scholarly journals Universal testing for COVID-19 in patients undergoing cancer treatment during the second outbreak in Brescia

2021 ◽  
pp. 030089162110349
Author(s):  
Stefano M. Magrini ◽  
Andrea E. Guerini ◽  
Paolo Borghetti ◽  
Giulia Volpi ◽  
Luca Triggiani ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Severe Disease ◽  
High Rate ◽  
Mild Disease ◽  
Patients With Cancer ◽  
Universal Testing ◽  
Antineoplastic Treatment ◽  
Asymptomatic Infections ◽  
Testing Schedule ◽  
The Impact

Background: The impact of coronavirus disease 2019 (COVID-19) has been overwhelming on patients with cancer, who may be at higher risk of developing severe disease. During the second COVID-19 outbreak in Italy, we planned universal microbiologic screening for patients scheduled for antineoplastic treatment. Methods: All patients with planned active treatment at Brescia University Radiation Oncology Department were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA with repeated nasopharyngeal swabs (NPS) from October 31, 2020. Treatment continuation, suspension, or delay was modulated for patients testing positive according to clinical presentation. Results: From October 31, 2020, to February 6, 2021, 636 patients were enrolled and 1243 NPS were performed, of which 28 (2.25%) were positive. The infection rate was 2.52%; 81.3% of the patients with a positive NPS were asymptomatic, 2 had mild disease, and 1 severe disease that led to death. All patients already on treatment with mild or asymptomatic COVID-19 carried on the therapy with no or minimal delay. Median delay for patients with infection detected before treatment start was 16.5 days. Conclusions: Detected incidence of COVID-19 was lower during the second outbreak in our patients (2.52% vs 3.23%), despite the extensive testing schedule, and substantiates the high rate of asymptomatic infections and the low mortality among patients with COVID-19 (6.3% vs 38.5% during the first outbreak). Universal SARS-CoV-2 screening for all patients with planned treatment might allow early identification of patients with COVID-19, resulting in timely management that could improve clinical outcomes and prevent spread of the infection.

scholarly journals Seroconversion rates following COVID-19 vaccination amongst patients with malignant disease- the impact of diagnosis and cancer-directed therapies

2021 ◽  
Author(s):  
Astha Thakkar ◽  
Jesus Gonzalez Lugo ◽  
Niyati Goradia ◽  
Radhika Gali ◽  
Lauren C. Shapiro ◽  
...  
Keyword(s):  
Passive Immunization ◽  
High Rate ◽  
Oncology Patients ◽  
Post Vaccination ◽  
Patients With Cancer ◽  
Immunization Strategies ◽  
Checkpoint Inhibitor Therapy ◽  
Hormonal Therapies ◽  
Anti Cd20 ◽  
The Impact

As COVID-19 has been shown to adversely affect patients with cancer, prophylactic strategies are critically needed. We determined the immunogenicity of COVID-19 vaccination in a cohort of cancer patients that had received full dosing with one of the FDA-approved COVID-19 vaccines. 201 oncology patients underwent anti-spike protein SARS-CoV-2 IgG testing post-vaccination and demonstrated a high rate of seroconversion (94%) overall. When compared to solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematological malignancies (85%), particularly recipients of anti-CD20 therapies (70%) and stem cell transplantation (74%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post-vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post-vaccination. Relatively lower IgG titers were noted following vaccination with the adenoviral when compared to the mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify vulnerable cohorts that need novel vaccination or passive immunization strategies.

scholarly journals Impact of SARS-CoV-2 Infection on Patients with Cancer: Retrospective and Transversal Studies in Spanish Population

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3513
Author(s):  
Javier Garde-Noguera ◽  
M. Leonor Fernández-Murga ◽  
Vicent Giner-Bosch ◽  
Victoria Dominguez-Márquez ◽  
José García Sánchez ◽  
...  
Keyword(s):  
Seroconversion Rate ◽  
High Rate ◽  
Cancer Treatments ◽  
Patients With Cancer ◽  
Related Symptom ◽  
Lower Ratio ◽  
The Impact ◽  
Transversal Study ◽  
Sensitive Population ◽  
Prevalence Of Cancer

