Clinical impact of SARS-CoV-2 infection among patients with vulvar cancer: the Gemelli Vul.Can multidisciplinary team

2021 ◽  
pp. ijgc-2021-003026
Author(s):  
Alex Federico ◽  
Simona Maria Fragomeni ◽  
Luca Tagliaferri ◽  
Linda Stella Guajardo Rios ◽  
Valentina Lancellotta ◽  
...  
Keyword(s):  
Vulvar Cancer ◽  
Clinical Impact ◽  
Nasopharyngeal Swab ◽  
Clinical Implications ◽  
Respiratory Complications ◽  
Chain Reaction ◽  
Patients With Cancer ◽  
Post Operative Period ◽  
Polymerase Chain ◽  
Clinical Worsening

Background‘Severe acute respiratory syndrome coronavirus-2’ (SARS-CoV-2) infection has dramatically affected the management of patients with cancer, who are most vulnerable to the consequences of the infection. Patients with vulvar cancer are frequently elderly and affected by multiple co-morbidities, thus representing a particularly frail population.ObjectiveTo assess the clinical impact of the SARS-CoV-2 infection among patients scheduled for treatment for active vulvar cancer.MethodsData on patients with vulvar tumors referred to Fondazione Policlinico Universitario Agostino Gemelli IRCCS between February 2020 and July 2021 were retrospectively analyzed. Patients with a positive reverse transcription polymerase chain reaction in nasopharyngeal swab were considered as positive for SARS-Cov-2.ResultsOne hundred and ninety-one patients with vulvar cancer were evaluated and scheduled for treatment. The median age was 72 years (range 35–94). Seven (3.7%) patients were diagnosed with SARS-Cov-2 infection: three (42.9%) had their treatment delayed, with no apparent consequences, two (28.6%) had their treatment delayed and later abandoned because of clinical worsening due to oncologic disease progression, and two (28.6%) contracted the infection in the post-operative period and died due to respiratory complications.ConclusionsIn most cases the infection had major clinical implications, being associated with significant delays in oncologic treatments and extremely high mortality when contracted in the post-operative period.

scholarly journals Outcome of COVID-19 in Solid Organ Malignancies: Experience From a Tertiary Cancer Center in Eastern India

2021 ◽  
pp. 1374-1379
Author(s):  
Somnath Roy ◽  
Joydeep Ghosh ◽  
Sandip Ganguly ◽  
Debapriya Mondal ◽  
Deepak Dabkara ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Median Duration ◽  
Cancer Center ◽  
Nasopharyngeal Swab ◽  
Solid Organ ◽  
Chain Reaction ◽  
Unique Challenge ◽  
Risk Of Death ◽  
Polymerase Chain

PURPOSE The COVID-19 pandemic has imposed a unique challenge to oncology patients. Outcome data on COVID-19 in patients with cancer from the Indian subcontinent are scarce in the literature. We aimed to evaluate the outcome of patients with COVID-19 on active systemic anticancer therapy. MATERIALS AND METHODS This is a retrospective study of patients with solid organ malignancies undergoing systemic therapy with a diagnosis of COVID-19 between March 2020 and February 2021. COVID-19 was diagnosed if a reverse transcriptase polymerase chain reaction assay from oropharyngeal or nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2. The objectives were to evaluate the outcome of COVID-19 and factors predicting the outcome. RESULTS A total of 145 patients were included with a median age of 58 years (range, 20-81 years). Treatment was curative in 60 (42%) patients. Of all symptomatic cases (n = 88, 61%), 50 had mild, 27 had moderate and 19 had severe COVID-19–related symptoms as per WHO criteria. Fifty (34%) patients required hospitalization with a median duration of hospital stay of 12 days (range, 4-25 days); five patients required intensive care unit admission. The rest were treated with home isolation and did not require further hospitalization. Twenty-two (15%) patients died, and the risk of death was significantly associated with severity of symptoms (odds ratio, 91.3; 95% CI, 9.1 to 919.5, P = .0001) but not with any other clinical factors. Drug holiday was given to 63 (44%) patients with a median duration of 25 days (range, 7-88 days). The median duration to reverse transcriptase polymerase chain reaction–negative was 16 days (range, 7-62 days). CONCLUSION COVD-19–related death rate was 15% among patients with solid organ malignancies. The severity of the symptoms was related to mortality. The majority of patients with mild symptoms were treated at home isolation.

