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1.
Tidsskr Nor Laegeforen ; 140(2)2021 02 02.
Article in English, No | MEDLINE | ID: covidwho-1110519

ABSTRACT

BACKGROUND: Cardiovascular disease and cancer have been described as possible risk factors for COVID-19 mortality. The purpose of this study was to investigate whether a history of cardiovascular disease or cancer affects the risk of dying after a COVID-19 diagnosis in Norway. MATERIAL AND METHOD: Data were compiled from the Norwegian Surveillance System for Communicable Diseases, the Norwegian Cardiovascular Disease Registry and the Cancer Registry of Norway. Univariable and multivariable regression models were used to calculate both relative and absolute risk. RESULTS: In the first half of 2020, 8 809 people tested positive for SARS-CoV-2 and 260 COVID-19-associated deaths were registered. Increasing age, male sex (relative risk (RR): 1.5; confidence interval (CI): 1.2-2.0), prior stroke (RR: 1.5; CI: 1.0-2.1) and cancer with distant metastasis at the time of diagnosis (RR: 3.0; CI: 1.1-8.2) were independent risk factors for death after a diagnosis of COVID-19. After adjusting for age and sex, myocardial infarction, atrial fibrillation, heart failure, hypertension, and non-metastatic cancer were no longer statistically significant risk factors for death. INTERPRETATION: The leading risk factor for death among individuals who tested positive for SARS-CoV-2 was age. Male sex, and a previous diagnosis of stroke or cancer with distant metastasis were also associated with an increased risk of death after a COVID-19 diagnosis.


Subject(s)
/mortality , Cardiovascular Diseases/complications , Neoplasms/complications , Female , Humans , Male , Norway/epidemiology , Risk Factors
2.
Tidsskr Nor Laegeforen ; 141(2)2021 02 02.
Article in English, No | MEDLINE | ID: covidwho-1106168
3.
Front Immunol ; 11: 624411, 2020.
Article in English | MEDLINE | ID: covidwho-1090416

ABSTRACT

SARS-CoV-2 is wreaking havoc around the world. To get the world back on track, hundreds of vaccines are under development. A deeper understanding of how the immune system responds to SARS-CoV-2 re-infection will certainly help. Studies have highlighted various aspects of T cell response in resolving acute infection and preventing re-infections. Lung resident memory T (TRM) cells are sentinels in the secondary immune response. They are mostly differentiated from effector T cells, construct specific niches and stay permanently in lung tissues. If the infection recurs, locally activated lung TRM cells can elicit rapid immune response against invading pathogens. In addition, they can significantly limit tumor growth or lead to pathologic immune responses. Vaccines targeting TRM cells are under development, with the hope to induce stable and highly reactive lung TRM cells through mucosal administration or "prime-and-pull" strategy. In this review, we will summarize recent advances in lung TRM cell generation and maintenance, explore their roles in different diseases and discuss how these cells may guide the development of future vaccines targeting infectious disease, cancer, and pathologic immune response.


Subject(s)
/immunology , Immunotherapy, Adoptive/methods , Lung/immunology , Neoplasms/immunology , T-Lymphocytes/immunology , Vaccines/immunology , Animals , Humans , Immunologic Memory , Lymphocyte Activation , T-Lymphocytes/transplantation
4.
Oncol Nurs Forum ; 48(2): 131-145, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1088625

ABSTRACT

OBJECTIVES: To identify research priorities addressing COVID-19 that build on the 2019-2022 Oncology Nursing Society (ONS) Research Agenda, in alignment with ONS's mission to promote excellence in oncology nursing and quality cancer care. METHODS & VARIABLES: Priority areas were identified using a multistep approach combining rapid review of the literature; consultation with experts/stakeholders; and review of priorities from other funding agencies, public health, and cancer-focused organizations. RESULTS: The rapid research response team identified five priority areas for research related to COVID-19. IMPLICATIONS FOR NURSING: Oncology nurses are well positioned to address the research priorities and cross-cutting themes identified through this review. The use of innovative methodologic approaches and attention to disparities are necessary to advance cancer care related to COVID-19.


