[Neurological manifestations in patients with severe COVID-19 in a tertiary care center]

Background: The SARS-CoV-2 disease, called COVID-19, emerged in China has acquired pandemic dimensions. According to the WHO situational report of March 15, 2021, the global fatality rate is 2.2%;in Mexico, around 194 944 deaths have been confirmed by COVID-19. Studies in China identified that patients with severe COVID-19, when compared with those who had non-severe COVID-19, presented more severe neurological manifestations. Objective: To determine the frequency of neurological symptoms and manifestations in patients with severe COVID-19 in a tertiary care center. Material and methods: A cross-sectional, observational and analytical study was carried out at the Hospital de Especialidades del Centro Medico Nacional Siglo XXI, in patients hospitalized with severe COVID-19. Results: 183 cases were analyzed, of which 130 were men (71%). The median age was 55 years (IQR: 44-65). The neurological symptoms were: headache, anosmia and dysgeusia. Neurological manifestations occurred in 27 patients (16%), the most frequent was ischemic-type cerebrovascular disease (CVD) in 12 (44%), in patients older than 76.5 years vs. 54 years (p = 0.000), with history of cardiovascular disease. Conclusions: The most frequent neurological symptoms were headache, anosmia and dysgeusia. The most frequent neurological manifestation was ischemic CVD that appeared in older patients with severe COVID-19 with a history of cardiovascular disease.

Professional standing of young medical oncologists in Spain during COVID-19 pandemic: A nationwide survey by the Spanish Society of Medical Oncology (SEOM) +MIR Section

