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6. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M, Uijl, A, Schut, A, Jakob, CEM, Romao, LR, Bell, RM, McFarlane, E, Stecher, M, Zondag, AGM, van Iperen, EPA, Hermans-van Ast, JF, Lea, NC, Schaap, J, Jewbali, LS, Smits, PC, Patel, RS, Aujayeb, A, van Smeden, M, Siebelink, HJ, Williams, S, Pilgram, L, Tieleman, RG, Williams, B, Asselbergs, FW, Al-Ali, AK, Al-Muhanna, FA, Al-Rubaish, AM, Al-Windy, NYY, Alkhalil, M, Almubarak, YA, Al Nafie, AN, Al Shahrani, M, Al Shehri, AM, Anning, C, Anthonio, RL, Badings, EA, Ball, C, Van Beek, EA, Ten Berg, JM, Von Bergwelt-Baildon, M, Bianco, M, Blagova, O, Bleijendaal, H, Bor, WL, Borgmann, S, van Boxem, AJM, van den Brink, FS, Bucciarelli-Ducci, C, Van Bussel, BCT, Byrom-Goulthorp, R, Captur, G, Caputo, M, Charlotte, N, vom Dahl, J, Dark, P, De Sutter, J, Degenhardt, C, Delsing, CE, Dolff, S, Dorman, HGR, Drost, JT, Eberwein, L, Emans, ME, Er, AG, Ferreira, JB, Forner, MJ, Friedrichs, A, Gabriel, L, Groenemeijer, BE, Groenendijk, AL, Gruener, B, Guggemos, W, Haerkens-Arends, HE, Hanses, F, Hedayat, B, Heigener, D, van der Heijden, DJ, Hellou, E, Hellwig, K, Henkens, MTHM, Hermanides, RS, Hermans, WRM, van Hessen, MWJ, Heymans, SRB, Hilt, AD, van der Horst, ICC, Hower, M, van Ierssel, SH, Isberner, N, Jensen, B, Kearney, MT, Kielstein, JT, Kietselaer, BLJH, Kochanek, M, Kolk, MZH, Koning, AMH, Kopylov, PY, Kuijper, AFM, Kwakkel-van, ERPJM, Lanznaster, J, van der Linden, MMJM, van der Lingen, ACJ, Linssen, GCM, Lomas, D, Maarse, M, Magdelijns, FJH, Magro, M, Markart, P, Martens, FMAC, Mazzilli, SG, McCann, GP, van der Meer, P, Meijs, MFL, Merle, U, Messiaen, P, Milovanovic, M, Monraats, PS, Montagna, L, Moriarty, A, Moss, AJ, Mosterd, A, Nadalin, S, Nattermann, J, Neufang, M, Nierop, PR, Offerhaus, JA, Van Ofwegen-Hanekamp, CEE, Parker, E, Persoon, AM, Piepel, C, Pinto, YM, Poorhosseini, H, Prasad, S, Raafs, AG, Raichle, C, Rauschning, D, Redon, J, Reidinga, AC, Ribeiro, MIA, Riedel, C, Rieg, S, Ripley, DP, Rommele, C, Rothfuss, K, Ruddel, J, Ruthrich, MM, Salah, R, Saneei, E, Saxena, M, Schellings, DAAM, Scholte, NTB, Schubert, J, Seelig, J, Shafiee, A, Shore, AC, Spinner, C, Stieglitz, S, Strauss, R, Sturkenboom, NH, Tessitore, E, Thomson, RJ, Timmermans, PJR, Tio, RA, Tjong, FVY, Tometten, L, Trauth, J, Van Craenenbroeck, EM, van Veen, HPAA, den Uil, CA, Vehreschild, MJGT, Veldhuis, L, Veneman, T, Verschure, DO, Voigt, I, Walter, L, vande Watering, DJ, de Vries, JK, vande Wal, RMA, Westendorp, ICD, Westendorp, PHM, Westhoff, T, Weytjens, C, Wierda, E, Wille, K, de With, K, Worm, M, Woudstra, P, Wu, KW, Zaal, R, Zaman, AG, van der Zee, PM, Zijlstra, LE, Alling, TE, Ahmed, R, Bayraktar-Verver, ECE, van