Objective This study aimed to describe the demographic and clinical characteristics of cancer inpatients with COVID-19 exploring clinical outcomes. Methods A retrospective search in the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 granted identification of 181 patients with COVID-19 confirmed by RT-PCR. Results The mean age was 55.3 years (SD ± 21.1). Comorbidities were present in 110 (60.8%) cases. The most prevalent solid tumors were breast (40 [22.1%]), gastrointestinal (24 [13.3%]), and gynecological (22 [12.2%]). Among hematological malignancies, lymphoma (20 [11%]) and leukemia (10 [5.5%]) predominated. Metastatic disease accounted for 90 (49.7%) cases. In total, 63 (34.8%) had recently received cytotoxic chemotherapy. The most common complications were respiratory failure (70 [38.7%]), septic shock (40 [22.1%]) and acute kidney injury (33 [18.2%]). A total of 60 (33.1%) patients died due to COVID-19 complications. For solid tumors, the COVID-19-specific mortality rate was 37.7% (52 out of 138 patients) and for hematological malignancies, 23.5% (8 out of 34). According to the univariate analysis COVID-19-specific mortality was significantly associated with age over 75 years (P = .002), metastatic cancer (p <0.001), two or more sites of metastases (P < .001), the presence of lung (P < .001) or bone metastases (P = .001), non-curative treatment or best supportive care intent (P < .001), higher C-reactive protein levels (P = .002), admission due to COVID-19 (P = .009), and antibiotics use (P = .02). After multivariate analysis, cases with admission due to symptoms of COVID-19 (P = .027) and with two or more metastatic sites (P < .001) showed a higher risk of COVID-19-specific death. Conclusion This is the first Brazilian cohort of cancer patients with COVID-19. The rates of complications and COVID-19-specific death were significantly high.

Background Subungual melanoma (SM) is rare. The lesions are thick at the time of diagnosis. Few studies have evaluated SM in Brazil. Objective The objective of this study was to investigate the factors associated with the survival of SM patients from the Brazilian National Cancer Institute. Methods One‐hundred and fifty‐seven patients diagnosed with SM were included in this study. We evaluated the epidemiologic, clinical, and histopathological data. Overall survival (OS) and relapse‐free survival (RFS) curves were computed using the Kaplan‐Meier method. Multivariable analyses were conducted using the Cox proportional hazard regression model. Results Among the 157 patients, 87 (55.4%) were female. The median age was 68 years old. Median tumor depth was 6.0 mm. Lesions were ulcerated in 94 (59.9%). OS and RFS rates for 5 years were 61.0% and 41.8%, respectively. Median follow‐up time was 28 months. The factors associated with OS were Breslow thickness and ulceration, and for RFS, they were the anatomical site, Breslow thickness, and ulceration. Conclusion This is the largest series of SM patients. The 5‐year OS and RFS rates were low (61.0% and 48.2%, respectively), and the main prognostic factors for OS were Breslow thickness and ulceration.

Acral melanoma (AM) is a rare subtype of melanoma arising on the palms, soles and subungual areas. In the Brazilian and Latin American populations, the sociodemographic and clinical-pathologic features of AM are unclear. AM tends to be more advanced at presentation because of delayed diagnoses, with poor survival. This study reports on a retrospective AM cohort from the Brazilian National Cancer Institute. We reviewed a database of 529 patients presenting with AM from 1997 to 2014 and analysed the sociodemographic and clinical-pathologic features of AM associated with overall survival and relapse-free survival. All patients were Brazilian, ranging in age from 19 to 101 years (mean 65.4; median 67.0). Two hundred and ninety-four (55.8%) patients were women. The Breslow primary lesion thicknesses ranged from 0.0 to 65.0 mm (mean 8.3 mm; median 5.0 mm). Of these patients, 43.3% had the acral lentiginous histologic subtype. Plantar was the most frequently involved site (68.5%), and ulcers and mitosis were present in 79.0 and 86.4% of these cases, respectively. Multivariate analysis results found that Breslow thickness of 1.03 (95% confidence interval: 1.01-1.05; P=0.01) and ulceration of 2.70 (95% confidence interval: 1.00-7.06; P=0.05) were poor prognostic indicators of overall survival. AM tumours were thick on diagnostic tests and were associated with poorer survival outcomes. Unfavourable prognosis likely derives from the delayed diagnosis compared with other melanoma subtypes.

We use an age-dependent SIR system of equations to model the evolution of the COVID-19. Parameters that measure the amount of interaction in different locations (home, work, school, other) are approximated from in-sample data using a random optimization scheme, and indicate changes in social distancing along the course of the pandemic. That allows the estimation of the time evolution of classical and age-dependent reproduction numbers. With those parameters we predict the disease dynamics, and compare our results with out-of-sample data from the City of Rio de Janeiro. Finally, we provide a numerical investigation regarding age-based vaccination policies, shedding some light on whether is preferable to vaccinate those at most risk (the elderly) or those who spread the disease the most (the youngest). There is no clear upshot, as the results depend on the age of those immunized, contagious parameters, vaccination schedules and efficiency.