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1.
Crit Care ; 25(1): 363, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1477449

ABSTRACT

BACKGROUND: Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19. METHODS: Patients aged ≥ 18 years with COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use from March 1, 2020 until March 31, 2021. After propensity score matching (1:1 ratio) based on the selected criteria, we assessed the association of zinc used as adjunctive therapy with the 30-day mortality. Secondary outcomes included the in-hospital mortality, ventilator free days, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay. RESULTS: A total of 164 patients were included, 82 patients received zinc. Patients who received zinc sulfate as adjunctive therapy have a lower 30-day mortality (HR 0.52, CI 0.29, 0.92; p = 0.03). On the other hand, the in-hospital mortality was not statistically significant between the two groups (HR 0.64, CI 0.37-1.10; p = 0.11). Zinc sulfate use was associated with a lower odds of acute kidney injury development during ICU stay (OR 0.46 CI 0.19-1.06; p = 0.07); however, it did not reach statistical significance. CONCLUSION: The use of zinc sulfate as an additional treatment in critically ill COVID-19 patients may improve survival. Furthermore, zinc supplementation may have a protective effect on the kidneys.


Subject(s)
COVID-19/drug therapy , COVID-19/mortality , Critical Illness/therapy , Neoadjuvant Therapy/methods , Zinc Sulfate/therapeutic use , Aged , Female , Humans , Male , Middle Aged , Propensity Score , Retrospective Studies , Saudi Arabia , Survival Rate
2.
Med Oncol ; 38(11): 137, 2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1439757

ABSTRACT

The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23-58) days versus 17(11-30) days (p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) (p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17-45) days, group 1 versus 49(26-78) days, group 2 (p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.


Subject(s)
COVID-19/prevention & control , Carcinoma, Ovarian Epithelial/therapy , Neoadjuvant Therapy/methods , Ovarian Neoplasms/therapy , Patient Care/methods , Time-to-Treatment , Aged , COVID-19/epidemiology , Carcinoma, Ovarian Epithelial/diagnosis , Carcinoma, Ovarian Epithelial/epidemiology , Female , Humans , Middle Aged , Neoadjuvant Therapy/trends , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/epidemiology , Pandemics , Patient Care/trends , Retrospective Studies , Time-to-Treatment/trends
3.
Cancer Rep (Hoboken) ; 4(2): e1320, 2021 04.
Article in English | MEDLINE | ID: covidwho-967725

ABSTRACT

BACKGROUND: COVID-19 outbreak was declared as a pandemic by the World Health Organization in March 2020. Over the last 3 months, the pandemic has challenged the diagnosis and treatment of all cancer, including rectal cancer. Constraints in resources call for a change in the treatment strategy without compromising efficacy. RECENT FINDINGS: Delivery of shorter treatment schedules for radiotherapy offers advantages like short overall treatment time, improved throughput on the machine, improved compliance and reduced risk of transmission of COVID 19. Other strategies include delaying surgery, reducing the intensity of chemotherapy and adoption of organ preservation approach. CONCLUSION: The curative treatment of rectal cancer should not be hindered during the COVID pandemic, and modifications in the multi-modality treatment will help achieve quality care.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/standards , Pandemics/prevention & control , Radiation Oncology/organization & administration , Rectal Neoplasms/therapy , COVID-19/epidemiology , COVID-19/transmission , Chemoradiotherapy, Adjuvant/methods , Chemoradiotherapy, Adjuvant/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Neoadjuvant Therapy/methods , Neoadjuvant Therapy/standards , Organ Sparing Treatments/methods , Organ Sparing Treatments/standards , Personal Protective Equipment/standards , Radiation Oncology/methods , Radiation Oncology/standards , Radiotherapy, Adjuvant/methods , Radiotherapy, Adjuvant/standards , Rectal Neoplasms/diagnosis , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/standards , Time Factors , Time-to-Treatment/standards , Treatment Outcome
4.
Chemotherapy ; 65(5-6): 141-146, 2020.
Article in English | MEDLINE | ID: covidwho-961184

ABSTRACT

BACKGROUND: The novel coronavirus disease 2019 has become a worldwide threat. We aimed to explore reflections of these unexpected changes to newly diagnosed cancer patients. METHOD: We searched the 2 months after the index case of our country. The first admission day and the first day of intravenous treatment of newly diagnosed patients were recorded. RESULTS: In the 60 days measured during the pandemic, the total number of patients on polyclinics was 159/weekdays, and the total applied chemotherapy cycles were 276/week. For comparison, the total numbers in the previous year were 267/weekday and 363/week for polyclinic and applied chemotherapy cycles, respectively. The total number of newly admitted patients in 2020 was 283. For comparison, the number of new patients in the same 60-day period in 2019 was 495. Patients who were admitted for adjuvant treatment required a median of 8 days for the first course, those who were admitted for neoadjuvant treatment required 12 days, and metastatic patients required 14 days; there were no significant differences between treatment types (p = 0.233). However, the median treatment time was 11.5 and 17 days, in 2020 and in 2019, respectively. A significant difference was observed between the 2 groups (p < 0.001). CONCLUSION: The effective shift of workers and accurate regulations have not resulted in apparent delays in patient care. While a decrease in the number of patients has detected, faster healthcare service was introduced to newly diagnosed patients. The reason for the decrease in the number of patients should be investigated with new studies.


Subject(s)
COVID-19/epidemiology , Neoplasms/drug therapy , Pandemics/statistics & numerical data , Female , Humans , Male , Middle Aged , Neoadjuvant Therapy/methods , SARS-CoV-2/isolation & purification , Treatment Outcome
5.
Respir Med Res ; 78: 100769, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-343140

ABSTRACT

The objective of this document is to formalize a degraded mode management for patients with thoracic cancers in the context of the COVID-19 pandemic. The proposals are based on those of the French High Council for Public Health, on published data outside the context of COVID-19, and on a concerted analysis of the risk-benefit ratio for our patients by a panel of experts specialized on thoracic oncology under the aegis of the French-Language Society of Pulmonology (SPLF)/French-language oncology group. These proposals are evolving (10 April 2020) according to the situations encountered, which will enrich it, and are to be adapted to our institutional organisations and to the evolution of resources during the COVID-19 epidemic. Patients with symptoms and/or COVID-19+ are not discussed in this document and are managed within the framework of specific channels.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , Thoracic Neoplasms/therapy , Antineoplastic Agents/therapeutic use , COVID-19/complications , Chemoradiotherapy/methods , Chemoradiotherapy/standards , Clinical Trials as Topic/methods , Clinical Trials as Topic/organization & administration , Clinical Trials as Topic/standards , Humans , Mutation , Neoadjuvant Therapy/methods , Neoadjuvant Therapy/standards , Neoplasm Metastasis , Pulmonary Medicine/methods , Pulmonary Medicine/organization & administration , Pulmonary Medicine/standards , Risk Factors , Risk Reduction Behavior , SARS-CoV-2 , Thoracic Neoplasms/epidemiology , Thoracic Neoplasms/genetics , Thoracic Neoplasms/pathology , Thoracic Surgical Procedures/methods , Thoracic Surgical Procedures/standards
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