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CIDRAP COVID-19 SCAN: Lives saved by COVID vaccine; Pandemic and cancer surgery; COVID-19 and irritable bowel disease

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  • CIDRAP COVID-19 SCAN: Lives saved by COVID vaccine; Pandemic and cancer surgery; COVID-19 and irritable bowel disease


    COVID-19 Scan for Oct 06, 2021
    Lives saved by COVID vaccine; Pandemic and cancer surgery; COVID-19 and irritable bowel disease
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    HHS: COVID vaccine saved 39,000 Medicare beneficiaries' lives

    A US Department of Health and Human Services (HHS) analysis of Medicare data and county vaccination rates indicates that COVID-19 vaccinations administered from January until May 2021 were estimated to reduce COVID-19 infections by 265,000 and deaths by 39,000 among Medicare beneficiaries.
    To conduct the study, HHS used Centers for Disease Control and Prevention (CDC) county-level COVID-19 vaccination rates for adults ages 18 to 64 and for those 65 years and older who were fully vaccinated to build a model that would determine how many cases, hospitalizations, and deaths were averted with full vaccination.
    The study found an 11% to 12% decrease in weekly COVID-19 hospitalizations and deaths among Medicare beneficiaries for every 10% increase in county vaccination rates.
    The study also suggested that 107,000 hospitalizations were avoided due to vaccination. These numbers represent an estimated 18% reduction in COVID-19 infections, 21% reduction in COVID-19 hospitalizations, and 22% reduction in COVID-19 deaths based on the number of potential COVID-19 outcomes of Medicare beneficiaries.
    "This report reaffirms what we hear routinely from states: COVID-19 vaccines save lives, prevent hospitalizations, and reduce infection," said HHS Secretary Xavier Becerra in a press release.
    The study authors conclude, "Vaccination rates have continued to rise over the summer, and with the surge in cases from the Delta variant, the importance of vaccination has likely grown substantially, given the Delta variant is more than twice as contagious as previous variants."
    Oct 5 HHS study
    Oct 5 HHS press release

    Pandemic lockdowns affected cancer surgery globally, study says

    Planned cancer surgery was delayed during the pandemic worldwide, with 15% of people putting off an operation during full COVID-19 lockdowns, according to a study yesterday in The Lancet Oncology.
    The researchers looked at 20,006 adults at 466 hospitals and 61 countries who were planning on receiving surgery for the 15 most common solid cancer types during the COVID-19 pandemic. All were followed for a minimum of 12 weeks (until surgery or Aug 31, 2020), but even after a median of 23 weeks, 10.0% still hadn't had their surgery. All had at least one COVID-19–related reason, most commonly concern about infection risk to the patient (72.8%), and 15.3% reported at least one additional non-COVID reason.
    Under light restrictions, 0.6% of patients didn’t have surgery, compared with 15.0% and 5.5% of people under full and moderate lockdowns, respectively (adjusted hazard ratios, 0.51 and 0.81, respectively). Almost 9 in 10 patients (88.7%) who didn't receive their surgery lived in areas with full lockdowns.
    Overall, being in a low- or middle-income country (LMIC), having more frailty or comorbidities, and having locally advanced or nodal disease (or both) were all independently associated with increased risk of not receiving surgery. Of those who didn't receive surgeries, 22.6% were re-staged (reassessed for cancer spread), 8.9% progressed to unresectable disease, and 2.4% died.
    Patients waiting for surgery in LMICs during full lockdowns were more likely to go without surgery than those under light restrictions (HR, 0.41). The researchers note that patients younger than 50 were more commonly from LMICs and were also less likely to receive their planned surgery.
    "In order to prevent further harm during future lockdowns, we must make the systems around elective surgery more resilient—protecting elective surgery beds and operating theatre space, and properly resourcing 'surge' capacity for periods of high demand on the hospital, whether that is COVID, the flu or other public health emergencies," said co-lead author James Glasbey, MBBCh, in a University of Birmingham press release.
    Oct 5 Lancet Oncol study
    Oct 5 University of Birmingham press release

    COVID-19 incidence may be higher in irritable bowel disease patients

    COVID-19 incidence was 4.7 per 1,000 person-years among irritable bowel disease (IBD) patients compared with 2.8 in the general population, according to a population-based study published in PLOS One yesterday.
    The researchers looked at COVID-19 patients admitted to the only two hospitals covering the South-Limburg region in the Netherlands from Feb 27, 2020, to Jan 4, 2021. The total population was 597,184 people, and 4,980 were estimated to have IBD. Twenty IBD patients (0.4%) and 1,425 of the general population (0.24%) were hospitalized due to COVID-19, leading to an incidence rate ratio of 1.68 (95% confidence interval [CI], 1.08 to 2.62, p = 0.019).
    COVID-19 patients with IBD were more likely to be younger (median age, 63.0 years vs 72.0) and have a higher body mass index (BMI) (average, 24.4 vs 24.1 kg/m2), but both groups had similar rates of intensive care unit (ICU) admission (12.5% vs 15.7%, P = 1.00), mechanical ventilation (6.3% vs 11.2%, P = 1.00), and death (6.3% vs 21.8%, P = 0.22).
    A post-hoc analysis found that BMI among ICU patients was significantly higher compared with non-ICU patients in both groups (mean, 25.8 vs 23.9), which the researchers say confirms that BMI as a risk factor for severe COVID-19.
    "Interestingly, none of the IBD patients with severe COVID-19 were on biologicals when in fact a substantial proportion of IBD patients in our population currently use biologicals, in particular anti-tumour necrosis factor (TNF) agents such as infliximab and adalimumab," the researchers add. "All in all, although cases were limited, the observation of no anti-TNF users among the IBD patients with severe COVID-19 in the current study further substantiates the potential protective role of anti-TNF agents in the pathophysiology of COVID-19."
    Oct 5 PLOS One study