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1.
J Gynecol Oncol ; 33(1): e10, 2022 01.
Article in English | MEDLINE | ID: covidwho-1573883

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. METHODS: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. RESULTS: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). CONCLUSION: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.


Subject(s)
COVID-19 , Endometrial Neoplasms , Endometrial Neoplasms/epidemiology , Endometrial Neoplasms/therapy , Female , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
2.
J Surg Oncol ; 122(2): 122-123, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1064394

ABSTRACT

At the beginning of 2020, coronavirus disease 2019 (COVID-19) spreads worldwide. Patients with ovarian cancer should be considered at high-risk of developing severe morbidity related to COVID-19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID-19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.


Subject(s)
Coronavirus Infections/prevention & control , Ovarian Neoplasms/surgery , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Surgical Oncology/methods , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Female , Gynecologic Surgical Procedures/methods , Gynecologic Surgical Procedures/standards , Humans , Infection Control/methods , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Laparoscopy/methods , Laparoscopy/standards , Ovarian Neoplasms/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Surgical Oncology/standards
5.
J Minim Invasive Gynecol ; 28(8): 1519-1525, 2021 08.
Article in English | MEDLINE | ID: covidwho-988422

ABSTRACT

STUDY OBJECTIVE: There are growing concerns regarding the potential risk of coronavirus disease transmission during surgery and in particular during minimally invasive procedures owing to the aerosolization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) particles. However, no study has demonstrated this hypothesis. Here, we aimed to investigate the presence of SARS-CoV-2 in surgical smoke. DESIGN: A prospective pilot study. SETTING: A tertiary cancer center in northern Italy. PATIENTS: Overall, 17 patients underwent laparoscopic procedures for the management of suspected or documented gynecologic malignancies. The median age was 57 years (range 26-77). The surgical indications included endometrial cancer (n = 11), borderline ovarian tumor (n = 3), early-stage ovarian cancer (n = 1), stage IA cervical cancer after diagnostic conization (n = 1), and an ovarian cyst that turned out to be benign at final histologic examination (n = 1). INTERVENTIONS: We evaluated all consecutive women scheduled to have laparoscopic procedures for suspected or documented gynecologic cancers. The patients underwent planned laparoscopic surgery. At the end of the laparoscopic procedures (after extubation), we performed reverse transcription-polymerase chain reaction (RT-PCR) tests for the detection of SARS-CoV-2 from both the endotracheal tube and the filter applied on the trocar valve. MEASUREMENTS AND MAIN RESULTS: In 1 patient, both swab tests (endotracheal tube and trocar valve filter) showed amplification of the N gene on RT-PCR analysis. This case was considered to be a presumptive positive case. In another case, the RT-PCR analysis showed an amplification curve for the N gene only in the swab test performed on the filter. No ORF1ab amplification was detected. CONCLUSION: Our study suggested the proof of principle that SARS-CoV-2 might be transmitted through surgical smoke and aerosolized native fluid from the abdominal cavity.


Subject(s)
COVID-19 , Laparoscopy , Adult , Aged , Female , Humans , Middle Aged , Pilot Projects , Prospective Studies , SARS-CoV-2 , Smoke/adverse effects
6.
J Gynecol Oncol ; 31(6): e92, 2020 11.
Article in English | MEDLINE | ID: covidwho-881380

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. METHODS: The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. RESULTS: Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%-15%), and to perform less radical surgical procedures (20%-25%) during COVID-19 pandemic. CONCLUSIONS: National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.


Subject(s)
Coronavirus Infections/prevention & control , Gynecology/methods , Infection Control/methods , Medical Oncology/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/transmission , Female , Genital Neoplasms, Female/therapy , Gynecologic Surgical Procedures/statistics & numerical data , Humans , International Cooperation , Italy , Pneumonia, Viral/transmission , SARS-CoV-2 , Societies, Medical , Surveys and Questionnaires , Triage/methods , Triage/statistics & numerical data
7.
Vaccines (Basel) ; 8(3)2020 Aug 02.
Article in English | MEDLINE | ID: covidwho-714559

ABSTRACT

In the present paper, Mohosen et al. [1] reviewed the evidence of the interaction between virus-like particles (VLPs) and the innate immune system. [...].

8.
Gynecol Oncol ; 158(2): 262-265, 2020 08.
Article in English | MEDLINE | ID: covidwho-592398

ABSTRACT

OBJECTIVE: SARS-CoV-2 pandemic is continuing to spread. There are growing concerns on the impact of COVID-19 in cancer patients. Several papers reporting recommendations and guidelines are published. But few data on cancer patients affected by COVID-19 are available. METHODS: This is a retrospective study including all consecutive patients affected by gynecological cancer who developed COVID-19. All patients were treated in an academic setting (in Milan, Lombardy, Italy) between February and March 2020. RESULTS: Overall, 355 patients had active treatment during the study period due to newly diagnosed or recurrent gynecological disease. Among those, 19 (5.3%) patients affected developed COVID-19. All patients were asymptomatic at the time of COVID-19 detection. Six patients were diagnosed before starting planned treatments; while the remaining 13 were diagnosed for COVID-19 after their started their treatments. Considering the first group of six patients, one patient died due to COVID-19 3 days after the diagnosis; while the other patients recovered from COVID-19 after a median of three weeks. The latter group of 13 patients (treatments started) included five patients who underwent surgery and eight patients who underwent chemotherapy. Focusing on five patients who were diagnosed after surgery, we observed that two patients died during postoperative course, while in other two cases prolonged hospitalization was needed. One patient had no issues. Chemotherapy was delayed for the remaining patents without sequelae. CONCLUSIONS: Our report highlights that COVID-19 impacts the quality of treatments for cancer patients. Mortality rate is high, especially after surgery. More important, patients under active treatment for cancer are at high risk of developing severe evolution of COVID-19. Prioritizing patients journey during COVID-19 is of paramount importance.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Genital Neoplasms, Female/epidemiology , Genital Neoplasms, Female/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , COVID-19 , Female , Genital Neoplasms, Female/therapy , Humans , Italy/epidemiology , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
9.
J Gynecol Oncol ; 31(4): e72, 2020 07.
Article in English | MEDLINE | ID: covidwho-381768

ABSTRACT

The World Health Organization (WHO) classified the novel coronavirus (i.e., coronavirus disease 2019 [COVID-19]) as a global public health emergency. COVID-19 threatens to curtail patient access to evidence-based treatment. Medicine is changing, basically due to the limited available resources. In the field of gynecologic oncology, we have to re-design our treatments' paradigm. During COVID-19 pandemic outbreak, the highest priority is to achieve the maximum benefit from less demanding procedures. Extensive procedures should be avoided, in order to reduce hospitalization and postoperative events that might increase the in-hospital spread of the virus. There are ongoing concerns on the use of laparoscopic procedures, related to the possible contamination of the staff working in the operation room. Other minimally invasive techniques, including, vaginal surgery as well as robotic-assisted and isobaric procedures would be preferred over laparoscopy. A fair allocation of resources is paramount adequate treatments.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Disease Outbreaks/prevention & control , Genital Neoplasms, Female/therapy , Pneumonia, Viral/therapy , COVID-19 , Coronavirus Infections/epidemiology , Disease Outbreaks/statistics & numerical data , Female , Genital Neoplasms, Female/epidemiology , Guidelines as Topic , Gynecology/standards , Humans , Oncologists/standards , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2
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