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1.
BMC Genomics ; 22(Suppl 5): 518, 2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1523282

ABSTRACT

BACKGROUND: All diseases containing genetic material undergo genetic evolution and give rise to heterogeneity including cancer and infection. Although these illnesses are biologically very different, the ability for phylogenetic retrodiction based on the genomic reads is common between them and thus tree-based principles and assumptions are shared. Just as the different frequencies of tumor genomic variants presupposes the existence of multiple tumor clones and provides a handle to computationally infer them, we postulate that the different variant frequencies in viral reads offers the means to infer multiple co-infecting sublineages. RESULTS: We present a common methodological framework to infer the phylogenomics from genomic data, be it reads of SARS-CoV-2 of multiple COVID-19 patients or bulk DNAseq of the tumor of a cancer patient. We describe the Concerti computational framework for inferring phylogenies in each of the two scenarios.To demonstrate the accuracy of the method, we reproduce some known results in both scenarios. We also make some additional discoveries. CONCLUSIONS: Concerti successfully extracts and integrates information from multi-point samples, enabling the discovery of clinically plausible phylogenetic trees that capture the heterogeneity known to exist both spatially and temporally. These models can have direct therapeutic implications by highlighting "birth" of clones that may harbor resistance mechanisms to treatment, "death" of subclones with drug targets, and acquisition of functionally pertinent mutations in clones that may have seemed clinically irrelevant. Specifically in this paper we uncover new potential parallel mutations in the evolution of the SARS-CoV-2 virus. In the context of cancer, we identify new clones harboring resistant mutations to therapy.


Subject(s)
COVID-19 , Neoplasms , Clone Cells , Humans , Mutation , Neoplasms/genetics , Phylogeny , SARS-CoV-2
2.
J Pak Med Assoc ; 71(11): 2563-2570, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1518960

ABSTRACT

Objective: To evaluate the extent of coronavirus infection in cancer patients along with their demographics, laboratory findings and outcomes in a tertiary care setting. METHODS: The study was conducted in Muscat, Oman, from March 24 to October 23, 2020. The data was collected from the cancer registry of the Directorate-General of Non-Communicable Diseases, Ministry of Health, Oman. Data of inpatient coronavirus cases were retrieved from the electronic medical records system of the Royal Hospital, Muscat, all tertiary hospitals linked electronically to the registry and the coronavirus registry of Oman. The data of cancer patients infected with coronavirus was analysed and compared with non-cancer coronavirus-infected patients. Data was analysed using IBM SPSS 2019 v26. RESULTS: Of the 16,260 cancer patients, 77(0.47%) were infected with COVID-19 compared to 111,837(2.17%) in the national population. Mortality among cancer patients with COVID-19 was high 27(35.1%) compared to 1,147(1.03%) in the national population. Cancer patients with COVID-19 also had diabetes 15(20%), hypertension 20(26%), renal complications 15(20%) and cardiac issues 9(12%). Of the total, 32(41.6%) cancer patients with COVID-19 had received active cancer treatment within the preceding 4 weeks. CONCLUSIONS: The data on coronavirus infection outcome is emerging at a rapid pace focussing on the impact of underlying diseases, and the capacity of healthcare systems. Oncologists should customise cancer management, while cancer patients must practise social distancing, and seek prompt evaluation of suspicious symptoms.


Subject(s)
COVID-19 , Diabetes Mellitus , Neoplasms , Humans , Neoplasms/epidemiology , Oman/epidemiology , SARS-CoV-2
3.
Front Public Health ; 9: 741188, 2021.
Article in English | MEDLINE | ID: covidwho-1518572

