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1.
Clinical Breast Cancer ; 22(1):E108-E108, 2022.
Article in English | Web of Science | ID: covidwho-1624274
3.
Annals of Oncology ; 32:S1138, 2021.
Article in English | EMBASE | ID: covidwho-1432867

ABSTRACT

Background: During the first year of the SARS-CoV-2 pandemic the management and treatment of COVID-19 have been improved. However, cancer patients continue to be one of the most affected. We evaluate the mortality rate due to COVID-19 and associated risk factors in the cancer population diagnosed in our center during the first year of pandemic. Methods: We retrospectively reviewed the medical records of 189 cancer patients who were diagnosed with COVID-19 between March 5, 2020 and February 28, 2021. Mortality rate nd associated risk factors were studied. Results: Mortality rate: 55/189 patients. Mean age: 72 years (34-95), 125/189 male patients. Predominant histologies: lung cancer (72/189), colorectal (31/189), breast (24/189). Predominant staging: metastatic disease (113/189). Predominant cancer treatment: chemotherapy (63/189);118/189 patients were receiving any type of oncological treatment with palliative intention. Mortality was associated with male gender (45/55 vs 10/55, p=0.004), presence of comorbidities (48/55 vs 7/55, p=0.01), lung cancer (28/72 deaths with this tumor vs 27/117 with the rest, p=0.02), palliative intention cancer treatment (41/55 vs 12/55, p=0.02), older median age (76 vs 71, p = 0.02), higher median CRP (p=115.6 mg/dl vs 46 mg/dl), lower median lymphocytes (600/mm3 vs 1000/mm3 p<0.001). No specific treatment against COVID-19 significantly decreased mortality. Neither IL-6 nor ferritin were prognostic biomarkers. In multivariate analysis, male gender (OR 2.58, 95% CI 1.1-5.9, p = 0.02), lung cancer (OR 2.0, CI 1.0-3.8, p = 0.03), cancer treatment with palliative intention (OR 2.4, CI 1.07-5.3, p = 0.03), higher median CRP (OR 1.0, CI 1.00-1.01, p <0.001), as well as low lymphocyte median (OR 0.5, CI 0.25-1.0, p = 0.56), continued to be evidenced as risk factors, regardless of comorbidities, staging, sex, and palliative intention cancer-specific treatment, among other variables. Conclusions: Men with lung cancer under cancer-specific treatment with palliative intention who present, at the diagnosis of SARS-CoV-2 infection with elevated CRP above 115 mg/dl and a decrease in lymphocytes below 600/mm3 have a higher risk of presenting fatal complications. Legal entity responsible for the study: Medical Oncology department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

4.
Annals of Oncology ; 32:S1137, 2021.
Article in English | EMBASE | ID: covidwho-1432864

ABSTRACT

Background: Cancer patients are one of the most affected by the current pandemic caused by SARS-CoV-2. Social inequalities influence the incidence rate of this disease, as we have seen in the high incidence in our center. In our study, we asked whether the last covid-19 treatment advances, the capacity for restructuring the health centers and their non-saturation, influences the cancer patients outcomes. Methods: Retrospective review of 189 cancer patients diagnosed in our center with COVID-19 from March 5, 2020 to February 28, 2021. Study data was collected and managed using REDCap. We compared COVID-19 diagnoses in first-wave cancer patients versus the full pandemic period until data cut-off, as well as patient characteristics and mortality rates. Results: Mortality rate: 55/189 patients during the entire pandemic period vs 40/85 patients in the first wave (p = 0.03). Median age: 72 years (34-95) vs 76 (34-94), 125/189 men in all the period vs 50/85 (p = 0.2). Most frequent histologies: lung cancer (72/189 vs 22/85, p = 0.07), colorectal (31/189 vs 19/85, p = 0.23), breast (24/189 vs 10/85, p = 0.82). Staging: 113/189 metastatic disease at diagnosis of infection vs 32/85 in first wave (p <0.001). During the 2 subsequent waves in our center, where 104 more patients have been detected, mortality has dropped significantly: from the initial 47% to 14.4% in the rest of the period (40/85 vs 15/104, p <0.001), despite having more metastatic involvement in infected patients. Conclusions: In our center, one of the worst hit by the coronavirus crisis in Spain, with a supersaturation of almost 250% in the middle of the first wave, we have verified how the knowledge of the behavior of this disease, improvements in its treatment and a multidisciplinary management in Oncology ward have led to a significant decrease in mortality, going from almost 50% in the first wave to less than 15%, despite having suffered the disease during the two subsequent waves a greater number of patients with metastatic disease. Legal entity responsible for the study: Medical Oncology Department, Hospital Universitario Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

