Background Immunocompromised cancer patients are presumed to be at high risk of developing COVID-19 infection. Predisposing factors to contracting COVID-19 and to severe outcomes have been described in registries but were not compared between solid tumors and hematological malignancies. Method This retrospective single oncologic center study included adults with solid tumors or hematological malignancies referred to testing by naso-pharyngeal swab for a SARS-CoV-2 RT-PCR from March 10 to May 18, 2020. Results A total of 212 patients were included in the study. Forty-five (21%) were tested positive with SARS-CoV-2. The univariate analysis with positive SARS-CoV-2 PCR as a dependent variable reveals significant odds ratios (ORs) for age—with a mean of 62.5 years—(OR: 1.05, 95% CI: 1.02–1.08), performance status ≥2 (OR: 2.38, 95% CI: 1.22–4.70), inpatient status (OR: 2.36, 95%CI: 1.11–4.91), and hematological malignancies (OR: 2.48, 95% CI: 1.23–4.96). In contrast, OR for solid tumors reveals a negative association (OR: 0.40, 95% CI: 0.20–0.81). When integrating severe outcome (ICU admission or COVID-19-related death) as a dependent variable, the univariate logistic regression model shows significant ORs for pre-existing lymphopenia (OR: 4.0, 95% CI: 1.17–15.04), hematological malignancies (OR: 3.73, 95% CI: 1.09–13.80), and a negative association for solid tumors (OR: 0.27; 95% CI: 0.07–0.92). Conclusion In patients referred for SARS-CoV-2 testing, hematological malignancies were associated with a higher risk of COVID-19 infection and severe outcomes. Other factors were age and inpatient status.

ObjectiveThis study aimed at evaluating the impact of COVID-19 on emergency department (ED) visits in a tertiary cancer centre and providing information on the features of the unplanned events during the first wave of COVID-19 pandemic.MethodsThis retrospective observational study based on data from ED reports was divided into three periods of 2 months each around the first lockdown announcement of 17 March 2020: pre-lockdown, lockdown and post-lockdown.ResultsA total of 903 ED visits were included in the analyses. The mean (±SD) daily number of ED visits did not change during the lockdown period (14.6±5.5) when compared with the periods before (13.6±4.5) and after lockdown (13.7±4.4) (p=0.78). The proportion of ED visits for fever and respiratory disorders increased significantly to 29.5% and 28.5%, respectively (p<0.01) during lockdown. Pain, the third most frequent motive, remained stable with 18.2% (p=0.83) throughout the three periods. Symptom severity also showed no significant differences in the three periods (p=0.31).ConclusionOur study shows that ED visits during the first wave of the COVID-19 pandemic remained stable for our patients regardless of the symptom’s severity. The fear of an in-hospital viral contamination appears weaker than the need for pain management or for the treatment of cancer-related complications. This study highlights the positive impact of cancer ED in the first-line treatment and supportive care of patients with cancer.

Foreign bodies such as implanted cardiac devices are susceptible to infections and may be involved in infective endocarditis. Exposure to pathogens, by frequent use of intravascular accesses for hemodialysis (i.e., catheters or fistulas), combined with high rates of degenerative heart valve diseases in hemodialysis patients, both favor the development of infective endocarditis in this population. The mitral and aortic valves are predominantly implicated in endocardial infections. The involvement of both mitral and tricuspid valves is rare in the general population but can occur in hemodialysis patients with implanted cardiac devices. Infective endocarditis is associated with high morbidity and mortality rates among hemodialysis patients, mostly because of the complications of septic emboli. Prevention, prophylaxis, and early diagnosis of endocarditis can be lifesaving in this fragile population. We report a case of right and left heart methicillin-sensitive Staphylococcus aureus endocarditis with cerebral septic emboli in an elderly hemodialysis patient carrier of an arteriovenous fistula and an ipsilateral nonleadless pacemaker.

Context Immunocompromised cancer patients are presumed to be at high risk of developing COVID-19 infection. Objective Predisposing factors to contracting COVID-19 and to severe outcomes have been described in registries but were not compared between solid tumors and hematological malignancies. Design This retrospective study included patients from March 10 to May 18, 2020. Setting The study took place in a single oncologic tertiary center in Belgium. Patients or Other Participants 212 adult patients with solid tumors or hematological malignancies referred to testing by naso-pharyngeal swab for a SARS-CoV-2 RT-PCR were included in the study. Interventions We collected data on demographics, symptoms, comorbidities, performance status, type and stage of cancer, anti-cancer treatment, blood work, imaging and outcome. Main Outcomes Meausres The primary endpoint was the incidence of COVID-19 among patients with concordant symptoms, close contact with a confirmed case or concordant imaging among patients with solid tumors or hematological malignancies. Results Among the 212 patients included in the study, 45 (21%) tested positive with SARS-CoV-2. The univariate analysis with positive SARS-CoV-2 PCR as a dependent variable reveals significant Odds Ratios (ORs) for age with a mean of 62.5 years - (OR: 1.05, 95% CI: 1.02-1.08), performance status ≥2 (OR: 2.38, 95% CI: 1.22-4.70), inpatient status (OR: 2.36, 95% CI: 1.11-4.91) and hematological malignancies (OR: 2.48, 95% CI: 1.23-4.96). In contrast, OR for solid tumors reveals a negative association (OR: 0.40, 95% CI: 0.20-0.81). When integrating severe outcome (ICU admission or COVID-19 related death) as a dependent variable, the univariate logistic regression model shows significant ORs for pre-existing lymphopenia (OR: 4.0, 95% CI: 1.17-15.04), hematological malignancies (OR: 3.73, 95% CI: 1.09-13.80), and a negative association for solid tumors (OR: 0.27; 95% CI: 0.07-0.92). Conclusions In patients referred for SARS-CoV-2 testing, hematological malignancies were associated with a higher risk of COVID-19 infection and severe outcomes. Other factors were age, active chemotherapy treatment and inpatient status.

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