ABSTRACT
Worldwide, during COVID-19 pandemic, the healthcare professionals have been exposed to professional and existential stress. The aims of this study were to evaluate of the emotional impact, the degree of resilience of medical staff, immediately after exposure to the risk of COVID-19. Material and methods: e enrolled 64 participants (30 doctors and 34 nurses), from the Emergency Department of the "Sf. Spiridon" County Clinical Emergency Hospital from Iasi. Each participant completed a self-report 63 items questionnaire. Self-perceived stress, de-pression symptoms, anxiety symptoms were measured in our research. SPSS 27.0 software was used for data analysis. Results: We have identified statistically significant difference between medical doctors and nursed regarding the possibility of managing the critical situa-tion at the workplace and the difficulty understanding the situation at workplace. Sleep qual-ity, positive emotions and life satisfaction need to be improved to increase the psychological resilience of healthcare professionals working during the COVID-19 pandemic. Conclu-sions: Doctors constitute the group with the lowest levels of psychological resilience among health care workers. This study confirms the need to improve positive emotions and weaken negative emotions of healthcare professionals.
ABSTRACT
Background: The novel COVID-19 outbreak spread rapidly around the world. Cancer patients (pts) consist of a highly vulnerable group due to underlying malignancy and/or treatment-induced immunosuppression. A high mortality rate from COVID-19 in cancer pts was previously reported. France is the fourth most affected country, with more than 150,000 infected individuals and over 28,000 deaths. GCO-002 CACOVID-19 study is a large French nationwide cohort of COVID-19 pts with solid tumors with the aim to identify risk factors of COVID-19 severity and evaluate impact on cancer treatment. Methods: Bispective multicenter cohort set up by the French Cooperative Groups in solid cancers: ANOCEF-IGCNO (CNS tumors), ARCAGY-GINECO (gynecological and breast cancers), FFCD (digestive cancers), GERCOR (digestive and other solid cancers), GORTEC/intergroupe ORL (head and neck cancers (H&N), and IFCT (thoracic cancers). French pts with solid cancers and COVID-19 diagnosed since 1 March 2020 were accrued. Exclusion criteria: pts treated curatively > 5 years ago. Results: From 6 April to 15 May 2020, 835 pts from 136 institutions (general hospitals 35%, university hospitals 35%, private centers 25%, cancer centers 5%) were registered. Men: 61%, median age: 69 years (20-100). Digestive cancers: 43% (16%/9% colorectal/pancreatic cancers), lung cancers: 22%, gynecological: 14%, (9% breast cancers), H&N: 10%, CNS: 4%, urologic cancers: 3%. Advanced or metastatic: 61%. Within 3 months before COVID-19 diagnosis, 69% of pts received a systemic anticancer treatment (chemotherapy, targeted or immune therapy) and 22% a local therapy (surgery, radiotherapy or local destruction). Diagnosis of COVID-19 was confirmed by RT-PCR, CT-scan or both in 91% or serology in 1.4%. COVID was treated in the same oncological center in 78%. During the follow-up period (mean 14 days), 208 (25%) pts died, including 173 (21%) COVID-19 related deaths. Conclusions: This first nationwide study of cancer pts with COVID-19 from France reports a high mortality rate. Updated and detailed data on anti-cancer treatments, risk factors of severe and fatal COVID-19 and impact of COVID-19 on cancer management will be presented. Legal entity responsible for the study: Fédération Francophone de Cancérologie Digestive. Funding: Has not received any funding. Disclosure: A. Lièvre: Honoraria (self), Advisory/Consultancy: AAA;Amgen, Pierre Fabre;Sandoz;Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Bayer;Novartis;Honoraria (self): Celgene;HalioDx;Lilly;Honoraria (self), Travel/Accommodation/Expenses: BMS;Roche;Honoraria (self), Research grant/Funding (self): Incyte;Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen;Merck;Servier;Research grant/Funding (self): Integragen;Travel/Accommodation/Expenses: AAA;Pfizer. A. Turpin: Honoraria (self): Servier;Advisory/Consultancy: Mylan;Merck Serono;Amgen;Travel/Accommodation/Expenses: Merck;Sanofi;Pfizer;AstraZeneca. I.L. Ray-Coquard: Honoraria (self), Advisory/Consultancy: Abbvie;Agenus;Advaxis;Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution): BMS;MSD;Honoraria (self), Advisory/Consultancy: PharmaMar;Genmab;Pfizer;Deciphera;Mersena;Amgen;Tesaro;Clovis;Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Merck Serono;Novartis;Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca;Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche;Honoraria (self), Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: GSK;Non-remunerated activity/ies: GINECO;ENGOT;GCIG;European