Aken, K, Jimenes, Bermudez FJ, Biole, CA, Den Boer-Penning, P, Bontje, M, Bos, M, Bosch, L, Broekman, M, Broeyer, FJF, de Bruijn, EAW, Bruinsma, S, Cardoso, NM, Cosyns, B, Len, van Da DH, Dekimpe, E, Domange, J, van Doorn, JL, van DOorn, P, Dormal, F, Drost, IMJ, Dunnink, A, van Eck, JWM, Elshinawy, K, Gevers, RMM, Gognieva, DG, van der Graaf, M, Grangeon, S, Guclu, A, Habib, A, Haenen, NA, Hamilton, K, Handgraaf, S, Heidbuchel, H, Hendriks-van Woerden, M, Hessels-Linnemeijer, BM, Hosseini, K, Huisman, J, Jacobs, TC, Jansen, SE, Janssen, A, Jourdan, K, ten Kate, GL, van Kempen, MJ, Kievit, CM, Kleikers, P, Knufman, N, van der Kooi, SE, Koole, BAS, Koole, MAC, Kui, KK, Kuipers-Elferink, L, Lemoine, I, Lensink, E, van Marrewijk, V, Meijer, EJ, Melein, AJ, Mesitskaya, DF, van Nes, CPM, Paris, FMA, Perrelli, MG, Pieterse-Rots, A, Pisters, R, Polkerman, BC, van Poppel, A, Reinders, S, Reitsma, MJ, Ruiter, AH, Selder, JL, van der Sluis, A, Sousa, AIC, Tajdini, M, Sanchez, Tercedor L, Van de Heyning, CM, Vial, H, Vlieghe, E, Vonkeman, HE, Vreugdenhil, P, de Vries, TAC, Willems, AM, Wils, AM, Zoet-Nugteren, SK, Cardiovascular Centre (CVC), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Cardiology, Intensive Care, RS: CAPHRI - R5 - Optimising Patient Care, MUMC+: MA Medische Staf IC (9), RS: Carim - H02 Cardiomyopathy, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Intensive Care (3), UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de cardiologie, CAPACITY-COVID Collaborative Consortium, LEOSS Study Group, Rheumatology, AII - Infectious diseases, AII - Inflammatory diseases, AMS - Musculoskeletal Health, AMS - Tissue Function & Regeneration, ACS - Heart failure & arrhythmias, General practice, Epidemiology and Data Science, Graduate School, Nuclear Medicine, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Male, Cardiac & Cardiovascular Systems, Epidemiology, education, Medizin, Comorbidity, AMERICAN-COLLEGE, GUIDELINES, DIAGNOSIS, Cohort Studies, Risk Factors, MANAGEMENT, Humans, AcademicSubjects/MED00200, Hospital Mortality, Aged, Heart Failure, Science & Technology, SARS-CoV-2, COVID-19, ASSOCIATION, Cardiovascular disease, EUROPEAN-SOCIETY, Hospitalization, surgical procedures, operative, Editorial, Cardiovascular System & Cardiology, behavior and behavior mechanisms, HEART-FAILURE, Female, Patient registry, Human medicine, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, psychological phenomena and processes, TASK-FORCE
Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66–75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02–1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10–1.30; P Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.