Background: Studies of patients with cancer affected by coronavirus disease 2019 (COVID-19) are needed to assess the impact of the disease in this sensitive population, and the influence of different cancer treatments on the COVID-19 infection and seroconversion. Material and Methods: We performed a retrospective analysis of all patients hospitalized with RT-PCR positive for COVID-19 in our region to assess the prevalence of cancer patients and describe their characteristics and evolution (Cohort 1). Concurrently, a transversal study was carried out in patients on active systemic cancer treatment for symptomatology and seroprevalence (IgG/IgM by ELISA-method) against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Cohort 2). Results: A total of 215 patients (Cohort 1) were admitted to hospital with a confirmed COVID-19 infection between February 28 and April 30, 2020, and 17 died (7.9%). A medical record of cancer was noted in 43 cases (20%), 6 of them required Intensive care unit ICU attention (14%), and 7 died (16%). There were thirty-six patients (83%) who tested IgG/IgM positive for SARS-CoV-2. Patients on immunosuppressive therapies presented a lower ratio of seroconversion (40% vs. 8%; p = 0.02). In Cohort 2, 166 patients were included in a symptoms-survey and tested for SARS-CoV-2. Any type of potential COVID-19-related symptom was referred up to 67.4% of patients (85.9% vs. 48.2% vs. 73.9%, for patients on chemotherapy, immunotherapy and targeted therapies respectively, p < 0.05). The seroprevalence ratio was 1.8% for the whole cohort with no significant differences by patient or treatment characteristics. Conclusion: Patients with cancer present higher risks for hospital needs for COVID-19 infection. The lack of SARS-CoV-2 seroconversion may be a concern for patients on immunosuppressive therapies. Patients receiving systematic therapies relayed a high rate of potentially COVID-19-related symptoms, particularly those receiving chemotherapy. However, the seroconversion rate remains low and in the range of general population.

Parenting and Family Support for Children with ADHD

1997 ◽  
Vol 22 (4) ◽  
pp. 15-23 ◽  
Author(s):  
Judith Sheridan ◽  
Sarah B. Dwyer ◽  
Matthew R. Sanders
Keyword(s):  
Family Support ◽  
Mood Disorders ◽  
Clinical Presentation ◽  
High Rate ◽  
Effective Management ◽  
Multilevel System ◽  
Stages Of Development ◽  
Children With Adhd ◽  
The Individual ◽  
The Impact

The objective of this paper is to examine the impact of ADHD on the functioning of families. A review of recent research indicated that the persistence of symptoms into adulthood and the high rate of comorbidity with behaviour, psychiatric and mood disorders, are major additional stressors for families. Although the clinical presentation, developmental manifestations and patterns of comorbidity have been refined, it is emphasised that effective management of this disorder requires access to interventions which are both multilevel and multimodal. A model of a multilevel system of intervention that can be tailored to the individual family's needs at different stages of development is presented.

Impact of Socio-Cultural Practice of Infant/Young Child Gum Lancing during Teething

2013 ◽  
Vol 37 (4) ◽  
pp. 355-359 ◽  
Author(s):  
BO Olabu ◽  
DO Okoro ◽  
JM Thigiti ◽  
VA Oramisi
Keyword(s):  
Clinical Presentation ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Cultural Practice ◽  
Medical Attention ◽  
Severe Dehydration ◽  
Economic Significance ◽  
History Of ◽  
The Common ◽  
The Impact

Background: Fever and diarrhea are among the common morbidities that do occur during infancy and are sometimes wrongly associated with teething by the community. Some societies practice gum lancing, ordinarily referred to as gum cutting, as a remedy for the “teething diarrhoea”. These myths have a potential of giving false security with the belief that these symptoms are part of the teething process, and so medical attention may not be sought when necessary. There are few studies focusing on the outcome of such practices despite their known potential dangers. Objective: To describe various methods of gum lancing and clinical presentation, management and outcome of gum lancing among the Akamba people as seen in Kangundo District Hospital. Method: One hundred and fifteen infants/children who were brought to the hospital with a positive history of gum lancing. Results: The common presenting complaints were persistent diarrhoea (74.0%), fever (44.3%), difficulty in breathing (27.8%) and refusal to feed (20.9%). 58.3% cases warranted admission and these included severe dehydration and shock (47.8%), severe and very severe pneumonia (40.3%), meningitis (26.9%) and generalized sepsis (17.9%). There were a total of 7 mortalities (6.1%), 3 on arrival and 4 within the pediatric ward. Invasive gum lancing procedures and delayed seeking of medical attention were associated with severe disease and poorer outcomes. Conclusion: The impact of gum lancing is of both a public health and economic significance. It is associated with unfavorable outcome if prompt measures are not put in place. There is need to conduct community sensitization and educate caregivers on the truths of teething and dangers of gum lancing as well as seeking health services for fever and diarrhoea. Use of broad-spectrum antibiotics and adequate rehydration are necessary in management of the victims.

scholarly journals The Impact of COVID-19 on Patients with Hematological Malignancies: The Mixed-Method Analysis of an Israeli National Survey

2021 ◽  
Author(s):  
Ilana Levy ◽  
Giora Sharf ◽  
Shlomit Norman ◽  
Tamar Tadmor
Keyword(s):  
High Risk ◽  
National Survey ◽  
Hematological Malignancies ◽  
Severe Disease ◽  
High Rate ◽  
Hematological Disease ◽  
Patient Health ◽  
Hebrew Version ◽  
The Impact ◽  
Method Analysis

