Factors Influencing Delayed Treatment in Patients With Breast Cancer During COVID-19 Pandemic.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has endangered human health and life. This pandemic has changed people's lifestyle and affected the regular delivery of standard cancer treatment. In the present study, we aimed to explore the influencing factors of delayed treatment in patients with breast cancer during COVID-19 pandemic. Methods: This study was a cross-sectional investigation, and the subjects were patients who were discharged from the department of burn and plastic surgery after February 2020. All participants completed this study's online questionnaire based on the WeChat and Wenjuanxing platforms. Levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Patients were divided into a delay group and non-delay group according to the occurrence of delayed treatment. Univariate analysis was performed by using the t test or chi-square test. A logistic regression model was employed to determine factors associated with delayed treatment. Results: The present study included a total of 397 patients with breast cancer, among whom delayed treatment occurred in 76 patients, accounting for 19.1%. Scores on both the anxiety subscale and depression subscale in delay group were significantly higher than those in non-delay group. Compared with non-delay group, we found that patients in delay group usually had a higher level of education (P = 0.020), worse self-feeling (P = 0.030), poor compliance of medical order (P = 0.042), and a higher prevalence of anxiety (P = 0.004) and depression (P = 0.012). Traffic inconvenience was also an important relevant factor for delayed treatment (P = 0.001). The prevalence of recurrence in delay group was higher than that in non-delay group (P = 0.018). By using logistic multivariate regression analysis, the results revealed that level of education and traffic inconvenience were independent factors influencing delayed treatment in patients with breast cancer during COVID-19 pandemic. Conclusion: The prevalence of delayed treatment in patients with breast cancer during COVID-19 pandemic is relatively high. Our findings reveal several influencing factors closely associated with delayed treatment, which is useful information that will be beneficial for patients to receive standardized therapy by taking targeted measures.

Psychological Status Among Anesthesiologists and Operating Room Nurses During the Outbreak Period of COVID-19 in Wuhan, China.

Background: Coronavirus Disease 2019 (COVID-19) caused by a novel strain of coronavirus (SARS-CoV-2) posed a major threat to public health. Anesthesiologists and operating room (OR) nurses are at high risk of occupational exposure to SARS-CoV-2 and developing COVID-19. We conducted a single-center survey to investigate the psychological status and perceived social support among operation room (OR) medical staffs during the outbreak of Coronavirus Disease 2019 (COVID-19). Methods: A total of 197 OR medical staffs were enrolled in the survey. The authors performed a cohort study during the period of Wuhan lockdown and then conducted a longitudinal follow-up after lifting of lockdown. The Patient Health Questionaire-9 (PHQ-9) was used to assess for depression and Generalized Anxiety Disorder-7 (GAD-7) for anxiety. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess perceived social support. We compared the psychological status of OR medical staffs before and after lifting of Wuhan lockdown. Results: During the period of city lockdown, 177 (89.8%) had close contact with confirmed COVID-19 cases. The prevalence of depression and anxiety in OR medical staffs was 41.6 and 43.1% under Wuhan lockdown, while 13.2 and 15.7% after lifting of lockdown (P = 0.002, P = 0.004). Logistic regression analysis showed that being female, living in suburb areas, shortage of protective equipment and close contact with COVID-19 patients were associated with a higher risk of depression and anxiety. Perceived social support was negatively correlated with depression and anxiety severity in the OR medical staffs (P < 0.05). Conclusions: OR medical staffs exhibited high incidence of anxiety and depression faced with the high risk of exposure to COVID-19 patients. More social support and social recognition for anesthesiologists and OR nurses might potentially help them relieve their psychological pressure.

Correlation analysis of risk factors and GSI score of a medical team assisting Wuhan city during the epidemic of COVID-19 in China -A cohort study (preprint)

Importance: There are few studies on the psychological status of medical staff during the COVID-19 outbreak. This study is the first in the world about the psychological status of the medical team during the COVID-19 outbreak. Objective: To study the correlation between risk factors and general symptom index (GSI) score of medical team members who support Wuhan against COVID-19. Design: Cohort study. Setting: Population-based. Participants: Anhui Province sent a total of eight medical teams,including 1382 members,to support Hubei Province. We adopted a stratified sampling method and selected the fourth team sent by Anhui Provincial Hospital, with a total of 137 members as our subjects. Exposures: Four main exposures were collected, including basic information, preparations before going to Wuhan, life issues and working issues after going to Wuhan. Main Outcomes and Measures: The GSI score of SCL-90 scale was used to reflect the frequency and intensity of psychological symptoms. We made the hypothesis of this study before data collection. Results: 110(80.29%) members completed the questionnaire, of which, 77(70.00%) female and 33(30.00%) male. When adjusted age, gender and covariates, DC, LCWT had a positive correlations with GSI score(beta was 10.17, 95%CI was 3.30 to 17.04 for DC, P=0.00<0.05;beta was 11.55, 95%CI was 0.40 to 22.71 for LCWT, P =0.04<0.05;respectively), RBT had a negative positive correlation with GSI score (beta was -28.09, 95%CI was -45.79 to -10.40, P=0.00<0.05), AoBI did not had a correlation with GSI score (beta was 11.55, 95%CI was 0.40 to 22.71, P=0.16>0.05). When adjusted covariates, DC had a positive and RBT had a negative correlation with GSI score of female (beta was 13.20, 95%CI was 4.55 to 21.85, P=0.00<0.05; beta was -57.85, 95%CI was -94.52 to -21.18, P=0.00<0.05; respectively), but for male was not (P=0.59>0.05, P=0.08>0.05, respectively), LCWT and AoBI didn't had correlation with GSI score between genders (P>0.05). Conclusions and Relevance: Improving DC, RBT and decreasing LCWT can reduce the GSI score. AoBI didn't affect the psychological status; male members have a more stable mood than female. Whether other countries medical team has the same result still needs further research.