5.
Annals of Oncology ; 32:S1098, 2021.
Article in English | EMBASE | ID: covidwho-1432837

ABSTRACT

Background: Cancer patients are at high risk of psychological problems and COVID-19 infection, which makes them even more vulnerable to mood disorders. Our objectives were to analyze the level of anxiety and depression among patients with advanced cancer during the COVID-19 pandemic and to analyze the association between sociodemographic, clinical, and psychological factors in patients with advanced cancer. Methods: A prospective, cross-sectional, multicenter study was conducted in 15 oncology departments in Spain. Patients with locally advanced unresectable or metastatic cancer who were candidates for systemic treatment were included. Patients completed demographic information and the Brief Symptom Inventory (BSI), Michel´s Uncertainty in Illness Scale (MUIS), Mental Adjustment to Cancer (MAC), and Cancer Worry Scale (CWS). Results: A total of 374 patients were recruited (April 2020-2021). The mean age was 64.2 years (34-88) and 48.7% were women. The most frequent were lung (30.7%) and colon (14.2%) cancers and most had metastases (78.6%). The most frequent therapy was chemotherapy (57.9%). The prevalence of anxiety and depression was 35% and 34%, respectively. Anxiety and depression levels were higher in women (p=0.001 and p=0.003, respectively). Patients <65 years (p=0.017) and with an oncologist-estimated survival of >18 months (p=0.033) had more anxiety symptoms. Logistic regression analysis revealed that women, patients with coping based on anxious preoccupation and hopelessness had higher risk of anxiety and depression (all, p<0.001). Conclusions: Patients with advanced cancer who start treatment during the COVID-19 pandemic experience high levels of depression and anxiety. Early diagnosis and the development of intervention strategies are needed especially in specific patient subgroups such as young women with long survival estimated times. Legal entity responsible for the study: The authors. Funding: This work was funded by FSEOM (Spanish Society of Medical Oncology Foundation). Disclosure: B. Obispo: Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: Fresenius;Financial Interests, Personal, Invited Speaker: Rovi. R. Hernandez: Financial Interests, Personal, Advisory Role: Amgen;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Merck;Financial Interests, Personal, Invited Speaker: Ipsen. P. Cruz: Financial Interests, Personal, Invited Speaker: Bristol;Financial Interests, Personal, Advisory Board: Boehringer Ingelheim. A. Fernandez Montes: Financial Interests, Personal, Advisory Role: BMS;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Advisory Role: AstraZeneca;Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck. N. Piera Molons: Financial Interests, Personal, Invited Speaker: Grunenthal;Financial Interests, Personal, Invited Speaker: Kyowa Hakko Kirin;Financial Interests, Personal, Expert Testimony: Ordesa. V. Pacheco-Barcia: Financial Interests, Personal, Invited Speaker: Eisai;Financial Interests, Personal, Invited Speaker: Merck;Financial Interests, Personal, Invited Speaker: Bristol-Myers Squibb;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Leo Pharma;Financial Interests, Personal, Invited Speaker: Kiowa Hakko Kyrin;Financial Interests, Personal, Invited Speaker: Grunenthal;Financial Interests, Personal, Invited Speaker: Prostakan;Financial Interests, Personal, Invited Speaker: Lilly. M.H. López de Ceballos: Financial Interests, Personal, Invited Speak r: Roche;Financial Interests, Personal, Invited Speaker: Eisai;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: AstraZeneca. M. Antoñanzas Basa: Financial Interests, Personal, Other, Personal fees: AstraZeneca;Financial Interests, Personal, Other, Personal fees and no financial support: Novartis;Financial Interests, Personal, Other, Personal fees: Pierre Fabre;Financial Interests, Personal, Other, Personal fees and non-financial support: MSD;Financial Interests, Personal, Other, Personal fees and non-financial support: Sanofi;Financial Interests, Personal, Other, Personal fees: Pfizer. D. Lorente: Financial Interests, Personal, Invited Speaker, Advisory, travel fees: Janssen;Financial Interests, Personal, Invited Speaker, Advisory, travel fees: Sanofi;Financial Interests, Personal, Invited Speaker: Bayer;Financial Interests, Personal, Invited Speaker, Advisory, travel fees: Astellas;Financial Interests, Personal, Invited Speaker, Consultancy, travel fees: BMS;Financial Interests, Personal, Invited Speaker, Advisory: AstraZeneca;Financial Interests, Personal, Invited Speaker, Travel fees: Pfizer. A. Manzano Fernández: Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Leo Pharma;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Personal, Invited Speaker: Rovi;Financial Interests, Personal, Invited Speaker: Pharmamar;Financial Interests, Personal, Advisory Board: Grunenthal;Financial Interests, Personal, Advisory Board: AstraZeneca. S. Hernando Polo: Financial Interests, Personal, Invited Speaker, Advisory role: Pfizer;Financial Interests, Personal, Advisory Board: GlaxoSmithKline;Financial Interests, Personal, Advisory Board: Clovis;Financial Interests, Personal, Advisory Board: Pharmamar;Financial Interests, Personal, Invited Speaker, Advisory role: AstraZeneca. M. Gonzalez Moya: Financial Interests, Personal, Invited Speaker: Bristol;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Merck. All other authors have declared no conflicts of interest.

