ABSTRACT
Introduction: Cancer healthcare has been affected by Coronavirus disease 2019 (COVID-19) pandemic, interfering the normal function of oncology units and increasing diagnostic delay. Nevertheless, the rising incidence of respiratory infections led to an increase in medical consultations and chest imaging explorations. The aim of the study was to assess whether the increase in medical evaluations in the context of the pandemic led to an increase in the detection of early-stage thoracic tumours. Methods: We performed a retrospective single-institution study, collecting data from patients diagnosed with thoracic tumours between March, 1, 2020 and December, 31, 2021. We analysed their demographic and clinical data, symptoms at diagnosis and those who were diagnosed due to SARS-CoV-2 infection. Results: A total of 378 patients were analysed. Main results are shown in Table-1. Only 5.3% of newly diagnosed thoracic tumours were related to a suspected or confirmed SARS-CoV-2 infection. However, these patients were not diagnosed at earlier stages (p = 0.414). When we evaluated symptoms at diagnosis, we found that asymptomatic patients presented in earlier stages (p <0.000, Figure-1), being the majority incidental findings during the follow-up of oncological and non-oncological pathologies. Regarding symptomatic patients, most presented as locally advanced or metastatic diseases and no changes have been observed in the pattern of presentation compared to studies prior to the pandemic. [Formula presented] Conclusions: COVID-19 pandemic did not seem to increase thoracic tumours diagnosis in our study. Lung cancer diagnosed in patients due to SARS-CoV-2 infection was not detected in earlier stages. Clinical presentation was similar to previous reported outside COVID-19 pandemic. Nevertheless, we find that asymptomatic patients diagnosed incidentally presented more frequently in localized stages in comparison with symptomatic patients. [Formula presented] Keywords: COVID19, Lung Cancer, Diagnosis
ABSTRACT
To ensure periodic prenatal follow-up in a safe manner, health professionals and especially nurses, have been adopting strategic safety measures to face the challenges in the midst of the COVID-19 pandemic. Thus, the present study aims to describe strategic actions adopted by nurses, to ensure the performance of periodic prenatal care in a safe manner, as well as to welcome pregnant women in this difficult time. Materials and Methods: This is an integrative review, whose data sources used were, LILACS;Scielo;VHL;PubMed and Google Scholar. Results: There was an increase in the prevalence of gestational diabetes around 25.6% in pregnant women hospitalized and symptomatic for COVID-19. There was also an increase in the rate of premature births;and stillbirth cases occurred around four times more in pregnant women who had SARS-CoV-2. It is also worth mentioning that SARS-COV-2 can progress between phases I, II and III, ranging from mild to more severe symptoms, and pregnant women who progress to assistance in the intensive care unit have a high mortality rate. Conclusion: Among the strategies that stood out: the reorganization of the service flow of the units;holding teleconsultations and postponing face-to-face consultations with symptomatic pregnant women, also reinforced the importance of the professional nurse in the practice of skillful listening. Thus, for the future it is expected that lessons are learned, where the experiences lived by the population and health professionals, result in improvement of maternal-fetal health, with access and quality of assistance superior to those found before the pandemic.
ABSTRACT
Background: Madrid has been the epicenter of the SARS-CoV2 pandemic in Spain. We analyzed the experience at our hospital with SARS-CoV2 infection and cancer patients (p). Method(s): We analyzed our experience from March 1 to April 30 at the Puerta de Hierro University Hospital in Madrid. Diagnosis of SARS-CoV2 infection was made by RT-PCR, suspected cases not confirmed were excluded. Result(s): Overall in-hospital mortality cancer p with COVID-19 was 15.2% (95%CI, 6.3;5.2), similar to 12.7% (95%CI,11.1;4.4) with p=0.615 of the global COVID-19 hospitalised population and greater than that of patients admitted without SARS-CoV-2 infection during the same period 4.3% (95%CI;3.6;5.2) p0.001. Among 653 patients receiving active cancer therapy during this period, 24 (3.7%) developed COVID-19 and required admission, 4.2% of were receiving chemotherapy, 9.5% immunotherapy and 2.1% targeted therapies. Lung and breast cancer were the most frequent (26.1%), followed by colorectal (19.6%) and breast cancer. No significant differences due to the cancer treatment received were observed. Mortality in lung cancer patients was the highest (25%). The univariate analysis (between p who developed serious event vs. those who did not), showed that higher Brescia, CURB-65 scale, lactate dehydrogenase (LDH) or C-reactive protein (CRP) levels at admission, the greater risk of developing severe complications (p0.05) [Formula presented]. Conclusion(s): Patients with cancer, especially lung cancer, and SARS-CoV2 infection have a worse overall prognosis than the general population. Objective parameters such as LDH, CRP at admission, Brescia index or CURB-65 should alert us to a more serious evolution and suggest early an early intensive care unit (ICU) admission. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest. Copyright © 2020