ABSTRACT

Introduction: The first year of the COVID-19 pandemic has been highly disruptive for people with cancer. Furthermore, it has been shown that accrual to cancer trials dropped substantially in 2020. Building on findings from a previous pilot survey, the present study used qualitative methods to gain insights into attitudes towards participation in research studies amongst people who have experienced cancer, in the context of the first year of the COVID-19 pandemic. Materials and Methods: We interviewed 13 participants from the UK, who were purposively sampled, including a broad sample of cancer types, and a mixture of individuals who have and have not taken part in research previously. Participants underwent semi-structured interviews (median interview duration: 47 min) and were asked open-ended questions about their attitude towards and experiences with COVID-19, and their attitude towards research participation. In addition to this, prompts were used to ask participants about concerns that were highlighted by our previous quantitative work on this topic, such as concerns about being older or having to travel to participate. Interview transcripts were analysed using a framework analysis approach. Results: Our findings suggest that cancer patient decision-making about research participation during an infectious disease pandemic may be a function of a basic cost-benefit analysis, which considers the benefit of taking part, either personally to themselves or to wider society. The benefit may then be weighed by the patient against the risk of being infected, which may be influenced by trust in the relevant clinicians/researchers; familiarity with the study location; provision of detailed information on safety protocols for infectious disease; and, in particular, the availability of safe transport to and from the study location. Discussion: Some cancer patients say that they would be less likely to participate in a research study in the middle of an infectious disease pandemic due to an increased risk to themselves. Patients' perceived risk to themselves from participating may be ameliorated via the provision of certain practical solutions that can be considered at the study protocol design stage, such as safe travel, information, and the use of staff and study sites familiar to the patient.


Subject(s)
COVID-19 , Cancer Survivors , Neoplasms , Attitude , Humans , Neoplasms/epidemiology , Pandemics , SARS-CoV-2
4.
Front Immunol ; 12: 741218, 2021.
Article in English | MEDLINE | ID: covidwho-1518486

ABSTRACT

The global outbreak of the SARS-Cov-2 virus in 2020 has killed millions of people worldwide and forced large parts of the world into lockdowns. While multiple vaccine programs are starting to immunize the global population, there is no direct cure for COVID-19, the disease caused by the SARS-Cov-2 infection. A common symptom in patients is a decrease in T cells, called lymphopenia. It is as of yet unclear what the exact role of T cells are in the immune response to COVID-19. The research so far has mainly focused on the involvement of classical αß T cells. However, another subset of T cells called γδ T cells could have an important role to play. As part of the innate immune system, γδ T cells respond to inflammation and stressed or infected cells. The γδ T cell subset appears to be particularly affected by lymphopenia in COVID-19 patients and commonly express activation and exhaustion markers. Particularly in children, this subset of T cells seems to be most affected. This is interesting and relevant because γδ T cells are more prominent and active in early life. Their specific involvement in this group of patients could indicate a significant role for γδ T cells in this disease. Furthermore, they seem to be involved in other viral infections and were able to kill SARS infected cells in vitro. γδ T cells can take up, process and present antigens from microbes and human cells. As e.g. tumour-associated antigens are presented by MHC on γδ T cells to classical T-cells, we argue here that it stands to reason that also viral antigens, such as SARS-Cov-2-derived peptides, can be presented in the same way. γδ T cells are already used for medical purposes in oncology and have potential in cancer therapy. As γδ T cells are not necessarily able to distinguish between a transformed and a virally infected cell it could therefore be of great interest to investigate further the relationship between COVID-19 and γδ T cells.


Subject(s)
COVID-19/immunology , Intraepithelial Lymphocytes/immunology , SARS-CoV-2 , Animals , Cytokine Release Syndrome/immunology , Humans , Neoplasms/immunology , Pulmonary Fibrosis/immunology
5.
J Med Internet Res ; 23(11): e26310, 2021 11 10.
Article in English | MEDLINE | ID: covidwho-1518431

