scholarly journals Chemotherapy resumption in breast cancer patient after COVID-19

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Julian Horiguchi ◽  
Ayako Nakashoji ◽  
Naoki Kawahara ◽  
Akira Matsui ◽  
Takayuki Kinoshita
Keyword(s):  
Cancer Treatment ◽  
Ductal Carcinoma ◽  
Clinical Symptoms ◽  
Clinical Information ◽  
Japanese Woman ◽  
Optimal Time ◽  
Rt Pcr ◽  
Case Presentation ◽  
Anti Cancer ◽  
Major Adverse Events

Abstract Background While many studies have verified the effect of recent anti-cancer treatment in patients with COVID-19, there are no data on the optimal time for cancer treatment resumption, as well as the safety of chemotherapy in COVID-19 patients. As many cancer patients are recovering from COVID-19, there is an urgent need for reliable clinical information. Herein, we report a case of invasive ductal carcinoma in which we were able to successfully resume chemotherapy after infection with SAR-CoV-2. Case presentation The patient was a 38-year-old non-smoking Japanese woman with no significant medical history. She had fever on days 5 and 6 of her second course of adjuvant FEC therapy, and on day 7, she tested positive for SARS-CoV-2 by RT-PCR. She was hospitalized for 11 days. We resumed the therapy on day 25 after discharge, as she had no remaining clinical symptoms. The patient completed four courses of the initial chemotherapy without any major adverse events nor the recurrence of COVID-19, and subsequently completed four courses of docetaxel as her second regimen therapy. Conclusions Evaluating the risk for each patient is essential when resuming anti-cancer therapy in cancer patient’s post-COVID-19.

scholarly journals Prolonged SARS-CoV-2-RNA Detection from Nasopharyngeal Swabs in an Oncologic Patient: What Impact on Cancer Treatment?

2021 ◽  
Vol 28 (1) ◽  
pp. 847-852
Author(s):  
Anna Ferrari ◽  
Marco Trevenzoli ◽  
Lolita Sasset ◽  
Elisabetta Di Liso ◽  
Toni Tavian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Clinical Symptoms ◽  
Palliative Radiotherapy ◽  
Rt Pcr ◽  
Cancer Treatments ◽  
Global Challenge ◽  
Viral Culture ◽  
Pcr Assays

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient’s infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.

scholarly journals Simultaneous enterovirus EV-D68 and CVA6 infections causing acute respiratory distress syndrome and hand, foot and mouth disease

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ivanildo Pedro de Sousa ◽  
Heloísa Ihle Giamberardino ◽  
Sonia Mara Raboni ◽  
Maria Carmo Debur ◽  
Maria de Lourdes Aguiar Oliveira ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Rt Pcr ◽  
Double Infection ◽  
Chinese Strain ◽  
Case Presentation ◽  
Foot And Mouth ◽  
Shed Light

Abstract Background Although most enterovirus (EV) infections can be asymptomatic, these viral agents can cause serious conditions associated with central nervous system, respiratory disease and uncommon manifestations of hand, foot and mouth disease (HFMD). EV-coinfections have been rarely reported with development of complications and severe clinical outcome. An atypical case of a child presenting HFMD and severe acute respiratory syndrome, co-infected with EV-D68 and CVA6, is reported herein. Case presentation A 3-year-old boy was admitted in the emergency department unit showing fever, abdominal pain and tachycardia. Twenty-four hours after hospitalization the child developed severe clinical symptoms associated with HFMD and was discharged after recovery. Two days later, the child was readmitted with fever, cough and respiratory distress. RT-PCR and Sanger sequencing confirmed positivity for EV-D68 and CVA6 in oro and nasopharynges swabs and vesicles fluid, respectively. Phylogenetic analysis based on VP1 gene sequences suggested that CVA6 was closely related with HFMD viruses circulating in Turkey, while EV-D68 was genetically related to a Chinese strain. Conclusions To the best of our knowledge, this case is the first report of a double infection caused by CVA6 and EV-D68, which shed light on the pathogenesis of enterovirus infections. Further studies must be conducted to ascertain the role and clinical significance of EV co-infections, as well as a potential synergistic pathway between these viruses.

scholarly journals Management of oncology patients receiving anti-cancer treatment in the COVID-19 pandemic

2020 ◽  
Author(s):  
Esat Namal ◽  
Nur Dinc ◽  
Sezer Saglam ◽  
Ali Vefa Ozturk ◽  
Safiye Koculu ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
World Health ◽  
Rt Pcr ◽  
Oncology Patients ◽  
Rna Detection ◽  
Recommended Treatment ◽  
Anti Cancer ◽  
The World ◽  
Oropharyngeal Swab ◽  
Health Organization

