Abstract
ObjectivesTo establish the role of BCG instillations in the incidence and mortality of COVID-19.Patients and methodsNMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables.Results175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%.ConclusionsAccording to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.
Highlights
The virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 has generated a pandemic never seen by mankind before [1]
Forty-three patients were diagnosed with COVID-19
There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed
Summary
The virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (better known as COVID-19) has generated a pandemic never seen by mankind before [1]. Major efforts focus on discovering a vaccine for the disease. In this context, the utility of Mycobacterium bovis Bacillus Calmette–Guérin (BCG) is proposed. BCG is a live attenuated vaccine for tuberculosis, and it has been described to provide protection against respiratory infections other than tuberculosis [3, 4], reducing its contagiousness, its severity and even mortality [5]. The mechanism by which BCG confers immunity to other infections is unknown [6], there is evidence that nonspecific protective effect is constituted by innate immune cells such as monocytes and natural killer cells, independent of T- and B-cell memory (called “trained inmmunity”) [7, 8]
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