PURPOSE This study aims to describe the clinical manifestations, laboratory findings, treatment, and outcomes of patients with cancer with COVID-19 infection in Syria. The primary objective was to identify the overall survival (OS) time, and the secondary objectives were to identify factors associated with severe COVID-19 infection. METHODS This multicenter retrospective study was undertaken at four hospitals in Damascus, Syria, between March 28, 2020, and March 29, 2021. Data extracted from medical records included clinical manifestations, radiologic findings, laboratory results, treatment, and outcomes. Survival analysis was done by using the Kaplan-Meier method and Cox regression model for follow-up and anticancer treatment patients to study the effect on OS time. The effects of potential risk factors of developing severe COVID-19 were studied by multivariable logistic regression. RESULTS Of 114 patients included, 61 (53.51%) were male. Smokers represented 29 (25.44%), and 63 (55.26%) patients had a history of coexisting chronic diseases. The most common cancer type was breast cancer 17 (14.91%). Sixty-eight (59.65%) patients were receiving anticancer treatment within 1 month of being diagnosed with COVID-19 infection and 46 (40.35%) were outpatient follow-ups. Multiple logistic regression analysis showed that comorbidities (odds ratio: 2.814, P = .044) and anticancer treatment (odds ratio: 8.790, P < .05) were risk factors linked to severe to critical COVID-19 infection. OS time was 245 (95% CI, 217.96 to 272.47) days, lower among patients with cancer with COVID-19 infection receiving anticancer treatment compared with follow-up patients ( P value < .05). CONCLUSION Patients with cancer with COVID-19 infection receiving anticancer treatment had a lower OS time. It may be worth considering stopping anticancer treatment in patients with cancer with COVID-19 when possible in search of better outcomes.

Purpose Our study aims to describe post-vaccination side effects, evaluate the effectiveness of Covid-19 vaccines and determine the reasons for vaccine hesitancy among Syrians. Methods This cross-sectional study was conducted between April 13 and May 28, 2022. The survey was distributed through social media platforms and face-to-face interviews. Data from vaccinated and unvaccinated participants were collected and analyzed using the chi-square test, multivariable logistic regression to detect factors associated with side effects and severe side effects, and Kaplan-Meier plot to evaluate vaccine efficacy. Results Of the 3509 participants included, 1672 (47.6%) were vaccinated. The most common reasons for not taking the vaccine were concerns about the vaccine’s side effects 815 (44.4%) and not being convinced with the vaccine benefits 762 (41.5%). The majority of symptoms were mild 788 (47.1%), followed by moderate 374 (22.3%), and severe 144 (8.6%). The most common symptoms were tiredness 1028 (61.5%), pain at the injection site 933 (55.8%), and low-grade fever 684 (40.9%). Multivariable logistic regression analysis revealed that < 40 years (vs. ≥40; OR: 2.113, p-value = 0.008), females (vs. males; OR: 2.245, p-value < .001), did not receive influenza shot last year (vs. did receive Influenza shot last year OR: 1.697, p-value = 0.041), AstraZeneca (vs. other vaccine brands; OR: 2.799, p-value < .001), co-morbidities (vs. no co-morbidities; OR: 1.993, p-value = 0.008), and diabetes mellitus (vs. no diabetes mellitus; OR: 2.788, p-value = 0.007) were associated with severe post-vaccine side effects. Serious side effects reported were blood clots 5 (0.3%), thrombocytopenia 2 (0.1%), anaphylaxis 1 (0.1%), seizures 1 (0.1%), and cardiac infarction 1 (0.1%). Fully vaccinated participants had higher free of infection time compared with partially vaccinated and previously infected unvaccinated participants (p-value < .001). Conclusion Our study revealed that most side effects reported were mild in severity and self-limiting. Increasing the public’s awareness of the nature of the vaccine’s side effects would reduce the misinformation and improve the public’s trust in vaccines. Larger studies to evaluate rare and serious adverse events and long-term side effects are needed to overcome vaccine hesitancy among people.

Background: Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death, and the second deadliest infectious disease after COVID-19 worldwide1. Extrapulmonary tuberculosis (EPTB) cases accounted for 15% of the 7.2 million cases of TB worldwide in 2019. ² global statistics indicate that Tuberculosis causes 4,500 deaths every day¹. We aim to study the epidemiology of EPTB and its risk factors. Methods: A multicenter retrospective study was conducted at the National Center for Tuberculosis Control in Damascus in the year 2020 to analyze the patients with extrapulmonary tuberculosis. Results: 205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year 2020, and the most common site of extrapulmonary tuberculosis was Lymph Nodes (102) 49.75%, while ear and breast were the least common (1 case of each). Cervical nodes were the most affected with EPTB (80.40%), while Mediastinal nodes were the least affected (1.96%). The most incidence rate was in patients between 25 and 34 years old, while the least incidence rate was in patients older than 65 years old. The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34%. The majority of infected patients were residents in the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidity was Hypertension: 23.41% of cases, while kidney diseases were the least common. Smoking was the most common risk factor. The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats were the least common symptom 14.63%. Conclusion: Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but still can be prevented by vaccination and avoiding the possible risk factors that were studied in this study.

Introduction Studying post-vaccination side effects and identifying the reasons behind low vaccine uptake are pivotal for overcoming the pandemic. Methods This cross-sectional study was distributed through social media platforms and face-to-face interviews. Data from vaccinated and unvaccinated participants were collected and analyzed using the chi-square test, multivariable logistic regression to detect factors associated with side effects and severe side effects. Results Of the 3509 participants included, 1672(47.6%) were vaccinated. The most common reason for not taking the vaccine was concerns about the vaccine’s side effects 815(44.4). The majority of symptoms were mild 788(47.1%), followed by moderate 374(22.3%), and severe 144(8.6%). The most common symptoms were tiredness 1028(61.5%), pain at the injection site 933(55.8%), and low-grade fever 684(40.9%). Multivariable logistic regression analysis revealed that <40 years (vs. ≥40; OR: 2.113, p-value = 0.008), females (vs. males; OR: 2.245, p-value< .001), did not receive influenza shot last year (vs. did receive Influenza shot last year OR: 1.697, p-value = 0.041), AstraZeneca (vs. other vaccine brands; OR: 2.799, p-value< .001), co-morbidities (vs. no co-morbidities; OR: 1.993, p-value = 0.008), and diabetes mellitus (vs. no diabetes mellitus; OR: 2.788, p-value = 0.007) were associated with severe post-vaccine side effects. Serious side effects reported were blood clots 5(0.3%), thrombocytopenia 2(0.1%), anaphylaxis 1(0.1%), seizures 1(0.1%), and cardiac infarction 1(0.1%). Conclusion Our study revealed that most side effects reported were mild in severity and self-limiting. Increasing the public’s awareness of the nature of the vaccine’s side effects would reduce the misinformation and improve the public’s trust in vaccines. Larger studies to evaluate rare and serious adverse events and long-term side effects are needed, so people can have sufficient information and understanding before making an informed consent which is essential for vaccination.