6.
Annals of Oncology ; 32:S1245-S1246, 2021.
Article in English | EMBASE | ID: covidwho-1432833

ABSTRACT

Background: Knowledge of the career paths and employment situation of young medical oncologists is lacking. The aim of our study was to evaluate the current professional standing of young medical oncologists during COVID-19 pandemic in Spain. Methods: The SEOM +MIR section conducted a national online survey in May 2021 of young medical oncology consultants (<6 years of expertise) and last year medical oncology residents. Using the electronic mailing available in the SEOM database, professionals from Spain were invited. Results: A total of 136 responses were eligible in the preliminary analysis. 86 (63%) were women. 106 (78%) were consultants and 30 (22%) were residents. 92 (68%) performed standard clinical care and 10 (7%) research activity. 97 (71%) were subspecialized in a main area of interest and almost half of them, 60 (48%), chose it because it was the only option available after residency. 75 (55%) had considered different employment opportunities other than standard clinical care and 33 (25%) showed an interest in increasing their research activity. 68 (50%) had considered working in foreign countries: 40 (29%) in the European Union. The main reasons were: 35 (26%) thought it might increase their professional development and 29 (22%) argued for better salary conditions abroad. Furthermore, 109 (80%) believed the professional standing in Spain was worse than other countries. After finishing their residency, only 20 (14%) were offered a job at their training hospital. Solely, 17 (12%) participants had an indefinite employment contract. 25 (18%) had previously signed a COVID-19 temporary contract. 55 (40%) were worried about their employment stability. Conclusions: The availability of subspecializing in medical oncology may depend on the job opportunity after residency rather than personal interest. The abundance of temporary contracts could have influenced the employment stability concerns observed. Our work contributes and is consistent with the ESMO values focused on the wellbeing of medical oncology professionals. Future mentoring strategies should engage in building a long-term career path for young medical oncologists. Legal entity responsible for the study: SEOM +MIR Section. Funding: Has not received any funding. Disclosure: V. Pacheco-Barcia: Financial Interests, Personal, Invited Speaker, Speaker Fee: Eisai;Financial Interests, Personal, Invited Speaker, Speaker Fee: Merck;Financial Interests, Personal, Invited Speaker, Speaker Fee: Bristol Myers Squibb;Financial Interests, Personal, Invited Speaker, Speaker Fee: LEO Pharma;Financial Interests, Personal, Invited Speaker, Speaker Fee: Kyowa Kirin;Financial Interests, Personal, Invited Speaker, Speaker Fee: Grunenthal;Financial Interests, Personal, Invited Speaker, Speaker FEE: Prostakan;Financial Interests, Personal, Invited Speaker, Speaker Fee: Lilly;Other, Other: Merck. D.A. Sanchez: Financial Interests, Personal, Invited Speaker: Janssen;Non-Financial Interests, Personal and Institutional, Leadership Role, National Representative of Young Doctors of Promotion of Employment in Organización Médica Colegial: Spanish Medical Association;Non-Financial Interests, Personal and Institutional, Leadership Role: President of the Murcian Health Service Company Committee;Non-Financial Interests, Personal and Institutional, Leadership Role: Vice-representative from the European Junior Doctors (EJD) in Oncology Section in UEMS (Uropean Union of Medical Specialties);Non-Financial Interests, Personal, Other: Member of +MIR Section of the Spanish Society of Medical Oncology;Non-Financial Interests, Personal, Other: ESMO member;Non-Financial Interests, Personal, Other: SEOM