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Mayo Clin Proc ; 98(3): 451-457, 2023 03.
Article in English | MEDLINE | ID: covidwho-2277982


There is scant information on the clinical progression, end-of-life decisions, and cause of death of patients with cancer diagnosed with COVID-19. Therefore, we conducted a case series of patients admitted to a comprehensive cancer center who did not survive their hospitalization. To determine the cause of death, 3 board-certified intensivists reviewed the electronic medical records. Concordance regarding cause of death was calculated. Discrepancies were resolved through a joint case-by-case review and discussion among the 3 reviewers. During the study period, 551 patients with cancer and COVID-19 were admitted to a dedicated specialty unit; among them, 61 (11.6%) were nonsurvivors. Among nonsurvivors, 31 (51%) patients had hematologic cancers, and 29 (48%) had undergone cancer-directed chemotherapy within 3 months before admission. The median time to death was 15 days (95% confidence interval [CI], 11.8 to 18.2). There were no differences in time to death by cancer category or cancer treatment intent. The majority of decedents (84%) had full code status at admission; however, 53 (87%) had do-not-resuscitate orders at the time of death. Most deaths were deemed to be COVID-19 related (88.5%). The concordance between the reviewers for the cause of death was 78.7%. In contrast to the belief that COVID-19 decedents die because of their comorbidities, in our study only 1 of every 10 patients died of cancer-related causes. Full-scale interventions were offered to all patients irrespective of oncologic treatment intent. However, most decedents in this population preferred care with nonresuscitative measures rather than full support at the end of life.

COVID-19 , Hematologic Neoplasms , Neoplasms , Humans , Cause of Death , Medical Oncology
Sociologia & Antropologia ; 11:13-30, 2021.
Article in Portuguese | ProQuest Central | ID: covidwho-2154425


Aborda a identificação de Mário de Andrade (1893-1945) com o diagnóstico médico da "neurastenia" e argumenta que o escritor afirmou sua "vontade forte" ao se reconhecer portador de "nervos fracos", a principal característica dessa doença. O médico norte-americano Geoge M. Beard (1839-1883) que, em 1869, formulou o diagnóstico de neurastenia, atribuiu sua ocorrência aos tempos modernos e ao excesso de estímulos nervosos nas grandes cidades. A partir dessa reflexão histórica, ensaio uma conexão entre a experiencia existencial de Mário de Andrade e a nossa experiência diante de uma doença nova, a Covid-19, fortemente conectada ao capitalismo globalizado e à devastação ambiental e que, se não é uma doença de ordem psiquiátrica, provoca desafios a nossa estabilidade emocional. Assim como Mário foi um exímio escritor de cartas, o texto salienta a importância dos meios contemporâneos de comunicação para a manuteção de laços de sociabilidade e de amizade em tempos difíceis.Alternate :The article explores the identification of Mário de Andrade (1893-1945) with the medical diagnosis of "neurasthenia", and argues the Brazilian writer affirmed his "strong will" from the recognition of having "weak nerves", the trait of this disease. The American physician Geoge M. Beard (1839-1883) formulated the diagnosis of neurasthenia in 1869. He attributed its occurrence to modern times and large cities. Based on the historical reflection, I suggest a link between Mário de Andrade's existential experience and our experience in the face of a new disease. The Covid-19 is connected to globalized capitalism and environmental devastation, and it is a disease that challenges our emotional stability. Just as Mário was a good letter writer, I argue that social media can serve to cultivate friendship in difficult times.

Critical Care Medicine ; 50:259-259, 2022.
Article in English | Academic Search Complete | ID: covidwho-1597354


Despite having advanced baseline malignancies, most patients received a trial of aggressive intensive care management with life support before considering any EOL measures. At hospital admission, 56% of patients had poor predicted 3-month cancer survival, and the treatment goal was predominantly for life prolongation (53%). B Introduction/Hypothesis: b Data detailing the end-of-life care (EOL) in cancer patients with COVID-19 is scarce. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)