Background: Knowledge of the career paths and employment situation of young medical oncologists is lacking. The aim of our study was to evaluate the current professional standing of young medical oncologists during COVID-19 pandemic in Spain. Methods: The SEOM +MIR section conducted a national online survey in May 2021 of young medical oncology consultants (<6 years of expertise) and last year medical oncology residents. Using the electronic mailing available in the SEOM database, professionals from Spain were invited. Results: A total of 136 responses were eligible in the preliminary analysis. 86 (63%) were women. 106 (78%) were consultants and 30 (22%) were residents. 92 (68%) performed standard clinical care and 10 (7%) research activity. 97 (71%) were subspecialized in a main area of interest and almost half of them, 60 (48%), chose it because it was the only option available after residency. 75 (55%) had considered different employment opportunities other than standard clinical care and 33 (25%) showed an interest in increasing their research activity. 68 (50%) had considered working in foreign countries: 40 (29%) in the European Union. The main reasons were: 35 (26%) thought it might increase their professional development and 29 (22%) argued for better salary conditions abroad. Furthermore, 109 (80%) believed the professional standing in Spain was worse than other countries. After finishing their residency, only 20 (14%) were offered a job at their training hospital. Solely, 17 (12%) participants had an indefinite employment contract. 25 (18%) had previously signed a COVID-19 temporary contract. 55 (40%) were worried about their employment stability. Conclusions: The availability of subspecializing in medical oncology may depend on the job opportunity after residency rather than personal interest. The abundance of temporary contracts could have influenced the employment stability concerns observed. Our work contributes and is consistent with the ESMO values focused on the wellbeing of medical oncology professionals. Future mentoring strategies should engage in building a long-term career path for young medical oncologists. Legal entity responsible for the study: SEOM +MIR Section. Funding: Has not received any funding. Disclosure: V. Pacheco-Barcia: Financial Interests, Personal, Invited Speaker, Speaker Fee: Eisai;Financial Interests, Personal, Invited Speaker, Speaker Fee: Merck;Financial Interests, Personal, Invited Speaker, Speaker Fee: Bristol Myers Squibb;Financial Interests, Personal, Invited Speaker, Speaker Fee: LEO Pharma;Financial Interests, Personal, Invited Speaker, Speaker Fee: Kyowa Kirin;Financial Interests, Personal, Invited Speaker, Speaker Fee: Grunenthal;Financial Interests, Personal, Invited Speaker, Speaker FEE: Prostakan;Financial Interests, Personal, Invited Speaker, Speaker Fee: Lilly;Other, Other: Merck. D.A. Sanchez: Financial Interests, Personal, Invited Speaker: Janssen;Non-Financial Interests, Personal and Institutional, Leadership Role, National Representative of Young Doctors of Promotion of Employment in Organización Médica Colegial: Spanish Medical Association;Non-Financial Interests, Personal and Institutional, Leadership Role: President of the Murcian Health Service Company Committee;Non-Financial Interests, Personal and Institutional, Leadership Role: Vice-representative from the European Junior Doctors (EJD) in Oncology Section in UEMS (Uropean Union of Medical Specialties);Non-Financial Interests, Personal, Other: Member of +MIR Section of the Spanish Society of Medical Oncology;Non-Financial Interests, Personal, Other: ESMO member;Non-Financial Interests, Personal, Other: SEOM member. B. Obispo: Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: Fresenius;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: Rovi;Financial Interes s, Personal, Invited Speaker: Leo Pharma. A. Quilez: Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Advisory Role: Clovis;Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: GSK;Financial Interests, Personal, Advisory Role: GSK. A. Sesma: Financial Interests, Personal, Invited Speaker: MSD. D. Paez: Financial Interests, Personal, Advisory Role: Amgen;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: F. Hoffman-La Roche Ltd;Financial Interests, Personal, Advisory Role: Sanofi;Financial Interests, Personal, Advisory Role: Ipsen;Financial Interests, Personal, Speaker’s Bureau: Advanced Accelerator Applications;Financial Interests, Personal, Research Grant, Research funding: Merck Serono. T. Quintanar Verduguez: Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Invited Speaker: Abbott;Financial Interests, Personal, Invited Speaker: Nestle;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Other, Consultancy: Astra Zeneca. M. Sánchez Cánovas: Financial Interests, Personal, Invited Speaker: Leo Pharma;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: KyowaKirin;Financial Interests, Institutional, Other: Leo Pharma;Other, Personal, Other, Attending Symposia: Sanofi;Other, Personal, Other, Attending Symposia: MSD;Other, Personal, Other, Attending Symposia: Esteve;Other, Personal, Other, Attending Symposia: Amgen;Other, Personal, Other, Attending Symposia: Servier;Other, Personal, Other, Attending Symposia: Angelini;Other, Personal, Other, Attending Symposia: Leo Pharma;Other, Personal, Other, Educational Programs: Angelini;Other, Personal, Other, Educational Programs: Sanofi;Other, Personal, Other, Educational Programs: Rovi;Other, Personal, Other, Educational Programs: Leo Pharma;Other, Personal, Other, Educational Programs: Servier;Other, Personal, Other, Educational Programs: Merck;Other, Personal, Other, Remunerations for authorship: KyowaKirin;Other, Personal, Other, Remunerations for authorship: Mylan. N. Tarazona: Financial Interests, Personal, Invited Speaker: Amgen;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Merck;Financial Interests, Institutional, Principal Investigator, Principal Investigator: Mutua Madrileña;Financial Interests, Institutional, Principal Investigator: SEOM;Financial Interests, Institutional, Principal Investigator: TTD Group;Non-Financial Interests, Personal, Leadership Role, Member of CIBERONC Liquid Biopsy Working Module since 2018: CIBERONC;Non-Financial Interests, Personal, Leadership Role, Member of ESMO Translational Research and Precision Medicine Working Group for the period 2019-2020.: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO-MCBS Extended Working Group since 2019: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO faculty member for the Gastro-Intestinal Tumours faculty group for the period 2019-2023.: ESMO Faculty;Non-Financial Interests, Personal, Leadership Role, Member of Executive Committee SEOM +MIR 2020-2022.: SEOM +MIR. A. Fernandez Montes: Financial Interests, Personal, Advisory Role: Bristol Myers Squibb;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck. E. Felip: Financial Interest , Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Beigene;Financial Interests, Personal, Advisory Board: Boehringer-Ingelheim;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Eli Lilly;Financial Interests, Personal, Advisory Board: F Hoffman-La Roche;Financial Interests, Personal, Advisory Board: Glaxo Smith Kline;Financial Interests, Personal, Advisory Board: Janssen;Financial Interests, Personal, Advisory Board: Medical Trends;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Merck Serono;Financial Interests, Personal, Advisory Board: Peptomyc;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Personal, Advisory Board: Puma;Financial Interests, Personal, Advisory Board: Regeneron;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Syneos Health;Financial Interests, Personal, Advisory Board: Takeda;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: AstraZeneca;Financial Interests, Personal, Speaker’s Bureau: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: Eli Lilly;Financial Interests, Personal, Speaker’s Bureau: F Hoffman-La Roche;Financial Interests, Personal, Speaker’s Bureau: Janssen;Financial Interests, Personal, Speaker’s Bureau: Medscape;Financial Interests, Personal, Speaker’s Bureau: Merck Sharp & Dohme;Financial Interests, Personal, Speaker’s Bureau: Merck Serono;Financial Interests, Personal, Speaker’s Bureau: Peervoice;Financial Interests, Personal, Speaker’s Bureau:Pfizer;Financial Interests, Personal, Speaker’s Bureau: Springer;Financial Interests, Personal, Speaker’s Bureau: Touch MEdical;Other, Personal, Other, Independent member of the board: GRIFOLS. A. Rodríguez-Lescure: Financial Interests, Personal, Advisory Role: Roche;Financial Interests, Personal, Advisory Role: Pfizer;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Institutional, Funding: Roche;Financial Interests, Institutional, Funding: Novartis;Financial Interests, Institutional, Funding: Pfizer;Financial Interests, Institutional, Funding: Lilly;Financial Interests, Institutional, Funding: Astra Zeneca;Financial Interests, Institutional, Funding: Amgen;Financial Interests, Institutional, Funding: MSD;Financial Interests, Institutional, Funding: Bristol-Myers Squibb;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Merck;Other, Personal, Other, Travel, accommodations: Roche;Other, Personal, Other, Travel, accomodations: Pfizer. M.E. Elez Fernandez: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: Array Biopharma;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Hoffman La- Roche;Financial Interests, Personal, Advisory Board: Merck serono;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Servier;Financial Interests, Institutional, Research Grant: Abbvie;Financial Interests, Institutional, Research Grant: Amgen;Financial Interests, Institutional, Research Grant: Array Pharmaceuticals;Financial Interests, Institution l, Research Grant: AstraZeneca;Financial Interests, Institutional, Research Grant: Boehringer Ingelheim;Financial Interests, Institutional, Research Grant: Bristol-Myers Squibb;Financial Interests, Institutional, Research Grant: GlaxoSmithKline;Financial Interests, Institutional, Research Grant: Hoffman La-Roche;Financial Interests, Institutional, Research Grant: Medimmune;Financial Interests, Institutional, Research Grant: Merck Serono;Financial Interests, Institutional, Research Grant: MSD;Financial Interests, Institutional, Research Grant: Novartis;Financial Interests, Institutional, Research Grant: Pierre-Fabre;Financial Interests, Institutional, Research Grant: Sanofi Aventis. All other authors have declared no conflicts of interest.

Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM).

BACKGROUND: Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS: Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS: In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS: Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.