Abstract Background: The COVID-19 pandemic required reevaluation of the therapeutic approach and added emotional stress for patients with hematological malignancies at high risk of contracting the virus. We aimed to evaluate how it affected such patients during the second lockdown in Israel.Methods: This national survey included Hebrew-speaking patients with hematological malignancy. This included three tools with 28 items of socio-demographic and medical baseline characteristics, management of hematological disease, and evaluation of emotional coping during COVID-19 pandemic; the Hebrew version of the Patient Health Questionnaire 9; and 3 qualitative open-ended questions. Data was analyzed by mixed methods which combined both quantitative and qualitative thematic analyses.Results: 408 patients responded to the survey. The management of their hematological disease included a decrease in the number of visits to the hematology clinic (37.0%), delay of some treatment schedules (9.1%), and prescription of replacement therapies permitting less visits to the clinic (2.2%). The frequency and intensity of “feeling afraid” regarding COVID-19 infection was increased (mean±SD: 4±1 to 5±2 in a 1-7 Likert scale), and a high rate of depression was recorded, which appeared to be more evident in patients with chronic myeloid leukemia (CML) (p<0.001).Conclusion: The management of hematological malignancies during pandemics should always take into consideration patients' fears, as well as the development of depression related to isolation and loneliness, in addition to the high risk of severe disease. Patients with CML had a high rate of depression which obviously needs to be managed very carefully during and after the COVID-19 pandemic.

scholarly journals COVID-19 in Immunosuppressed and Cancer Patients: A review

2020 ◽  
Vol 5 (S1) ◽  
pp. 69-73
Author(s):  
Shirin Haghighat ◽  
Mehdi Dehghani
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Cancer Patients ◽  
Severe Disease ◽  
Review Article ◽  
Epidemic Spread ◽  
Patients With Cancer ◽  
The World ◽  
Novel Coronavirus ◽  
The Impact

The rapidly spreading outbreak of infection by novel coronavirus 2 (SARS-CoV-2) from Wuhan, China around the world has started since December 2019. Since the epidemic spread of this infection, individuals with comorbidities are at high risk of severe disease and increased rate of mortality. As patients with cancer are considered immunosuppressed caused by some host and treatment factors, a more detailed investigation on the impact of cancer on COVID-19 outcome seems to be necessary. This review article provides data on cancer patients affected by SARS-CoV-2 infection. Although underlying immunosuppression has not proven as a risk factor for severe COVID-19 infection, most authors have identified cancer patients as a highly vulnerable population. We need more detailed especially randomized studies to compare the outcome of cancer and non-cancer patients with SARS-CoV-2 infection. The more precise studies would help oncologists to make the best decision in cancer therapy.  

scholarly journals P611 Incidence, clinical presentation, and severity of SARS-CoV-2 infection in IBD patients in the second and the third wave of infection

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S556-S556
Author(s):  
A Algaba Garcia ◽  
I Guerra ◽  
S Castro ◽  
L Jiménez ◽  
D Garza ◽  
...  
Keyword(s):  
Median Duration ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Severe Infection ◽  
Low Grade ◽  
Third Wave ◽  
Cross Sectional ◽  
Mild Disease ◽  
The Third ◽  
Dendritic Cell Sarcoma

Abstract Background Data about the SARS-CoV-2 infection in inflammatory bowel disease patients (IBD) are scarce. Our aim was to analyse the incidence, clinical presentation, and severity of SARS-CoV-2 infection in IBD patients in the second and the third wave of infection. Methods Cross-sectional, observational study in IBD patients with confirmed SARS-CoV-2 infection by RCP and/or antigen tests from 01 July 2020 to 01 March 2021. All data were collected by telephone interview and reviewing the electronical medical records. Results Fifty-one of 805 IBD patients followed in our Unit were diagnosed of SARS-CoV-2 infection in this period (6.3%; 95% CI 4.6–8.0). Mean age: 45±13 years old; 56.9% female, 23.5% smokers, 56.9% Crohn’s disease, 29.4% comorbidities and 17.6% asymptomatic. Digestive symptoms were reported in 22 patients (43.1%), with diarrhoea as the most common (39.2%, median duration: 4 days; IQR 1–7). The most frequent symptoms other than diarrhoea were low-grade fever/fever in 43.1% (median duration: 3 days; IQR 1–6.5) and dysosmia/dysgeusia in 39.2% (median duration: 15 days; IQR 7–30). Only one patient (2%) was diagnosed with IBD flare-up during infection. Six patients (11.8%) temporarily withdrew their IBD treatment because of COVID-19. Most of the patients had a mild disease (88.2%), no patient had to be admitted in the intensive care unit. Only one patient died (2%) due to SARS-CoV-2 infection and multiple previous comorbidities, 52 years old male with ulcerative colitis in treatment with Mesalazine and dendritic cell sarcoma, common variable inmunodefiency, and primary sclerosing cholangitis progressing to cirrhosis. In the multivariate analysis, the presence of dyspnoea was associated with more severe infection (p=0.007; OR:25.7; 95% CI 2.4–277.8). Patients on immunomodulators and/or biological therapy did not have more severe disease compared to non-immunosuppressed patients (p&gt;0.05). Conclusion SARS-CoV-2 infection was relatively frequent is our series. Dyspnoea was associated with a more severe infection. Severity of SARS-CoV-2 infection was not related to immunosuppression or development of IBD flare-ups and only a small percentage of patients needed to modify IBD medication during infection

