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1.
Cancer Treat Res Commun ; 25: 100261, 2020.
Article in English | MEDLINE | ID: covidwho-956074

ABSTRACT

BACKGROUND: UK COVID-19 mortality rates are amongst the highest globally. Controversy exists on the vulnerability of thoracic cancer patients. We describe the characteristics and sequelae of patients with thoracic cancer treated at a UK cancer centre infected with COVID-19. METHODS: Patients undergoing care for thoracic cancer diagnosed with COVID-19 (RT-PCR/radiology/clinically) between March-June 2020 were included. Data were extracted from patient records. RESULTS: Thirty-two patients were included: 14 (43%) diagnosed by RT-PCR, 18 (57%) by radiology and/or convincing symptoms. 88% had advanced thoracic malignancies. Eleven of 14 (79%) patients diagnosed by RT-PCR and 12 of 18 (56%) patients diagnosed by radiology/clinically were hospitalised, of which four (29%) and 2 (11%) patients required high-dependency/intensive care respectively. Three (21%) patients diagnosed by RT-PCR and 2 (11%) patients diagnosed by radiology/clinically required non-invasive ventilation; none were intubated. Complications included pneumonia and sepsis (43% and 14% respectively in patients diagnosed by RT-PCR; 17% and 11% respectively in patients diagnosed by radiology/clinically). In patients receiving active cancer treatment, therapy was delayed/ceased in 10/12 (83%) and 7/11 (64%) patients diagnosed by RT-PCR and radiology/clinically respectively. Nine (28%) patients died; all were smokers. Median time from symptom onset to death was 7 days (range 3-37). CONCLUSIONS: The immediate morbidity from COVID-19 is high in thoracic cancer patients. Hospitalisation and treatment interruption rates were high. Improved risk-stratification models for UK cancer patients are urgently needed to guide safe cancer-care delivery without compromising efficacy.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2/pathogenicity , Thoracic Neoplasms/epidemiology , Adult , COVID-19/complications , COVID-19/virology , Critical Care , Female , Hospitalization , Humans , Male , Middle Aged , Thoracic Neoplasms/complications , Thoracic Neoplasms/virology , United Kingdom/epidemiology
4.
Thorac Cancer ; 11(8): 2370-2375, 2020 08.
Article in English | MEDLINE | ID: covidwho-649797

ABSTRACT

To date, the impact, timeline and duration of COVID-19 pandemic remains unknown and more than ever it is necessary to provide safe pathways for cancer patients. Multiple triage systems for nonemergent surgical procedures have been published, but potentially curative cancer procedures are essential surgery rather than elective surgery. In the present and future scenario of our country, thoracic oncology teams may have the difficult decision of weighing the utility of surgical intervention against the risk for inadvertent COVID-19 exposure for patients and medical staff. In consequence, traditional pathways of surgical care must be adjusted to reduce the risk of infection and the use of resources. It is recommended that all thoracic cancer patients should be offered treatment according to the accepted standard of care until shortage of services require a progressive reduction in surgical cases. Here, we present a consensus of recommendations discussed by a multidisciplinary panel of experts on thoracic oncology and based on the best available evidence, and hope it will provide a modifiable framework of guidance for local strategy planners in thoracic cancer care services in Mexico. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This article provides recommendations to guarantee the continuity of surgical care for thoracic oncology cases during COVID-19 pandemic, whilst maintaining the safety of patients and medical staff. WHAT THIS STUDY ADDS: This guideline is the result of an expert consensus on thoracic surgical oncology with recommendations adapted to medical, economic and social realities of Mexico.


Subject(s)
COVID-19/epidemiology , Lung Neoplasms/epidemiology , Pandemics , Thoracic Neoplasms/epidemiology , COVID-19/complications , COVID-19/virology , Guidelines as Topic , Humans , Lung Neoplasms/complications , Lung Neoplasms/surgery , Lung Neoplasms/virology , Medical Oncology/trends , Mexico/epidemiology , SARS-CoV-2/pathogenicity , Thoracic Neoplasms/complications , Thoracic Neoplasms/surgery , Thoracic Neoplasms/virology , Triage
5.
Cancer Cell ; 37(6): 742-745, 2020 06 08.
Article in English | MEDLINE | ID: covidwho-628515

ABSTRACT

Prior publications on small subsets of cancer patients infected with SARS CoV-2 have shown an increased risk of mortality compared to the general population. Furthermore, patients with thoracic malignancies are thought to be at particularly high risk given their older age, smoking habits, and pre-existing cardio-pulmonary comorbidities. For this reason, physicians around the world have formed TERAVOLT, a global consortium dedicated to understanding the impact of COVID-19 on patients with thoracic malignancies.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/therapy , Medical Oncology/organization & administration , Pneumonia, Viral/therapy , Registries , Thoracic Neoplasms/therapy , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Global Burden of Disease , Humans , International Cooperation , Intersectoral Collaboration , Medical Oncology/standards , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Practice Guidelines as Topic , SARS-CoV-2 , Thoracic Neoplasms/complications , Thoracic Neoplasms/mortality
6.
Crit Rev Oncol Hematol ; 153: 103033, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-611931

ABSTRACT

The world currently faces a pandemic due to SARS-CoV-2. Relevant information has emerged regarding the higher risk of poor outcomes in lung cancer patients. As such, lung cancer patients must be prioritized in terms of prevention, detection and treatment. On May 7th, 45 experts in thoracic cancers from 11 different countries were invited to participate. A core panel of experts regarding thoracic oncology care amidst the pandemic gathered virtually, and a total of 60 initial recommendations were drafted based on available evidence, 2 questions were deleted due to conflicting evidence. By May 16th, 44 experts had agreed to participate, and voted on each of the 58 recommendation using a Delphi panel on a live voting event. Consensus was reached regarding the recommendations (>66 % strongly agree/agree) for 56 questions. Strong consensus (>80 % strongly agree/agree) was reached for 44 questions. Patients with lung cancer represent a particularly vulnerable population during this time. Special care must be taken to maintain treatment while avoiding exposure.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus , Pandemics/prevention & control , Patient Care/standards , Pneumonia, Viral/prevention & control , Thoracic Neoplasms/therapy , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Societies, Medical , Thoracic Neoplasms/complications
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