Subject(s)
/epidemiology , Neoplasms/nursing , Nursing Research , Oncology Nursing , Societies, Nursing , Humans
5.
Oncologist ; 26(2): e350, 2021 02.
Article in English | MEDLINE | ID: covidwho-1086514

Subject(s)
Neoplasms , Humans
6.
Zhonghua Zhong Liu Za Zhi ; 43(2): 218-223, 2021 Feb 23.
Article in Chinese | MEDLINE | ID: covidwho-1084794

ABSTRACT

Objective: To explore the latest progress of oncology drug clinical trials in China under COVID-19, as well as to provide decision-making evidence for related stakeholders. Research progress of oncology drug trials and approved cancer drugs in China in 2020 were systematically summarized and compared with 2019. Methods: Information Disclosure Platform for Drug Clinical Studies and China Food and Drug Administration Query System for Domestic and Imported Drug were searched for registered clinical trials and approved oncology drugs, respectively. The trial scope, stage, drug type, effect and mechanism of domestic and global pharmaceutical enterprises were compared between 2019 and 2020. Results: A total of 722 cancer drug trials registered in China in 2020, with an annual growth rate of 52.3%, accounting for 28.3% of all registered trials. Among them, 603 (83.5%) trials were initiated by domestic pharmaceutical enterprises, and 105 (14.5%) were international multicenter trials, phase I trials accounted for 44.5%. For all those trials, there were 458 cancer drug varieties, with an annual growth rate of 36.7%, and 361 (85.8%) were developed by domestic enterprises. Most of the investigational products were therapeutic innovative drugs (77.1%), major in tumor treatment (92.8%). In terms of mechanism, targeted drugs were the most popular, accounting for 76.6%, and programmed cell death-1 (PD-1) and epithelial growth factor receptor (EGFR) were the most common targets. In addition, there were 19 anticancer drugs from 17 companies approved in China in 2019, with 10 drugs from domestic companies. Lung cancer and breast cancer are the most common indications for both registered trials and marketed drugs. No statistically significant differences were found between 2020 and 2019 in terms of the distribution of trial sponsor, scope and stage, as well as the distribution of drug type, effect and mechanism (P>0.05). Conclusions: During the Covid-19 epidemic period, clinical trials of oncology drugs in China progress smoothly and maintain a high growth rate. Series of innovative products obtained by domestic enterprises in 2020 is the main driving force of development of oncology drug clinical trials in China.


Subject(s)
Antineoplastic Agents , Neoplasms , Antineoplastic Agents/therapeutic use , China , Clinical Trials as Topic , Humans , Medical Oncology , Neoplasms/drug therapy , United States
7.
Clin J Oncol Nurs ; 25(1): 41-47, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1084640

ABSTRACT

BACKGROUND: The COVID-19 pandemic generated challenges to the delivery of safe, efficient, and high-quality cancer care. In ambulatory oncology, where most cancer care is delivered, these challenges required the rapid development of infrastructure. OBJECTIVES: This article describes challenges to the design and implementation of ambulatory oncology infrastructures that support clinical oncology care during a pandemic. METHODS: This article reviews clinical experiences in interprofessional, multicenter, academic, and community settings during the COVID-19 pandemic. Cohesive and efficient services, collaborative processes, and workflows; patient triage and symptom management; technology and equipment; and communication strategies are discussed. National ambulatory care guidelines and practice recommendations are included as applicable and available. FINDINGS: Continued treatment delivery and support for patients with cancer, as well as infrastructure to minimize viral exposure to patients and oncology healthcare workers, are essential when caring for this high-risk population.


Subject(s)
Ambulatory Care/standards , Medical Oncology/standards , Neoplasms/nursing , Oncology Nursing/standards , Practice Guidelines as Topic , Telemedicine/standards , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , United States/epidemiology
8.
Clin J Oncol Nurs ; 25(1): 61-68, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1084208

ABSTRACT

BACKGROUND: The disruption in the supply chain of resources and interruptions in cancer treatments caused by the pandemic presented tremendous challenges to the healthcare system. OBJECTIVES: This article describes the National Academy of Medicine-defined states of medical and nursing care delivery for which local plans should be drawn and the shifting and evolving systems framework that can guide decisions to optimize the crisis standards of care. METHODS: A case study is presented to describe the process of shifting the state of medical and nursing care delivery and bioethical nursing considerations during the pandemic and beyond. FINDINGS: An evolving and shifting systems framework for crises rooted in deontology, principlism, and the ethics of care model provide meaningful guidance for establishing priorities for patient care.