member. B. Obispo: Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Sanofi;Financial Interests, Personal, Invited Speaker: Fresenius;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: Rovi;Financial Interes s, Personal, Invited Speaker: Leo Pharma. A. Quilez: Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Advisory Role: Clovis;Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: GSK;Financial Interests, Personal, Advisory Role: GSK. A. Sesma: Financial Interests, Personal, Invited Speaker: MSD. D. Paez: Financial Interests, Personal, Advisory Role: Amgen;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: F. Hoffman-La Roche Ltd;Financial Interests, Personal, Advisory Role: Sanofi;Financial Interests, Personal, Advisory Role: Ipsen;Financial Interests, Personal, Speaker’s Bureau: Advanced Accelerator Applications;Financial Interests, Personal, Research Grant, Research funding: Merck Serono. T. Quintanar Verduguez: Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Invited Speaker: Abbott;Financial Interests, Personal, Invited Speaker: Nestle;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Other, Consultancy: Astra Zeneca. M. Sánchez Cánovas: Financial Interests, Personal, Invited Speaker: Leo Pharma;Financial Interests, Personal, Invited Speaker: Angelini Pharma;Financial Interests, Personal, Invited Speaker: KyowaKirin;Financial Interests, Institutional, Other: Leo Pharma;Other, Personal, Other, Attending Symposia: Sanofi;Other, Personal, Other, Attending Symposia: MSD;Other, Personal, Other, Attending Symposia: Esteve;Other, Personal, Other, Attending Symposia: Amgen;Other, Personal, Other, Attending Symposia: Servier;Other, Personal, Other, Attending Symposia: Angelini;Other, Personal, Other, Attending Symposia: Leo Pharma;Other, Personal, Other, Educational Programs: Angelini;Other, Personal, Other, Educational Programs: Sanofi;Other, Personal, Other, Educational Programs: Rovi;Other, Personal, Other, Educational Programs: Leo Pharma;Other, Personal, Other, Educational Programs: Servier;Other, Personal, Other, Educational Programs: Merck;Other, Personal, Other, Remunerations for authorship: KyowaKirin;Other, Personal, Other, Remunerations for authorship: Mylan. N. Tarazona: Financial Interests, Personal, Invited Speaker: Amgen;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Merck;Financial Interests, Institutional, Principal Investigator, Principal Investigator: Mutua Madrileña;Financial Interests, Institutional, Principal Investigator: SEOM;Financial Interests, Institutional, Principal Investigator: TTD Group;Non-Financial Interests, Personal, Leadership Role, Member of CIBERONC Liquid Biopsy Working Module since 2018: CIBERONC;Non-Financial Interests, Personal, Leadership Role, Member of ESMO Translational Research and Precision Medicine Working Group for the period 2019-2020.: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO-MCBS Extended Working Group since 2019: ESMO;Non-Financial Interests, Personal, Leadership Role, Member of ESMO faculty member for the Gastro-Intestinal Tumours faculty group for the period 2019-2023.: ESMO Faculty;Non-Financial Interests, Personal, Leadership Role, Member of Executive Committee SEOM +MIR 2020-2022.: SEOM +MIR. A. Fernandez Montes: Financial Interests, Personal, Advisory Role: Bristol Myers Squibb;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Servier;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck. E. Felip: Financial Interest , Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Beigene;Financial Interests, Personal, Advisory Board: Boehringer-Ingelheim;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Eli Lilly;Financial Interests, Personal, Advisory Board: F Hoffman-La Roche;Financial Interests, Personal, Advisory Board: Glaxo Smith Kline;Financial Interests, Personal, Advisory