[EXCESS WEIGHT AND SOCIODEMOGRAPHIC RISK FACTORS FOR SARS-COV-2 INFECTION IN ISRAEL].

BACKGROUND: Studies to date have demonstrated an increased prevalence of obesity and low socioeconomic status (SES( among people with confirmed cases of COVID-19, and low SES has been linked to obesity. OBJECTIVES: Our goal was to better understand the important relationship between body weight and sociodemographic variables affecting the COVID-19 burden. METHODS: We conducted a cross-sectional study of subjects presenting to Israel's largest emergency department and their odds for positive SARS-CoV-2 virus PCR testing during the first wave of the pandemic. RESULTS: We found that as BMI rises, as compared to normal weight, it is associated with increasing odds for testing positive, independently of age, gender, SES and population density (BMI 25-29.9 kg/m2: OR = 1.42, 95% CI 1.07 - 1.90; BMI 30-34.9 kg/m2: OR = 1.50, 95% CI 1.06 - 2.11; BMI ≥ 35 kg/m2: OR = 1.61, 95% CI 1.02 - 2.46). Furthermore, male gender, low SES and high population density are also associated with excess risk for positive test results independently of body weight. CONCLUSIONS: Understanding these risk factors for infection and how they might interplay can help the medical community develop approaches to protect at-risk groups from infection and severe disease secondary to seasonal and pandemic viral infections.

Isolated autoimmune adrenocorticotropic hormone deficiency: A positive predictor of survival among cancer patients treated with checkpoint inhibitors.

OBJECTIVE: We aimed to characterize cancer patients who developed isolated adrenocorticotrophic hormone (ACTH) deficiency (IAD) after treatment with checkpoint-inhibitors (CPIs), including clinical manifestations, laboratory findings and risk factors, and to evaluate the prognostic significance of this complication. DESIGN: A retrospective case-control study. METHODS: We conducted a retrospective analysis of 2225 cancer patients treated with CPIs between 2015 and 2021 in our institute. We identified a subgroup of patients with sub-normal cortisol levels due to ACTH deficiency, and comprehensively extracted all relevant data. We compared the patients survival rates using a log-rank test and a multi-variable Cox regression. RESULTS: Among 2225 patients, hypocortisolemia was documented in 99 (4.45%) patients, and 19 of them were diagnosed with IAD (0.85%). Asthenia and diarrhea were the most reported complaints (36.8%), and melanoma was the most common malignancy (68.42%) within the IAD group. In multivariable analysis, IAD was associated with better survival rates (p = .018), female gender (63.2% vs 40%, p = .041), treatment with Ipilimumab (57.9% vs. 19.4%, p < .001), and younger age (median 56 IQR 51-69, vs. median 69 IQR 60-76, p = .004). CONCLUSIONS: IAD is the dominant autoimmune etiology for cortisol deficiency among patients receiving immunotherapy and is reported for the first time as a positive predictor of survival among cancer patients treated with CPIs. In our patients, IAD development was associated with female gender, treatment with ipilimumab, and younger age.