Subject(s)
/nursing , Decision Making/ethics , Delivery of Health Care/ethics , Neoplasms/nursing , Oncology Nursing/ethics , Oncology Nursing/standards , Pandemics/ethics , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Practice Guidelines as Topic
10.
Clin J Oncol Nurs ; 25(1): 48-55, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1081409

ABSTRACT

BACKGROUND: The COVID-19 pandemic has required healthcare systems to transform the delivery of care. Although the core principles of care for patients with cancer have not changed, this pandemic has led to heightened awareness concerning the fragility of patients with cancer and how healthcare systems can protect them. OBJECTIVES: The aims were to identify and implement inpatient and ambulatory care clinical practice changes during the COVID-19 pandemic, based on defining moments and coping strategies from clinical oncology nurses, advanced practice RNs, nurse leaders, and researchers. METHODS: This article presents a Lean Six Sigma framework, accompanied by numerous rapid cycle tests of change. FINDINGS: The COVID-19 pandemic required clinical healthcare providers at the authors' institution to focus on seven priority areas. Nurses tested and implemented practice changes.


Subject(s)
Adaptation, Psychological , Ambulatory Care/standards , Health Personnel/psychology , Neoplasms/nursing , Oncology Nursing/standards , Preventive Medicine/standards , Adult , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Practice Guidelines as Topic , Stress, Psychological
11.
Clin J Oncol Nurs ; 25(1): 76-84, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1080953

ABSTRACT

BACKGROUND: In the environment of an infectious pandemic, vaccines are a primary public health strategy to prevent the spread of disease. With the COVID-19 pandemic, there is heightened interest in safe and effective vaccines and their use in the context of clinical oncology practice. OBJECTIVES: This article provides foundational information about vaccines in general and vaccines developed to protect against the SARS-CoV-2 virus in the United States, as well as clinical nurse strategies to apply vaccines in clinical oncology practice. METHODS: The article is based on a review of public health literature and reputable websites about vaccines and their development in clinical care. FINDINGS: This foundational information about vaccines reviews their history and development, as well as the development of COVID-19 vaccines specifically, and discusses COVID-19 vaccines as part of clinical oncology care. Supporting best practices in clinical oncology care, nurses can provide factual, evidence-based information about vaccine safety, effectiveness, and safe administration.


Subject(s)
/administration & dosage , Medical Oncology/organization & administration , Neoplasms/nursing , Nursing Staff, Hospital/psychology , Oncology Nursing/organization & administration , Vaccination/psychology , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , United States/epidemiology , Vaccination/statistics & numerical data
12.
Intern Med J ; 51(1): 125-133, 2021 01.
Article in English | MEDLINE | ID: covidwho-1078972

ABSTRACT

The COVID-19 pandemic has precipitated the rapid uptake of telehealth in cancer care and in other fields. Many of the changes made in routine clinical practice could be embedded beyond the duration of the pandemic. This is intended as a practical guide to cancer clinicians and others in establishing and improving the quality of consultations performed by telehealth.


Subject(s)
Medical Oncology/trends , Neoplasms , Pandemics , Telemedicine/trends , Humans , Neoplasms/therapy
13.
Rev Peru Med Exp Salud Publica ; 37(4): 611-619, 2020.
Article in Spanish, English | MEDLINE | ID: covidwho-1076941

ABSTRACT

OBJECTIVE: Development of severe disease and death from COVID-19 is more frequent in patients with comorbidities. Some studies report an increased frequency of severe COVID-19 in cancer patients. This review aims to describe the risk of infection and developing severe COVID-19 in cancer patients. MATERIALS AND METHODS: A systematic review was carried out through an exhaustive search of literature in PubMed and Scopus until May 2020. A secondary search was performed to include more studies. RESULTS: The initial search identified 2,192 records, which included 17 publications with at least 10 infected cancer patients. Also, 5 articles were added from the additional search of the references cited by those 17 publications. Ten publications were from Chinese authors. Data analysis showed that COVID-19 infection is more frequent in cancer patients, and frequent therapeutic visits to the healthcare facility may be the cause. The presence of neoplasia predisposed patients to develop severe disease. Advanced age, associated comorbidities, advanced malignancy, and the presence of serum inflammatory markers increased the risk of developing severe disease. Initial studies indicate that the use of systemic treatment may also be a predisposing factor. CONCLUSIONS: The risk of becoming infected by COVID-19 and developing severe disease is higher in the oncological population.