Board: Janssen;Financial Interests, Personal, Advisory Board: Medical Trends;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Merck Serono;Financial Interests, Personal, Advisory Board: Peptomyc;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Personal, Advisory Board: Puma;Financial Interests, Personal, Advisory Board: Regeneron;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Syneos Health;Financial Interests, Personal, Advisory Board: Takeda;Financial Interests, Personal, Speaker’s Bureau: Amgen;Financial Interests, Personal, Speaker’s Bureau: AstraZeneca;Financial Interests, Personal, Speaker’s Bureau: Bristol Myers Squibb;Financial Interests, Personal, Speaker’s Bureau: Eli Lilly;Financial Interests, Personal, Speaker’s Bureau: F Hoffman-La Roche;Financial Interests, Personal, Speaker’s Bureau: Janssen;Financial Interests, Personal, Speaker’s Bureau: Medscape;Financial Interests, Personal, Speaker’s Bureau: Merck Sharp & Dohme;Financial Interests, Personal, Speaker’s Bureau: Merck Serono;Financial Interests, Personal, Speaker’s Bureau: Peervoice;Financial Interests, Personal, Speaker’s Bureau:Pfizer;Financial Interests, Personal, Speaker’s Bureau: Springer;Financial Interests, Personal, Speaker’s Bureau: Touch MEdical;Other, Personal, Other, Independent member of the board: GRIFOLS. A. Rodríguez-Lescure: Financial Interests, Personal, Advisory Role: Roche;Financial Interests, Personal, Advisory Role: Pfizer;Financial Interests, Personal, Advisory Role: Novartis;Financial Interests, Personal, Advisory Role: Lilly;Financial Interests, Personal, Advisory Role: MSD;Financial Interests, Personal, Advisory Role: Astra Zeneca;Financial Interests, Institutional, Funding: Roche;Financial Interests, Institutional, Funding: Novartis;Financial Interests, Institutional, Funding: Pfizer;Financial Interests, Institutional, Funding: Lilly;Financial Interests, Institutional, Funding: Astra Zeneca;Financial Interests, Institutional, Funding: Amgen;Financial Interests, Institutional, Funding: MSD;Financial Interests, Institutional, Funding: Bristol-Myers Squibb;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: Pfizer;Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Lilly;Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Personal, Invited Speaker: MSD;Financial Interests, Personal, Invited Speaker: Merck;Other, Personal, Other, Travel, accommodations: Roche;Other, Personal, Other, Travel, accomodations: Pfizer. M.E. Elez Fernandez: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: Array Biopharma;Financial Interests, Personal, Advisory Board: Bayer;Financial Interests, Personal, Advisory Board: Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Hoffman La- Roche;Financial Interests, Personal, Advisory Board: Merck serono;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: Servier;Financial Interests, Institutional, Research Grant: Abbvie;Financial Interests, Institutional, Research Grant: Amgen;Financial Interests, Institutional, Research Grant: Array Pharmaceuticals;Financial Interests, Institution l, Research Grant: AstraZeneca;Financial Interests, Institutional, Research Grant: Boehringer Ingelheim;Financial Interests, Institutional, Research Grant: Bristol-Myers Squibb;Financial Interests, Institutional, Research Grant: GlaxoSmithKline;Financial Interests, Institutional, Research Grant: Hoffman La-Roche;Financial Interests, Institutional, Research Grant: Medimmune;Financial Interests, Institutional, Research Grant: Merck Serono;Financial Interests, Institutional, Research Grant: MSD;Financial Interests, Institutional, Research Grant: Novartis;Financial Interests, Institutional, Research Grant: Pierre-Fabre;Financial Interests, Institutional, Research Grant: Sanofi Aventis. All other authors have declared no conflicts of interest.

