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Blood ; 136(Supplement 1):21-21, 2020.
Article in English | PMC | ID: covidwho-1339047


BackgroundCOVID-19 pandemic disrupted heath care system all around the world and overwhelmed the capacity of hospital to manage regular patients including cancer patients. We implemented a new program to help managing oncology patients visited our Emergency Rooms (ER) and discharged home.MethodsOur home care program designed to cover all aspects of patients care while they are at home by checking the ER list on daily basis and identify all oncology patients on this list. We developed an algorithm, to follow up our patients and the COVID-19 test status and to act accordingly (figure 1). The team consists of oncologist, oncology nurse specialists, patient educator and data management person. The primary oncologist of each patient is notified and consulted on the plan. The team follows the result and decide further steps of management accordingly. The intervention includes regular clinical assessment by calling the patient, arranging medication delivery, sending patients brochures explaining the necessary protective measured needs to be taken by patient and care givers and respond to patient and family queries and concerns.ResultsBetween May 31 and July 31, 237 oncology patients seen in ED with different clinical presentations. One hundred forty two patients did not need admission and therefore discharged home. COVID-19 test was carried out according to the presenting symptoms and ARI score (test requested if score is 4 or more). Only 30 patients (21%) needed COVID-19 testing prior to discharge from ED and 6 patients tested positive. However, on our follow of those patients at home further 16 patients (11%) needed to be tested due to new developments of their symptoms and 3 patients tested positive. The main reasons for nor requesting COVID-19 for some patients either 1) recent testing in outpatient clinics or other health centers outside our institution Ministry of Health, 2) they are known to have covid-19 and still in active infection, 3) based on patient`s MRP decision not to swab patient for COVID -19. During our daily monitoring of patients at their homes, 12 patients (8%) were called back due to worsening of their symptoms and needed further assessment and management after discussion with their MRP. As per our infection control department guidelines, repeating COVID-19 testing for asymptomatic patients was not necessary and patient can be discharged from our records. This new model of care in our institution was presented to the COVID-19 pandemic command center and the program got the approval and recommended to be implemented in other departments as per patients need.ConclusionOncology patients are vulnerable especially at this time of COVID-19 pandemic and our program is designed to reduce the risk of exposure and infection by looking after those patient while they are at home in addition to maintain the continuity of their cancer management.Figure

Bone Marrow Transplant ; 56(9): 2144-2151, 2021 09.
Article in English | MEDLINE | ID: covidwho-1205432


The coronavirus disease-2019 (COVID-19) caused by SARS Coronavirus 2 (SARS-CoV-2) is a potentially lethal infection. Cancer patients, and specifically hematopoietic cell transplant (HCT) recipients are severely immunocompromised and may be at a higher risk of a complicated course with this infection. We aimed to study the COVID-19 outcomes and severity in post HCT patients. We retrospectively reviewed post-HCT patients diagnosed with COVID-19 between March 15, 2020, and December 1, 2020 at 10 transplant centers across the Middle East. We identified 91 patients with confirmed SARS-CoV-2 infection across 10 transplant centers. The median age upon presentation with COVID-19 was 35. Fifty two patients were post allo-HCT while the remaining 39 patients were post auto-HCT. The median time from transplant was 14.9 months. Mortality rate was 4.4%. Hospital admission rate was 53%. ICU admission rate was 14%. Mechanical ventilation rate was 10%. Oxygen supplementation rate was 18%. Time from HCT to COVID-19 >6 months was associated with lower admission rates and lower rates of the "severity" composite endpoint. Antibody responses was seen 67% of evaluable patients. In this series of HCT recipients, we report overall favorable clinical outcomes for patients with COVID-19 and provide preliminary insights into the clinical course of this disease in this specific population.

COVID-19 , Hematopoietic Stem Cell Transplantation , Humans , Retrospective Studies , SARS-CoV-2 , Transplant Recipients
Clin Lymphoma Myeloma Leuk ; 21(1): e66-e75, 2021 01.
Article in English | MEDLINE | ID: covidwho-718689


Histiocytic disorders are an exceptionally rare group of diseases with diverse manifestations and a paucity of approved treatments, thereby leading to various challenges in their diagnosis and management. With the discovery of novel molecular targets and the incorporation of targeted agents in the management of various adult histiocytic disorders, their management has become increasingly complex. In an attempt to improve the understanding of the clinical features and management of common adult histiocytic disorders (Langerhans cell histiocytosis, Erdheim-Chester disease, Rosai-Dorfman disease, and hemophagocytic lymphohistiocytosis), we created this document based on existing literature and expert opinion.

Erdheim-Chester Disease/drug therapy , Histiocytosis, Langerhans-Cell/drug therapy , Histiocytosis, Sinus/drug therapy , Lymphohistiocytosis, Hemophagocytic/drug therapy , Adult , Drug Therapy, Combination , Erdheim-Chester Disease/diagnosis , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Sinus/diagnosis , Humans , Lymphohistiocytosis, Hemophagocytic/diagnosis , Treatment Outcome