community;ESMO;ASCO;ESGO;IGSC;Inca;Swiss and German Health Authorities;Italian Health Authority;Belgium Health Authority. J. Thariat: Honoraria (self): BMS;Honoraria (institution), Travel/Accommodation/Expenses, Full/Part-time employment: Centre François Baclesse;Leadership role: President of the French Head and Neck Intergroup, GORTEC secretary;Non-remunerated activity/ies: Director of Easy-CRF society;Research grant/Funding (institution): Nanobiotix. G. Ahle: Travel/Accommodation/Expenses: Abbvie;Biogen;Novartis;Roche;Sanofi;Non-remunerated activity/ies: ANOCEF;NENO;AlSacEP. R. Mathieu: Honoraria (self), Research grant/Funding (self): Astellas;Honoraria (self): AstraZeneca;Ferring;Ipsen;Janssen;MSD;Pfizer;Sanofi;Takeda. D. Debieuvre: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer;Roche;Novartis;BMS;MSD;Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca;Honoraria (self), Research grant/Funding (institution): Chugaï;Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Boerhinger-Ingelheim;Research grant/Funding (institution): Chiesi;Sandoz;Takeda;GSK;Research grant/Funding (self): Lilly. A. Canellas: Honoraria (self), Advisory/Consultancy: BMS;Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca;Travel/Accommodation/Expenses: Oxyvie;LVL Medical;Boerhinger Ingelheim. A-C. Hardy-Bessard: Advisory/Consultancy: Clovis;Novartis;Roche;MSD;AstraZeneca;GSK. L. Mansi: Honoraria (institution), Advisory/Consultancy: Sandoz;Advisory/Consultancy: Roche;Eisai;Pfizer;Novartis;Speaker Bureau/Expert testimony: Exact Sciences;Travel/Accommodation/Expenses: Lilly. P. Gorphe: Honoraria (self): Intuitive Surgical;Non-remunerated activity/ies: Chair, scientific board, French Head and Neck Intergroup;Research grant/Funding (institution): MSD. A. IDBAIH Ahmed: Research grant/Funding (institution): Transgene;Sanofi;Air Liquide;Travel/Accommodation/Expenses: Carthera;Leo Pharma. G. Zalcman: Honoraria (self), Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: BMS;Honoraria (self), Honoraria (institution), Travel/Accommodation/Expenses: AstraZeneca;Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche;Honoraria (institution): Takeda;Travel/Accommodation/Expenses: Pfizer;AbbVie;MSD. O. Bouche: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Roche;Honoraria (self), Advisory/Consultancy: Merck KgaA;Bayer;AstraZeneca;Grunenthal;MSD;Honoraria (self), Speaker Bureau/Expert testimony: Amgen;Pierre Fabre;Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Servier. All other authors have declared no conflicts of interest.
ABSTRACT
Background: Patients with cancer are more susceptible to infection because of immunosuppressive treatment given to cure cancer. Several guidelines published at the beginning of the COVID-19 pandemic recommend delaying systemic anticancer treatment until complete resolution of COVID-19 symptoms. In addition, it is important to segregate patients with cancer from patients with COVID-19 to avoid transmission. Nevertheless, some patients will present both diseases, and the duration of eviction from cancer units and delay of cancer treatment after COVID-19 remains unclear. Notably the duration of viral excretion after COVID-19 is a concern in immunosuppressed patients. Methods: We tested all patients with a confirmed initial diagnosis of COVID-19 who needed to receive cancer or immunosuppressive treatment for a solid tumour, haematological or inflammatory disease in our centre from April 1st to May 15th 2020. We have repeated SARS-COV2 RT-PCR until negative viral shedding. Results: We tested 49 consecutive patients: 53% had solid tumours, 37% haematological disease and 10% inflammatory disease. 59% were under 65 years. Overall, 82% of patients had a positive RT-PCR from day 14 to 20 after the initial diagnosis of COVID-19 infection, 60% from day 21 to 27 and 30% from day 28 to 34. Only 4/37 patients evaluated remained with a positive RT-PCR after day 35. No predictive factors were associated with a positive RT-PCR but our results suggest that patients treated for inflammatory disease had a shorter duration of positive RT-PCR. 18 patients had their treatment delayed according to guideline recommendations and 17 patients received their treatment in a dedicated COVID-19 outpatient unit. No symptomatic COVID-19 recurrence was observed during follow-up in patients who had received chemotherapy despite persistent positive RT-PCR. Conclusions: We report here the first assessment of SARS-CoV2 RT-PCR kinetic in cancer patients. A prolonged viral excretion is observed in patients treated for cancer. A systematic retest is needed after day 14 if RT-PCR remains positive. A specific unit dedicated to outpatients with persistent positive RT-PCR allows urgent anticancer treatment and avoids the risk of viral exposure for other immunodepressed patients. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.