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2.
Ann Thorac Surg ; 110(2): 692-696, 2020 08.
Article in English | MEDLINE | ID: covidwho-701363

ABSTRACT

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.


Subject(s)
Coronavirus Infections/epidemiology , Medical Oncology/organization & administration , Pneumonia, Viral/epidemiology , Thoracic Neoplasms/surgery , Thoracic Surgery/organization & administration , Triage , Betacoronavirus , Consensus , Humans , Pandemics , Thoracic Surgical Procedures
3.
Chest ; 158(1): 406-415, 2020 07.
Article in English | MEDLINE | ID: covidwho-700492

ABSTRACT

BACKGROUND: The risks from potential exposure to coronavirus disease 2019 (COVID-19), and resource reallocation that has occurred to combat the pandemic, have altered the balance of benefits and harms that informed current (pre-COVID-19) guideline recommendations for lung cancer screening and lung nodule evaluation. Consensus statements were developed to guide clinicians managing lung cancer screening programs and patients with lung nodules during the COVID-19 pandemic. METHODS: An expert panel of 24 members, including pulmonologists (n = 17), thoracic radiologists (n = 5), and thoracic surgeons (n = 2), was formed. The panel was provided with an overview of current evidence, summarized by recent guidelines related to lung cancer screening and lung nodule evaluation. The panel was convened by video teleconference to discuss and then vote on statements related to 12 common clinical scenarios. A predefined threshold of 70% of panel members voting agree or strongly agree was used to determine if there was a consensus for each statement. Items that may influence decisions were listed as notes to be considered for each scenario. RESULTS: Twelve statements related to baseline and annual lung cancer screening (n = 2), surveillance of a previously detected lung nodule (n = 5), evaluation of intermediate and high-risk lung nodules (n = 4), and management of clinical stage I non-small cell lung cancer (n = 1) were developed and modified. All 12 statements were confirmed as consensus statements according to the voting results. The consensus statements provide guidance about situations in which it was believed to be appropriate to delay screening, defer surveillance imaging of lung nodules, and minimize nonurgent interventions during the evaluation of lung nodules and stage I non-small cell lung cancer. CONCLUSIONS: There was consensus that during the COVID-19 pandemic, it is appropriate to defer enrollment in lung cancer screening and modify the evaluation of lung nodules due to the added risks from potential exposure and the need for resource reallocation. There are multiple local, regional, and patient-related factors that should be considered when applying these statements to individual patient care.


Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Coronavirus Infections , Lung Neoplasms , Multiple Pulmonary Nodules/diagnosis , Pandemics , Pneumonia, Viral , Radiography, Thoracic/methods , Betacoronavirus/isolation & purification , Consensus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Neoplasm Staging , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Resource Allocation , Risk Assessment/methods
4.
Neurologia ; 35(4): 252-257, 2020 May.
Article in English, Spanish | MEDLINE | ID: covidwho-700407

ABSTRACT

INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.


Subject(s)
Coronavirus Infections , Health Care Surveys , Nervous System Diseases/therapy , Neurology/trends , Pandemics , Pneumonia, Viral , Administrative Personnel/psychology , Clinical Laboratory Techniques , Clinical Trials as Topic/methods , Consensus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Management , Distance Counseling , Forecasting , Hospital Departments/organization & administration , Humans , Nervous System Diseases/diagnosis , Neurologic Examination , Neurology/methods , Neurology/organization & administration , Pandemics/prevention & control , Patient Isolation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Spain/epidemiology
5.
Arch Bronconeumol ; 56 Suppl 2: 11-18, 2020 07.
Article in English, Spanish | MEDLINE | ID: covidwho-699748

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials.