scholarly journals Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19

2020 ◽  
Vol 99 (11) ◽  
pp. 1239-1244 ◽  
Author(s):  
R. Liu ◽  
S. Yi ◽  
J. Zhang ◽  
Z. Lv ◽  
C. Zhu ◽  
...  
Keyword(s):  
Viral Load ◽  
Quantitative Polymerase Chain Reaction ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Global Pandemic ◽  
Observational Cohort ◽  
Polymerase Chain ◽  
Underlying Diseases ◽  
Temporal Profiles ◽  
Substantial Morbidity

Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.

scholarly journals COVID-19 Autopsies, Oklahoma, USA

2020 ◽  
Vol 153 (6) ◽  
pp. 725-733 ◽  
Author(s):  
Lisa M Barton ◽  
Eric J Duval ◽  
Edana Stroberg ◽  
Subha Ghosh ◽  
Sanjay Mukhopadhyay
Keyword(s):  
Diffuse Alveolar Damage ◽  
Nasopharyngeal Swab ◽  
Protective Equipment ◽  
Chain Reaction ◽  
Polymerase Chain Reaction Testing ◽  
Standard Procedures ◽  
History Of ◽  
Polymerase Chain ◽  
Viral Inclusions ◽  
Postmortem Examinations

Abstract Objectives To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020. Methods Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs. Results A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis. Conclusions SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.

scholarly journals Detection of SARS-CoV-2 by real time Reverse Transcriptase-Polymerase Chain Reaction assay in pleural effusion

2021 ◽  
pp. 201
Author(s):  
Keyword(s):  
Polymerase Chain Reaction ◽  
Pleural Effusion ◽  
Reverse Transcriptase ◽  
Pleural Fluid ◽  
Interstitial Pneumonia ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Pleural Involvement

SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) is a novel coronavirus identified for the first time in Wuhan (China) in 2019, responsible of the current pandemic infection known as Coronavirus-19 disease (COVID-19). Wide range of clinical presentation of COVD -19 has been observed, from asymptomatic carriers to ARDS. The common signs and symptoms of SARS-CoV-2 infection include fever, fatigue, dry cough, and dyspnoea; the severity of the disease is due to the impairment of the respiratory function. The radiological findings include a large variety of lesions; bilateral interstitial pneumonia is the most concerning presentation of COVID-19. Pleural involvement has been described in a minority of cases: pleural thickening had been observed in 32% of cases whereas pleural effusion is uncommon being described in only 5%. Furthermore, pleural involvement has been significantly associated with a worse prognosis. Coronavirus 2 (SARS-CoV-2), beyond the nasopharyngeal swab, has been detected in other samples; up to now, data about RT-PCR specific results in the pleural fluid of patients suffering from coronavirus disease 2019 5 (COVID-19) are very limited. The current gold standard for diagnosis is nucleic acid detection by real time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in nasopharyngeal swab. In this report, a case of a positive RT-PCR for Sars-Cov-2 in the pleura fluid and in the naso- pharyngeal swab of a patient affected by bilateral interstitial pneumonia and severe respiratory failure is described. As the presence of SARS-Cov-2 in the pleural fluid seems to be associated to a poor prognosis, physicians should carry out the specific RT-PCR assay both in the nasopharyngeal swab and in the pleural sample also when the fluid amount is very scarce and not recognizable in the chest X ray. Furthermore, the analysis of multiple samples allows to increase the test reliability.

scholarly journals Performance of qualitative and quantitative antigen tests for SARS-CoV-2 in early symptomatic patients using saliva