ABSTRACT

BACKGROUND: Cancer ranks among the most serious public health challenges worldwide. In China-the world's most populous country-about one-quarter of the population consists of people with cancer. Social media has become an important platform that the Chinese public uses to express opinions. OBJECTIVE: We investigated cancer-related discussions on the Chinese social media platform Weibo (Sina Corporation) to identify cancer topics that generate the highest levels of user engagement. METHODS: We conducted topic modeling and regression analyses to analyze and visualize cancer-related messages on Weibo and to examine the relationships between different cancer topics and user engagement (ie, the number of retweets, comments, and likes). RESULTS: Our results revealed that cancer communication on Weibo has generally focused on the following six topics: social support, cancer treatment, cancer prevention, women's cancers, smoking and skin cancer, and other topics. Discussions about social support and cancer treatment attracted the highest number of users and received the greatest numbers of retweets, comments, and likes. CONCLUSIONS: Our investigation of cancer-related communication on Weibo provides valuable insights into public concerns about cancer and can help guide the development of health campaigns in social media.


Subject(s)
COVID-19 , Neoplasms , Social Media , China , Communication , Female , Humans , Neoplasms/therapy , SARS-CoV-2
6.
JCO Clin Cancer Inform ; 5: 1134-1140, 2021 10.
Article in English | MEDLINE | ID: covidwho-1518337

ABSTRACT

PURPOSE: Patients with cancer are at greater risk of developing severe symptoms from COVID-19 than the general population. We developed and tested an automated text-based remote symptom-monitoring program to facilitate early detection of worsening symptoms and rapid assessment for patients with cancer and suspected or confirmed COVID-19. METHODS: We conducted a feasibility study of Cancer COVID Watch, an automated COVID-19 symptom-monitoring program with oncology nurse practitioner (NP)-led triage among patients with cancer between April 23 and June 30, 2020. Twenty-six patients with cancer and suspected or confirmed COVID-19 were enrolled. Enrolled patients received twice daily automated text messages over 14 days that asked "How are you feeling compared to 12 hours ago? Better, worse, or the same?" and, if worse, "Is it harder than usual for you to breathe?" Patients who responded worse and yes were contacted within 1 hour by an oncology NP. RESULTS: Mean age of patients was 62.5 years. Seventeen (65%) were female, 10 (38%) Black, and 15 (58%) White. Twenty-five (96%) patients responded to ≥ 1 symptom check-in, and overall response rate was 78%. Four (15%) patients were escalated to the triage line: one was advised to present to the emergency department (ED), and three were managed in the outpatient setting. Median time from escalation to triage call was 11.5 minutes. Four (15%) patients presented to the ED without first escalating their care via our program. Participant satisfaction was high (Net Promoter Score: 100, n = 4). CONCLUSION: Implementation of an intensive remote symptom monitoring and rapid NP triage program for outpatients with cancer and suspected or confirmed COVID-19 infection is possible. Similar tools may facilitate more rapid triage for patients with cancer in future pandemics.


Subject(s)
COVID-19 , Neoplasms , Text Messaging , Female , Humans , Middle Aged , Neoplasms/diagnosis , SARS-CoV-2 , Triage
8.
Elife ; 102021 08 05.
Article in English | MEDLINE | ID: covidwho-1513039

ABSTRACT

For an emerging disease like COVID-19, systems immunology tools may quickly identify and quantitatively characterize cells associated with disease progression or clinical response. With repeated sampling, immune monitoring creates a real-time portrait of the cells reacting to a novel virus before disease-specific knowledge and tools are established. However, single cell analysis tools can struggle to reveal rare cells that are under 0.1% of the population. Here, the machine learning workflow Tracking Responders EXpanding (T-REX) was created to identify changes in both rare and common cells across human immune monitoring settings. T-REX identified cells with highly similar phenotypes that localized to hotspots of significant change during rhinovirus and SARS-CoV-2 infections. Specialized MHCII tetramer reagents that mark rhinovirus-specific CD4+ cells were left out during analysis and then used to test whether T-REX identified biologically significant cells. T-REX identified rhinovirus-specific CD4+ T cells based on phenotypically homogeneous cells expanding by ≥95% following infection. T-REX successfully identified hotspots of virus-specific T cells by comparing infection (day 7) to either pre-infection (day 0) or post-infection (day 28) samples. Plotting the direction and degree of change for each individual donor provided a useful summary view and revealed patterns of immune system behavior across immune monitoring settings. For example, the magnitude and direction of change in some COVID-19 patients was comparable to blast crisis acute myeloid leukemia patients undergoing a complete response to chemotherapy. Other COVID-19 patients instead displayed an immune trajectory like that seen in rhinovirus infection or checkpoint inhibitor therapy for melanoma. The T-REX algorithm thus rapidly identifies and characterizes mechanistically significant cells and places emerging diseases into a systems immunology context for comparison to well-studied immune changes.


