ABSTRACT
OBJECTIVE: To identify lessons learned from haemophilia care experience in Wuhan (COVID-19 outbreak epicenter in China) and Tianjin (with relatively low COVID-19 incidence) in the pandemic. METHODS: We compared the challenges in haemophilia management attributed to local COVID-19 containment policies, healthcare resource availability, clotting factors supply, daily living restrictions and coping strategies employed. RESULTS: Wuhan was in lockdown with strict traffic controls, enforced quarantine and overwhelmed resources. Tianjin was in relatively relaxed countermeasures to COVID-19. In Wuhan, haemophilia treatment (for bleeding, prophylaxis, multidisciplinary team care, immune tolerance induction) and patient education were severely affected, while the challenges in Tianjin were less. In both cities, patients' fear for COVID-19 infection also affected their management. Coping strategy in Wuhan included channelling of clotting factors supply from hospitals to nine pharmacies; timely transfers of in-need patients to healthcare facilities by a volunteer service network jointly coordinated by the government, hospitals and the community. Although factor concentrate supply in each city was adequate, patients still worried whether there would be enough supply to last through the pandemics. Consequently, many downgraded their treatment regimens resulting in increased bleeding episodes. In both cities, telemedicine was promoted for patient care and education. CONCLUSIONS: The COVID-19 pandemic had varying adverse impacts on haemophilia care depending on the local infection incidence. Our experience suggests that haemophilia management strategies in the pandemic need to be established according to the local virus containment/mitigation policies, daily living restrictions and resource availability.
Subject(s)
COVID-19/epidemiology , Hemophilia A/epidemiology , Quarantine/methods , SARS-CoV-2/physiology , Adaptation, Psychological , COVID-19/transmission , China/epidemiology , Cities , Containment of Biohazards , Health Policy , Health Resources , Health Services Accessibility , Humans , Incidence , Pandemics , Patient Care , Telemedicine , VolunteersABSTRACT
OBJECTIVE: To assess the screening and isolation measures for preventing coronavirus disease 2019 (COVID-19) infection from newly admitted patients into a pediatric oncology ward. METHODS: We retrospectively analyzed 44 patients with established hematologic malignancies admitted for chemotherapy from January 23 to March 27, 2020 in the Department of Pediatric Hematology of Tongji Hospital, Wuhan. Every patient and their caregivers were well educated on personal protection and put it into effect at home and in hospital. Screening for COVID-19 of all the patients and caregivers before admission was performed. Both clinical features and screening results including chest computerized tomography (CT); nucleic acid testing of nasopharyngeal, oropharyngeal or anal swabs; and quantitative antibodies (IgM and IgG) detecting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of these patients were described. RESULTS: The results of nucleic acid and antibodies (IgM and IgG) testing of all the 44 inpatients and their caregivers were negative. Abnormal chest CT images were observed in six symptomatic patients, while chest CT images of their caregivers did not show the changes related to viral pneumonia. These symptomatic patients all recovered after antibacterial combined with antifungal treatment, but without any antiviral agents. CONCLUSIONS: COVID-19 infection could be prevented in pediatric patients with malignancies if proper protective measures were implemented. For patients presenting suspicious symptoms, comprehensive examinations should be carried out.
Subject(s)
COVID-19/prevention & control , Disease Transmission, Infectious/prevention & control , Hematologic Neoplasms/therapy , Infection Control/methods , Adolescent , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing/methods , Child , Child, Preschool , China , Female , Hematologic Neoplasms/epidemiology , Hospitals , Humans , Infant , Male , Patient Admission , Personal Protective Equipment , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/isolation & purification , Tomography, X-Ray ComputedABSTRACT
The SARS-CoV-2 infection status of hospitalized children was surveyed in the department of pediatric hematology and oncology in three different hospitals of epidemic areas in Hubei, China. A cross-sectional study was performed to investigate the clinical characteristics, lung CT scan, SARS-CoV-2 nucleic acid test and serum antibodies of hospitalized children with hemato-oncological diseases from January 23 to April 24, 2020. 299 children were enrolled in this study, including 176 males (58.9%) and 123 females (41.1%), aged from 2 months to 16 years. 255 cases (85.3%) received chemotherapy or other immunosuppressive therapies, and there were 44 cases (14.7%) of other benign diseases. Nucleic acid test was performed on 258 children (86.3%) and one case was positive. 163 cases (54.5%) were tested for serum antibodies, and all of them were negative. Lung CT scan was performed on 247 children (82.6%), and 107 of them showed infectious changes. Only one case (0.33%) of COVID-19 was diagnosed in the group. The prevalence rate of COVID-19 in enrolled children with hemato-oncological diseases in Hubei was 0.33%. Immunosuppressed patients are not prone to produce related antibodies. Comprehensive protective measures and ward management can reduce the risk of SARS-CoV-2 infection in the group patients.