Published
2021

7. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries

Author

Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., Zoet-Nugteren, S. K., Linschoten, M., Uijl, A., Schut, A., Jakob, C. E. M., Romao, L. R., Bell, R. M., McFarlane, E., Stecher, M., Zondag, A. G. M., van Iperen, E. P. A., Hermans-van Ast, J. F., Lea, N. C., Schaap, J., Jewbali, L. S., Smits, P. C., Patel, R. S., Aujayeb, A., van Smeden, M., Siebelink, H. J., Williams, S., Pilgram, L., Tieleman, R. G., Williams, B., Asselbergs, F. W., Al-Ali, A. K., Al-Muhanna, F. A., Al-Rubaish, A. M., Al-Windy, N. Y. Y., Alkhalil, M., Almubarak, Y. A., Al Nafie, A. N., Al Shahrani, M., Al Shehri, A. M., Anning, C., Anthonio, R. L., Badings, E. A., Ball, C., Van Beek, E. A., Ten Berg, J. M., Von Bergwelt-Baildon, M., Bianco, M., Blagova, O., V, Bleijendaal, H., Bor, W. L., Borgmann, S., van Boxem, A. J. M., van den Brink, F. S., Bucciarelli-Ducci, C., Van Bussel, B. C. T., Byrom-Goulthorp, R., Captur, G., Caputo, M., Charlotte, N., vom Dahl, J., Dark, P., De Sutter, J., Degenhardt, C., Delsing, C. E., Dolff, S., Dorman, H. G. R., Drost, J. T., Eberwein, L., Emans, M. E., Er, A. G., Ferreira, J. B., Forner, M. J., Friedrichs, A., Gabriel, L., Groenemeijer, B. E., Groenendijk, A. L., Gruener, B., Guggemos, W., Haerkens-Arends, H. E., Hanses, F., Hedayat, B., Heigener, D., van der Heijden, D. J., Hellou, E., Hellwig, K., Henkens, M. T. H. M., Hermanides, R. S., Hermans, W. R. M., van Hessen, M. W. J., Heymans, S. R. B., Hilt, A. D., van der Horst, I. C. C., Hower, M., van Ierssel, S. H., Isberner, N., Jensen, B., Kearney, M. T., Kielstein, J. T., Kietselaer, B. L. J. H., Kochanek, M., Kolk, M. Z. H., Koning, A. M. H., Kopylov, P. Y., Kuijper, A. F. M., Kwakkel-van, E. R. P. J. M., Lanznaster, J., van der Linden, M. M. J. M., van der Lingen, A. C. J., Linssen, G. C. M., Lomas, D., Maarse, M., Magdelijns, F. J. H., Magro, M., Markart, P., Martens, F. M. A. C., Mazzilli, S. G., McCann, G. P., van der Meer, P., Meijs, M. F. L., Merle, U., Messiaen, P., Milovanovic, M., Monraats, P. S., Montagna, L., Moriarty, A., Moss, A. J., Mosterd, A., Nadalin, S., Nattermann, J., Neufang, M., Nierop, P. R., Offerhaus, J. A., Van Ofwegen-Hanekamp, C. E. E., Parker, E., Persoon, A. M., Piepel, C., Pinto, Y. M., Poorhosseini, H., Prasad, S., Raafs, A. G., Raichle, C., Rauschning, D., Redon, J., Reidinga, A. C., Ribeiro, M. I. A., Riedel, C., Rieg, S., Ripley, D. P., Rommele, C., Rothfuss, K., Ruddel, J., Ruthrich, M. M., Salah, R., Saneei, E., Saxena, M., Schellings, D. A. A. M., Scholte, N. T. B., Schubert, J., Seelig, J., Shafiee, A., Shore, A. C., Spinner, C., Stieglitz, S., Strauss, R., Sturkenboom, N. H., Tessitore, E., Thomson, R. J., Timmermans, P. J. R., Tio, R. A., Tjong, F. V. Y., Tometten, L., Trauth, J., Van Craenenbroeck, E. M., van Veen, H. P. A. A., den Uil, C. A., Vehreschild, M. J. G. T., Veldhuis, L., I, Veneman, T., Verschure, D. O., Voigt, I, Walter, L., vande Watering, D. J., de Vries, J. K., vande Wal, R. M. A., Westendorp, I. C. D., Westendorp, P. H. M., Westhoff, T., Weytjens, C., Wierda, E., Wille, K., de With, K., Worm, M., Woudstra, P., Wu, K. W., Zaal, R., Zaman, A. G., van der Zee, P. M., Zijlstra, L. E., Alling, T. E., Ahmed, R., Bayraktar-Verver, E. C. E., van Aken, K., Jimenes, Bermudez F. J., Biole, C. A., Den Boer-Penning, P., Bontje, M., Bos, M., Bosch, L., Broekman, M., Broeyer, F. J. F., de Bruijn, E. A. W., Bruinsma, S., Cardoso, N. M., Cosyns, B., Len, van Da D. H., Dekimpe, E., Domange, J., van Doorn, J. L., van DOorn, P., Dormal, F., Drost, I. M. J., Dunnink, A., van Eck, J. W. M., Elshinawy, K., Gevers, R. M. M., Gognieva, D. G., van der Graaf, M., Grangeon, S., Guclu, A., Habib, A., Haenen, N. A., Hamilton, K., Handgraaf, S., Heidbuchel, H., Hendriks-van Woerden, M., Hessels-Linnemeijer, B. M., Hosseini, K., Huisman, J., Jacobs, T. C., Jansen, S. E., Janssen, A., Jourdan, K., ten Kate, G. L., van Kempen, M. J., Kievit, C. M., Kleikers, P., Knufman, N., van der Kooi, S. E., Koole, B. A. S., Koole, M. A. C., Kui, K. K., Kuipers-Elferink, L., Lemoine, I, Lensink, E., van Marrewijk, V, Meijer, E. J., Melein, A. J., Mesitskaya, D. F., van Nes, C. P. M., Paris, F. M. A., Perrelli, M. G., Pieterse-Rots, A., Pisters, R., Polkerman, B. C., van Poppel, A., Reinders, S., Reitsma, M. J., Ruiter, A. H., Selder, J. L., van der Sluis, A., Sousa, A. I. C., Tajdini, M., Sanchez, Tercedor L., Van de Heyning, C. M., Vial, H., Vlieghe, E., Vonkeman, H. E., Vreugdenhil, P., de Vries, T. A. C., Willems, A. M., Wils, A. M., and Zoet-Nugteren, S. K.

