scholarly journals Management of Colorectal Cancer Patients During The COVID-19 Pandemic: Triage and Treatment

Author(s):  
Pengcheng Xiang ◽  
Junyi Han ◽  
Tiffany I. Leung ◽  
Naomi I. Maria ◽  
jie Tang ◽  
...  

Abstract Background The outbreak of coronavirus disease-2019(COVID-19)cause significant difficulties to the treatment of oncological patients, including colorectal cancer(CRC) patients. Establishing new manage strategies and emergency triage system is urgent. Methods We collected the outpatients, inpatients and surgeries number and COVID-19 nucleic acid test results of Shanghai East Hospital from December 2019 to January 2020, and the changes during this period were analyzed. Result The number of outpatients, inpatients and surgeries all decreased significantly. Not a single case of COVID-19 infection occurred in Shanghai East Hospital in this period. The triage system and management strategy are shared here. Conclusion Our triage strategy can help reduce the infection rate of COVID-19 in hospital, and the management strategies of CRC can be used as a reference for clinicians.

Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27933
Author(s):  
Yanru Cui ◽  
Jilin Wang ◽  
Gaofeng Wang ◽  
Xiuguo Xie ◽  
Lizhen Tian

Author(s):  
G. G. Li ◽  
Z. Lv ◽  
Y. S. Wang ◽  
J. F. Li ◽  
L. F. Feng ◽  
...  

The 2019 novel coronavirus (2019-nCov) has caused increasing number of infected cases globally. This study was performed to analyze information regarding the transmission route and presence of viral nucleic acids on several clinical samples. Confirmed 2019-nCov-infected cases were identified in Dongyang and were treated according to guidelines for the diagnosis of 2019-nCov infection released by the National Health Commission. Information regarding the contacts that the infected people had was collected to determine whether it caused clustered cases. A series of successive nucleic acid examination of feces, oropharyngeal swabs, and sputum was also performed, and the results were analyzed. A total of 19 confirmed cases of 2019-nCov infection were identified in Dongyang, Zhejiang Province, China. Five cases showed severe symptoms, and the remaining ones showed mild manifestations. Ten cases infected from two asymptomatic individuals were clustered into two groups. Among 14 cases with consecutive nucleic acid test results, four patients showed positive results in feces after their negative conversion in oropharyngeal swabs. Asymptomatic individuals with the virus could cause 2019-nCov clustered cases, and the clustered cases may differ from sporadic cases on age and length of hospitalization. In addition, nucleic acids in feces last longer than those in oropharyngeal swabs.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2559-2559
Author(s):  
C. Zanon ◽  
M. Airoldi ◽  
R. Passera ◽  
L. Cattel ◽  
P. Milla ◽  
...  

2559 Background: Neurotoxicity is a common OXA toxicity in FOLFOX4 regimen for patients with advanced colorectal cancer. Recently, Cascinu et al. (JCO 2002; 20: 3478–3483) provided evidence that GSH reduces the OXA-induced neurotoxicity, but GSH influence on the formation of Pt-DNA adducts still remains unknown. This study evaluated the effect of GSH addition on OXA pk and on Pt-DNA adducts formation Table of Contents Methods: 28 patients were given twelve FOLFOX4 courses and randomized to receive either GSH 1,500 mg/m2 or normal saline solution (placebo) before OXA iv infusion. OXA pk and Pt-DNA adducts formation were evaluated at courses 5, 9 and 12. Total and ultrafiltered platinum were analyzed by atomic adsorption, Pt-DNA adducts in leukocytes (as model for tumour tissue) by adsorptive stripping voltammetry. Pk analysis were done by non-compartmental analysis, statistical analysis by non-parametric Mann-Whitney test. Results: Median total and ultrafiltered platinum median Cmax and AUCtot values were comparable to previously reported ones, being higher in the placebo arm, due to a moderate reduction of platinum clearance. The formation of Pt-DNA adducts was more pronounced in GSH arm (median value 20.3 Pt atoms/106 nucleotides vs. 5.7 Pt atoms/106 nucleotides), even not statistically significant. Conclusions: The addition of GSH to FOLFOX4 regimen is able to reduce the OXA-induced neurotoxicity, without affecting either the OXA pk behaviour or the formation of Pt-DNA adducts, without modifying FOLFOX4 clinical efficacy. [Table: see text] No significant financial relationships to disclose.


2020 ◽  
Author(s):  
Xiao-Jin Li ◽  
Bing-Xing Shuai ◽  
Zhong-Wei Zhang ◽  
Yan Kang

Background and ObjectiveSince the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in Wuhan, Hubei Province, China, it has spread throughout the world and become a global public health emergency. It is important to distinguish COVID-19 from other viral pneumonias to properly screen and diagnose patients, reduce nosocomial infections, and complement the inadequacy of nucleic acid testing. In this study, we retrospectively analysed the clinical data of COVID-19 versus non-COVID-19 patients treated at our hospital between January 17 and February 27, 2020 to summarize our clinical experience in the differential diagnosis of COVID-19.MethodsIn this retrospective cohort study, 23 confirmed COVID-19 patients were consecutively enrolled from January 17 to February 27, 2020, and 29 confirmed non-COVID-19 patients were enrolled in the West China Hospital of Sichuan University. We collected baseline data, epidemiological data, clinical characteristics, imaging findings, viral nucleic acid test results, and survival data. SPSS v22.0 was used for the statistical analysis. Outcomes were followed-up until March 25.ResultsA total of 52 patients were included in this study, including 23 COVID-19 patients and 29 non-COVID-19 patients. No significant between-group differences were observed for age, sex, primary signs or symptoms, cellular immunity, or platelet count. Significant between-group differences were observed in clinical characteristics such as dry cough, contact with individuals from Wuhan, some underlying diseases, nucleated cell count, chest imaging findings, viral nucleic acid test results, 28-day mortality, and 28-day survival.ConclusionEpidemiological data, clinical symptoms, nucleic acid test results for COVID-19 and chest CT manifestation may help distinguish COVID-19 from non-COVID-19 cases, prevent imported cases and nosocomial infections.


2020 ◽  
Author(s):  
Meng Xu ◽  
Xun Liu ◽  
Chuhong Su ◽  
Yuping Zeng ◽  
Jinqian Zhang ◽  
...  

AbstractBackgroundCoronavirus disease 2019 (COVID-19) has become a global health problem. We aim to investigate the changes in the results of viral nucleic acid tests on pharyngeal swabs and feces of patients with COVID-19 and CT imaging of lungs as the disease progresses.MethodsSeven patients with COVID-19 in the third affiliated hospital of Sun Yat-sen University Yuedong Hospital were retrospectively enrolled with clinical features, including imaging staging, and performance characteristics of viral nucleic acid test results of pharyngeal swabs and feces. The dynamic changes of these features were observed during hospitalization, and therapeutic effect and prognosis of patients were evaluated.ResultsThe results of seven cases with COVID-19 were positive for viral nucleic acid tests on pharyngeal swabs early after the onset of symptoms, and then turned negative; while the results of viral nucleic acid tests on feces were persistently positive in the mid-term clinical treatment and recovery period. And the viral nucleic acid test results were capricious in three cases. Pulmonary CT imaging showed characteristic changes in early, advanced and recovery phases.ConclusionThe application of viral nucleic acid detection and pulmonary CT imaging can be used for screening of suspected cases. Fecal nucleic acid test should be recommended as the reference of discharge standard, in order to minimize the risk of transmission from digestive tract.


2020 ◽  
Vol 221 (12) ◽  
pp. 1940-1947 ◽  
Author(s):  
Yanfeng Pan ◽  
Xue Yu ◽  
Xinwei Du ◽  
Qingqing Li ◽  
Xianyang Li ◽  
...  

Abstract Background We retrospectively analyzed 26 persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriers. Methods Epidemiological and clinical characteristics from the 26 asymptomatic patients with positive results for SARS-CoV-2 ribonucleic acid testing were obtained. Results Twenty-two patients (84.6%) correlated with clustering occurrence. The median period from contact to diagnosis and the last positive nucleic acid test was 19 (8–24 days) and 21.5 days (10–36 days), respectively. The median period from diagnosis to negative nucleic acid test was significantly different between patients with normal or atypical chest computed tomography (CT) findings (n = 16, 61.5%; 7.5 days [2–20 days]) and patients with typical ground-glass or patchy opacities on CT (n = 10, 38.5%; 12.5 days [8–22 days]; P < .01). Seven patients (70.0%) with initial positive nucleic acid test results had a negative result simultaneously with improved CT findings. Obvious improvement in CT findings was observed in 3 patients (30.0%) despite positive nucleic acid test results. Conclusions In asymptomatic patients, changes in biochemical and inflammatory variables are small and changes on chest CT can occur. It is worth noting that the long existence of SARS-CoV-2 in some asymptomatic patients and false-negative results need to be considered in SARS-CoV-2 nucleic acid test.


Author(s):  
Yuanchao Li ◽  
Tuoyun Yang ◽  
Sicong Wang ◽  
Junbo Zheng ◽  
Jing Zhou ◽  
...  

Peripheral blood lymphocyte count is shown to be decreased in patients with COVID-19 in the early stage of the disease. The degree of lymphocyte count reduction is related to COVID-19 severity and could be used as an indicator to reflect the disease severity. Our aim was to investigate the value of lymphocyte count in determining COVID-19 severity and estimating the time for SARS-CoV-2 nucleic acid test results to turn negative. We retrospectively analyzed clinical data of 201 patients with severe and critical COVID-19. The patients were admitted to the West Campus of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology. The data included age, gender, chronic disease, lymphocyte count, and SARS-CoV-2 nucleic acid test results. The age of patients in critically ill group was higher than in severely ill group (p = 0.019). The lymphocyte count of critically ill patients was lower than of severely ill patients. The cutoff value of lymphocyte count to distinguish between the critically ill and the severely ill was 0.735 × 109/L (p = 0.001). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill patients with chronic diseases (hypertension, diabetes, and coronary heart disease) was 0.835 × 109/L (p = 0.017). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill male patients was 0.835 × 109/L (p < 0.0001). Lymphocyte count could be an effective indicator to predict COVID-19 severity. It may also be useful in determining the time for nucleic acid test results to turn negative in COVID-19 patients with underlying chronic diseases or male COVID-19 patients with severe and critical conditions.


Author(s):  
Ying Su ◽  
Ling-Shuang Zhu ◽  
Yong Gao ◽  
Yuncheng Li ◽  
Zhanlu Xiong ◽  
...  

AbstractBackgroundWith coronavirus disease 2019 (Covid-19) ravaging the global, concern has been aroused whether discharged Covid-19 patients with reappeared positive nucleic acid test results are infected again.ObjectiveTo analyze the clinical characteristics of discharged Covid-19 patients with reappeared positive nucleic acid test results and to track clinical outcomes of them.MethodsWe extracted clinical data on 938 Covid-19 patients from Wuhan Union Hospital (West Branch), and we obtained information about residual symptoms and nucleic acid tests after discharge through follow-up study. We evaluated the relationship of clinical characteristics and reappeared positive results. Each patient had at least 44 days of follow-up.ResultsOf 938 discharged patients, a total of 58 (6.2%) had reappeared positive nucleic acid test results and 880 remain negative. Among patients over the age of 50, the factors we found to be associated with re-positive results were coronary artery disease (14.1%, vs. 5.5% among those without coronary artery disease; odds ratio, 2.81; 95% confidence interval [CI], 1.28 to 6.15), and hypertension (9.5%, vs. 4.9% among those without hypertension; odds ratio, 2.05; 95% CI, 1.10 to 3.82). As of May 11, 2020, 54 (93.1%) re-positive patients turned negative again while two patients remained positive, and two patients was lost to the second follow-up.ConclusionCoexisting diseases including coronary artery disease and hypertension were substantial risk factors for re-positive outcomes among patients over 50. And most re-positive patients tended to return negative eventually.


2020 ◽  
Author(s):  
Weihua Yang ◽  
Jian Chen ◽  
Mingjie Xu ◽  
Jun Wang ◽  
Huanjie Li ◽  
...  

AbstractThe SARS-CoV-2 virus first broke out in China in early 2020. The early symptoms of COVID-19 are similar to those of influenza. Therefore, during the epidemic, patients with similar symptoms will be tested for multiple pathogens at the same time. In order to control the spread of SARS-CoV-2, China has taken many measures. Under this special situation, have the types and epidemic characteristics of respiratory viruses changed? The nucleic acid test results of influenza A virus, influenza B virus and respiratory syncytial virus, as well as the antibody test results of 8 common respiratory viruses of Jinan Central Hospital were collected before and after the occurrence of SARS-CoV-2, and age distribution and time distribution characteristics were statisticed. Furthermore the epidemiological characteristics of this new virus before and after the SARS-CoV-2 epidemic was compared. In the early stage of the SARS-CoV-2 epidemic, influenza A, influenza B and respiratory syncytial virus nucleic acid test samples were large, and the positive rate of the three viruses was high. After that, the sample size and positive rate decreased significantly. No co-infection of SARS-CoV-2 and other viruses was found in our hospital. The sample size before the SARS-CoV-2 outbreak was larger than that after the outbreak, but the positive rate of the outbreak was lower than that after the outbreak. And the infection rate of children decreased in the middle and late stages of the epidemic. This is because since January 23, in order to prevent the spread of the new crown epidemic, my country has adopted measures such as wearing masks, not gathering together, and quarantining at home. This not only prevents the spread of the new crown virus, but also prevents the common respiratory tract. The spread of the virus has reduced the incidence of residents.


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