted hazard ratio[AHR]=1.25;95%confidence interval[CI]:0.76–2.06;P=0.378)and mortality(relative risk[RR]=0.90,95%CI:0.79–1.04;P=0.416)in the cancer survivor cohort were comparable to those of the matched non-cancer patient cohort.However,the cancer survivor cohort showed a higher incidence of secondary infection(52.5%vs.30.1%;RR=1.47,95%CI:1.11–1.95;P=0.002)and a prolonged viral RNA shedding duration(32 days[IQR 26.0–46.0]vs.24.0 days[IQR 18.0–33.0];AHR=0.54;95%CI:0.38–0.80;P<0.05).Conclusion Compared to non-cancer patients,cancer survivors with COVID-19 exhibited a higher incidence of secondary infection,a prolonged period of viral shedding,but comparable risks of the development of severe events and mortality.It is helpful for clinicians to take tailored measures to treat cancer survivors with COVID-19.

An early-onset case of post-cardiac injury syndrome after coronary stenting

Dear editor,Post-cardiac injury syndrome(PCIS) refers to a group of syndromes characterized by inflammation of the pericardium, pleura, and lung parenchyma after various heart injuries, including cardiac surgery or trauma, acute myocardial infarction(AMI), radiofrequency catheter ablation, coronary intervention, pacemaker implantation and pericardiocentesis.[1-5]Although advanced PCIS is well understood after cardiac surgery and AMI, known as post-pericardiotomy syndrome and post-myocardial infarction syndrome,[6,7]early-onset cases of PCIS after coronary intervention are rarely reported in China.

Does Percutaneous Coronary Intervention on Off Days have an Effect on Long-term Prognosis in Patients with Coronary Artery Disease in China?

As generally known,many hospitals provide routine care on weekdays but only emergency or urgent care on holidays and weekends.Hospital staffing is numerically reduced on holidays and weekends,as well as the available expertise on duty.The onset of acute myocardial infarction (AMI) on off days was reported to be associated with higher short-term mortality[1,2].