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ERJ Open Research ; 6(4):1-9, 2020.
Article | WHO COVID | ID: covidwho-917913


Objectives: The aim of this study was to validate a composed coronavirus disease 2019 (COVID-19) chest radiography score (CARE) based on the extension of ground-glass opacity (GG) and consolidations (Co), separately assessed, and to investigate its prognostic performance Methods: COVID-19-positive patients referring to our tertiary centre during the first month of the outbreak in our area and with a known outcome were retrospectively evaluated Each lung was subdivided into three areas and a three-grade score assessing the extension of GG and Co was used The CARE was derived from the sum of the subscores A mixed-model ANOVA with post hoc Bonferroni correction was used to evaluate whether differences related to the referring unit (emergency room, COVID-19 wards and intensive care unit (ICU)) occurred Logistic regression analyses were used to investigate the impact of CARE, patients’ age and sex on the outcome To evaluate the prognostic performance of CARE, receiver operating characteristic curves were computed for the entire stay and at admission only Results: A total of 1203 chest radiographs of 175 patients (120 males;mean age 67 81±15 5 years old) were examined On average, each patient underwent 6 8±10 3 radiographs Patients in ICU as well as deceased patients showed higher CARE scores (p<0 05, each) Age, Co and CARE significantly influenced the outcome (p<0 05 each) The CARE demonstrated good accuracy (area under the curve (AUC)=0 736) using longitudinal data as well as at admission only (AUC=0 740) A CARE score of 17 5 during hospitalisation showed 75% sensitivity and 69 9% specificity Conclusions: The CARE was demonstrated to be a reliable tool to assess the severity of pulmonary involvement at chest radiography with a good prognostic performance

Annals of Oncology ; 31:S1003, 2020.
Article | WHO COVID | ID: covidwho-806338


Background: The health emergency caused by the SarS-Cov-2 pandemic has a strong impact on oncological patients’ (pts) life The purpose of this study is to explore the emotional impact and pts’ perception experienced who accessed to our Oncology section at University Hospital and Trust of Verona (Italy) regarding these rules Methods: An questionnaire was designed by our Psycho-Oncology service and administered to all pts accessing to our outpatient facilities during a 21-days period (April 9th - April 30th, 2020) Two main areas were investigated: i) organizational aspects and ii) awareness about infection risks, protective strategies, and new rules adopted (14 items, plus demographic data) Percentage of relevant answers to questionnaire items are reported with 95% confidence intervals (95% CI) Results: Among 241 respondents, fear of accessing hospital facilities and that chemotherapy treatment could increase the infection risk was reported to be quite high or high in 34% (95% CI: 29-41%) and 27% (95% CI: 21-33%), respectively Awareness of disease-related risks of infection and strategies to reduce them was "very clear" or "fairly clear" [83% (95% CI: 78-88%) and 93% (95% CI: 90-96%), respectively] Availability of medical personnel to be contacted while not in hospital was perceived as "very high" Almost all pts felt that organizational measures were clearly expressed (98%, 95% CI: 96-100%) and mainly obtained through the information received at the triage (73%, 95% CI: 67-79%) Overall acceptance of these measures was very high (>70%) Of note, the acceptance of phone-based follow-up and visits were perceived as "not very adequate" or "absolutely not adequate" by 17% (95% CI: 12-22 %) and 18% (95% CI: 13-23%) of respondents, respectively Conclusions: Herein, we report among the first real-life experiences about oncological pts’ perception of infection risks and their level of acceptance of protective measures during SarS-Cov-2 pandemic A timely and thoughtful measures adoption, the coordinated efforts of all figures involved in cancer care and an effective communication strategy to share the necessary risks and sacrifices with pts/caregivers, can lead to effective protection of oncological pts Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest

Annals of Oncology ; 31:S1011, 2020.
Article | WHO COVID | ID: covidwho-805536


Background: On February 23rd the first case of SARS-CoV-2 infection was diagnosed at the University Hospital Trust of Verona, Italy On March 13th, the Oncology Section was converted into a 22 inpatient beds COVID unit and we had to reshape our organization and personnel to face the SARS-CoV-2 epidemic, while maintaining our oncological activity Methods: We tracked down oncological activity from January 1st to March 31st, 2020, in relationship to the organizational changes implemented and in comparison to the same period of 2019 We also recorded cases of SARS-CoV-2 infections observed in oncology health professionals and hospital admissions of active oncology patients for SARS-CoV-2 infection Results: Progressive restrictions in patients', visitors', and caregivers' access to the inpatient and outpatient facilities of the Oncology section and organizational changes were adopted early on during the epidemic peak Since March 13th, segregated personnel teams were created, one dedicated to the COVID unit and a "clean" one dedicated to oncological patients, resulting in an overall 40% and 43% reduction in oncology-dedicated medical and nursing/auxiliary staff, respectively As compared with the same trimester in 2019, the overall reduction in total numbers of inpatient admissions, chemotherapy administrations, and specialty visits in the period January-March 2020 was 8%, 6%, and 3%, respectively;based on the weekly average of daily accesses, reduction in some of the oncological activities became statistically significant from week 11 Patient's acceptance of adopted measures was very high (see abstract by Tregnago D) Overall, 8/85 (9%) health professionals tested positive for SARS-CoV-2 (no hospital admissions and no treatment required) and 7/525 (1 3%) active oncology patients were admitted for SARS-CoV-2 infection (of whom, 2 died of infection-related complications) Conclusions: A minimal (<10%) reduction in Oncology activity was registered during the peak of SARS-CoV-2 epidemic in Verona, Italy Organizational and protective measures adopted appear to have contributed to keep infections in both health professionals and oncological patients to a minimum Legal entity responsible for the study: University of Verona Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest