scholarly journals Treatment Strategies for Cancer Patients in Post-Peak of the Novel Coronavirus Disease (COVID-19) Period in China

2020 ◽  
Vol 10 ◽  
Author(s):  
Binliang Liu ◽  
Hongnan Mo ◽  
Fei Ma
Author(s):  
Xudan Chen ◽  
Yuying Zhang ◽  
Baoyi Zhu ◽  
Jianwen Zeng ◽  
Wenxin Hong ◽  
...  

AbstractBackgroundThe novel coronavirus disease 2019 (COVID-19) characterized by respiratory symptoms has become a global pandemic although factors influencing viral RNA clearance remained unclear to inform optimal isolation period and treatment strategies.MethodsIn this retrospective study, we included patients with confirmed COVID-19 admitted to Guangzhou Eighth People’s Hospital from 20th January 2020 to 15th March 2020. The associations of clinical characteristics and treatment regimens on time to viral RNA clearance were analyzed.ResultsWe examined 284 consecutive COVID-19 cases, accounting for 82% of confirmed cases in Guangzhou during this period. At the time of reporting (20th March 2020), 276 (97.2%) had recovered and were discharged from hospital with a median hospital stay of 18 days (interquartile range [IQR]:13-24). Overall, 280 patients achieved viral RNA clearance with a median length of 12 days (IQR: 8-16) after onset of illness. Amongst them, 66.1% had viral RNA cleared within 14 days, and 89.3% within 21 days. Older age, severity of disease, time lag from illness onset to hospital admission, high body temperature, and corticosteroid use were associated with delayed clearance of viral RNA. None of the antiviral regimens (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) improved viral RNA clearance. The use of lopinavir/ritonavir was associated with delayed clearance of viral RNA after adjusting for confounders.ConclusionIn patients with COVID-19, isolation for a minimum of 21 days after onset of illness may be warranted, while the use of antiviral drugs does not enhance viral RNA clearance.Brief SummaryViral RNA was cleared in 89% of the COVID-19 patients within 21 days after illness onset. The use of antiviral drugs (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) did not shorten viral RNA clearance, especially in non-serious cases.


2020 ◽  
Vol 39 (12) ◽  
pp. 2211-2223 ◽  
Author(s):  
Hongjun Miao ◽  
Han Li ◽  
Yinying Yao ◽  
Mingfu Wu ◽  
Chao Lu ◽  
...  

AbstractSince the outbreak of novel coronavirus infection pneumonia in Wuhan City, China, in late 2019, such cases have been gradually reported in other parts of China and abroad. Children have become susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of their immature immune function. As the outbreak has progressed, more cases of novel coronavirus infection/pneumonia in children have been reported. Compared with adults, the impact of SARS-CoV-2 infection in children is less severe, with a lower incidence and susceptibility in children, which results in fewer children being tested, thereby underestimating the actual number of infections. Therefore, strengthening the diagnosis of the disease is particularly important for children, and early and clear diagnosis can determine treatment strategies and reduce the harm caused by the disease to children. According to the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (trial version 7) issued by National Health Committee and the latest diagnosis and treatment strategies for novel coronavirus infection pneumonia in children, this review summarizes current strategies on diagnosis and treatment of SARS-CoV-2 infection in children.


Chemotherapy ◽  
2020 ◽  
pp. 1-6
Author(s):  
Naziye Ak ◽  
Sezai Vatansever

<b><i>Background:</i></b> The novel coronavirus disease 2019 has become a worldwide threat. We aimed to explore reflections of these unexpected changes to newly diagnosed cancer patients. <b><i>Method:</i></b> We searched the 2 months after the index case of our country. The first admission day and the first day of intravenous treatment of newly diagnosed patients were recorded. <b><i>Results:</i></b> In the 60 days measured during the pandemic, the total number of patients on polyclinics was 159/weekdays, and the total applied chemotherapy cycles were 276/week. For comparison, the total numbers in the previous year were 267/weekday and 363/week for polyclinic and applied chemotherapy cycles, respectively. The total number of newly admitted patients in 2020 was 283. For comparison, the number of new patients in the same 60-day period in 2019 was 495. Patients who were admitted for adjuvant treatment required a median of 8 days for the first course, those who were admitted for neoadjuvant treatment required 12 days, and metastatic patients required 14 days; there were no significant differences between treatment types (<i>p</i> = 0.233). However, the median treatment time was 11.5 and 17 days, in 2020 and in 2019, respectively. A significant difference was observed between the 2 groups (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The effective shift of workers and accurate regulations have not resulted in apparent delays in patient care. While a decrease in the number of patients has detected, faster healthcare service was introduced to newly diagnosed patients. The reason for the decrease in the number of patients should be investigated with new studies.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247797
Author(s):  
Renee L. Higgins ◽  
Stephen A. Rawlings ◽  
Jamie Case ◽  
Florence Y. Lee ◽  
Clarence W. Chan ◽  
...  

