ABSTRACT
Introduction Despite the advance in vaccination, the SARS-CoV-2 infection remains a challenge for the medical community. Outpatient and hospital therapy for COVID-19 are still improving. Our study aimed to report the results of a series of patients with COVID-19 who participated in an outpatient treatment protocol since the first clinical manifestation. Methods A case series report of individuals aged ≥ 18 years with clinical symptoms and a confirmed test for COVID-19 submitted to a treatment protocol. Patients were enrolled between May and September 2020 and followed for at least 15 days. The assessed clinical outcomes were the need for hospitalization, admission to the intensive care unit, orotracheal intubation, and death. Results We studied a hundred and sixteen patients. The mean age was 48 ± 14 years. Females formed 53%. The main comorbidities were type II diabetes (6%), systemic arterial hypertension (10.3%), obesity (15.5%), and lung diseases (6.0%). Temperature > 37.7°C (51.7%), cough (55.2%), myalgia (37.1%), headache (37.9%) and fatigue (34.5%) were the most frequent signs and symptoms. According to different disease staging, the most administered drugs were: azithromycin, ivermectin, corticosteroid, antibiotics, and anticoagulants. There was no death, and hospitalization accounted for only 8.6% of the patients (one in ICU);none required orotracheal intubation. The mean length of hospital stay was 5.8 days.
ABSTRACT
Introduction Despite the advance in vaccination, the SARS-CoV-2 infection remains a challenge for the medical community. Outpatient and hospital therapy for COVID-19 are still improving. Our study aimed to report the results of a series of patients with COVID-19 who participated in an outpatient treatment protocol since the first clinical manifestation. Methods A case series report of individuals aged ≥ 18 years with clinical symptoms and a confirmed test for COVID-19 submitted to a treatment protocol. Patients were enrolled between May and September 2020 and followed for at least 15 days. The assessed clinical outcomes were the need for hospitalization, admission to the intensive care unit, orotracheal intubation, and death. Results We studied a hundred and sixteen patients. The mean age was 48 ± 14 years. Females formed 53%. The main comorbidities were type II diabetes (6%), systemic arterial hypertension (10.3%), obesity (15.5%), and lung diseases (6.0%). Temperature > 37.7°C (51.7%), cough (55.2%), myalgia (37.1%), headache (37.9%) and fatigue (34.5%) were the most frequent signs and symptoms. According to different disease staging, the most administered drugs were: azithromycin, ivermectin, corticosteroid, antibiotics, and anticoagulants. There was no death, and hospitalization accounted for only 8.6% of the patients (one in ICU);none required orotracheal intubation. The mean length of hospital stay was 5.8 days. RESUMEN Introducción A pesar del avance en la vacunación, la infección por SARS-CoV-2 sigue siendo un desafío para la comunidad médica. La terapia ambulatoria y hospitalaria para COVID-19 sigue mejorando. Nuestro estudio tuvo como objetivo informar los resultados de una serie de pacientes con COVID-19 que participaron en un protocolo de tratamiento ambulatorio desde la primera manifestación clínica. Métodos This is a prospective study with case reports of individuals ≥ 18 years old with clinical symptoms and confirmed tests for COVID-19 undergoing a treatment protocol. Patients were enrolled consecutively between May and September 2020 and followed up for at least 15 days. The clinical outcomes evaluated were the need for hospitalization, the intensive care unit, orotracheal intubation and death. Resultados Se estudiaron ciento dieciséis pacientes. La edad media fue de 48 ± 14 años. Las hembras formaron el 53%. Las principales comorbilidades fueron diabetes tipo II (6%), hipertensión arterial sistémica (10,3%), obesidad (15,5%) y enfermedades pulmonares (6,0%). Temperatura > 37,7°C (51,7%), tos (55,2%), mialgia (37,1%), cefalea (37,9%) y fatiga (34,5%) fueron los signos y síntomas más frecuentes. Según los diferentes estadios de la enfermedad, los fármacos más administrados fueron: azitromicina, ivermectina, corticoides, antibióticos y anticoagulantes. La hospitalización representó sólo el 8,6% de los pacientes (uno en UCI);ninguno requirió intubación orotraqueal y ningún fallecimiento. La estancia hospitalaria media fue de 5,8 días.