2020 ◽  
Author(s):  
Isao Yokota ◽  
Takayo Sakurazawa ◽  
Junichi Sugita ◽  
Sumio Iwasaki ◽  
Keiko Yasuda ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Gold Standard ◽  
Rapid Detection ◽  
Disease Outbreaks ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Qualitative And Quantitative ◽  
Polymerase Chain ◽  
Antigen Tests ◽  
Chemiluminescent Enzyme Immunoassay

AbstractBackgroundThe rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an urgent need for the prevention and containment of disease outbreaks in communities. Although the gold standard is polymerase chain reaction (PCR), antigen tests such as immunochromatographic assay (ICA) and chemiluminescent enzyme immunoassay (CLEIA) that can yield results within 30 minutes.MethodsWe evaluated performance of ICA and CLEIA using 34 frozen PCR-positive specimens (17 saliva and 17 nasopharyngeal swab) and 307 PCR-negative samples.ResultsICA detected SARS-CoV-2 in only 14 (41%) samples, with positivity of 24% in saliva and 59% in NPS. Notably, ICA detected SARS-CoV-2 in 5 (83%) of 6 samples collected within 4 days after symptom onset. CLEIA detected SARS-CoV-2 in 31 (91%) samples, with positivity of 82% in saliva and 100% in NPS. CLEIA was negative in 3 samples with low viral load by PCR.ConclusionsThese results suggest that use of ICA should be limited to earlier time after symptom onset and CLEIA is more sensitive and can be used in situations where quick results are required.

scholarly journals Acute Severe Bilateral Visual Loss as Presenting Symptom of COVID-19 Infection

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Kazem Ghaemi ◽  
Tahereh Darvishpour Kakhki ◽  
Fatemeh Abbasi ◽  
Malihe Nikandish
Keyword(s):  
Visual Loss ◽  
Posterior Cerebral Artery ◽  
Cranial Nerves ◽  
Occipital Cortex ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Case Presentation ◽  
Wide Range ◽  
Brain Ct Scan ◽  
Polymerase Chain

Introduction: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and is accompanied by extraordinary morbidity and mortality. Critically ill COVID-19 patients have frequent thrombotic problems and laboratory evidence of hypercoagulability. The spectrum of presentations and complications of COVID-19 is still evolving. We describe a patient with unusual visual symptoms as the presenting signs of COVID-19. Case Presentation: In this case report, we describe a patient who presented with acute severe bilateral visual loss and headache. On neurological examination, cranial nerves were normal. There was no motor and sensorial abnormality. While the patient was in the emergency room, he was tested positive for COVID-19 via nasopharyngeal swab polymerase chain reaction (PCR) as part of COVID-19 surveillance. An unenhanced brain CT scan showed infarction in the occipital cortex bilaterally due to ischemic stroke involving the Posterior Cerebral Artery (PCA). A few hours later, oxygen saturation was 42%, and a sudden decline of consciousness was observed, progressing to coma. The neurosurgery intervention failed to change the patient's status, and he was pronounced dead in the next few hours. Conclusions: This case illuminates a wide range of COVID-19-related symptomatology and highlights the need for clinicians to be aware of different clinical appearances associated with this infection.

scholarly journals Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Raffaele Costa ◽  
Alberto Castagna ◽  
Carlo Torchia ◽  
Carmen Ruberto ◽  
Viviana Vespertini ◽  
...  
Keyword(s):  
At Risk ◽  
Drug Interaction ◽  
Qt Dispersion ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Main Determinant ◽  
Hospitalized Elderly ◽  
Repolarization Phase ◽  
Polymerase Chain ◽  
Electrocardiographic Parameters