Subject(s)
COVID-19/immunology , Leukemia, Myeloid, Acute/immunology , Melanoma/immunology , Picornaviridae Infections/immunology , Unsupervised Machine Learning , Adolescent , Adult , Algorithms , CD4-Positive T-Lymphocytes/immunology , Humans , Leukemia, Myeloid, Acute/drug therapy , Melanoma/drug therapy , Neoplasms , Rhinovirus/isolation & purification , SARS-CoV-2/isolation & purification , Young Adult
9.
CA Cancer J Clin ; 71(5): 366-368, 2021 09.
Article in English | MEDLINE | ID: covidwho-1512012
10.
Stud Health Technol Inform ; 286: 99-106, 2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1512004

ABSTRACT

Due to the COVID-19 pandemic, multidisciplinary team (MDT) meetings have to switch from physical to digital meetings. However, the technology they currently use to facilitate these meetings can sometimes be lacking, therefore many software companies have developed new software to ease our new digital workspace. In this study, we propose a new method, a comparative participatory cognitive walkthrough, which can show mismatches in cognitive models. To test our method, we tested the compatibility of EPIC EMR (EPIC Care) and the NAVIFY Tumor Board for preparing MDT meetings. The identified mismatches are categorized in the HOT-fit model by Yusof et al, a common way to evaluate if a healthcare information system fits with the healthcare professionals and the organization. In total, 16 mismatches were identified. These mismatches were discussed in a feedback session with an implementation manager of the NAVIFY Tumor Board. The proposed method seems to be a fast and cheap method to gain useful insights in how well new software matches with the software currently in use, by comparing the cognitive models in place when performing tasks involved with specific scenarios. The identified aspects can be of use for the development and adaptation of the new software, as well as provide guidelines on which aspects to focus on when training healthcare professionals to use the new software to have a smooth transition of software.


Subject(s)
COVID-19 , Neoplasms , Cognition , Humans , Pandemics , Patient Care Team , SARS-CoV-2
11.
Med Oncol ; 39(1): 6, 2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1506526

ABSTRACT

To assess the prognostic role of different inflammatory indices on the outcome of cancer patients with COVID-19. Sixty-two adults and 22 pediatric cancer patients with COVID-19 infection were assessed for the prognostic value of certain inflammatory indices including the neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), derived NLR (dNLR), systemic inflammation index (SII), mean platelet volume to platelet ratio (MPR), C-reactive protein to lymphocyte ratio (CRP/L), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), and neutrophil to lymphocyte, platelet ratio (NLPR). Data were correlated to patients' outcome regarding ICU admission, and incidence of mortality. Increased CRP/L ratio in adult COVID-19 cancer patients was significantly associated with inferior survival [152 (19-2253) in non-survivors, compared to 27.4 (0.8-681) in survivors (P = 0.033)]. It achieved a sensitivity (60%) and a specificity (90.2%) at a cut-off 152, while it achieved a sensitivity of 60% and specificity 95.1% at a cut-off 252 (AUC 0.795, P = 0.033). When combining both CRP/L and NLPR for the prediction of poor outcome in adult cancer patients with COVID19, the sensitivity increased to 80% and the specificity was 70.7% (AUC 0.805, P = 0.027). Increased incidence of ICU admission in pediatric cancer patients associated significantly with the severity of covid19 infection, decreased mean corpuscular hemoglobin (MCH) < 28.3, increased red cell distribution width (RDW) > 16, lymphopenia < 1.04, pseudo Pelger-Huet appearance, and PLR < 196.4 (P = 0.004, P = 0.040, P = 0.029, P = 0. 0.039, P = 0.050, and P = 0.040; respectively). The mean corpuscular volume (MCV), MCH, and RDW could be useful prognostic markers for poor outcome in COVID-19 pediatric cancer patients (P < 0.05 for all). Increased both CRP/L and NLPR associated significantly with poor survival in adult COVID-19 cancer patients, while PLR associated significantly with ICU admission in pediatric COVID-19 cancer patients.


Subject(s)
COVID-19/pathology , Inflammation/pathology , Neoplasms/pathology , Adolescent , Adult , Aged , Blood Platelets/pathology , Child , Child, Preschool , Female , Humans , Inflammation/virology , Leukocyte Count/methods , Lymphocytes/pathology , Male , Middle Aged , Neoplasms/virology , Neutrophils/pathology , Prognosis , Retrospective Studies , SARS-CoV-2/pathogenicity , Sensitivity and Specificity , Young Adult
12.
BMJ Open ; 11(10): e047275, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1504015

ABSTRACT

OBJECTIVE: Family caregivers play an essential role in end-of-life care but suffer considerable impact on their own health. A better understanding of main factors related to carers' health is important to inform interventions. The purpose of the study was to test for the first time the potential impact of a comprehensive set of observable variables on carer health during end-of-life caregiving within a population-based carer sample. DESIGN: National retrospective, cross-sectional, 4-month post-bereavement postal census survey of family carers of people who died from cancer. SETTING AND PARTICIPANTS: Relatives who registered a death from cancer during a 2-week period in England were identified from death certificates by the Office of National Statistics; response rate was 1504/5271 (28.5%). OUTCOME MEASURES: Carers' mental health was measured through General Health Questionnaire (GHQ)-12; general health was measured through EuroQoL EQ-Visual Analogue Scale (EQ-5D VAS). METHODS: Survey questions to measure potential variables associated with carer health were based on past research and covered patients' symptoms and functioning; caregiving activities and hours; informal and formal help received; work hours, other caregiving, volunteering; changes to work, income and expenditure; sleep and relaxation; and demographic variables. Bivariate analyses and ordinary least square regression were performed to investigate these variables' relationship with outcomes. RESULTS: Patients' psychological symptoms and functioning, caregiving hours, female gender and self-sought formal help related to worse mental health. General practitioner and social care input and relaxation related to better mental health. Patients' psychological symptoms, caregiving hours and female gender were associated with worse general health, and older age, employment and relaxation were associated with better general health. CONCLUSIONS: Improvements in carers' health overall may be made by focusing on potential impacts of patients' psychological symptoms on carers, facilitating respite and relaxation, and paying particular attention to factors affecting female carers.


Subject(s)
Bereavement , Neoplasms , Aged , Caregivers , Cross-Sectional Studies , Death , Female , Humans , Retrospective Studies , Surveys and Questionnaires
13.
Int J Environ Res Public Health ; 18(21)2021 11 02.
Article in English | MEDLINE | ID: covidwho-1502419

ABSTRACT

This study aimed to examine the awareness and status of cancer patients and healthcare providers (physicians, nurses and social workers) regarding community linkage, in order to establish a desirable care plan model in a future research project. The survey was conducted via two methods: face-to-face for cancer patients (n = 308) and oncology physicians (n = 210), and due to COVID-19 circumstances, online for nurses (n = 200) and social workers (n = 313). As a result, more than 95% of the healthcare providers responded that cancer patients required community-linked services and discharge plans, whereas 50.7% and 79.2% of cancer patients noted the importance of community-linked services and discharge plans, respectively. Social workers, among healthcare providers, showed the most positive experience about connecting patients to community services since 69.7% of them responded as "excellent". However, as a group, cancer patients considered the necessity of community-linked service as less important, as only 50.7% responded as agreeing it was necessary. The barriers to community linkage were the lack of communication among the different professions of healthcare providers, and the ambiguity in their roles. The findings of this study will inform future community-linked health research, policies and systems for cancer patients. In particular, an in-depth interview with cancer patients will be required to explore their lack of acknowledgment about the necessity of community-linked services. Therefore, this study is expected to contribute to the improvement and supplementation of cancer policies.