Subject(s)
Betacoronavirus , Consensus , Coronavirus Infections/complications , Noninvasive Ventilation/methods , Pneumonia, Viral/complications , Respiratory Distress Syndrome, Adult/therapy , Respiratory Insufficiency/therapy , Acute Disease , Adult , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Health Personnel , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Noninvasive Ventilation/standards , Occupational Diseases/diagnosis , Occupational Diseases/prevention & control , Oxygen Inhalation Therapy/methods , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Respiratory Distress Syndrome, Adult/etiology , Respiratory Insufficiency/etiology , Societies, Medical , Spain
6.
Ocul Immunol Inflamm ; 28(5): 709-713, 2020 Jul 03.
Article in English | MEDLINE | ID: covidwho-691353

ABSTRACT

This document summarizes the experience of the International Uveitis Study Group (IUSG), the Intraocular Inflammation Society (IOIS), and the Foster Ocular Inflammation Society (FOIS) and can aid as a guide for the treatment of uveitis patients in the era of COVID-19 pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Ophthalmology/organization & administration , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/standards , Uveitis/diagnosis , Uveitis/therapy , Consensus , Coronavirus Infections/diagnosis , Humans , Internationality , Pandemics , Pneumonia, Viral/diagnosis , Risk Factors , Societies, Medical
8.
Heart Lung Circ ; 29(6): e69-e77, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-664510

ABSTRACT

The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.


Subject(s)
Betacoronavirus , Consensus , Coronavirus Infections , Critical Care , Intensive Care Units , Pandemics , Pneumonia, Viral , Australia/epidemiology , Cardiology/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Humans , New Zealand/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Practice Guidelines as Topic
10.
Arch Bronconeumol ; 56 Suppl 2: 19-26, 2020 07.
Article in English, Spanish | MEDLINE | ID: covidwho-663262

ABSTRACT

This consensus document has been drawn up by the Techniques and Transplantation and Nursing areas of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Respiratory Endoscopy (AEER) with the aim of providing information on the safe and effective use of bronchoscopy in patients with suspected or confirmed COVID-19 infection. Our priority is to ensure the safety of our patients, the health workers caring for them, and the community in general. At this stage in the pandemic, our information on the use of bronchoscopy in patients of this type is based on the experience of hospitals in other countries, and scientific publications are scarce. The objective of this document is to compile these experiences, based on recommendations from official agencies, in a document offering guidance in daily clinical practice.


Subject(s)
Betacoronavirus , Bronchoscopy/methods , Consensus , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Bronchoscopes/standards , Bronchoscopy/adverse effects , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disinfection/methods , Health Personnel , Humans , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Protective Clothing/standards , Pulmonary Medicine , Societies, Medical , Spain , Specimen Handling/methods
11.
Anaesthesiol Intensive Ther ; 52(2): 83-90, 2020.
Article in English | MEDLINE | ID: covidwho-663002

ABSTRACT

Respiratory failure is a dominating medical issue in the severe course of COVID-19. Both at the stage of diagnostics prior to admission to the intensive care unit and during the monitoring of lesion evolution, diagnostic imaging techniques may significantly influence clinical decisions. Although computed tomography remains the gold standard for diagnosing lung diseases, its usefulness for infected, critically ill patients has been largely limited during the pandemic. Reports from those countries in which the healthcare systems were most seriously overloaded with patients with COVID-19-induced pneumonia stress the key role of point-of-care lung ultrasound performed by clinicians first during preliminary diagnostics and then while monitoring disease dynamics. This consensus, worked out by an interdisciplinary team of specialists forming the Study Group for Point-of-Care Lung Ultrasound in the Intensive Care Management of COVID-19 Patients, presents a broad spectrum of aspects regarding the analysed issue. Its concise form is meant to serve clinicians who perform ultrasound as a straightforward and informative guide.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Critical Care , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Point-of-Care Systems , Ultrasonography/methods , Consensus , Coronavirus Infections/therapy , Humans , Pandemics , Pneumonia, Viral/therapy , Respiration, Artificial
12.
J Thorac Cardiovasc Surg ; 160(2): 447-451, 2020 08.
Article in English | MEDLINE | ID: covidwho-661781

ABSTRACT

The COVID-19 pandemic necessitates aggressive infection mitigation strategies to reduce the risk to patients and healthcare providers. This document is intended to provide a framework for the adult cardiac surgeon to consider in this rapidly changing environment. Preoperative, intraoperative, and postoperative detailed protective measures are outlined. These are guidance recommendations during a pandemic surge to be used for all patients while local COVID-19 disease burden remains elevated.