Abstract Background/Aim: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has deeply affected life all over the World. The World Health Organization named this disease as COVID-19. The most important factor in the transmission of the disease is asymptomatic carriers. We’ve tested all oncology patients, that receive anti-cancer therapy, for COVİD-19 to prevent asymptomatic oncology patients from spreading infection and to make the decision to postpone chemotherapy in infected patients. Then, we analyzed the clinical and radiological findings of infected patients.Materials and Methods: Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography (CT) examination. Infected patients were given the recommended treatment for COVID-19. Anti-cancer treatment of all patients that had positive PCR results was delayed for 14 days.Results: PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms; 2 of whom had dyspnea and cough, and 1 had headache, and 25 patients (89.3%) had no symptoms.Conclusion: In oncology patients, who are receiving anti-cancer treatment, we have to recognize the asymptomatic COVID-19 infection. We recommend testing for COVID-19 in oncology patients receiving chemotherapy, periodically or before each anti-cancer treatment, in order to continue their treatment without any problems and to prevent the risk of transmission.

scholarly journals Diagnostic, Clinical and Post-SARS-CoV-2 Scenarios in Cancer Patients with SARS-CoV-2: Retrospective Analysis in Three German Cancer Centers

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2917
Author(s):  
Evgenii Shumilov ◽  
Petra Hoffknecht ◽  
Raphael Koch ◽  
Rudolf Peceny ◽  
Steffen Voigt ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Progressive Disease ◽  
Significant Risk ◽  
Rt Pcr ◽  
Cancer Centers ◽  
Remission Status ◽  
Increased Risk ◽  
Anti Cancer

Oncologists face challenges in the management of SARS-CoV-2 infections and post-SARS-CoV-2 cancer treatment. We analyzed diagnostic, clinical and post-SARS-CoV-2 scenarios in patients from three German cancer centers with RT-PCR confirmed SARS-CoV-2 infection. Sixty-three patients with SARS-CoV-2 and hematologic or solid neoplasms were included. Thirty patients were initially asymptomatic, 10 of whom developed COVID-19 symptoms subsequently. Altogether 20 (32%) patients were asymptomatic, 18 (29%) had mild, 12 (19%) severe and 13 (20%) critical courses. Lymphocytopenia increased risk of severe/critical COVID-19 three-fold (p = 0.015). Asymptomatic course was not associated with age, remission status, therapies or co-morbidities. Secondary bacterial infection accompanied more than one third of critical COVID-19 cases. Treatment was delayed post-SARS-CoV-2 in 46 patients, 9 of whom developed progressive disease (PD). Cancer therapy was modified in 8 SARS-CoV-2 survivors because of deteriorating performance or PD. At the last follow-up, 17 patients had died from COVID-19 (n = 8) or PD (n = 9) giving an estimated 73% four-month overall survival rate. SARS-CoV-2 infection has a heterogenous course in cancer patients. Lymphocytopenia carries a significant risk of severe/critical COVID-19. SARS-CoV-2 disruption of therapy is as serious as SARS-CoV-2 infection itself. Careful surveillance will allow early restart of the anti-cancer treatment.

scholarly journals Safety of systemic anti-cancer treatment in oncology patients with non-severe COVID-19: a cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. van Marcke ◽  
N. Honoré ◽  
A. van der Elst ◽  
S. Beyaert ◽  
F. Derouane ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Adverse Events ◽  
Cancer Treatment ◽  
Performance Status ◽  
Rt Pcr ◽  
Bleeding Events ◽  
Oncology Patients ◽  
Treatment Delays ◽  
Ambulatory Oncology ◽  
Anti Cancer

Abstract Background The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is an important matter in daily practice. Methods ONCOSARS-1 was a single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were prospectively included. All patients (n = 363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the first peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to retrospectively determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients. Results Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P < 0.001). This association remained significant (odds ratio (OR) 4.1, P = 0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P < 0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients. Conclusion Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.

scholarly journals Single Center Experience on Screening Oncology Patients for Covid-19 Before Anti-Cancer Treatment

2020 ◽  
Vol 30 (4) ◽  
pp. 207-212
Author(s):  
ESAT NAMAL
Keyword(s):  
Cancer Treatment ◽  
High Rate ◽  
Rt Pcr ◽  
Oncology Patients ◽  
Rna Detection ◽  
Asymptomatic Carriers ◽  
Single Center Experience ◽  
Recommended Treatment ◽  
Anti Cancer ◽  
Oropharyngeal Swab

The most important factor in the transmission of the COVID-19 is asymptomatic carriers. We’ve tested all oncology patients , that receive anti-cancer therapy, for COVID-19. We aimed to determine the rate of asymptomatic carriers, and analyze the clinical and ra- diological findings of infected patients. Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography examination. Infected patients were given the recommended treatment for COVID-19. PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms, 25 patients (89.3%) had no symptoms. Covid-19 testing before anti-cancer treatment may be recommended in order to continue their treatment without any problems and to prevent the risk of transmission due to the high rate of asymptomatics in infected patients. Keywords: COVID-19, Pandemic, Chemotherapy, Oncology