Subject(s)
COVID-19 , Neoplasms , Nurses , Physicians , Health Personnel , Humans , Neoplasms/therapy , Perception , SARS-CoV-2 , Social Workers
14.
Sci Rep ; 11(1): 21472, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500505

ABSTRACT

Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to death are limited. We examined time-trend specificities based on sex, age, and cause of death in the last 2 years of life. Datasets containing all hospitalizations and EDVs of elderly residents in Friuli-Venezia Giulia, Italy (N = 411,812), who died between 2002 and 2014 at ≥ 65 years, have been collected. We performed subgroup change-point analysis of monthly trends in the 2 years preceding death according to sex, age at death (65-74, 75-84, 85-94, and ≥ 95 years), and main cause of death (cancer, cardiovascular, or respiratory disease). The proportion of decedents (N = 142,834) accessing acute healthcare services increased exponentially in proximity to death (hospitalizations = 4.7, EDVs = 3.9 months before death). This was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively. Healthcare use among cancer patients intensified earlier in life (hospitalizations = 6.8, EDVs = 5.8 months before death). Decedents from respiratory diseases were most likely to access hospital-based services during the last month of life. No sex-based differences were found. The greater use of acute healthcare services among younger decedents and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services.


Subject(s)
Emergency Service, Hospital/trends , Hospitalization/trends , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/virology , Cardiovascular Diseases/mortality , Cardiovascular Diseases/pathology , Cause of Death , Emergency Service, Hospital/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Italy , Neoplasms/mortality , Neoplasms/pathology , Retrospective Studies , SARS-CoV-2/isolation & purification , Terminal Care
17.
JCO Oncol Pract ; 17(10): e1460-e1472, 2021 10.
Article in English | MEDLINE | ID: covidwho-1496295

ABSTRACT

PURPOSE: This randomized, double-blind study sought to understand whether cancer clinical trial consent form verbosity detracts from patients' decision making on trial enrollment. METHODS: This trial tested mock consent forms of 2,000, 4,000, and 6,000 words. The first two comprised the two experimental arms and the third the control arm. Phase II was conducted to identify the promising arm, which, in phase III, was compared with the control arm. Each consent form described the same trial. Eligible adult patients reported a cancer history and English literacy. The primary end point used a patient-reported Likert scale to assess the relationship between information in the consent form and trial decision making. RESULTS: In phase II, 93 patients were accrued and prompted the selection of the 2,000-word consent form for phase III. In phase III, 182 patients were recruited, resulting in 240 total evaluable patients to compare the 2,000-word versus the 6,000-word arm (control). For the primary end point, 103 (84%) and 107 (91%) patients in the 2,000- and 6,000-word arms, respectively, strongly agreed or agreed with the following: "The information in this consent form helped me make a decision about whether or not to enroll in the trial" (two-sided, P = .14). Median time to read each consent form was 8 and 12 minutes, respectively (two-sided, P < .0001). Among those assigned these consent forms, 84% and 73%, respectively (two-sided, P = .04) signed or expressed a willingness to sign. CONCLUSION: This study's primary end point was not met. However, secondary outcomes suggest a need to further study the efficiency and efficacy of shorter consent forms for cancer clinical trial enrollment.


