Survey on the efficacy of telephone-based communication with relatives of hospitalized cancer patients in COVID-19 era in Italy

Background: Physical distancing and no-visitor policies adopted to prevent COVID-19 spread in hospital wards have deeply impacted communication with patients and their relatives. Whereas in pre-COVID-19 era family-clinician meetings were held in person, during the SARSCoV- 2 pandemic interactions often take place over the phone. The frequently unilateral direction of the communication might cause feelings of uncertainty and distress to those who are at home. Until now little data about this topic have been collected, and most of them refer to COVID-19 patients. Literature about hospital communication with non-COVID-19 patients and their relatives during the pandemic is lacking. Material and methods: After no-visitor policy was adopted in the Onco-Hematological Unit of Modena, inpatients' relatives were contacted daily for clinical updates. After discharge, a telephone satisfaction survey was administered to all relatives of patients consecutive admitted between December 2020 and January 2021 (n=97). Mean score of response and potential statistically significative differences depending on respondents' characteristics were assessed. Suggestions were collected. Results: Most relatives were satisfied with the communication received, with a mean score over all items of 4.69 on a 5-point Likert scale (standard deviation: 0.60). Results showed high satisfaction rate with both the informative (mean?}SD: 4.66?}0.64) and emotional (mean?}SD: 4.66?}0.58) content, with no significant difference depending on respondents' demographic characteristics (p>0.05). Among suggestions, 13% found it useful to organize more video calls;12% would have preferred to have always talked to the same clinician;4% suggested the first meeting be held in person and 2% would have liked to have seen the patient before discharge, especially after a long hospital stay. Conclusions: Our findings show that a structured telephone- based interaction might help overcome communication barriers imposed by pandemic-related restrictions. We believe that these findings could stimulate other clinicians to think about ways to involve relatives in continuous care of their loved ones when personal contact is impossible and might lead to other studies with a higher number of participants. In our view, anything that can help with the identification of relational and communication strategies that have worked during the pandemic will contribute to the creation of a precious know-how in view of future crises.

Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era.

INTRODUCTION: The present analysis aims to evaluate the consequences of a 2-month interruption of mammographic screening on breast cancer (BC) stage at diagnosis and upfront treatments in a region of Northern Italy highly affected by the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) virus. METHODS: This retrospective single-institution analysis compared the clinical pathological characteristics of BC diagnosed between May 2020 and July 2020, after a 2-month screening interruption, with BC diagnosed in the same trimester of 2019 when mammographic screening was regularly carried out. RESULTS: The 2-month stop in mammographic screening produced a significant decrease in in situ BC diagnosis (-10.4%) and an increase in node-positive (+11.2%) and stage III BC (+10.3%). A major impact was on the subgroup of patients with BC at high proliferation rates. Among these, the rate of node-positive BC increased by 18.5% and stage III by 11.4%. In the subgroup of patients with low proliferation rates, a 9.3% increase in stage III tumors was observed, although node-positive tumors remained stable. Despite screening interruption, procedures to establish a definitive diagnosis and treatment start were subsequently carried out without delay. CONCLUSION: Our data showed an increase in node-positive and stage III BC after a 2-month stop in BC screening. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm and meet infection prevention requirements.

ISEV and ISCT statement on EVs from MSCs and other cells: considerations for potential therapeutic agents to suppress COVID-19

STATEMENT: The International Society for Cellular and Gene Therapies (ISCT) and the International Society for Extracellular Vesicles (ISEV) recognize the potential of extracellular vesicles (EVs, including exosomes) from mesenchymal stromal cells (MSCs) and possibly other cell sources as treatments for COVID-19. Research and trials in this area are encouraged. However, ISEV and ISCT do not currently endorse the use of EVs or exosomes for any purpose in COVID-19, including but not limited to reducing cytokine storm, exerting regenerative effects or delivering drugs, pending the generation of appropriate manufacturing and quality control provisions, pre-clinical safety and efficacy data, rational clinical trial design and proper regulatory oversight.