Abstract

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .

Published
2022

12. COVID-19 in cancer patients: Clinical characteristics and outcome - a first analysis of the LEOSS registry

Author

Ruethrich, M. M., Kniele, G., Tometten, L., Borgmann, S., Schneider, J., Dolff, S., Hanses, F., Norma, J., Isberner, N., Wettstein, M., Classen, A., Schons, M., Vehreschild, J. J., Giessen-Jung, C., Beutel, G., von Lilienfeld-Toal, M., Wille, K., Ruethrich, M. M., Kniele, G., Tometten, L., Borgmann, S., Schneider, J., Dolff, S., Hanses, F., Norma, J., Isberner, N., Wettstein, M., Classen, A., Schons, M., Vehreschild, J. J., Giessen-Jung, C., Beutel, G., von Lilienfeld-Toal, M., and Wille, K.

Published
2020

21. COVID-19 in cancer patients: clinical characteristics and outcome—an analysis of the LEOSS registry.

Author

Rüthrich, Maria Madeleine, Giessen-Jung, C., Borgmann, S., Classen, A. Y., Dolff, S., Grüner, B., Hanses, F., Isberner, N., Köhler, P., Lanznaster, J., Merle, U., Nadalin, S., Piepel, C., Schneider, J., Schons, M., Strauss, R., Tometten, L., Vehreschild, J. J., von Lilienfeld-Toal, M., and Beutel, G.

Subjects
COVID-19, CANCER patients, SARS-CoV-2, AGE distribution, PANDEMICS
Abstract

Introduction: Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Patients and methods: We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. Results: In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. Conclusion: Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions. [ABSTRACT FROM AUTHOR]

Published
2021
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34. TRANSPLANTATION BASIC SCIENCE, ALLOGENIC AND XENOGENIC TOLERANCE

Author

Berthelot, L., primary, Robert, T., additional, Tabary, T., additional, Vuiblet, V., additional, Drame, M., additional, Toupance, O., additional, Rieu, P., additional, Monteiro, R. C., additional, Toure, F., additional, Ferrario, S., additional, Cantaluppi, V., additional, De Lena, M., additional, Dellepiane, S., additional, Beltramo, S., additional, Rossetti, M., additional, Manzione, A. M., additional, Messina, M., additional, Gai, M., additional, Dolla, C., additional, Biancone, L., additional, Camussi, G., additional, Pontrelli, P., additional, Oranger, A. R., additional, Accetturo, M., additional, Rascio, F., additional, Gigante, M., additional, Castellano, G., additional, Schena, A., additional, Fiorentino, M., additional, Zito, A., additional, Zaza, G., additional, Stallone, G., additional, Gesualdo, L., additional, Grandaliano, G., additional, Pattonieri, E. F., additional, Gregorini, M., additional, Corradetti, V., additional, Rocca, C., additional, Milanesi, S., additional, Peloso, A., additional, Ferrario, J., additional, Cannone, M., additional, Bosio, F., additional, Maggi, N., additional, Avanzini, M. A., additional, Minutillo, P., additional, Paulli, M., additional, Maestri, M., additional, Rampino, T., additional, Dal Canton, A., additional, Wu, K. S. T., additional, Coxall, O., additional, Luque, Y., additional, Candon, S., additional, Rabant, M., additional, Noel, L.-H., additional, Thervet, E., additional, Chatenoud, L., additional, Snanoudj, R., additional, Anglicheau, D., additional, Legendre, C., additional, Zuber, J., additional, Hruba, P., additional, Brabcova, I., additional, Krepsova, E., additional, Slatinska, J., additional, Sekerkova, A., additional, Striz, I., additional, Zachoval, R., additional, Viklicky, O., additional, Scholbach, T. M., additional, Wang, H.-K., additional, Loong, C.-C., additional, Yang, A.-H., additional, Wu, T.-H., additional, Guberina, H., additional, Rebmann, V., additional, Dziallas, P., additional, Dolff, S., additional, Wohlschlaeger, J., additional, Heinemann, F. M., additional, Witzke, O., additional, Zoet, Y. M., additional, Claas, F. H. J., additional, Horn, P. A., additional, Kribben, A., additional, Doxiadis, I. I. N., additional, Prasad, N., additional, Yadav, B., additional, Agarwal, V., additional, Jaiswal, A., additional, Rai, M., additional, Hope, C. M., additional, Coates, P. T., additional, Heeger, P. S., additional, Carroll, R., additional, Masola, V., additional, Secchi, M. F., additional, Onisto, M., additional, Gambaro, G., additional, Lupo, A., additional, Matsuyama, M., additional, Kobayashi, T., additional, Yoneda, Y., additional, Chargui, J., additional, Touraine, J. L., additional, Yoshimura, R., additional, Vizza, D., additional, Perri, A., additional, Lupinacci, S., additional, Toteda, G., additional, Lofaro, D., additional, Leone, F., additional, Gigliotti, P., additional, La Russa, A., additional, Papalia, T., additional, Bonofilgio, R., additional, Sentis Fuster, A., additional, Kers, J., additional, Yapici, U., additional, Claessen, N., additional, Bemelman, F. J., additional, Ten Berge, I. J. M., additional, Florquin, S., additional, Glotz, D., additional, Rostaing, L., additional, Squifflet, J.-P., additional, Merville, P., additional, Belmokhtar, C., additional, Le Ny, G., additional, Lebranchu, Y., additional, Papazova, D. A., additional, Friederich-Persson, M., additional, Koeners, M. P., additional, Joles, J. A., additional, Verhaar, M. C., additional, Trivedi, H. L., additional, Vanikar, A. V., additional, Dave, S. D., additional, Suarez Alvarez, B., additional, Garcia Melendreras, S., additional, Carvajal Palao, R., additional, Diaz Corte, C., additional, Ruiz Ortega, M., additional, Lopez-Larrea, C., additional, Yadav, A. K., additional, Bansal, D., additional, Kumar, V., additional, Minz, M., additional, Jha, V., additional, Kaminska, D., additional, Koscielska-Kasprzak, K., additional, Chudoba, P., additional, Mazanowska, O., additional, Banasik, M., additional, Zabinska, M., additional, Boratynska, M., additional, Lepiesza, A., additional, Korta, K., additional, Klinger, M., additional, Csohany, R., additional, Prokai, A., additional, Pap, D., additional, Balicza-Himer, N., additional, Vannay, A., additional, Fekete, A., additional, Kis-Petik, K., additional, Peti-Peterdi, J., additional, Szabo, A., additional, Masajtis-Zagajewska, A., additional, Muras, K., additional, Niewodniczy, M., additional, Nowicki, M., additional, Pascual, J., additional, Srinivas, T. R., additional, Chadban, S., additional, Citterio, F., additional, Henry, M., additional, Oppenheimer, F., additional, Lee, P.-C., additional, Tedesco-Silva, H., additional, Zeier, M., additional, Watarai, Y., additional, Dong, G., additional, Hexham, M., additional, Bernhardt, P., additional, Vincenti, F., additional, Rocchetti, M. T., additional, Su owicz, J., additional, Wojas-Pelc, A., additional, Ignacak, E., additional, Janda, K., additional, Krzanowski, M., additional, Su owicz, W., additional, Mitsuhashi, M., additional, Murakami, T., additional, Benso, A., additional, Leuning, D., additional, Reinders, M., additional, Lievers, E., additional, Duijs, J., additional, Van Zonneveld, A. J., additional, Van Kooten, C., additional, Engelse, M., additional, Rabelink, T., additional, Assounga, A., additional, Omarjee, S., additional, Ngema, Z., additional, Ersoy, A., additional, Gultepe, A., additional, Isiktas Sayilar, E., additional, Akalin, H., additional, Coskun, F., additional, Oner Torlak, M., additional, Ayar, Y., additional, Riegersperger, M., additional, Plischke, M., additional, Steinhauser, C., additional, Jallitsch-Halper, A., additional, Sengoelge, G., additional, Winkelmayer, W. C., additional, Sunder-Plassmann, G., additional, Foedinger, M., additional, Kaziuk, M., additional, Kuz'Niewski, M., additional, B Tkowska- Prokop, A., additional, Pa Ka, K., additional, Dumnicka, P., additional, Kolber, W., additional, and Su Owicz, W., additional

Published
2014
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36. Influence of COVID-19 on general stress and posttraumatic stress symptoms among hospitalized high-risk patients.

Author

Wesemann, U., Hadjamu, N., Willmund, G., Dolff, S., Vonderlin, N., Wakili, R., Vogel, J., Rassaf, T., and Siebermair, J.

Subjects
COVID-19, CONFIDENCE intervals, POST-traumatic stress disorder, MEDICAL screening, RISK assessment, HOSPITAL care, DISEASE prevalence, DESCRIPTIVE statistics, BLIND experiment, CHI-squared test, QUESTIONNAIRES, PSYCHOLOGICAL stress, COMORBIDITY
Published
2022
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37. Treatment of lupus nephritis.