7.
ESMO Open ; 6(4): 100215, 2021 08.
Article in English | MEDLINE | ID: covidwho-1330817

ABSTRACT

BACKGROUND: Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS: Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS: In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS: Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.


Subject(s)
Burnout, Professional , COVID-19 , Oncologists , Burnout, Professional/epidemiology , Burnout, Psychological/epidemiology , Burnout, Psychological/prevention & control , Humans , Medical Oncology , Pandemics , SARS-CoV-2
8.
Clinical Cancer Research ; 26(18 SUPPL), 2020.
Article in English | EMBASE | ID: covidwho-992045

ABSTRACT

Background: Covid-19 has been shown to present more complications in immunosuppressed patients. Wedetermine whether differences exist in Covid-19-related mortality between cancer patients and general population inour hospital, and we also describe associated risk factors. Methods: We reviewed 2,216 medical records of all patients admitted to hospitalization in Infanta Leonor UniversityHospital in Madrid, Spain, with Covid-19 diagnosis between 5 March and 13 May, 2020. Study data were collectedand managed using REDCap electronic data capture tools. We described Covid-19 cumulative incidence in cancerpatients, treatment outcome, mortality, and associated risk factors. Results: We detected 85/2,216 cancer patients between all Covid-19 diagnoses. Mortality rate: 40/85 cancerpatients vs. 260/2,131 in general ward (p<0.001). Median age: 76 years old (34-94), 50/85 male patients. Mostfrequent histologies were lung cancer (22/85), colorectal cancer (19/85), prostate cancer (15/85), and breast cancer(10/85). Most frequent staging was metastatic disease (32/85). Only 2/85 patients were admitted to ICU. Mortality was associated with older median age (79.5 vs. 73, p=0.03), high d dimer levels (1630 vs. 830, p=0.03), high LDHlevels (315.5 vs. 224, p=0.003), bilateral pneumonia (24/42 vs. 5/22 with unilateral pneumonia, p=0.02), ARDS(12/13 vs. 28/72 without ARDS, p<0.0001), and metastatic disease (20/32 metastatic vs. 20/53 non-metastaticpatients, p=0.02). Differences were maintained in multivariate analyses regarding ARDS (OR 23.7, p=0.007) andmetastatic disease (OR 2.5, p=0.05). Conclusions: Covid-19 had a significant mortality in cancer patients. High D dimer and LDH levels and ARDSdevelopment in elderly metastatic patients carry an elevated risk of death in cancer patients diagnosed with Covid-19. However, only 2/85 patients were admitted to ICU and these data were decisive. It is a priority to createmeasures to avoid Covid-19 transmission in oncologic patients.

9.
Annals of Oncology ; 31:S1026, 2020.
Article in English | EMBASE | ID: covidwho-806090

ABSTRACT

Background: Currently we still have limited information on how COVID-19 infection has affected lung cancer patients. In our study, we analysed whether there are differences in terms of mortality from COVID-19 between patients diagnosed with lung cancer and the overall population within our hospital health area (320,000 people). We have also studied the most frequent characteristics of lung cancer patients who develop infection with COVID-19, and we have analysed possible factors of poor prognosis, as well as treatment outcome. Methods: We performed a retrospective review of a total of 2216 patients admitted to Hospital Universitario Infanta Leonor in Madrid between March 5 and May 13, 2020 to identify the cumulative incidence of COVID-19 in patients with lung cancer and make a description of the characteristics of these patients, treatment outcome, risk factors for poor prognosis and mortality. We performed uni and multivariate logistic regression. Results: 22/2216 of the total number of patients diagnosed with COVID-19 in our hospital had lung cancer (0.99%). 12/22 lung cancer patients with a COVID-19 diagnosis died (54.5%) vs 300/2216 COVID-19 patients in our hospital (p<0.0001). Lung cancer patients who died had a median age of 72 years (range of 49-84 years). Infection with COVID-19 in lung cancer patients was more frequent in men (72.73%). 18/22 (81.81%) had locally advanced or metastatic tumours. We observed a trend towards higher mortality among patients with hypertension than among non-hypertensive patients (10/15 vs 2/7;P=0.095). We found higher mortality among patients who developed acute respiratory distress syndrome (ARDS) than among those who did not (4/4 vs 8/12;P=0.044). There seems to be a trend towards lower mortality among patients who received treatment with the combination of hydroxychloroquine and azithromycin than among those who did not (6/14 vs 6/8;P=0.145). Conclusions: Lung cancer patients who became infected with COVID-19 have higher mortality than the general population. It is more frequent among men and the development of ARDS results in a worse prognosis with higher mortality. Although treatment with azithromycin and hydroxychloroquine appears to be a good treatment option, we must wait until we have more data on the safety of the combination and results in larger patient series. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