Subject(s)
Betacoronavirus/pathogenicity , Cardiac Surgical Procedures/standards , Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Heart Diseases/surgery , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Operating Rooms/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Recovery Room/standards , Cardiac Surgical Procedures/adverse effects , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Heart Diseases/epidemiology , Humans , Occupational Health/standards , Patient Safety/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , Virulence
15.
J Cosmet Dermatol ; 19(8): 1829-1837, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-644018

ABSTRACT

BACKGROUND: The novel coronavirus (COVID-19) pandemic is expected to last for an extended time, making strict safety precautions for office procedures unavoidable. The lockdown is going to be lifted in many areas, and strict guidelines detailing the infection control measures for aesthetic clinics are going to be of particular importance. METHODS: A virtual meeting was conducted with the members (n = 12) of the European Academy of Facial Plastic Surgery Focus Group to outline the safety protocol for the nonsurgical facial aesthetic procedures for aesthetic practices in order to protect the clinic staff and the patients from SARS-CoV-2 infection. The data analysis was undertaken by thematic and iterative approach. RESULTS: Consensus guidelines for nonsurgical facial aesthetic procedures based on current knowledge are provided for three levels: precautions before visiting the clinic, precautions during the clinic visit, and precautions after the clinic visit. CONCLUSIONS: Sound infection control measures are mandatory for nonsurgical aesthetic practices all around the world. These may vary from country to country, but this logical approach can be customized according to the respective country laws and guidelines.


Subject(s)
Coronavirus Infections/prevention & control , Cosmetic Techniques/standards , Dermatology/standards , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Betacoronavirus/pathogenicity , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Esthetics , Face , Female , Focus Groups , Health Personnel/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Rejuvenation
16.
Arch Bronconeumol ; 56 Suppl 2: 11-18, 2020 07.
Article in English, Spanish | MEDLINE | ID: covidwho-638595

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials.


Subject(s)
Betacoronavirus , Consensus , Coronavirus Infections/complications , Noninvasive Ventilation/methods , Pneumonia, Viral/complications , Respiratory Distress Syndrome, Adult/therapy , Respiratory Insufficiency/therapy , Acute Disease , Adult , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Health Personnel , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Noninvasive Ventilation/standards , Occupational Diseases/diagnosis , Occupational Diseases/prevention & control , Oxygen Inhalation Therapy/methods , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Respiratory Distress Syndrome, Adult/etiology , Respiratory Insufficiency/etiology , Societies, Medical , Spain
17.
BMC Cancer ; 20(1): 641, 2020 Jul 10.
Article in English | MEDLINE | ID: covidwho-638535

ABSTRACT

BACKGROUND: The COVID-19 pandemic has caused a global health crisis. Numerous cancer patients from non-Western countries, including the United Arab Emirates (UAE), seek cancer care outside their home countries and many are sponsored by their governments for treatment. Many patients interrupted their cancer treatment abruptly and so returned to their home countries with unique challenges. In this review we will discuss practical challenges and recommendations for all cancer patients returning to their home countries from treatment abroad. METHOD: Experts from medical, surgical and other cancer subspecialties in the UAE were invited to form a taskforce to address challenges and propose recommendations for patients returning home from abroad after medical tourism during the SARS-COV-19 Pandemic. RESULTS: The taskforce which consisted of experts from medical oncology, hematology, surgical oncology, radiation oncology, pathology, radiology and palliative care summarized the current challenges and suggested a practical approaches to address these specific challenges to improve the returning cancer patients care. Lack of medical documentation, pathology specimens and radiology images are one of the major limitations on the continuation of the cancer care for returning patients. Difference in approaches and treatment recommendations between the existing treating oncologists abroad and receiving oncologists in the UAE regarding the optimal management which can be addressed by early and empathic communications with patients and by engaging the previous treating oncologists in treatment planning based on the available resources and expertise in the UAE. Interruption of curative radiotherapy (RT) schedules which can potentially increase risk of treatment failure has been a major challenge, RT dose-compensation calculation should be considered in these circumstances. CONCLUSION: The importance of a thorough clinical handover cannot be overstated and regulatory bodies are needed to prevent what can be considered unethical procedure towards returning cancer patients with lack of an effective handover. Clear communication is paramount to gain the trust of returning patients and their families. This pandemic may also serve as an opportunity to encourage patients to receive treatment locally in their home country. Future studies will be needed to address the steps to retain cancer patients in the UAE rather than seeking cancer treatment abroad.