Author

Dolff, S., Berden, J.H.M., Bijl, M. van der, Dolff, S., Berden, J.H.M., and Bijl, M. van der

Abstract

1 november 2010, Contains fulltext : 87620.pdf (publisher's version ) (Open Access), Renal involvement in systemic lupus erythematosus patients is a severe disease manifestation characterized by various clinical and histopathological alterations. The revised International Society of Nephrology/Renal Pathology Society 2003 classification defines the subclasses of lupus nephritis (LN) according to their pathological glomerular patterns, which has a crucial impact on the prognosis and treatment options for LN patients. There are widely accepted therapeutic agents available, such as cyclophosphamide, mycophenolate mofetil, azathioprine and corticosteroids. Several trials have tried to determine a gold standard for induction and maintenance therapy in LN, and the place of newer drugs, biologicals, has been investigated. We review recently reported data on current treatment regimens in LN, in particular in the context of the International Society of Nephrology/Renal Pathology Society 2003 classification.

Published
2010

44. Characterization of urinary CD4+ and CD8+ T cells in kidney transplantation patients with polyomavirus BK infection and allograft rejection.

Author

Doesum, W.B., Abdulahad, W.H., Dijk, M.C.R.F., Dolff, S., Son, W.J., Stegeman, C.A., and Sanders, J.S.F.

Subjects
T cells, CD4 antigen, CD8 antigen, KIDNEY transplant patients, POLYOMAVIRUS diseases, BK virus diseases, GRAFT rejection
Abstract

Background and objectives The objective of this study was to characterize CD4+ and CD8+ T-cell populations in blood and urine of renal transplant patients with BK virus ( BKV) infection or allograft rejection. Materials and methods Percentages and absolute numbers of CD4+ and CD8+ effector memory T-cell subtype (TEM) and terminal differentiated T cells (TTD) in renal transplant patients with BKV infection ( n = 14), with an episode of allograft rejection ( n = 9), and in uncomplicated renal transplant patients with a stable kidney function ( n = 12) were measured and compared using 4-color fluorescence-activated cell sorting. Results were correlated with the number of CD4+ and CD8+ T cells in renal biopsies. Results In patients with allograft rejection, the number of urinary CD4+ TEM and CD8+ TEM cells was significantly increased compared to patients with BKV infection or patients without complications. Positive correlation was found between the number of CD4+ and CD8+ cells in the renal biopsies and the number of CD4+ and CD8+ cells in urine. In patients with rejection, after 2 months of immunosuppressive therapy, a reduction in urinary CD8+ TEM cells was found. Conclusions CD4+ TEM and CD8+ TEM cells in urine could be a marker to distinguish allograft rejection from BKV-associated nephropathy and to monitor therapy effectiveness in renal transplant patients with allograft rejection. [ABSTRACT FROM AUTHOR]

Published
2014
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46. Increased percentages of PD-1 on CD4+ T cells is associated with higher INF-γ production and altered IL-17 production in patients with systemic lupus erythematosus.

Author

Dolff, S, Quandt, D, Feldkamp, T, Jun, C, Mitchell, A, Hua, F, Specker, C, Kribben, A, Witzke, O, and Wilde, B

Subjects
*PROGRAMMED cell death 1 receptors, *SYSTEMIC lupus erythematosus, *T cells, *INTERFERONS, *INTERLEUKIN-17, *AUTOIMMUNE diseases
Abstract

Objectives: Programmed death (PD)-1 is a cell death receptor that, upon stimulation, leads to apoptosis. Previous studies have shown alteration of PD-1 expression on T cells and PD-1 genes in patients with systemic lupus erythematosus (SLE). The aim of this study was to assess the expression of this receptor on effector T cells in patients with SLE. Method: In this study we enrolled 32 SLE patients and 31 healthy controls. T cells from peripheral blood were analysed by flow cytometry for the expression of PD-1. Interferon (IFN)-γ and interleukin (IL)-17-producing cells were investigated for the expression of this co-stimulatory marker. Results: Percentages of CD4+ T cells expressing PD-1 were significantly increased in patients with SLE compared to healthy controls. The percentage of PD-1 expression was correlated with the production of INF-γ (r = 0.83, p < 0.0001). We also investigated the production of IL-17 by PD-1+ CD3+ T cells. Inactive patients (3.2 ± 1.2% vs. 5.9 ± 3.5%, p = 0.002) and patients without lupus nephritis (LN) (3.2 ± 1.5% vs. 5.9 ± 3.5%, p = 0.005) showed lower levels of IL-17 compared to healthy controls. Conclusion: We have demonstrated increased expression of PD-1 on CD4+ T cells in SLE patients and an association between PD-1 expression on CD4+ T cells and IFN-γ expression on CD3+ T cells. We have also shown that there is an altered subset of PD-1+ T cells in inactive patients and patients without LN producing lower amounts of IL-17. [ABSTRACT FROM AUTHOR]

Published
2014
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47. Peripherally Circulating CD4+ FOXP3+ CXCR3+ T Regulatory Cells Correlate with Renal Allograft Function.