10.
Annals of Oncology ; 31:S997, 2020.
Article in English | EMBASE | ID: covidwho-805959

ABSTRACT

Background: There are no large reported series determining the outcome of cancer patients with COVID-19. We aimed to determine whether differences exist in COVID-19 related mortality between cancer patients and the general population in our hospital, and we also describe associated risk factors. Methods: We reviewed 2216 medical records of all patients admitted to hospital with COVID-19 diagnosis between 5 March and 13 May 2020. Study data were collected using REDCap electronic data capture tools. We described COVID-19 cumulative incidence in cancer patients, treatment outcome, mortality and associated risk factors. Results: We detected 85/2216 cancer patients in all COVID-19 diagnoses. Mortality rate: 40/85 cancer patients vs 260/2131 patients in the general ward (P<0.001). Median age: 76 years old (34-94), 50/85 male patients. Most frequent histologies: lung cancer (22/85), colorectal cancer (19/85) and prostate cancer (15/85). Most frequent staging: metastatic disease (32/85). Only 2/85 patients were admitted to ICU. Mortality was associated with older median age (79.5 vs 73, P=0.03), high d dimer levels (1630 vs 830, P=0.03), high LDH levels (315.5 vs 224, P=0.003), bilateral pneumonia (24/42 vs 5/22 with unilateral pneumonia, P=0.02), acute respiratory distress syndrome (ARDS) (12/13 vs 28/72 without ARDS, P<0.0001) and metastatic disease (20/32 metastatic vs 20/53 non-metastatic, P=0.02). Differences were maintained in multivariate analyses regarding ARDS (OR 23.7, P=0.007) and metastatic disease (OR 2.5, P=0.05). Combined treatment with hydroxychloroquine and azithromycin showed a better outcome in uni and multivariate analyses with only 21/61 dead patients (OR 0.13, P=0.005), adjusted by sex, histology, staging, ARDS and comorbidities. Conclusions: COVID-19 had significant mortality in cancer patients. High D dimer and LDH levels and ARDS development in elderly metastatic patients carry an elevated risk of death in cancer patients diagnosed with COVID-19. However, only 2/85 patients were admitted to ICU and this data was decisive. Combined hydroxychloroquine and azithromycin could be a good treatment option in COVID-19 cancer patients. It is a priority to create measures to avoid COVID-19 transmission in oncological patients. Legal entity responsible for the study: Medical Oncology Department, HU Infanta Leonor. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

11.
Annals of Oncology ; 31:S1028, 2020.
Article in English | EMBASE | ID: covidwho-805693

ABSTRACT

Background: Small case series of patients with active cancer and coronavirus infection have been described since the beginning of the pandemic. The patients most affected by this infection are those with lung cancer but it also affects other types of cancer such as breast cancer. We described the characteristics of patients with breast cancer and COVID 19, their associated risk factors, treatment and evolution. Methods: We reviewed 2216 medical records of all patients admitted to hospitalization with COVID-19 diagnosis between 5 March and 13 May 2020. Study data were collected and managed using RedCap electronic data capture tools. We described breast cancer patients, associated risk factors, mortality and outcome. Results: We detected 85/2216patients cancer with a mortality rate 47% (40/85). Of all cancer patients, 11% (10/85) had breast cancer. Median age breast cancer patients was 70.5 years old (35-86). Most frecuent staging was locally advanced (50 %, 5/10) and most of them were on hormone therapy (50%, 5/10). As associated risk factors, 20% (2/10) had heart disease, 50% (5/10) had hypertension, 20 (2/10) were obese, 30% (3/10) had diabetes, 40% (4/10) had dyslipemia and only 10% (1/10) was smoker. Half the patients 50% (5/10) had bilateral pneumonia, none of them were admitted to the ICU and 20% (2/10) died. All patients were treated with the combination of azithromycin and hydroxychloroquine and 40% (4/10) with lopinavir/ritonavir. Mortality was associate with high LDH levels (1529 vs. 264 U/L, p=0,0002), high PCR levels (159.15 vs. 29 mg/L, p=0.0140), ARDS (1/1 vs. 1/9 without ARDS p=0.035). A posible relation has been found with history of hypertension (2/5 vs. 0/5 without hypertension, p=0.114) and bilateral pneumonia (2/5 vs. 0/5, p= 0.114). Conclusions: COVID 19 appears to have lower mortality in breast cancer patients than in other tumor types. High LDH and PCR levels and ARDS could be related with increased risk of death. Combined treatment in these patients with azithromycin and hydroxychloroquine might be a good option. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

