A hospital challenge: experience of a gynecology team in the comprehensive management of patients COVID 19 / Desafío hospitalario: experiencia de un equipo de ginecología en el manejo integral de pacientes COVID 19

INTRODUCCIÓN: La infección por el coronavirus SARS-CoV2 (COVID 19), causal de la pandemia actual, ha significado a nivel mundial la hospitalización simultánea de múltiples pacientes poniendo a prueba la infraestructura hospitalaria y la capacidad de reacción del personal de salud. Una de las estrategias para el manejo es la reconversión de camas y servicios clínicos. OBJETIVOS: presentar experiencia de un equipo ginecológico en el manejo integral de pacientes no gineco-obstétricas con COVID 19, durante el mes de junio de 2020 en un hospital público de la Región Metropolitana. MÉTODOS: Estudio de corte transversal observacional, descriptivo. Se consideró el total de pacientes adultos hombres y mujeres sin patología gineco-obstétrica con COVID 19 ingresados al puerperio del Hospital Santiago Oriente, obteniéndose datos clínicos y demográficos a través del registro interno de la unidad y del sistema de información de red asistencial. RESULTADOS: Ingresaron 82 pacientes, 32 mujeres y 50 hombres, promedio de edad 64. El promedio de días de hospitalización fue 5, con diagnóstico de ingreso principal neumonía viral por COVID-19. Las comorbilidades frecuentes fueron hipertensión arterial sistémica y diabetes mellitus. La complicación más frecuente fue el tromboembolismo pulmonar agudo. Hubo una alta cobertura de entrega de información vía telefónica a familiares. De los 82 ingresos, 54 pacientes egresaron a su domicilio. El resto a otras unidades dentro de la institución, centros de menor complejidad o residencias sanitarias. Una paciente sexo femenino de 75 años fallece a causa de descompensación de patologias de base secundario a neumonia por Staphylococus aereus. En ella, se descarta la infección por COVID 19 dado tres exámenes por reacción de polimerasa en cadena negativos realizado antes y durante su hospitalización. CONCLUSIONES: Esta experiencia constituyó un desafío para todo el equipo de salud gineco-obstétrico, considerando que nos enfrentamos a otro tipo de pacientes y a una patología nueva. Los resultados médicos son promisorios, la experiencia humana y sentido de trabajo en equipo fue extraordinario.

INTRODUCTION: The infection by the SARS-CoV2 coronavirus (COVID 19), the cause of the current pandemic we are experiencing, has meant the simultaneous hospitalization of many patients worldwide, putting the hospital infrastructure and the reaction capacity of health personnel to the test. One of the management strategies is the reconversion of clinical services. OBJECTIVES: present the experience of a gynecological team in the comprehensive management of non-gyneco-obstetric patients with COVID 19, during the month of June 2020 in a public hospital in the Metropolitan Region. METHODS: descriptive, observational cross-sectional study. The total number of patients admitted to the ex-puerperium of the Santiago Oriente Hospital was considered, obtaining clinical and demographic data through the unit's internal registry and the healthcare network information system. RESULTS: 82 patients were admitted, 32 women and 50 men, average age 64. The average number of days of hospitalization was 5, with the main admission diagnosis being viral pneumonia due to COVID-19. Frequent comorbidities were systemic arterial hypertension and diabetes mellitus. The most frequent complication was acute pulmonary thromboembolism. There was a high coverage of the delivery of information via telephone to relatives. Of the 82 admissions, 54 patients were discharged home and the rest to other units within the institution, less complex centers or health residences. One 75 years old female patient dies from concomitant pathologies, and she wasn't positive for COVID-19. CONCLUSIONS: This experience was a challenge for the entire gynecological-obstetric health team, considering that we are facing other types of patients and a new pathology. The medical results are promising, the human experience and sense of teamwork was extraordinary.

Management of non-invasive tumours, benign tumours and breast cancer during the COVID-19 pandemic: recommendations based on a Latin American survey.

INTRODUCTION: The COVID-19 pandemic has changed health systems across the world, both in general hospitals and in oncology institutes or centres.For cancer specialists, particularly breast cancer (BC), the COVID-19 pandemic represents a combination of challenges since the hospital resources and staff have become more limited; this has obliged oncology specialists to seek a consensus and establish which patients with BC require more urgent attention and which patients can wait until there is a better control of this pandemic. The health system in Latin America has some special characteristics; in some of the countries, there are shortages which limit access to several specialities (surgery, clinical oncology and radiotherapy) in some regions. OBJECTIVE: After a systematic review of the most recent literature regarding the management of BC during the COVID-19 pandemic, the main objective is to understand the position of the different Latin American Societies of Mastology in terms of available alternatives for the treatment of BC. METHODS: After carrying out a comprehensive and exhaustive search of the most recent guides on the management of BC during the COVID-19 pandemic, the board members of the Latin American Federation of Mastology invited, via email, different specialists, all experts in BC care, to complete an anonymous survey online.The survey was distributed between 30 and 10 May 2020. The survey included 27 questions on four topics: demographic information, consultations, imaging and treatment of BC.The questionnaire was sent and then distributed to various health specialists including breast surgeons, clinical oncologists, radiation oncologists and radiologists via the Presidents of the different Latin American Societies of Mastology in 18 countries. The results are summarised as tallies based on the number of responses to each question. RESULTS: A total of 499 responses were received. The majority of the respondents were males (275 (55.11%)); 290 participants were over 45 years (58.11%).The questionnaire presented those surveyed with three possible answers (agree, disagree and neither agree nor disagree). The results reflect that there was consensus in the majority of situations presented. Only seven questions revealed disagreement among those responding. The results are presented as recommendations. CONCLUSION: The management of patients with BC presents unique challenges during the current world health situation produced by COVID-19 pandemic. Breast care specialists (surgical oncologists, breast care clinicians, clinical oncologists, radiation oncologists and radiologists) from 18 countries in Central and South America submitted through their responses and recommendations for the treatment of BC during the COVID-19 pandemic.