Subject(s)
/epidemiology , Inflammation Mediators/blood , Neoplasms/complications , Age Factors , /physiopathology , Comorbidity , Humans , Risk Factors , Severity of Illness Index
14.
Cancer Control ; 28: 1073274821989709, 2021.
Article in English | MEDLINE | ID: covidwho-1076105

ABSTRACT

The 2019 novel coronavirus (COVID-19) pandemic has prompted the reorganization in the scheduling and method of care for many patients, including patients diagnosed with cancer. Cancer patients, who have an immunocompromised status, may be at a higher risk of severe symptoms from infection with COVID-19. While information is rapidly evolving regarding COVID-19, Canada, both nationally and provincially, has been conveying new information to patients online. We assessed the content and readability of COVID-19-related online Canadian patient education material (PEM) for cancer patients to determine if the content of the material was written at a grade reading level that the majority of Canadians can understand. PEMs were extracted from provincial cancer agencies and the national Canadian Cancer Society, evaluated using 10 readability scales, qualitatively analyzed to identify their themes and difficult word content. Thirty-eight PEMs from both national and provincial cancers associations were, on average, written above the recommended 7th grade level. Each of the associations' average grade levels were: BC Cancer (11.00 95% confidence interval [CI] 8.27-13.38), CancerControl Alberta (10.46 95% CI 8.29-12.62), Saskatchewan Cancer Agency (11.08 95% CI 9.37-12.80), Cancer Care Manitoba (9.55 95% CI 6.02-13.01), Cancer Care Ontario (9.35 95% CI 6.80-11.90), Cancer Care Nova Scotia (10.95 95% CI 9.86-12.04), Cancer Care Eastern Health Newfoundland and Labrador (10.14 95% CI 6.87-13.41), and the Canadian Cancer Society (10.06 95% CI 8.07-12.05). Thematic analysis identified 4 themes: public health strategy, information about COVID-19, patient instructions during COVID-19, and resources. Fifty-three percent of the complex words identified were medical jargon. This represents an opportunity to improve PEM readability, to allow for greater comprehension amongst a wider target audience.


Subject(s)
/prevention & control , Health Services , Medical Oncology/methods , Neoplasms/therapy , Patient Education as Topic/methods , /isolation & purification , /epidemiology , Canada , Comprehension , Health Literacy , Humans , Neoplasms/diagnosis , Pandemics , Patient Education as Topic/statistics & numerical data , Patient Education as Topic/trends , Reading , /physiology
15.
Eur J Heart Fail ; 22(12): 2173-2174, 2020 12.
Article in English | MEDLINE | ID: covidwho-1068673
16.
Anticancer Res ; 41(1): 307-316, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1068193

ABSTRACT

BACKGROUND/AIM: Knowledge of Coronavirus 19 (COVID19) pathogenetic mechanisms is necessary to provide new treatment strategies. This study aims to assess how oncological disease impacts on the clinical course of COVID-19 patients. PATIENTS AND METHODS: From 1st March to 30th April 2020, 96 COVID-19 patients were classified according to clinical outcome as severe (n=67) and moderate (n=29). Demographic data, medical history, admission lymphocytes, procalcitonin (PCT), c-reactive-protein (CRP), D-dimer, and Interleukin-6 (IL-6) were collected. RESULTS: A statistically significant association was found between hypertension (p=0.007) and three or more comorbidities with severe outcomes (p=0.034). No statistical differences were found between the severe and moderate groups with regards to the rate of patients with past oncological history. However, no patient allocated in the moderate group had received oncological treatment within 12 months. Higher values of CRP, IL-6, D-Dimer and lower values of lymphocytes were reported in the severe group (p=0.0007, p=0.00386, p=0.041, and p=0.007, respectively). Using binary logistic regression, higher values of CRP (OR=8.861; p=0.012) and PCT were associated with a higher risk of severe outcome (OR=21.075; p=0.008). Within the oncological population, D-Dimer and IL-6 did not confirm their prognostic significance as in the general population (p>0.05). CONCLUSION: Specific prognostic factors for oncological patients should be designed for COVID-19 clinical practice.


Subject(s)
Coronavirus Infections/complications , Coronavirus , Fibrin Fibrinogen Degradation Products , Interleukin-6/blood , Lymphocytes , Neoplasms/blood , Neoplasms/complications , Aged , Biomarkers/blood , Female , Humans , Lymphocyte Count , Male , Middle Aged , Multivariate Analysis , Neoplasms/mortality , Prognosis
17.
Epidemiol Prev ; 44(5-6 Suppl 2): 308-314, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068152