Critical Alert for Otolaryngologists: Earache May be the Early Signs of COVID-19

2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Seyyed Mohammad Miri ◽  
Mohammad Ajalloueyan
Keyword(s):  
Clinical Symptoms ◽  
Close Contact ◽  
Clinical Manifestations ◽  
Rt Pcr ◽  
National Guidelines ◽  
High Resolution Computed Tomography ◽  
Case Presentation ◽  
First Case ◽  
International Airline ◽  
Test Result

Introduction: The pandemic coronavirus disease 2019 or COVID-19 is infecting as fast as possible in more than 200 countries and creating the most horrible domino-like demolition ever seen. From its beginning in Wuhan, China, the SARS-CoV-2 infected the similar groups of 100,000 patients in 67, 11, 4, and 2 days. Healthcare workers are in the frontline of attacking by SARS-CoV-2, especially those who are in close contact with upper respiratory mucosa like otolaryngologists. Objectives: To describe ear pain as one of the first clinical manifestations of COVID-19, we present two cases of a family (a mother and her daughter) with a positive RT-PCR test for COVID-19 who presented earache as their first symptoms. Case Presentation: The first case was a 32 years old female patient (stewardess of an international airline, Tehran, Iran) was labeled as at risk due to her air flight to China in Dec 2019. She was first admitted for moderate ear pain in her left ear with mild itching of the external ear to an otolaryngology outpatient clinic by a general practitioner. After 7 days, her test for RT-PCR against COVID-19 was positive. No lung involvement was reported by high-resolution computed tomography (HRCT) of the thorax. Another case was her mother who were in close contact with each other and experienced severe ear pain after 7 days. She acquired mild COVID-19 symptoms with anosmia was a positive test result for COVID-19. Conclusions: The earache must be considered as their first clinical symptoms during the early phase of the coronavirus outbreak. It seems that local and international scientific groups of otolaryngologists must prepare their national guidelines to protect their practitioners against COVID-19 based on practical strategies. Using personal protective equipment is of utmost importance in reducing the risk of nosocomial infection among otolaryngologists.

scholarly journals Diagnostic accuracy of a SARS-CoV-2 rapid test and optimal time for seropositivity according to the onset of symptoms

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Caroline Nespolo de David ◽  
Fernanda Hammes Varela ◽  
Ivaine Tais Sauthier Sartor ◽  
Márcia Polese-Bonatto ◽  
Ingrid Rodrigues Fernandes ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Rapid Test ◽  
Lateral Flow Immunoassay ◽  
Optimal Time ◽  
Rt Pcr ◽  
Serological Tests ◽  
Over Time

Point-of-care serological tests for SARS-CoV-2 have been used for COVID-19 diagnosis. However, their accuracy over time regarding the onset of symptoms is not fully understood. We aimed to assess the accuracy of a point-of-care lateral flow immunoassay (LFI). Subjects, aged over 18 years, presenting clinical symptoms suggestive of acute SARS-CoV-2 infection were tested once by both nasopharyngeal and oropharyngeal RT-PCR and LFI. The accuracy of LFI was assessed in periodic intervals of three days in relation to the onset of symptoms. The optimal cut-off point was defined as the number of days required to achieve the best sensitivity and specificity. This cut-off point was also used to compare LFI accuracy according to participants’ status: outpatient or hospitalized. In total, 959 patients were included, 379 (39.52%) tested positive for SARS-CoV-2 with RT-PCR, and 272 (28.36%) tested positive with LFI. LFI best performance was achieved after 10 days of the onset of symptoms, with sensitivity and specificity of 84.9% (95%CI: 79.8-89.1) and 94.4% (95%CI: 91.0-96.8), respectively. Although the specificity was similar (94.6% vs. 88.9%, p = 0.051), the sensitivity was higher in hospitalized patients than in outpatients (91.7% vs. 82.1%, p = 0.032) after 10 days of the onset of symptoms. Best sensitivity of point-of-care LFI was found 10 days after the onset of symptoms which may limit its use in acute care. Specificity remained high regardless of the number of days since the onset of symptoms.

scholarly journals Safety of systemic anti-cancer treatment in oncology patients with non-severe COVID-19: a prospective cohort study

2020 ◽  
Author(s):  
Cédric Van Marcke ◽  
Natasha Honoré ◽  
Athénaïs van der Elst ◽  
Simon Beyaert ◽  
Françoise Derouane ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Adverse Events ◽  
Cancer Treatment ◽  
Performance Status ◽  
Rt Pcr ◽  
Bleeding Events ◽  
Oncology Patients ◽  
Treatment Delays ◽  
Ambulatory Oncology ◽  
Anti Cancer

Abstract Background The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is unknown.Methods ONCOSARS-1 was a prospective, single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were included. All patients (n=363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients.Results Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P<0.001). This association remained significant (odds ratio (OR) 4.1, P=0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P<0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients.Conclusion Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.

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