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Care of immunocompromised patients with head and neck cancer during the COVID-19 pandemic: Two challenging and informative clinical cases.
Civantos, Alyssa M; Carey, Ryan M; Lichtenstein, Gary R; Lukens, John N; Cohen, Roger B; Rassekh, Christopher H.
  • Civantos AM; Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Carey RM; Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Lichtenstein GR; Department of Medicine, Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Lukens JN; Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Cohen RB; Department of Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Rassekh CH; Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Head Neck ; 42(6): 1131-1136, 2020 06.
Article in English | MEDLINE | ID: covidwho-66373
Semantic information from SemMedBD (by NLM)
1. Malignant Head and Neck Neoplasm COEXISTS_WITH COVID-19
Subject
Malignant Head and Neck Neoplasm
Predicate
COEXISTS_WITH
Object
COVID-19
2. Malignant Head and Neck Neoplasm PROCESS_OF Patients
Subject
Malignant Head and Neck Neoplasm
Predicate
PROCESS_OF
Object
Patients
3. Disease COEXISTS_WITH COVID-19
Subject
Disease
Predicate
COEXISTS_WITH
Object
COVID-19
4. Malignant Head and Neck Neoplasm COEXISTS_WITH COVID-19
Subject
Malignant Head and Neck Neoplasm
Predicate
COEXISTS_WITH
Object
COVID-19
5. Malignant Head and Neck Neoplasm PROCESS_OF Patients
Subject
Malignant Head and Neck Neoplasm
Predicate
PROCESS_OF
Object
Patients
6. Disease COEXISTS_WITH COVID-19
Subject
Disease
Predicate
COEXISTS_WITH
Object
COVID-19
ABSTRACT
BACKGROUND AND

METHODS:

There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances.

RESULTS:

After careful consideration of the options, we took different approaches in the care of these two patients.

CONCLUSIONS:

Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Immunocompromised Host / Coronavirus Infections / Pandemics / Time-to-Treatment / Conservative Treatment / Head and Neck Neoplasms Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Head Neck Journal subject: Neoplasms Year: 2020 Document Type: Article Affiliation country: Hed.26165

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Immunocompromised Host / Coronavirus Infections / Pandemics / Time-to-Treatment / Conservative Treatment / Head and Neck Neoplasms Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Head Neck Journal subject: Neoplasms Year: 2020 Document Type: Article Affiliation country: Hed.26165