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ACTA MEDICA PORTUGUESA ; 35(7-8):606-607, 2022.
Article in English | Web of Science | ID: covidwho-1939526
European Respiratory Journal ; 58:2, 2021.
Article in English | Web of Science | ID: covidwho-1700031
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407117
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277604


RATIONALE: Coronavirus Disease 2019 (COVID-19) that has caused an ongoing pandemic, is diagnosed by realtime reverse transcriptase polymerase chain reaction (RT-PCR). Computed tomography (CT) scans have shown typical changes of the disease but there is limited data comparing CT scan findings with COVID-19 clinical severity and illness duration. The study aims to determine the common chest CT findings of COVID-19 pneumonia in association with clinical severity and duration of symptoms.METHODS: This is a single-center, retrospective study including all adult patients with COVID-19 pneumonia, admitted from March 2020 to August 2020, with baseline RT-PCR and chest CT scan. Demographic data and CT scan findings were tabulated and analyzed using STATA 13.1.RESULTS: In this study of 304 patients, majority were above 60 years old (49%), male(62%), non-smokers (72.6%) with associated hypertension(56%) and diabetes mellitus(34%). Most common symptoms were cough (82%), dyspnea (76%) and fever (69%). Predominant chest CT patterns of COVID-19 pneumonia were ground glass opacity (GGO) (65%) and consolidation (39%) in bilateral, peripheral, and lower lobe distribution. Moderate group had higher GGO (72%, p0.047), unilateral (10%,p0.001) and peripheral distribution (68%,p0.001). Severe to critical groups had higher consolidation, number of lobes (>4 lobes), and diffuse involvement. Subjects with less than 14 days of symptoms, had more GGO. Those with more than 4 days of symptoms, had CT findings that were bilateral, more than 4 lobes, and extending to middle and upper lobes.CONCLUSION: Chest CT patterns typical of COVID-19 pneumonia and their extent of involvement were associated with clinical severity and illness duration. A simple Chest CT scan would help support physicians' decision making and prognostication.

Journal of Thoracic Oncology ; 16(3):S285-S286, 2021.
Article in English | EMBASE | ID: covidwho-1159457


Introduction: The first patient with COVID-19 in Portugal was diagnosed on March 2. There was a lack of knowledge concerning the risks of COVID-19 infection in lung cancer patients, prognostic factors, the influence of cancer treatments and cure criteria. Treatments and consultations were readjusted in order to maintain the ones that increase patients’ survival, while reducing the risks of SARS-CoV-2 infection. International and national “guidelines” were followed, but each hospital had its own strategies to reduce COVID-19 risk. Purpose: The Portuguese Lung Cancer Study Group launched a survey in order to study the early impact of COVID-19 in lung cancer patients, changes in treatments and the way of implementation of COVID-free circuits. Methods: A survey was sent to lung cancer doctors of all the Portuguese hospitals. Results: At the data cut-off, information from twenty one hospitals was collected, corresponding to about 66% (n=3.446) of each year new diagnoses of lung cancer in Portugal. In March and April there was a reduction in newly lung cancer diagnosed patients while comparing with 2019: in March, 86% had a reduction;in April, 90% of the hospitals reported a reduction and it was greater than 40% in eight hospitals (38%). About 62% of the doctors considered less referral from primary care as a cause, and 33% delayed biopsies or other imaging exams. The most difficult exams to obtain were CT guided biopsies and EBUS for 48%. The majority of the hospitals (57%) were also referral for COVID-19 patients’ treatment. In 48% of the lung cancer treating departments’ there were doctors reallocated to COVID-19 treatment areas. In 48% the assistance teams were divided into teams that weren’t previously working together. The majority of doctors (90%) reported having individual protection equipment available. Hospitals performed teleconsultation (100%), and, in seven hospitals (33%), more than half of the consultations were done using communication technology. All the hospitals were able to perform SARS-CoV-2 testing. It was done before every cycle of chemotherapy in 90% of the hospitals. In the majority (67%) it was only performed before day D1, in D1 and D8 chemotherapy protocols. About 19% reported changes in prescription of adjuvant chemotherapy and in maintenance chemotherapy, 33% increased the prescription of oral chemotherapy, 33% changed the periodicity, 29% reported reduction in inclusion in clinical trials. In 33% there was an earlier end of chemotherapy in ECOG2 and vulnerable patients. In 38% the prescription of G-CSF (Granulocity-colony stimulating factor) increased, being used for prophylaxis if the risk of febrile neutropenia was more than 10-15%. The periodicity of consultations was changed for patients under TKI treatment in 86%, and 67% hospitals reported changes in immune checkpoint inhibitor treatment schedule. In 29% oral drugs could be delivered at patients’ home. All the patients admitted for surgery were tested for SARS-CoV-2, and 86% performed SARS-COV-2 testing before radiotherapy. Conclusion: Portuguese hospitals responded to the sudden need of creation of COVID-free circuits, change protocols and even teleconsultation. With a larger follow up we will study the late consequences of COVID-19 pandemic in lung cancer diagnosis and treatment. Keywords: COVID-19, survey, Portuguese Lung Cancer Study Group