ABSTRACT

BACKGROUND: the COVID-19 pandemic represents a challenge for health systems around the world, with just under 10,000 cases in Tuscany Region (Central Italy) and about 4,500 in the Local Health Unit (LHU) 'Toscana Centro', updated on 11 May 2020. The risk factors reported are several, including age, being male, and some chronic diseases such as hypertension, diabetes, respiratory and cardiovascular diseases. However, the relative importance of chronic diseases is still to be explored. OBJECTIVES: to evaluate the role of chronic diseases on the risk to develop clinically evident (at least mild symptomatic) forms of SARS-CoV-2 infection in the population of the LHU Toscana Centro. DESIGN: case-population study. SETTING AND PARTICIPANTS: 'case' is a subject with SARS-CoV-2 positive swab with at least mild clinical status, who lives in the LHU Toscana Centro area; 'controls' are all people residing in the LHU Toscana Centro area at 1 January 2020. People aged under 30 and patients living in nursing care homes are excluded from the analysis. MAIN OUTCOME MEASURES: the analysis assesses the effect of gender, age, neoplasm, and the main chronic diseases on the onset of an infection with at least mild symptoms by calculating odds ratios (OR) by multivariate logistic regression models (to produce adjusted OR by potential confounders). RESULTS: among the 1,840 cases, compared to the general population, the presence of males and over-60-year-old people is greater. Almost all the considered chronic diseases are more frequent among the cases, compared to the general population. A chronic patient has a 68% greater risk to be positive with at least mild symptoms. Many of the considered diseases show an effect on the risk of getting COVID-19 in a symptomatic form, which remains even adjusting by other comorbidities. The main ones include heart failure, psychiatric disorders, Parkinson's disease, and rheumatic diseases. CONCLUSIONS: these results confirm evidence already shown in other studies on COVID-19 patients and add information on the chronic diseases attributable risk in the population, referred to the symptomatic forms and adjusted by age, gender or the possible copresence of more diseases. These risk estimates should guide prevention interventions by health services in order to protect the chronic patients affected by the pathologies most at risk.


Subject(s)
/epidemiology , Chronic Disease/epidemiology , Pandemics , Adult , Age Distribution , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Neoplasms/epidemiology , Nervous System Diseases/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Rheumatic Diseases/epidemiology , Sex Distribution
18.
Epidemiol Prev ; 44(5-6 Suppl 2): 88-94, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068127

ABSTRACT

We are presenting here the findings of the reaction to the COVID-19 epidemic during the period March to June 2020 of those centres participating in the research EASY-NET which is on-going in Italy, funded by the Ministry of Health and co-founded by the Regional Health Authorities. The objective of EASY-NET is to evaluate the effectiveness of the audit and feedback (A&F) strategies in different clinical and organizational settings in seven regions. As a negative consequence of the COVID-19 epidemic, the activities of the project have suddenly slowed down; nevertheless, the COVID-19 epidemic represented an opportunity to apply the A&F methodology and support the healthcare within the regional authorities in order to manage and monitor the impact of this new disease. The reaction to the crisis on behalf of EASY-NET was inconsistent across the participating regions for various reasons. Factors which influenced the reaction levels in relation to the rapidity and efficiency of the implementation of the A&F strategies were as follows: the varying epidemiological impact of the COVID-19 epidemic in the various territories, the different clinical and organizational context and availability of expert research teams together with A&F procedures which had already been tested before the start of the epidemic.


Subject(s)
/epidemiology , Formative Feedback , Management Audit , Pandemics , Quality Assurance, Health Care , Chronic Disease/epidemiology , Critical Pathways , Emergencies/epidemiology , Geography, Medical , Humans , Italy/epidemiology , Neoplasms/epidemiology , Outcome Assessment, Health Care , Quality Improvement
20.
Future Oncol ; 17(9): 1097-1104, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1067596

ABSTRACT

We presented the rationale for the use of thymosin α1 as prophylaxis of severe COVID-19 in cancer patients undergoing active treatment, constituting the background for the PROTHYMOS study, a prospective, multicenter, open-label, Phase II randomized study, currently in its start-up phase (Eudract no. 2020-006020-13). We aim to offer new hope for this incurable disease, especially to frail patient population, such as patients with cancer. The hypothesis of an effective prophylactic approach to COVID-19 would have immediate clinical relevance, especially given the lack of curative approaches. Moreover, in the 'COVID-19 vaccine race era' both clinical and biological results coming from the PROTHYMOS trials could even support the rationale for future combinatorial approaches, trying to rise vaccine efficacy in frail individuals.


Subject(s)
/complications , Neoplasms/complications , Thymalfasin/therapeutic use , Adjuvants, Immunologic/therapeutic use , Clinical Trials, Phase II as Topic , Humans , Randomized Controlled Trials as Topic , Research Design
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