Could severe COVID be a sign of undiagnosed cancer? The results of this study are not credible and are analyzed in full
Epi-Phare, a scientific research team composed of the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance Fund, and a joint research team with the Geneva Institute for Global Health and the University of Geneva, published a paper in the journal Scientific Reports pointing out that severe disease may be a sign of undiagnosed cancer.
The paper is of little significance and cannot explain whether people with a higher risk of cancer are more likely to get severe from the new crown, or people with severe new crown disease are more likely to get cancer, or people who smoke and are poor are more likely to get severe and develop cancer.
I personally tend to the third conclusion.
If you can really understand the characteristics of critically ill patients with the new crown (because at present, not all of them are elderly), it is indeed of great significance, but this paper does not work.
Full text analysis
Data were taken from the SNDS database containing the entire French population, and we collected data from individuals aged ≥ 16 years, living in mainland France, who had received at least one healthcare reimbursement in the 2 years prior to the index date, and who had no history of cancer in the last 5 years. Individuals living in nursing homes and
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There are some differences in the baseline comparison between the two groups:
(1) more people from ICU-gr belonged to the poorest strata (ICU-gr 24.5%; C-gr 19.7%）；
(2) smoking cessation programmes were more prevalent in C-gr (ICU-gr 3.8%; C-gr 5.0%）；
(3) the number of people receiving immunosuppressive therapy in ICU-gr was more than twice that of C-gr compared with C-gr (ICU-gr 2.4%; C-gr 0.9%), and more people in ICU-gr received oral corticosteroids (including any oral dose) compared with C-gr (ICU-gr 3.1%; C-gr 0.7%）；
(4) Individuals in ICU-gr have more comorbidities overall than individuals in C-gr.
The first two are actually influencing factors of cancer themselves, and it can be said that the baselines are not equal, and the significance of the research is greatly reduced.
Cancer outcomes in both groups
In total, 897/41,302 (2.2%) in ICU-gr and 10,944/713,670 (1.5%) in C-gr were diagnosed with cancer.
Using a Cox model adjusted only for age and sex, individuals in ICU-gr had a 1.45 higher risk of being diagnosed with cancer during follow-up compared to C-gr. Using the multivariate model, ICU-gr has an adjusted HR of 1.31. That's 1.45 times and 1.31 times.
The association between the risk of being diagnosed with cancer and COVID exposure was stronger during the first 3 months of follow-up compared to other follow-up periods (HR 1.65)
The association between exposure and cancer risk was stronger in women than in men (aHR 1.69 vs aHR 1.20) and stronger in individuals under 60 years of age than in older adults (aHR 1.78 vs aHR 1.22). The association was strongest in women under 60 years of age (aHR 2.15).
The following cancers have a significantly higher risk of being diagnosed in ICU-gr than C-gr: kidney cancer (aHR 3.16), blood cancer (aHR 2.54), colon cancer (aHR 1.72), lung cancer (aHR 1.70), and other malignancies (aHR 1.18). Among hematologic cancers, the ICU-gr group had a significantly higher risk of being diagnosed with leukemia (ahr 3.28), myeloma (ahr 2.21), or non-Hodgkin lymphoma (ahr 2.15) compared to the C-gr group. There was no difference between the two groups for the following cancers: Hodgkin lymphoma, melanoma, breast, prostate, rectal, liver, bladder, and uterine cancer.
Although the article has reached a conclusion, this conclusion is only a phenomenon, and the cause of this phenomenon can be explained by a variety of explanations, and the paper itself still has great limitations.