RESUMO
Objective: The authors monitored positivity rates of asymptomatic SARS-CoV-2 tests during the second wave of COVID-19 at Guy's Cancer Centre. Methods: Logistic regression was used to investigate factors associated with asymptomatic COVID-19 positivity rates between 1 December 2020 and 28 February 2021 (n = 1346). Results: Living 20-40 km and 40-60 km from the alpha variant was associated with a reduced chance of a positive SARS-CoV-2 test compared with 0-20 km (odds ratio [OR]: 0.20; CI: 0.07-0.53 and OR: 0.38; CI: 0.15-0.98, respectively). An increased number of tests was associated with an increased chance of a positive SARS-CoV-2 test (OR: 1.10; CI: 1.04-1.16). Conclusion: The COVID-19 positivity rate of asymptomatic cancer patients is partly due to increased testing, with some contribution from the proximity of the patient population to the epicenter of the alpha variant.
The UK's second wave of COVID-19 was partly driven by the emergence of the alpha variant in the southeast of England in November 2020, spreading farther to become the predominant variant across England in December 2020. The alpha variant is associated with a greater transmissibility rate, posing an increased risk to the vulnerable population. This raised concerns about the welfare of cancer patients, as the disease and its treatment can lower one's ability to fight infection. This resulted in some cancer treatments being interrupted or stopped on the grounds of clinical safety and some follow-up care being disrupted. In order to investigate the factors associated with asymptomatic COVID-19 positivity rates between 1 December 2020 and 28 February 2021, the authors gathered information on the number of tests taken per cancer patient at Guy's and extracted data from Guy's approved research database, which houses all routinely collected clinical data on cancer patients. This included demographic data, such as post code and age, as well as number of visits to the hospital. From their analysis, the authors concluded that living closer to the epicenter of the alpha variant was associated with a high positivity rate; also, the more tests taken, the more likely the patients are to test positive. Therefore, the authors can conclude that attending the hospital does not increase the risk of transmission.
Assuntos
Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Neoplasias/complicações , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-IdadeRESUMO
Background: Few studies have investigated the long-term effects of COVID-19 on cancer patients. Materials & methods: The authors conducted a telephone survey on the long-term symptoms of cancer patients from Guy's Cancer Centre. They compared patients whose symptoms occurred/got worse over 4 weeks after COVID-19 diagnosis (classified as long COVID) with patients who did not develop symptoms or whose symptoms occurred/got worse in the first 4 weeks after diagnosis. Results: The authors analyzed responses from 80 patients with a previous COVID-19 diagnosis; 51.3% (n = 41) developed long COVID. The most common symptoms were fatigue, breathlessness and cognitive impairment. Conclusion: Findings suggest that over half of the cancer population will experience long-term effects after their initial COVID-19 diagnosis. Further studies are required to validate the findings of this study.
Assuntos
COVID-19 , Neoplasias , Humanos , Síndrome de COVID-19 Pós-Aguda , Teste para COVID-19 , COVID-19/complicações , COVID-19/epidemiologia , Neoplasias/complicações , Neoplasias/epidemiologia , DispneiaRESUMO
Induced pluripotency provides a tool to explore mechanisms underlying establishment, maintenance, and differentiation of naive pluripotent stem cells (nPSCs). Here, we report that self-renewal of nPSCs requires minimal Sox2 expression (Sox2-low). Sox2-low nPSCs do not show impaired neuroectoderm specification and differentiate efficiently in vitro into all embryonic germ lineages. Strikingly, upon the removal of self-renewing cues Sox2-low nPSCs differentiate into both embryonic and extraembryonic cell fates in vitro and in vivo. This differs from previous studies which only identified conditions that allowed cells to differentiate to one fate or the other. At the single-cell level self-renewing Sox2-low nPSCs exhibit a naive molecular signature. However, they display a nearer trophoblast identity than controls and decreased ability of Oct4 to bind naïve-associated regulatory sequences. In sum, this work defines wild-type levels of Sox2 as a restrictor of developmental potential and suggests perturbation of naive network as a mechanism to increase cell plasticity.