12.
J Thromb Thrombolysis ; 51(1): 40-46, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-620198

ABSTRACT

Recent studies suggest that thrombotic complications are a common phenomenon in the novel SARS-CoV-2 infection. The main objective of our study is to assess cumulative incidence of pulmonary embolism (PE) in non critically ill COVID-19 patients and to identify its predicting factors associated to the diagnosis of pulmonary embolism. We retrospectevely reviewed 452 electronic medical records of patients admitted to Internal Medicine Department of a secondary hospital in Madrid during Covid 19 pandemic outbreak. We included 91 patients who underwent a multidetector Computed Tomography pulmonary angiography(CTPA) during conventional hospitalization. The cumulative incidence of PE was assessed ant the clinical, analytical and radiological characteristics were compared between patients with and without PE. PE incidence was 6.4% (29/452 patients). Most patients with a confirmed diagnosed with PE recieved low molecular weight heparin (LMWH): 79.3% (23/29). D-dimer peak was significatly elevated in PE vs non PE patients (14,480 vs 7230 mcg/dL, p = 0.03). In multivariate analysis of patients who underwent a CTPA we found that plasma D-dimer peak was an independen predictor of PE with a best cut off point of > 5000 µg/dl (OR 3.77; IC95% (1.18-12.16), p = 0.03). We found ninefold increased risk of PE patients not suffering from dyslipidemia (OR 9.06; IC95% (1.88-43.60). Predictive value of AUC for ROC is 75.5%. We found a high incidence of PE in non critically ill hospitalized COVID 19 patients despite standard thromboprophylaxis. An increase in D-dimer levels is an independent predictor for PE, with a best cut-off point of > 5000 µg/ dl.


Subject(s)
Anticoagulants/therapeutic use , COVID-19 , Chemoprevention , Lung , Pulmonary Embolism , COVID-19/complications , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/physiopathology , Causality , Chemoprevention/methods , Chemoprevention/statistics & numerical data , Computed Tomography Angiography/methods , Electronic Health Records/statistics & numerical data , Female , Fibrin Fibrinogen Degradation Products/analysis , Hospitalization/statistics & numerical data , Humans , Incidence , Lung/blood supply , Lung/diagnostic imaging , Male , Middle Aged , Pulmonary Embolism/blood , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , SARS-CoV-2/isolation & purification , Spain/epidemiology , Thrombophilia/diagnosis , Thrombophilia/etiology
13.
Clin Transl Oncol ; 22(12): 2364-2368, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-361210

ABSTRACT

BACKGROUND: There are no large reported series determining the Covid-19 cancer patient's characteristics. We determine whether differences exist in cumulative incidence and mortality of Covid-19 infection between cancer patients and general population in Madrid. MATERIAL AND METHODS: We reviewed 1069 medical records of all cancer patients admitted at Oncology department between Feb 1 and April 7, 2020. We described Covid-19 cumulative incidence, treatment outcome, mortality, and associated risk factors. RESULTS: We detected 45/1069 Covid-19 diagnoses in cancer patients vs 42,450/6,662,000 in total population (p < 0.00001). Mortality rate: 19/45 cancer patients vs 5586/42,450 (p = 0.0001). Mortality was associated with older median age, adjusted by staging and histology (74 vs 63.5 years old, OR 1.06, p = 0.03). Patients who combined hydroxychloroquine and azithromycin presented 3/18 deaths, regardless of age, staging, histology, cancer treatment and comorbidities (OR 0.02, p = 0.03). CONCLUSION: Cancer patients are vulnerable to Covid-19 with an increase in complications. Combined hydroxychloroquine and azithromycin is presented as a good treatment option.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/mortality , Neoplasms/complications , Neoplasms/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Aged , Azithromycin/therapeutic use , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Drug Combinations , Female , Humans , Hydroxychloroquine/therapeutic use , Incidence , Male , Middle Aged , Neoplasms/pathology , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Risk Factors , SARS-CoV-2 , Spain/epidemiology , Treatment Outcome
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