ABSTRACT
Introduction Literature on the impact of COVID-19 on cancer patients pointed towards an increase in uncertainty, anxiety, fear and distress. Our aim was to analyze cancer patient-reported experiences through a qualitative approach to identify their potential concerns, needs and resources during the pandemic and to evaluate their levels of distress and resilience. Methods Semi-structured telephone interviews were conducted after the second wave, March to July 2021, with cancer patients from three hospitals in the French-speaking part of Switzerland. Transcripts were analyzed using an iterative thematic analysis approach. Quantitative data included measurement of distress and resilience by the NCCN distress thermometer and the 2-item Connor-Davidson Resilience Scale. Results Patients with lung, breast, colon cancer or melanoma were included (n=35). Mean distress score was 2 (SD=2.1) and mean resilience score was 6.7 (SD=1.3). Thematic analysis highlighted five themes evoking changes in life, concerns, cancer care, resources and vaccination. Conclusions Cancer patients from the French-speaking part of Switzerland reported relatively low distress and high resilience. Nevertheless, interviews revealed COVID-related elements having an influence on patients' lives and trajectory of care. These results allow for a better understanding of the cancer patients' experiences during the COVID-19 pandemic in Switzerland and provide suggestions for better support.
ABSTRACT
During the COVID-19 pandemic, psychotrauma and its potential sequelae, such as posttraumatic stress disorder (PTSD), are of increased concern to family medicine. Trauma exposure and PTSD both increase the risks of a broad range of physical diseases. The knowledge of these diseases supports targeted prevention and early diagnosis. This paper provides a brief overview of diseases associated with psychotrauma and PTSD. The identified diseases include inadequate immune response, infectious diseases, dermatoses, cardiovascular and pulmonary diseases, cancer, metabolic dysfunction, traumatic brain injury, pain disorders, and musculoskeletal, gastrointestinal, and urogenital disorders. Various possible relationships between trauma exposure, PTSD, and somatic disorders are highlighted. Not only can trauma exposure and PTSD increase the risk for or be a consequence of illnesses, but also affect the course of sequelae or comorbid diseases and their treatment. Family physicians play an essential role in the health care of patients with traumatic experiences or PTSD. Knowledge of the associations between trauma exposure, PTSD, and somatic diseases can facilitate targeted prevention of somatic diseases, early diagnosis, and structured treatment planning for multimorbid patients. © Deutscher Ärzteverlag ;ZFA ;Zeitschrift für Allgemeinmedizin.
ABSTRACT
Purpose or Objective It has been shown that the COVID-19 pandemic during 2020 has prompted the quality of cancer care, as it induced more cases of late diagnosis of many cancers, in particular HN cancer. As consequence, these delays in diagnosis and treatment initiation may impact the prognosis. Aim of this study is to analyse features of the pts treated for an HN cancer in 2020 during the COVID-19 in our RO department, and to compare these patients with those treated in 2019, in order to highlight differences in staging and prognosis. Materials and Methods We analysed the electronic charts of patients addressed for curative RT-CT to our Dpt for a HN cancer in 2019 and in 2020. We performed a descriptive analysis for demographics and staging and we compared pts using a two-tailed Fisher's exact test. The chi-square test was used to compare the distribution of the clinical features of the patients. A p-value of >0.05 was considered as statistically significant. Results A total of 48 pts were addressed to our Department, 21 in 2019 and 27 in 2020. Median age was 63.6 years (38 - 88) in 2019 and 60.3 (30-78) years in 2020 (p-value = NS) Table 1 summarized data of the pts. Patients features 2019 2020 p-value (Chi square test) Male/Female ratio 19/2 22/5 NS P16 status (positive/negative/NA) 7/3/11 6/10/11 NS T stage distribution (T1/T2/T3/T4) 4/6/4/7 3/4/5/15 NS N stage distribution (N0/N1/N2/N3) 9/4/6/2 7/5/12/2 NS TNM stage (I/II/III/IV) 3/7/3/8 3/2/6/16 NS We found significantly more pts with advanced diseases (stage III-IV) in 2020 when compared to 2019 (22 vs 11), in particular because of a higher number of T4 tumors (15 vs 7) and N2 tumors (12 vs 6) in patients treated in 2020. The small samples of our populationn could explain the lack of significativity. Fig 1 shows the 2X2 contingency table for the Ficher's exact test. $Φg Conclusion In our analysis, pts addressed to our Dpt for a HN cancer in 2020 presented more advanced stages when compared to 2019. The follow-up of pts was too short to present data on LC and OS in this abstract, but clinical data will be presented during the congress.
ABSTRACT
The drug discovery process currently employed in the pharmaceutical industry typically requires about 10 years and $2-3 billion to deliver one new drug. This is both too expensive and too slow, especially in emergencies like the COVID-19 pandemic. In silico methodologies need to be improved both to select better lead compounds, so as to improve the efficiency of later stages in the drug discovery protocol, and to identify those lead compounds more quickly. No known methodological approach can deliver this combination of higher quality and speed. Here, we describe an Integrated Modeling PipEline for COVID Cure by Assessing Better LEads (IMPECCABLE) that employs multiple methodological innovations to overcome this fundamental limitation. We also describe the computational framework that we have developed to support these innovations at scale, and characterize the performance of this framework in terms of throughput, peak performance, and scientific results. We show that individual workflow components deliver 100 × to 1000 × improvement over traditional methods, and that the integration of methods, supported by scalable infrastructure, speeds up drug discovery by orders of magnitudes. IMPECCABLE has screened ∼1011 ligands and has been used to discover a promising drug candidate. These capabilities have been used by the US DOE National Virtual Biotechnology Laboratory and the EU Centre of Excellence in Computational Biomedicine. © 2021 ACM.
ABSTRACT
Background: Early in March, NYC Hospitals became inundated, especially safety net public hospitals, The physicians at Elmhurst Hospital Center (EHC) encountered countless cases of respiratory failure often accompanied by AKI. Autopsy studies from China described an interstitial nephritis, with macrophage infiltrates and complement deposition along with fibrotic changes. We report our experience with COVID-19 and AKI. Methods: We reviewed the charts of 137 SARS-CoV-2 positive patients (PCR of a nasopharyngeal sample) admitted to EHC 3/7/2020 - 4/7/2020. We categorized patients as having KDIGO defined AKI vs no AKI within the first seven days of admission. Comorbidities, renal associated markers and inflammatory markers were anlayzed. Clinical outcomes were assessed. Exclusion criteria: <18 years old, pregnant, ESRD, mortality prior to day 7 of hospitalization. Welch T test and Chi square were used for AKI vs non-AKI Results: Age was similar in both groups as was gender (male 74% vs 79%) and incidence of diabetes. Early AKI developed in 35% of whom 55% needed RRT;85% of the AKI patients required mechanical ventilation vs 11.2% of the non-AKI group. Inflammatory markers (WBC, CRP, LDH);urine protein and urine white cells (but not CPK) were significantly higher in the AKI group. Procalcitonin and D-dimers as maximum levels became significant. We found that 20% of those not with early AKI developed late-onset AKI. Mortality was 76.7% in the AKI and 17.9% in the non-AKI group. Conclusions: Early AKI developing in the first week of hospitalization was associated with overwhelming respiratory failure. The accompanying higher inflammatory markers, elevated urine WBCs and protein could implicate interstitial nephritis as an underlying pathology as described earlier.