Subject(s)
Continuity of Patient Care/standards , Coronavirus Infections/epidemiology , Medical Oncology/standards , Medical Tourism , Neoplasms/therapy , Pneumonia, Viral/epidemiology , Advisory Committees , Betacoronavirus , Consensus , Humans , Medical Oncology/organization & administration , Pandemics , United Arab Emirates
18.
J Gastrointest Cancer ; 51(3): 800-804, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-640099

ABSTRACT

PURPOSE: Today, the rapid outbreak of COVID-19 is the leading health issue. Patients with cancer are at high risk for the development of morbidities of COVID-19. Hence, oncology centers need to provide organ-based recommendations for optimal management of cancer in the COVID-19 era. METHODS: In this article, we have provided the recommendations on management of locally advanced rectal cancer during the COVID-19 pandemic based on our experience in Shohada-e Tajrish Hospital, Iran. RESULTS: We recommend that patients with locally advanced rectal cancer should be managed in an individualized manner in combination with local conditions related to COVID-19. CONCLUSION: Our recommendation may provide a guide for oncology centers of developing countries for better management of locally advanced rectal cancer.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Medical Oncology/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic/standards , Rectal Neoplasms/therapy , Age Factors , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/standards , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Betacoronavirus/isolation & purification , Chemotherapy, Adjuvant/standards , Clinical Decision-Making , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Infection Control/standards , Iran/epidemiology , Medical Oncology/methods , Neoadjuvant Therapy/standards , Neoplasm Staging , Palliative Care/methods , Palliative Care/standards , Patient Selection , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Proctectomy/standards , Rectal Neoplasms/pathology , Rectum/pathology , Rectum/surgery
20.
Am J Obstet Gynecol ; 223(1): 3-8, 2020 07.
Article in English | MEDLINE | ID: covidwho-634523

ABSTRACT

Since December 2019, the outbreak of novel coronavirus disease 2019 became a major epidemic threat in China and later spread worldwide. During the coronavirus disease 2019 outbreak in mainland China, the Chinese Obstetricians and Gynecologists Association distributed guidelines regarding the care of gynecologic patients. These guidelines were developed by the Department of Obstetrics and Gynecology at the Peking Union Medical College Hospital and represent an effort to integrate infection control strategy and promote professionalism in medical practice. The guidelines represent collaboration with experts from 31 provinces and autonomous regions of mainland China over 2 weeks' time. With the implementation of these guidelines, no nosocomial infections of coronavirus disease 2019 have been identified at the Peking Union Medical College Hospital. We think these guidelines might be helpful to departments of obstetrics and gynecology internationally during these unprecedented times. In our guidelines, we describe basic infection precaution principles, an epidemiologic screening tool, prioritization of surgical procedures, and operating room requirements. Using these principles, we then review the management of gynecologic patients during the coronavirus disease 2019 epidemic in the outpatient and operative and nonoperative inpatient settings and in clinical trials.


Subject(s)
Coronavirus Infections/epidemiology , Gynecology/methods , Pneumonia, Viral/epidemiology , Betacoronavirus , China , Clinical Trials as Topic , Consensus , Coronavirus Infections/diagnosis , Female , Gynecologic Surgical Procedures , Hospitals , Humans , Infection Control , Operating Rooms/standards , Pandemics , Pneumonia, Viral/diagnosis , Pregnancy
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