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Feron Agbo C, Assogba E, Bertaut A, Mamguem Kamga A, Coutant C, Desmoulins I, Dancourt V, Sandrine Dabakuyo Yonli T. Impact of Covid-19 on breast cancer stage at discovery, and time to treatment in Cote d'Or, France. Prev Med Rep 2023; 34:102248. [PMID: 37292424 PMCID: PMC10193771 DOI: 10.1016/j.pmedr.2023.102248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/10/2023] Open
Abstract
Due to the COVID-19 pandemic, and ensuing overcrowding in the French health system, management of patients with COVID-19 was given priority over that of patients with other pathologies, including chronic diseases. The aim of this study was to study the impact of COVID-19 on the stage of discovery of cancers diagnosed in the context of an organized breast cancer screening programme, as well as the impact on time to treatment. All women diagnosed with cancer in the Côte d'Or via organized breast cancer screening (first or second reading) from January 1, 2019 to December 31, 2020 were included in this study. Using data from pathological laboratories, clinical centers, and the breast and gynecological cancer registry of the Côte d'Or, France, we collected socio-demographic, clinical and treatment data on all patients. We compared data from the year 2019 (before-Covid) with the year 2020 (Covid). We did not observe a significant difference in the stage of breast cancer at discovery, or in time to treatment. However, the number of invasive cancers and the clinical size of in situ cancers both increased in 2020. Although these results are reassuring, continued monitoring is needed to determine the downstream effects of the pandemic.
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Affiliation(s)
- Clémence Feron Agbo
- Breast and Gynaecologic Cancer Registry of Côte d'Or / Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Cancer Centre-UNICANCER Centre, 1 rue Professeur Marion, 21000 Dijon, France
| | - Emerline Assogba
- Breast and Gynaecologic Cancer Registry of Côte d'Or / Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Cancer Centre-UNICANCER Centre, 1 rue Professeur Marion, 21000 Dijon, France
- National Clinical Research Platform on Quality of Life and Cancer, 21000 Dijon, France
| | - Aurélie Bertaut
- Methodology and Biostatistics Unit, Centre Georges-François Leclerc, Dijon, France
| | - Ariane Mamguem Kamga
- Breast and Gynaecologic Cancer Registry of Côte d'Or / Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Cancer Centre-UNICANCER Centre, 1 rue Professeur Marion, 21000 Dijon, France
- Lipids, Nutrition, Cancer Research Center, French National Institute of Health and Medical Research (INSERM) U1231, 21000 Dijon, France
| | - Charles Coutant
- Department of Surgical Oncology, Georges François Leclerc Comprehensive Cancer Centre, 1 rue Professeur Marion, 21000 Dijon, France
- Faculty of Medicine and Pharmacy, Université Bourgogne Franche-Comté, 21000 Dijon, France
| | | | - Vincent Dancourt
- Inserm U866, Faculté de médecine, Université de Bourgogne, Dijon, France
- Association pour le Dépistage des Cancers en Côte d'Or et dans la Nièvre (ADECA 21-58), Dijon, France
| | - Tienhan Sandrine Dabakuyo Yonli
- Breast and Gynaecologic Cancer Registry of Côte d'Or / Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Cancer Centre-UNICANCER Centre, 1 rue Professeur Marion, 21000 Dijon, France
- Lipids, Nutrition, Cancer Research Center, French National Institute of Health and Medical Research (INSERM) U1231, 21000 Dijon, France
- National Clinical Research Platform on Quality of Life and Cancer, 21000 Dijon, France
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2
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Davin-Casalena B, Jardin M, Guerrera H, Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data. Rev Epidemiol Sante Publique 2021; 69:255-264. [PMID: 34454792 PMCID: PMC8818324 DOI: 10.1016/j.respe.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
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Affiliation(s)
- B Davin-Casalena
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille.
| | - M Jardin
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - H Guerrera
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - J Mabille
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - H Tréhard
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - D Lapalus
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - C Ménager
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - S Nauleau
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - V Cassaro
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - P Verger
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - V Guagliardo
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
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3
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Lucchi-Angellier E, Mino JC, Burnod A, Cottu P, Bozec L, Escalup L, Massing L, Papon M, Rizand P, Fumoleau P, Bouleuc C. [Adapting to the SARS-CoV2 pandemic: Experience of the Curie Institute]. Bull Cancer 2021; 108:787-797. [PMID: 34334191 PMCID: PMC8233851 DOI: 10.1016/j.bulcan.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/05/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022]
Abstract
L’Institut Curie prend en charge exclusivement des personnes atteintes de cancer, considérées dès le début de la pandémie SARS-CoV2 comme particulièrement « vulnérables ». Cette pandémie, qui a surpris le monde médical, est venue exiger brusquement de l’Ensemble Hospitalier une réorganisation rapide et multimodale, tout en ayant un impact sur chacun à des degrés divers. Nous examinerons ici comment cet hôpital a fait face, dans le souci d’une nouvelle balance bénéfices-risques, en temps de plus grande incertitude médicale et de rareté de certaines ressources, pour ces malades « vulnérables » mais aussi leurs proches et les personnels. Nous dégagerons par thématique les aspects positifs et les difficultés rencontrées, et ensuite ce qui pourrait être utile à d’autres hôpitaux alors que la pandémie se poursuit.
