Association between delayed surgery and survival in early-stage cervical cancer in mainland China: Implications during the coronavirus pandemic (preprint)

Objective: The COVID-19 pandemic has had a significant impact on oncogynecologic patients worldwide, particularly with respect to delayed diagnosis and treatment. During the COVID-19 pandemic, few studies have examined the impact of delayed surgery on survival in early-stage cervical cancer patients. The purpose of this study was to determine the effect of delayed surgical time on survival in patients with early cervical cancer. Design A retrospective cohort study. Setting A single general hospital in Shaanxi, Northwest China. Population A total of 1207women with early cervical cancer were recruited between April 2013 and December 2018 in Mainland China and followed up until 29 Feb 2022. Methods This retrospective cohort study was conducted in a comprehensive tertiary hospital in Shaanxi, Xi’an, China. We used a Cox proportional hazard model with delay time in weeks as a categorical variable to analyse the effect of surgical delay time on survival. Main Outcome Measures The 5-year overall and disease-free survival were used as the primary outcome measures. Results A total of 800 participants were included in the final cohort. In the multivariate Cox regression analysis (median follow-up, 58 months), patients in the long delay time group had DFS (5-year rates, 91.5% versus 90.9%, HR 0.99, 95% CI 0.62~1.59, P=0.98) and OS (5-year rates of 92.9% versus 90.8%, HR 0.68, 95% CI 0.42~1.10, P=0.11) similar to those in the short delay time group. Conclusions Our findings indicate that a 12-week delay in surgery is not associated with long-term survival in women with early-stage cervical cancer.

Impact of the COVID-19 pandemic on congenital diaphragmatic hernia patients: a single-center retrospective study (preprint)

Purpose To investigate the impact of COVID-19 on the treatment of children with congenital diaphragmatic hernia (CDH).Methods We retrospectively collected and compared the data of patients with CDH admitted between January 1, 2020 and December 31, 2021 with the CDH patients admitted before the pandemic between January 1, 2018 and December 31, 2019 (control group).Results During the pandemic, 41 patients with CDH diagnosed prenatally were transferred to our hospital, and 40 underwent surgical repair. The number of patients treated in our hospital increased by 24.2% compared with that before the pandemic. During the pandemic, the overall survival rate, postoperative survival rate and recurrence rate were 85.4%, 87.5% and 7.3%, respectively, and there were no significant differences compared with the control group. The average length of hospital stay in patients admitted during the pandemic was longer than that in the control group, and the incidence of nosocomial infection was higher than that in the control group.Conclusions CDH patients confirmed to be SARS-CoV-2 infection-free can receive routine treatment. Our data indicate that the implementation of protective measures during the COVID-19 pandemic, along with appropriate screening and case evaluation, do not have a negative impact on the prognosis of children.

Increased circulating microparticles and inflammatory factors aggravate coronavirus disease 2019 (COVID-19) (preprint)

Background The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed tremendous challenges to the world's public health. The conditions of some patients can quickly progress to acute respiratory distress syndrome and even death. Current studies suggest that an outbreak of inflammatory response known as cytokine storm may play a key role in the process. This study was performed to investigate the relativity of the production of circulating microparticles (cMPs) and the expression of inflammatory factors (interleukin [IL]-6, IL-8 and IL-10) expression in the blood on the degree of COVID-19. Methods A total of 89 patients infected with SARS-CoV-2 were divided into four groups, namely, mild, moderate, severe and critically ill groups, according to China's COVID-19 Diagnosis and Treatment Program (6th trial version), and 30 healthy persons were selected as the control group. The groups were compared in terms of cMP production and IL-6, IL-8 and IL-10 levels in their blood, and the correlation between cMP production and the expression of inflammatory factors with the degree of COVID-19 were analysed. Results Differences in cMP production and IL-6, IL-8 and IL-10 expression levels among the five groups were statistically significant (P<0.05). Pearson correlation analysis showed a positive correlation between cMP production or the expression of IL-6, IL-8 and IL-10 and the degree of COVID-19 (cMP, r=0.981; IL-6, r=0.954; IL-8, r=0.863; IL-10, r=0.895; P<0.05). Conclusion Increased levels of cMP, IL-6, IL-8 and IL-10 aggravate COVID-19. cMP production and the expression of IL-6, IL-8 and IL-10 may predict the degree of COVID-19 to a certain extent. The early inhibition of cMP overproduction and IL-6, IL-8 and IL-10 expression may be an important therapeutic target for the prevention of COVID-19 progression.