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1.
Anesth Analg ; 131(1): 16-23, 2020 07.
Article in English | MEDLINE | ID: covidwho-677481

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. Since then, it has spread across the world to become one of the most serious life-threatening pandemics since the influenza pandemic of 1918. This review article will focus on the specific risks and nuanced considerations of COVID-19 in the cancer patient. Important perioperative management recommendations during this outbreak are emphasized, in addition to discussion of current treatment techniques and strategies available in the battle against COVID-19.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/therapy , Neoplasms/complications , Neoplasms/therapy , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Disease Outbreaks , Humans , Pandemics , Patient Care Management
2.
Oncology (Williston Park) ; 34(7): 270-271, 2020 07 15.
Article in English | MEDLINE | ID: covidwho-648015

ABSTRACT

Patients with cancer represent a vulnerable population and are at greater risk of developing serious complications as a result of a COVID-19 infection. In response, oncology societies around the world have proposed changes to their standards of care. These changes have helped guide health care providers in prioritizing clinical management of patients with cancer: identifying situations in which urgent intervention is needed and those that can be triaged until the risk of infection has lessened.


Subject(s)
Coronavirus Infections , Critical Pathways/trends , Delivery of Health Care/organization & administration , Neoplasms , Pandemics , Patient Care Management , Pneumonia, Viral , Psycho-Oncology , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Delivery of Health Care/methods , Humans , Neoplasms/epidemiology , Neoplasms/psychology , Organizational Innovation , Pandemics/prevention & control , Patient Care Management/organization & administration , Patient Care Management/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Psycho-Oncology/methods , Psycho-Oncology/trends , Psychological Distress
3.
Intern Med J ; 50(7): 798-804, 2020 07.
Article in English | MEDLINE | ID: covidwho-639949

ABSTRACT

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.


Subject(s)
Coronavirus Infections , Gastroenterology , Immunologic Factors/pharmacology , Inflammatory Bowel Diseases , Pandemics , Patient Care Management , Pneumonia, Viral , Australia , Betacoronavirus/isolation & purification , Change Management , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Management , Gastroenterology/organization & administration , Gastroenterology/trends , Humans , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/immunology , Inflammatory Bowel Diseases/therapy , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Risk Management
4.
Chest ; 158(1): 106-116, 2020 07.
Article in English | MEDLINE | ID: covidwho-634902

ABSTRACT

With more than 900,000 confirmed cases worldwide and nearly 50,000 deaths during the first 3 months of 2020, the coronavirus disease 2019 (COVID-19) pandemic has emerged as an unprecedented health care crisis. The spread of COVID-19 has been heterogeneous, resulting in some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 and others having community transmission that has led to overwhelming numbers of severe cases. For these regions, health care delivery has been disrupted and compromised by critical resource constraints in diagnostic testing, hospital beds, ventilators, and health care workers who have fallen ill to the virus exacerbated by shortages of personal protective equipment. Although mild cases mimic common upper respiratory viral infections, respiratory dysfunction becomes the principal source of morbidity and mortality as the disease advances. Thoracic imaging with chest radiography and CT are key tools for pulmonary disease diagnosis and management, but their role in the management of COVID-19 has not been considered within the multivariable context of the severity of respiratory disease, pretest probability, risk factors for disease progression, and critical resource constraints. To address this deficit, a multidisciplinary panel comprised principally of radiologists and pulmonologists from 10 countries with experience managing patients with COVID-19 across a spectrum of health care environments evaluated the utility of imaging within three scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions, corresponding to 11 decision points within the three scenarios and three additional clinical situations, were rated by the panel based on the anticipated value of the information that thoracic imaging would be expected to provide. The results were aggregated, resulting in five main and three additional recommendations intended to guide medical practitioners in the use of chest radiography and CT in the management of COVID-19.