Since the initial identification of the novel coronavirus SARS-CoV-2 in December of 2019, researchers have raced to understand its pathogenesis and begun devising vaccine and treatment strategies. An accurate understanding of the body’s temporal immune response against SARS-CoV-2 is paramount to successful vaccine development and disease progression monitoring. To provide insight into the antibody response against SARS-CoV-2, plasma samples from 181 PCR-confirmed COVID-19 patients collected at various timepoints post-symptom onset (PSO) were tested for the presence of anti-SARS-CoV-2 IgM and IgG antibodies via lateral flow. Additionally, 21 donors were tracked over time to elucidate patient-specific immune responses. We found sustained levels of anti-SARS-CoV-2 antibodies past 130 days PSO, with 99% positivity observed at 31–60 days PSO. By 61–90 days PSO, the percentage of IgM-/IgG+ results were nearly equal to that of IgM+/IgG+ results, demonstrating a shift in the immune response with a decrease in IgM antibody levels. Results from this study not only provide evidence that the antibody response to COVID-19 can persist for over 4 months, but also demonstrates the ability of Easy Check™ to monitor seroconversion and antibody response of patients. Easy Check was sufficiently sensitive to detect antibodies in patient samples as early as 1–4 days PSO with 86% positivity observed at 5–7 days PSO. Further studies are required to determine the longevity and efficacy of anti-SARS-CoV-2 antibodies, and whether they are protective against re-infection.


2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 29-29
Author(s):  
Reese Garcia ◽  
Andrea Dwyer ◽  
Molly McDonnell

29 Background: The novel coronavirus (COVID-19) has caused numerous disruptions across the cancer prevention and treatment landscape. Conservative modeling studies examining the effect of COVID-19 on cancer screening and treatment for breast and colorectal cancer (CRC) suggest that there will be 10,000 excess deaths from both cancers combined over the next decade. The goal of this analysis was to better understand the impact of COVID-19 on the CRC community, including gaps and opportunities for improving access to care and survivorship needs, and to advocate for the best possible care through policy, education and engagement of the entire cancer ecosystem. Methods: In April 2020, Fight Colorectal Cancer (Fight CRC) distributed an online survey to the colorectal cancer community. The survey was distributed through social media channels and targeted emails from April 24-May 5, 2020. Virtual focus groups were also conducted to gather rich qualitative data from cancer patients and caregivers about their experiences during the novel coronavirus pandemic. Results: In total, 222 individuals responded to the survey (survivors = 68%, caregiver = 12%, first degree family member = 8%, other = 8%), and 10 CRC survivors participated in focus groups (stage III = 30%, stage IV = 70%). Treatment disruptions and mental health were prevalent themes in both the survey and focus group. Over one-third of survey respondents indicated facing treatment disruptions (37%) and a majority (78%) of colorectal cancer patients reported feeling nervous and anxious. Another primary concern among respondents was access to care. Patients on Medicare were more likely than patients on private insurance to report having difficulties affording food and basic supplies. People living in rural areas were more likely to have greater concerns about maintaining a supportive network than those living in suburban areas. Conclusions: People with cancer face unique challenges as a result of the novel coronavirus, including treatment disruptions, increased feelings of anxiety, and financial concerns. Numerous health inequities also exist among low-income and rural patient groups. Identifying the barriers that patients face provides an opportunity to address the nuanced needs of the colorectal cancer community. Clinicians, supportive care providers, and advocacy organizations can tailor care delivery, increase access to care, and prepare patients for the future with reliable and accurate resources amidst a pandemic.


2020 ◽  
Vol 163 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Julia E. Noel ◽  
Lisa A. Orloff ◽  
Kwang Sung

The novel coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, has quickly become a global pandemic since its initial outbreak in China in late 2019. Institutions are faced with the challenge of upholding the standard of care while maintaining safety for health care personnel and patients. Due to the common performance of aerosol-generating endoscopic procedures in the upper respiratory tract, otolaryngologists are at uniquely high risk for potential infection. When possible, alternative diagnostic and treatment strategies should be pursued. For patients suspected of having functional laryngeal abnormalities, transcervical laryngeal ultrasound provides a rapid and noninvasive evaluation of vocal fold motion to inform decisions about safety of feeding, airway, and progression of care.


Author(s):  
Sherin Joseph ◽  
Anila Kutty Narayanan

COVID -19 a global pandemic that has brought all the greater global countries to a hook. The novel coronavirus (SARS-CoV-2) outbreak was first reported in Wuhan, China which then started spreading to different countries around the world. ACE2 receptors are present in various organs but the overexpression of ACE2 at lung epithelia makes them more vulnerable to respiratory symptoms. SARS-CoV-2 binds to ACE2 receptors for entry into host cells which may serve as potential target for future therapy .Repurposing of drugs are the present strategy undertaken as the SARS-CoV-2 shows similar respiratory distress symptoms as in the case of SARS and MERS. At present the antiviral medications and vaccines are at the early stages and may take few months to years, to achieve their complete efficacy to solve the public crisis. The technological advancements have brought passive immunisation, which is an anecdotal success, but the ideal approach to future outbreaks of SARS-CoV-2 is done by vaccines that are under clinical trials. There are a large percentage of population under psychological crisis either due to the fear of infection or stress from the quarantine lives. High levels of viral loads at the initial stages cause higher chances of transmission hence immediate isolations and screening methods must be undertaken. This review mainly focuses on the treatment strategies followed with no definitive approval from authorities. This is an attempt to gather all the materialistic evidences available for now.


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