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Head Neck ; 42(7): 1507-1515, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-614117


INTRODUCTION: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has altered the health care environment for the management of head and neck cancers. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management in order to achieve a medically and ethically appropriate balance of risks and benefits. METHODS: Creation of consensus document. RESULTS: The process yielded a consensus statement among a wide range of practitioners involved in the management of patients with head and neck cancer in a multihospital tertiary care health system. CONCLUSIONS: These guidelines support an ethical approach for the management of head and neck cancers during the COVID-19 epidemic consistent with both the local standard of care as well as the head and neck oncological literature.

Betacoronavirus , Coronavirus Infections/prevention & control , Head and Neck Neoplasms/therapy , Infection Control/standards , Medical Oncology/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Ambulatory Care/standards , COVID-19 , Combined Modality Therapy , Continuity of Patient Care/standards , Coronavirus Infections/diagnosis , Head and Neck Neoplasms/diagnosis , Humans , Multi-Institutional Systems , Otorhinolaryngologic Surgical Procedures/standards , Palliative Care/standards , Patient Safety , Pennsylvania , Personal Protective Equipment , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Terminal Care/standards , Tertiary Care Centers
Head Neck ; 42(6): 1268-1272, 2020 06.
Article in English | MEDLINE | ID: covidwho-116903


AIM: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has put health care workers at risk when exposed to aerosolized viral particles during upper airway mucosal surgery. The objective of this review was to discuss topical preparations that could be utilized preoperatively to help to decrease viral load and potentially reduce the risks of viral transmission. METHODS: A PubMed/MEDLINE database review of articles was performed querying topical preparations with virucidal activity against coronaviruses. RESULTS: Povidone-iodine (PVP-I) solutions ranging from 0.23% to 7% have been found to demonstrate highly effective virucidal activity against a broad range of viruses including several coronaviruses responsible for recent epidemics including SARS-CoV-1 and MERS-CoV. CONCLUSIONS: While specific evidence regarding SARS-CoV-2 is lacking, PVP-I-based preparations have been successfully demonstrated to reduce viral loads of coronaviruses. They are relatively safe to use in the upper airway and may reduce risk of SARS-CoV-2 aerosolization during upper airway mucosal surgery.

Anti-Infective Agents, Local/therapeutic use , Betacoronavirus , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Otolaryngology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Administration, Topical , Aerosols , COVID-19 , Humans , Mucous Membrane/surgery , SARS-CoV-2