Subject(s)
Coronavirus Infections , Lung/diagnostic imaging , Pandemics , Patient Care Management , Pneumonia, Viral , Radiography, Thoracic/methods , Respiratory Tract Diseases , Tomography, X-Ray Computed/methods , Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Diagnosis, Differential , Disease Progression , Early Diagnosis , Humans , International Cooperation , Patient Care Management/methods , Patient Care Management/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/virology
5.
Anesth Analg ; 131(1): 16-23, 2020 07.
Article in English | MEDLINE | ID: covidwho-623286

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. Since then, it has spread across the world to become one of the most serious life-threatening pandemics since the influenza pandemic of 1918. This review article will focus on the specific risks and nuanced considerations of COVID-19 in the cancer patient. Important perioperative management recommendations during this outbreak are emphasized, in addition to discussion of current treatment techniques and strategies available in the battle against COVID-19.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/therapy , Neoplasms/complications , Neoplasms/therapy , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Disease Outbreaks , Humans , Pandemics , Patient Care Management
6.
RMD Open ; 6(2)2020 06.
Article in English | MEDLINE | ID: covidwho-617044

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has come with many challenges for healthcare providers and patients alike. In addition to the direct burden it has placed on societies and health systems, it had a significant impact in the care of patients with chronic diseases, as healthcare resources were deployed to fight the crisis, and major travel and social restrictions were adopted. In the field of rheumatology, this has required notable efforts from departments and clinicians to adapt to the novel status quo and assure the follow-up of patients with rheumatic and musculoskeletal diseases. In the present viewpoint, we provide a practical approach to tackle this reality. Key measures include setting up preventive team management strategies, optimising communication with patients and reorganising patient care in all its dimensions. We then anticipate the nuances of rheumatology practice as restrictive measures are progressively lifted, while an effective vaccine is still pending. This includes the need to reimpose the same strategy as further waves unfold. Finally, we look ahead and address the lessons we can incorporate into post-COVID-19 rheumatology.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections , Organizational Innovation , Pandemics , Patient Care Management , Pneumonia, Viral , Rheumatic Diseases , Rheumatology/methods , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/prevention & control , Critical Pathways/organization & administration , Critical Pathways/trends , Humans , Immunity , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Rheumatic Diseases/epidemiology , Rheumatic Diseases/therapy , Telemedicine/methods
7.
Anesth Analg ; 131(1): 86-92, 2020 07.
Article in English | MEDLINE | ID: covidwho-606367

ABSTRACT

Coronavirus disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers, health systems, and economies. As it reaches low- and middle-income countries, its effects could be even more dire, because it will be difficult for them to respond aggressively to the pandemic. There is a great shortage of all health care providers, who will be at risk due to a lack of personal protection equipment. Social distancing will be almost impossible. The necessary resources to treat patients will be in short supply. The end result could be a catastrophic loss of life. A global effort will be required to support faltering economies and health care systems.


Subject(s)
Coronavirus Infections/economics , Developing Countries , Pandemics/economics , Pneumonia, Viral/economics , Poverty , Coronavirus Infections/therapy , Humans , International Cooperation , Patient Care Management/economics , Patient Care Management/organization & administration , Personal Protective Equipment , Pneumonia, Viral/therapy
10.
Anesth Analg ; 131(1): 16-23, 2020 07.
Article in English | MEDLINE | ID: covidwho-599932

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. Since then, it has spread across the world to become one of the most serious life-threatening pandemics since the influenza pandemic of 1918. This review article will focus on the specific risks and nuanced considerations of COVID-19 in the cancer patient. Important perioperative management recommendations during this outbreak are emphasized, in addition to discussion of current treatment techniques and strategies available in the battle against COVID-19.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/therapy , Neoplasms/complications , Neoplasms/therapy , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Disease Outbreaks , Humans , Pandemics , Patient Care Management
12.
Clin Rheumatol ; 39(7): 2043-2047, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-549229

ABSTRACT

COVID-19 is a world health emergency which may inevitably affect the management of a complex autoimmune disease such as systemic sclerosis (SSc). Several SSc patients are frail and, in this pandemic, need a careful protection. The COVID-19 infection might complicate the clinical scenario of interstitial lung disease (ILD) in SSc because it determines a severe pneumonia characterized by radiological features similar to SSc-ILD. The striking CT similarities between the 2 diseases make it difficult to distinguish a worsening of SSc-ILD from COVID-19-ILD superinfection. Moreover, other aspects, like isolation during lock down, may cause a significant psychological stress which will pile up on the already difficult contact with the patients for a routine check-up. Moreover, the drug shortage is a real problem in these times. For these reasons, the rheumatologist in daily clinical practice should carefully differentiate the possible COVID-19 infection in order to optimize the patient management. Therefore, the challenge in everyday life will be to achieve in due time the differential diagnosis as well as the long-term psychological impact.Key Points• SSc patients should be encouraged to continue their chronic therapy; in case of immunosuppressive therapy it must be discontinued for safety in case of COVID-19 infection.• Psychological support must be guaranteed to every SSc patients.• COVID-19 pneuminia is hard to distinguish from an interstitial lung disease due to SSc lung involvment.• Data sharing is fundamental for an optimal managment of SSc patients during COVID-19 pandemia.


