ABSTRACT
The COVID-19 pandemic has been at the center of the lives of many of us for at least a couple of years, during which periods of isolation and lockdowns were common. How all that affected our mental well-being, especially the ones' who were already in distress? To investigate the matter we analyse the online discussions on Sanctioned Suicide, a forum where users discuss suicide-related topics freely. We collected discussions starting from March 2018 (before pandemic) up to July 2022, for a total of 53K threads with 700K comments and 16K users. We investigate the impact of COVID-19 on the discussions in the forum. The data show that covid, while being present in the discussions, especially during the first lockdown, has not been the main reason why new users registered to the forum. However, covid appears to be indirectly connected to other causes of distress for the users, i.e. anxiety for the economy. © 2023 ACM.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Material(s) and Method(s): This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Result(s): Charts of 5,164 EC patients were retrieved. Overall, 2,718 and 2,446 women with EC received treatment in period 1 and 2, respectively. The prevalence of patients aged > 65 years was similar between the 2 study periods (1,400 [51.5%] in period 1 vs. 1,248 [51.0%];p=0.726). Considering data on the histological characterization, the prevalence of endometrioid FIGO grade 1, 2, and 3 was consistent over the study period (p=0.855). However, the prevalence of non-endometrioid EC was lower in period 1 than in period 2 (15.6% vs. 17.9%;p=0.032). Surgery was the mainstay of treatment before and during the COVID-19 pandemic. Overall, 2,539 and 2,286 women received surgery in period 1 and 2, respectively (93.4% vs. 93.5%;p=0.948). Primary conservative attempts (i.e., progesterone-based therapy) was performed in 72 (2.7%) and 56 (2.3%) patients in period 1 and 2, respectively (p=0.406). The adoption of minimally invasive surgery was consistent in the two study periods (p=0.976). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). The adoption of vaginal brachytherapy as adjuvant treatment remained stable in the study periods (11.9% vs. 11.1%;p=0.325). Adjuvant therapies indication has increased during the COVID-19 pandemic (p<0.001). In particular, the use of adjuvant radiotherapy (26.8% vs. 30.7%;p=0.001) and chemotherapy (25.1% vs. 30.1%;p<0.001) alone or in combination increased from period 1 to 2. Conclusion(s): Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.
ABSTRACT
Background: COVID-19 outbreak has correlated with the disruption of screening activities, regular follow up visits, and diagnostic assessments. The risk of misdiagnosis and delayed diagnosis has consequently increased during the pandemic. Endometrial cancer is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms (e.g. abnormal vaginal bleeding). Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of endometrial cancer patients. Material and methods: This is a retrospective study involving 53 centers in Italy. We evaluated patterns of presentation and treatment of endometrial cancer patients before (i.e. period 1: from 03/01/2019 to 02/29/2020) and during (i.e. period 2: from 01/04/2020 to 3/31/2021) the COVID-19 outbreak. Results: Medical records of 5,117 endometrial cancer patients have been retrieved: 2,688 and 2,429 women treated in period 1 and period 2, respectively. The prevalence of endometrioid International Federation of Obstetrics and Gynecologists (FIGO) grade 1, 2, and 3 was consistent over the study period (p=0.769). However, the prevalence of non-endometrioid endometrial cancer was lower in period 1 than in period 2 (15.7% vs. 17.9%;p=0.015). The characteristics and pattern of different surgical approaches were consistent in the two study periods (p=0.664). Before COVID-19 pandemic, 1,838 (73.2%), 647 (25.7%), and 25 (0.9%) patients had minimally invasive, open and vaginal surgery, respectively. During the COVID-19 pandemic, 1,661 (73.2%), 567 (24.9%), and 41 (1.8%) patients had minimally invasive, open, and vaginal surgery, respectively. Nodal assessment was omitted in 684 (27.3%) and 478 (21%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.8% in period 1 vs. 53.1% in period 2;p<0.001). Adjuvant therapy was omitted in 1,269 (50.5%) and 1,019 (44.9%) patients receiving treatment in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during the COVID-19 pandemic (p<0.001). Conclusions: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of endometrial cancer patients. These findings highlight the need to implement healthcare services during the pandemic.
ABSTRACT
ObjectiveSeveral attempts are done in order to control COVID-19 and promote a fair allocation of resources during the outbreak. The Italian society of obstetrics and gynecologist (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) are promoting research activities in the field of gynecologic oncology on a national basis, even in the era of COVID-19.MethodsThe SIGO and MITO group promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and the implementation of containment measures of COVID-19 diffusion.ResultsOverall, 604 participants completed the questionnaire with a response rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize the in-hospital diffusion of COVID-19. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease in the use of laparoscopy in favor of open (19%) and vaginal (2%) surgery. Interestingly, about 5% of the participants stated that the use of laparoscopic surgery has increased during the COVID-19 outbreak. However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10–15%), and to perform less radical surgical procedures (20–25%) during COVID-19 pandemic.ConclusionsInternational cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is giving rise to a relevant impact on the wellbeing and mental health of several Health Care Providers (HCPs). Among HCPs, those who work in the field of obstetrics repre-sent a particular group of HCPs who are susceptible to stressful events, given the stress derived from a physically, emotionally, and intellectually demanding work, the difficulty in reschedul-ing and postponing daily activities during a health emergency, and the special ability to develop personal resilience. Based on this background, the aim of the present study is to assess the acute psychological and professional impact of the SARS-CoV-2 outbreak on this group of HCPs at four University Hospitals in Italy (Verona, Roma Policlinico Gemelli, Varese, Brescia). For this purpose, a 104-items survey named Impatto PSicologico Covid in Ostetricia (IPSICO) has been developed and administered with a web-based platform. This survey, divided into four sections, will collect demographic data and information about past personal and mental health history, the impact of the epidemic on the personal and professional life, and the outcomes of this health care emergency. The results of this survey will help to plan effective strategies in order to face the psychological consequences of possible future new health care emergencies of this type.