Subject(s)
COVID-19 , Neoplasms , Adult , Consent Forms , Double-Blind Method , Humans , Neoplasms/therapy , SARS-CoV-2 , Treatment Outcome
18.
JCO Glob Oncol ; 7: 1513-1521, 2021 09.
Article in English | MEDLINE | ID: covidwho-1496260

ABSTRACT

This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares perspectives from eight different countries, including Austria, Brazil, Ghana, Honduras, Ireland, the Philippines, South Africa, and the United Arab Emirates, which provide insight to their unique issues, challenges, and barriers to quality improvement in cancer care during the pandemic. These perspectives shed light on some key recommendations applicable on a global scale and focus on access to care, importance of expanding and developing new treatments for both COVID-19 and cancer, access to telemedicine, collecting and using COVID-19 and cancer registry data, establishing measures and guidelines to further enhance quality of care, and expanding communication among governments, health care systems, and health care providers. The impact of the COVID-19 pandemic on cancer care and quality improvement has been and will continue to be felt across the globe, but this report aims to share these experiences and learnings and to assist ASCO's international members and our global fight against the pandemic and cancer.


Subject(s)
COVID-19 , Neoplasms , Delivery of Health Care , Humans , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics , Quality Improvement , SARS-CoV-2
19.
Med Educ Online ; 26(1): 1996923, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1493438

ABSTRACT

In this paper, Mixed Reality (MR) has been exploited in the operating rooms to perform laparoscopic and open surgery with the aim of providing remote mentoring to the medical doctors under training during the Covid-19 pandemic. The employed architecture, which has put together MR smartglasses, a Digital Imaging Player, and a Mixed Reality Toolkit, has been used for cancer surgery at the IRCCS Hospital 'Giovanni Paolo II' in southern Italy. The feasibility of using the conceived platform for real-time remote mentoring has been assessed on the basis of surveys distributed to the trainees after each surgery.


Subject(s)
Augmented Reality , COVID-19 , Laparoscopy , Mentoring , Neoplasms , Humans , Neoplasms/epidemiology , Neoplasms/surgery , Pandemics , SARS-CoV-2
20.
Cell Death Dis ; 12(11): 1019, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1493083

ABSTRACT

Clinical outcomes of COVID-19 patients are worsened by the presence of co-morbidities, especially cancer leading to elevated mortality rates. SARS-CoV-2 infection is known to alter immune system homeostasis. Whether cancer patients developing COVID-19 present alterations of immune functions which might contribute to worse outcomes have so far been poorly investigated. We conducted a multi-omic analysis of immunological parameters in peripheral blood mononuclear cells (PBMCs) of COVID-19 patients with and without cancer. Healthy donors and SARS-CoV-2-negative cancer patients were also included as controls. At the infection peak, cytokine multiplex analysis of blood samples, cytometry by time of flight (CyTOF) cell population analyses, and Nanostring gene expression using Pancancer array on PBMCs were performed. We found that eight pro-inflammatory factors (IL-6, IL-8, IL-13, IL-1ra, MIP-1a, IP-10) out of 27 analyzed serum cytokines were modulated in COVID-19 patients irrespective of cancer status. Diverse subpopulations of T lymphocytes such as CD8+T, CD4+T central memory, Mucosal-associated invariant T (MAIT), natural killer (NK), and γδ T cells were reduced, while B plasmablasts were expanded in COVID-19 cancer patients. Our findings illustrate a repertoire of aberrant alterations of gene expression in circulating immune cells of COVID-19 cancer patients. A 19-gene expression signature of PBMCs is able to discriminate COVID-19 patients with and without solid cancers. Gene set enrichment analysis highlights an increased gene expression linked to Interferon α, γ, α/ß response and signaling which paired with aberrant cell cycle regulation in cancer patients. Ten out of the 19 genes, validated in a real-world consecutive cohort, were specific of COVID-19 cancer patients independently from different cancer types and stages of the diseases, and useful to stratify patients in a COVID-19 disease severity-manner. We also unveil a transcriptional network involving gene regulators of both inflammation response and proliferation in PBMCs of COVID-19 cancer patients.


Subject(s)
Antibodies, Viral/blood , COVID-19/immunology , Cytokines/blood , Leukocytes, Mononuclear/immunology , Neoplasms/immunology , COVID-19/pathology , Case-Control Studies , Female , Humans , Leukocytes, Mononuclear/cytology , Male , Neoplasms/pathology
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