Dutch Oncology COVID-19 consortium:Outcome of COVID-19 in patients with cancer in a nationwide cohort study

Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible. Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years). Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered

Proper training and use of ultrasonography facilitates lumbar puncture

Abstract With great interest, we read the study of Line Dussourd et al. concluding that ultrasonography allows better identification of anatomical structures before performing a lumbar puncture. We cannot concur with the conclusions of the study because the authors did not visualize the conus medullaris directly, nor did they assess the individual intervertebral levels. In our commentary, we make some suggestions for improvement using ultrasound to locate the optimal site for a lumbar puncture. We do agree that neuraxial ultrasound is of great benefit for the performance of lumbar punctures. Proper training and applying the correct technique, however, is necessary for obtaining all benefits ultrasonography offers

Optical spectra and the corresponding blood similarity parameters.

<p>Spectra acquired from one volunteer for subcutaneous needle (upper panes) and intravascular needle positioning (lower panes), as confirmed by positive blood aspiration. Left: full spectra, indicating the intensity of light received by the stylet (linear arbitrary units, a.u.) as a function of the wavelength (nanometers, nm). Center: an enlarged image of the spectrum that is used to determine the blood similarity parameter B (dashed lines indicate the wavelengths that are used for the calculation). Right: Ln (natural logarithm) of the blood similarity parameter as calculated for these two acquisitions.</p

Consort flowchart of the study.

<p>Consort flowchart of the study.</p

All blood similarity parameters.

<p>Overview of all blood similarity parameters (B) determined for the different measurement locations in all volunteers. Results are plotted as the average natural logarithm Ln (B) (crosses), with standard deviations determined for the set of spectra acquired at each measurement location in each subject. Volunteer 14 was excluded. Because of the considerable differences in blood similarity parameters (B) between the two groups, more details in the data are visible by plotting Ln(B) instead of B directly.</p