Subject(s)
Coronavirus Infections , Immunosuppressive Agents/therapeutic use , Lung Diseases, Interstitial , Pandemics , Pneumonia, Viral/diagnosis , Scleroderma, Systemic , Betacoronavirus/isolation & purification , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Diagnosis, Differential , Humans , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/etiology , Patient Care Management/methods , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Psychological Distress , Scleroderma, Systemic/epidemiology , Scleroderma, Systemic/psychology , Scleroderma, Systemic/therapy , Social Isolation/psychology , Tomography, X-Ray Computed/methods
15.
Lima; Perú. Ministerio de Salud; 20200500. 4 p.
Monography in Spanish | LILACS (Americas) | ID: covidwho-525863

ABSTRACT

El documento contiene el listado de bienes esenciales para el manejo y tratamiento del COVID-19


Subject(s)
Patient Care Management , Coronavirus Infections , Equipment and Supplies , Ambulatory Care
16.
J Thorac Oncol ; 15(7): 1119-1136, 2020 07.
Article in English | MEDLINE | ID: covidwho-478255

ABSTRACT

The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available.


Subject(s)
Coronavirus Infections , Infection Control/organization & administration , Lung Neoplasms/therapy , Pandemics , Patient Care Management , Pneumonia, Viral , Betacoronavirus/isolation & purification , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Interdisciplinary Communication , International Cooperation , Lung Neoplasms/epidemiology , Lung Neoplasms/pathology , Neoplasm Staging , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Prognosis
18.
Euro Surveill ; 25(21)2020 05.
Article in English | MEDLINE | ID: covidwho-437617

ABSTRACT

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.


Subject(s)
Civil Defense/organization & administration , Coronavirus Infections/epidemiology , Coronavirus , Disease Outbreaks , Patient Care Management , Pneumonia, Viral/epidemiology , Adult , Betacoronavirus , Germany/epidemiology , Humans , Middle Aged , Pandemics , Risk Assessment , Tertiary Care Centers , Triage
19.
Aging (Albany NY) ; 12(10): 9959-9981, 2020 05 29.
Article in English | MEDLINE | ID: covidwho-430864

ABSTRACT

The severity and outcome of coronavirus disease 2019 (COVID-19) largely depends on a patient's age. Adults over 65 years of age represent 80% of hospitalizations and have a 23-fold greater risk of death than those under 65. In the clinic, COVID-19 patients most commonly present with fever, cough and dyspnea, and from there the disease can progress to acute respiratory distress syndrome, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy, multiple organ failure and death. Comorbidities such as cardiovascular disease, diabetes and obesity increase the chances of fatal disease, but they alone do not explain why age is an independent risk factor. Here, we present the molecular differences between young, middle-aged and older people that may explain why COVID-19 is a mild illness in some but life-threatening in others. We also discuss several biological age clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase the survival of older people, not simply by inhibiting the virus, but by restoring patients' ability to clear the infection and effectively regulate immune responses.


Subject(s)
Aging/physiology , Coronavirus Infections , Epigenesis, Genetic/physiology , Immunity/physiology , Pandemics , Patient Care Management/methods , Pneumonia, Viral , Aged , Betacoronavirus/isolation & purification , Betacoronavirus/physiology , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/therapy , Cytokine Release Syndrome/etiology , Cytokine Release Syndrome/immunology , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/therapy , Respiratory Distress Syndrome, Adult/etiology , Respiratory Distress Syndrome, Adult/immunology , Risk Assessment , Risk Factors , Severity of Illness Index
20.
S Afr Med J ; 110(5): 341-342, 2020 03 27.
Article in English | MEDLINE | ID: covidwho-380142
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