The aim of our study was to characterize the repolarization disorders propensity induced by drug-drug interaction. In this observational retrospective study, we report our experience on all elderly patients with ascertained diagnosis of coronavirus disease 2019 through nasopharyngeal swab with real time-polymerase chain reaction at our Pugliese-Ciaccio hospital in Catanzaro, who received hydroxychloroquine (HCQ), with or without azithromycin (AZY). 33 hospitalized patients were examined. We calculated QT value, cQT, QT dispersion, and cQT dispersion and examined possible progression on the basal electrocardiogram (T0) and after the insertion of the drug (T1). The QT value is increased by T0 vs T1 (370±40.74 vs 420±36.91 ms; P=0.000), as well as the cQT value (408±25.40 vs 451.54±58.81; P=0.003), the QT dispersion (QTd: 36.36±14.53 vs 50.90±13.12 ms; P=0.000); the dispersion of cQTc (cQTd 46.27±18.72 vs 63.18±21.93 ms; P=0.001). The ΔQT was 37.44±44.09 while the ΔcQT was 32.01±56.47). The main determinant of QTc prolongation is the number of drug at risk of prolongation of the QT that could influence the ventricular repolarization phase. The use of HCQ in combination with AZY, in patients suffering from severe acute respiratory syndrome-related coronavirus-2, can favor the onset of serious side effects, even potentially fatal. Finally, the measures of QTd and cQTd confirmed additional electrocardiographic parameters useful in identifying patients being treated with drugs at risk of potential adverse arrhythmic events following drug interaction.

scholarly journals High Resolution CHEST CT(HRCT) Evaluation in Patients Hospitalized with COVID-19 Infection

2020 ◽  
Author(s):  
Maulin Patel ◽  
Junad Chowdhury ◽  
Matthew Zheng ◽  
Osheen Abramian ◽  
Steven Verga ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Reverse Transcriptase ◽  
Retrospective Analysis ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Bottom Line ◽  
Polymerase Chain

AbstractIntroductionCurrently the main diagnostic modality for COVID-19 (Coronavirus disease-2019) is reverse transcriptase polymerase chain reaction (RT-PCR) via nasopharyngeal swab which has high false negative rates. We evaluated the performance of high-resolution computed tomography (HRCT) imaging in the diagnosis of suspected COVID-19 infection compared to RT-PCR nasopharyngeal swab alone in patients hospitalized for suspected COVID-19 infection.MethodsThis was a retrospective analysis of 324 consecutive patients admitted to Temple University Hospital. All hospitalized patients who had RT-PCR testing and HRCT were included in the study. HRCTs were classified as Category 1, 2 or 3. Patients were then divided into four groups based on HRCT category and RT-PCR swab results for analysis.ResultsThe average age of patients was 59.4 (±15.2) years and 123 (38.9%) were female. Predominant ethnicity was African American 148 (46.11%). 161 patients tested positive by RT-PCR, while 41 tested positive by HRCT. 167 (52.02%) had category 1 scan, 63 (19.63%) had category 2 scan and 91 (28.35%) had category 3 HRCT scans. There was substantial agreement between our radiologists for HRCT classification (κ = 0.64). Sensitivity and specificity of HRCT classification system was 77.6 and 73.7 respectively. Ferritin, LDH, AST and ALT were higher in Group 1 and D-dimers levels was higher in Group 3; differences however were not statistically significant.ConclusionDue to its high infectivity and asymptomatic transmission, until a highly sensitive and specific COVID-19 test is developed, HRCT should be incorporated into the assessment of patients who are hospitalized with suspected COVID-19.Key PointsKey QuestionCan High Resolution CT chest (HRCT) improve diagnostic accuracy of current Nasopharyngeal swab in suspected COVID-19 patients?Bottom LineIn this retrospective analysis, our novel HRCT classification identified 20% of all COVID-19 patients who had negative nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) tests but had HRCT findings consistent with COVID-19 pneumonia. These patients were ruled out for other infections and laboratory markers were similar to other RT-PCR positive patientsWhy Read onOur new HRCT classification when combined with RT-PCR can improve diagnostic accuracy while promptly improving triaging in COVID-19 patients.

Sign in / Sign up

Export Citation Format

Share Document