Author

Hoerning, A., Köhler, S., Jun, C., Tebbe, B., Fu, J., Menke, J., Wilde, B., Dolff, S., Feldkamp, T., Briscoe, D. M., Kribben, A., Hoyer, P. F., and Witzke, O.

Subjects
PERIPHERAL circulation, T cells, CHEMOKINE receptors, IMMUNOSUPPRESSION, KIDNEY transplantation, KIDNEY function tests, CALCINEURIN, BLOOD cells
Abstract

Peripheral immunoregulation depends on T regulatory cell trafficking into the allograft to modulate the local alloresponse. Little is known about the relevance of trafficking receptors for Tregs after solid organ transplantation in humans. In this study, expression of the peripheral chemokine receptors CXCR3 and CCR5 on CD4+ FOXP3+ Treg cells was analysed and correlated with allograft function in renal transplant recipients. Flow cytometry analysis of peripheral blood mononuclear cells of 54 renal transplant recipients receiving a calcineurin inhibitor-based immunosuppression was performed for CD4, CD25, FOXP3, CXCR3 and CCR5 within the first 18 months post-transplantation. Correlation analysis of chemokine receptor expression and glomerular filtration rate as calculated by MDRD (eGFR) was performed. Expression of the peripheral homing receptors CXCR3 ( r = 0.44, P < 0.05) and CCR5 ( r = 0.45, P < 0.05) on FOXP3+ Tregs correlated with renal allograft function (eGFR) in patients receiving tacrolimus ( n = 28), but not cyclosporine A (CsA) ( n = 26). CsA but not tacrolimus reduced surface expression of CXCR3 on FOXP3+ Tregs in renal transplant recipients as correlated to trough levels ( r = −0.42, P < 0.05). In contrast to CD4+ CXCR3+ CD25lo T cells, flow-sorted CD4+ CXCR3+ CD25hi Tregs isolated from healthy individuals did not produce IFNγ or IL-17 ex vivo and expressed high levels of GARP mRNA both at baseline as well as after TCR activation indicating functional regulatory activity. Expression of the peripheral trafficking receptors CXCR3 and CCR5 on FOXP3+ Tregs is associated with renal allograft function. These results suggest that Treg trafficking may also depend on the interaction of CXCR3 or CCR5 and their respective ligands. [ABSTRACT FROM AUTHOR]

Published
2012
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48. Cyclosporin but not everolimus inhibits chemokine receptor expression on CD4+ T cell subsets circulating in the peripheral blood of renal transplant recipients.

Author

Hoerning, A., Köhler, S., Jun, C., Lu, J., Fu, J., Tebbe, B., Dolff, S., Feldkamp, T., Kribben, A., Hoyer, P. F., and Witzke, O.

Subjects
KIDNEY transplantation, CYCLOSPORINS, CHEMOKINE receptors, GENE expression, T cells, BLOOD circulation, IMMUNOSUPPRESSIVE agents, KIDNEY surgery, ADRENOCORTICAL hormones
Abstract

Summary The peripheral chemokine receptors chemokine receptor 3 (CXCR3) and CC chemokine receptor 5 (CCR5) have been reported to be associated with allograft rejection. The impact of the expression of immunosuppressive drugs on peripherally circulating CD4+ T cell subsets after renal transplantion is unknown. Expression of CXCR3 and CCR5 was investigated by flow cytometry in 20 renal allograft recipients participating in a prospective, randomized trial (NCT00514514). Initial immunosuppression consisted of basiliximab, cyclosporin A (CsA), mycophenolate sodium and corticosteroids. After 3 months, patients were treated either with CsA, mycophenolate sodium (MPA) plus corticosteroids ( n = 6), CsA and everolimus plus corticosteroids ( n = 8) or CsA-free (CsAfree) receiving everolimus, MPA and corticosteroids ( n = 6). After initial reduction of CD4+forkhead box protein 3 (FoxP3)+ and CD4+CD25hiFoxP3+ regulatory T cells (Tregs) ( P < 0·05; P < 0·01), 3-month post-transplant percentages of Tregs were reconstituted in CsAfree and CsAlo arms compared to CsAreg 12 months post transplant. Expression of CCR5 and CXCR3 on CD4+FoxP3+ and CD4+FoxP3- T cells 12 months post transplant was increased in CsAfree versus CsAreg. Increase in CCR5+CXCR3+ co-expressing CD4+FoxP3- cells between 3 and 12 months correlated negatively with the glomerular filtration rate (GFR) slope/year [modification of diet in renal disease (MDRD); r = −0·59, P < 0·01]. CsA, but not everolimus, inhibits both Treg development and expression of CXCR3 and CCR5 on CD4+ T cell subsets. Increase in CCR5+CXCR3+ co-expressing CD4+FoxP3- T cells is associated with early loss in allograft function. [ABSTRACT FROM AUTHOR]