scholarly journals A survey of the burden of allergic rhinitis in Hungary from a specialist’s perspective

2012 ◽  
Vol 7 ◽  
Author(s):  
Mária Szilasi ◽  
Gabriella Gálffy ◽  
Károly Fónay ◽  
Zsuzsa Márk ◽  
Zoltán Rónai ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Everyday Life ◽  
Disease Severity ◽  
Severe Disease ◽  
Significant Proportion ◽  
Well Being ◽  
High Rate ◽  
Cross Sectional ◽  
Intranasal Corticosteroids ◽  
The Impact

Background: The casual and severity distribution of allergic rhinitis (AR) in Hungary is unknown. The aim of this survey was to evaluate symptom perception, disease severity, concomitant asthma frequency and the impact of AR on everyday life activities in a cross-sectional, multicenter study in Hungary under the supervision of Hungarian Respiratory Society. Methods: Data were recorded by 933 AR patients (65.93% women) and their treating specialists. The perceptions of patients regarding the symptoms (nasal, ocular and others) of AR and its severity, together with its impact on everyday life were assessed. Physicians recorded data regarding the diagnosis and severity of AR, and comorbidities. Results: 52.5% of patients suffered from seasonal AR, 35.1% from perennial AR. A large proportion of patients had moderate to severe disease (MS-AR) (57.34%), persistent disease (98.0%) and concomitant asthma (53.32% in the mild, 57.52% in the MS-AR group). MS-AR was more frequent among women. Despite the treatment used, in MS-AR the proportions of patients reporting moderate to severe rhinorrhoea, nasal obstruction, ocular itching/redness, watering, itchy throat and sneezing were as high as 52.0%, 54.0%, 33.8%, 26.5%, 44.0% and 31.2%, respectively. Overall, there was a poor agreement between disease severity reported by patients and specialists. The adherence to oral antihistamines and intranasal corticosteroids was found to be between 50 and 65%; mostly depending on the dosage form. Conclusions: AR remains a significant health problem in Hungary because of the burden of symptoms, high rate of concomitant asthma and the significant proportion of MS-AR affecting general well being.

scholarly journals Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

2020 ◽  
Vol 179 (8) ◽  
pp. 1315-1323 ◽  
Author(s):  
Niccolò Parri ◽  
◽  
Anna Maria Magistà ◽  
Federico Marchetti ◽  
Barbara Cantoni ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Disease ◽  
Case Series ◽  
High Rate ◽  
Respiratory Support ◽  
Hospital Level ◽  
Mild Disease ◽  
Moderate Disease ◽  
Increased Risk

Abstract Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered. Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known:• There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New:• Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease.• However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.

scholarly journals Is the Perinatal Outcome of Placental Abruption Modified by Clinical Presentation?

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Seishi Furukawa ◽  
Hiroshi Sameshima ◽  
Tsuyomu Ikenoue ◽  
Masanao Ohashi ◽  
Yoshio Nagai
Keyword(s):  
Perinatal Outcome ◽  
Placental Abruption ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Perinatal Outcomes ◽  
Premature Labor ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Induced Hypertension ◽  
The Impact

Objective. The purpose of this study was to elucidate the impact of the clinical presentation on perinatal outcome in placental abruption.Study Design. A retrospective study was performed in 97 placental abruptions. Placental abruptions were classified according to clinical presentation: pregnancy-induced hypertension (HT,n=22), threatened premature labor and/or premature rupture of membranes (TPL/ROM,n=35), clinically low risk (LR,n=27), and others (n=13). Perinatal outcomes were compared among the HT, TPL/ROM, and LR groups.Results. The HT had significantly higher incidence of IUGR, IFUD, and low fibrinogen. The TPL/ROM had less severe disease. However, the LR had significantly higher incidence of IUFD, low UA pH < 7.1, low Apgar score of <7 at 5 min, and low fibrinogen.Conclusion. Disease severity in placental abruption is likely to depend on the clinical presentation.

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