ABSTRACT
BACKGROUND: Pneumonia is the main manifestation of coronavirus disease 2019 (COVID-19) infection. Chest computed tomography is recommended for the initial evaluation of the disease; this technique can also be helpful to monitor the disease progression and evaluate the therapeutic efficacy. AIM: To review the currently available literature regarding the radiological follow-up of COVID-19-related lung alterations using the computed tomography scan, to describe the evidence about the dynamic evolution of COVID-19 pneumonia and verify the potential usefulness of the radiological follow-up. METHODS: We used pertinent keywords on PubMed to select relevant studies; the articles we considered were published until October 30, 2020. Through this selection, 69 studies were identified, and 16 were finally included in the review. RESULTS: Summarizing the included works' findings, we identified well-defined stages in the short follow-up time frame. A radiographic deterioration reaching a peak roughly within the first 2 wk; after the peak, an absorption process and repairing signs are observed. At later radiological follow-up, with the limitation of little evidence available, the lesions usually did not recover completely. CONCLUSION: Following computed tomography scan evolution over time could help physicians better understand the clinical impact of COVID-19 pneumonia and manage the possible sequelae; a longer follow-up is advisable to verify the complete resolution or the presence of long-term damage.
ABSTRACT
BACKGROUND: Given the several radiological features shared by coronavirus disease 2019 pneumonia and other infective or non-infective diseases with lung involvement, the differential diagnosis is often tricky, and no unequivocal tool exists to help the radiologist in the proper diagnosis. Computed tomography is considered the gold standard in detecting pulmonary illness caused by severe acute respiratory syndrome coronavirus 2. AIM: To conduct a systematic review including the available studies evaluating computed tomography similarities and discrepancies between coronavirus disease 2019 pneumonia and other pulmonary illness, then providing a discussion focus on cancer patients. METHODS: Using pertinent keywords, we performed a systematic review using PubMed to select relevant studies published until October 30, 2020. RESULTS: Of the identified 133 studies, 18 were eligible and included in this review. CONCLUSION: Ground-glass opacity and consolidations are the most common computed tomography lesions in coronavirus disease 2019 pneumonia and other respiratory diseases. Only two studies included cancer patients, and the differential diagnosis with early lung cancer and radiation pneumonitis was performed. A single lesion associated with pleural effusion and lymphadenopathies in lung cancer and the onset of the lesions in the radiation field in the case of radiation pneumonitis allowed the differential diagnosis. Nevertheless, the studies were heterogeneous, and the type and prevalence of lesions, distributions, morphology, evolution, and additional signs, together with epidemiological, clinical, and laboratory findings, are crucial to help in the differential diagnosis.
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BACKGROUND: Coronavirus disease (COVID-19), an acute respiratory syndrome caused by a novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), has rapidly spread worldwide, significantly affecting the outcome of a highly vulnerable group such as cancer patients. The aim of the present study was to evaluate the clinical impact of COVID-19 infection on outcome and oncologic treatment of cancer patients. PATIENT AND METHODS: We retrospectively enrolled cancer patients with laboratory and/or radiologic confirmed SARS-CoV-2 infection, admitted to our center from February to April 2020. Descriptive statistics were used to summarize the clinical data and univariate analyses were performed to investigate the impact of anticancer treatment modifications due to COVID-19 outbreak on the short-term overall survival (OS). RESULTS: Among 61 patients enrolled, 49 (80%) were undergoing anticancer treatment and 41 (67%) had metastatic disease. Most patients were men; median age was 68 years. Median OS was 46.6 days (40% of deaths occurred within 20 days from COVID-19 diagnosis). Among 59 patients with available data on therapeutic course, 46 experienced consequences on their anticancer treatment schedule. Interruption or a starting failure of the oncologic therapy correlated with significant shorter OS. Anticancer treatment delays did not negatively affect the OS. Lymphocytopenia development after COVID was significantly associated with worst outcome. CONCLUSIONS: COVID-19 diagnosis in cancer patients may affect their short-term OS, especially in case of interruption/starting failure of cancer therapy. Maintaining/delaying cancer therapy seems not to influence the outcome in selected patients with recent COVID-19 diagnosis.
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Aim: Evaluating the incidence and course of COVID-19 in cancer patients treated with immunotherapy. Patients & methods: We reported the influenza-like illness events with diagnosis of COVID-19 within the patient cohort enrolled in the prospective observational multicenter INVIDIa-2 study in the single center of Parma. Results: Among 53 patients, eight experienced influenza-like illness during the influenza season 2019/2020, and three of them had diagnosis of COVID-19. They were males, elderly, with cardiovascular disease. Radiological features of COVID-19 pneumonitis were found in all of three cases, although the pharyngeal swab resulted positive in only two. Two of these three patients died due to respiratory failure. Conclusion: Cancer patients are at high risk of severe events from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.