Published
2012
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49. CD134 expression on CD4+ T cells is associated with nephritis and disease activity in patients with systemic lupus erythematosus.

Author

Patschan, S., Dolff, S., Kribben, A., Dürig, J., Patschan, D., Wilde, B., Specker, C., Philipp, T., and Witzke, O.

Subjects
*LUPUS nephritis, *SKIN diseases, *LUPUS erythematosus, *KIDNEY diseases, *IMMUNE system
Abstract

Systemic lupus erythematosus (SLE) is characterized by a deviation of the immune system that involves T cell-dependent autoantibody production. The aim of this study was to investigate the role of co-stimulatory markers on T cells in this disease. Twenty-eight patients with SLE as defined by the American College of Rheumatology (ACR) criteria and 11 healthy controls were included into the study. Eleven patients had biopsy-proven lupus nephritis while 17 patients had no clinical evidence of lupus nephritis. Clinical disease activity was assessed according to the systemic lupus erythematosus disease index (SLEDAI). CD4+ T cell populations in the peripheral blood were analysed for the expression of co-stimulatory markers CD45RO, CD70, CD80, CD86, CD137, CD137L, CD134, CD152, CD154 and ICOS. SLE patients showed an increased frequency of peripheral CD4+ T cells expressing high levels of CD80, CD86 and CD134 compared to healthy controls (7·1 ± 1·5% versus 1·7 ± 0·9%; P < 0·005; 2·3 ± 0·4% versus 1·0 ± 0·2%; P = 0·008, 20·2 ± 2·0% versus 10·6 ± 1·9%; P < 0·005, respectively). Significantly higher levels of CD80 on CD4+ T cells were detected in SLE patients with lupus nephritis compared to patients without nephritis (11·9 ± 3·3% versus 4·0 ± 0·7%; P < 0·005). There was an increased presence of CD134+ CD4+ cells in SLE patients with lupus nephritis (27·5 ± 4·0% versus 15·5 ± 1·3%; P < 0·005). CD80 and CD134 expression was significantly correlated with SLEDAI ( r = 0·42, P = 0·03; r = 0·56, P < 0·005). Co-stimulatory molecules on CD4+ T cells are associated with renal disease and disease activity in patients with systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Published
2006
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50. Brief Communication

Author

Türk, T., Pietruck, F., Dolff, S., Kribben, A., Janssen, O. E., Mann, K., Philipp, T., Heemann, U., and Witzke, O.

Abstract

The purpose of this study was to investigate the use of the short-acting insulin secretion drug repaglinide in new-onset diabetes mellitus (NODM) after renal transplantation. Twenty-three Caucasian patients with NODM after renal transplantation were selected to receive repaglinide therapy and were followed for at least 6 months. A control group treated with rosiglitazone was chosen for comparison. Successful repaglinide treatment was defined as a significant improvement of blood glucose concentrations and HbA1c <7% in the absence of glucosuria and without the need for the addition of further anti-diabetic agents. After 6 months of treatment with repaglinide, 14 of the 23 patients were successfully treated. Mean HbA1c decreased from 7.6 ± 0.6% to 5.8 ± 0.6% in 14 patients treated successfully. In nine patients, hyperglycemia persisted, and they were switched to insulin treatment (HbA1c 8.5 ± 2.9% at the beginning to 7.4 ± 2.2%). Mean serum creatinine levels, cyclosporine A and tacrolimus blood levels did not change significantly following institution of repaglinide therapy. The rate of successful treatment and the degree of HbA1c decrease were similar compared to rosiglitazone-treated control patients. The data from our observational study indicate that repaglinide can be an effective treatment option in Caucasian patients with NODM after renal transplantation.

Published
2006

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