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Affiliation(s)
- Elisabeth Lucchi-Angellier
- Institut Curie Site Saint Cloud, département de Soins de Support, 35, rue Dailly, 92210 Saint-Cloud, France; Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France.
| | | | - Alexis Burnod
- Institut Curie Site Paris, dpartement de soins de support, 26, rue d'Ulm, 75005 Paris, France
| | - Paul Cottu
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie Site Paris, département d'oncologie médicale, 26, rue d'Ulm, 75005 Paris, France
| | - Laurence Bozec
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie Site Saint-Cloud, département d'oncologie médicale, 35, rue Dailly, 92210 Saint Cloud, France
| | - Laurence Escalup
- Institut Curie, département de pharmacie, 26, rue d'Ulm, 75005 Paris, France
| | - Louise Massing
- Institut Curie, cellule qualité de vie au travail, 26, rue d'Ulm, 75005 Paris, France
| | - Marc Papon
- Institut Curie, psychologue pour le personnel, 26, rue d'Ulm, 75005 Paris, France
| | - Philippe Rizand
- Institut Curie, direction des systèmes d'information, 26, rue d'Ulm, 75005 Paris, France
| | - Pierre Fumoleau
- Institut Curie, direction générale, 73, rue Claude-Bernard, 75005 Paris, France
| | - Carole Bouleuc
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie, département de soins de support, 26, rue d'Ulm, 75005 Paris, France
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4
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Martin S, Kaeuffer C, Leyendecker P, Tuzin N, Tazi Y, Schaff-Wendling F, Kleinheny T, Husson-Wetzel S, Pamart G, Limacher JM, Clerc O, Dicop E, Kurtz JE, Barthélémy P, Gantzer J. COVID-19 in Patients with Cancer: A Retrospective Study of 212 Cases from a French SARS-CoV-2 Cluster During the First Wave of the COVID-19 Pandemic. Oncologist 2021; 26:e1656-e1659. [PMID: 34028132 PMCID: PMC8242566 DOI: 10.1002/onco.13831] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 05/11/2021] [Indexed: 12/16/2022] Open
Abstract
We describe a large series of patients with solid tumors in an early COVID-19 cluster in the eastern part of France. From February to May 2020, this multicenter retrospective study enrolled 212 patients with cancer under treatment or on follow-up for any type of malignant solid tumor and positive for SARS-CoV-2. The mortality rate was 30%. Patients with gastrointestinal cancers were identified as a subset of more vulnerable patients; immunotherapy and radiotherapy within 3 months from COVID-19 diagnosis were risk factors for death. The reported data support the essential need to be proactive and weigh the risks of morbidity from COVID-19 against the magnitude of benefits of intended cancer therapies during this pandemic. IMPLICATIONS FOR PRACTICE: This article supports the essential need to be proactive (treatment delay or modification) in oncology in the setting of pandemic. This study identified patients with gastrointestinal cancers as a more vulnerable subset of patients with cancer and found that immunotherapy and radiotherapy within 3 months from COVID-19 diagnosis to be risk factors for death. The reported data indicate the necessity of weighing the risks of morbidity from COVID-19 against the magnitude of benefits of intended cancer therapies in any future wave of COVID-19.
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Affiliation(s)
- Sophie Martin
- Department of Medical Oncology, ICANS, Strasbourg, France
| | - Charlotte Kaeuffer
- Department of Infectious Diseases, Strasbourg, University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Pierre Leyendecker
- Department of Radiology, Strasbourg, University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Nicolas Tuzin
- Department of Public Health, Strasbourg, University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Youssef Tazi
- Department of Medical Oncology, Clinique Sainte-Anne, Strasbourg, France
| | | | - Tiffanie Kleinheny
- Department of Medical Oncology, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Stéphanie Husson-Wetzel
- Department of Gastroenterology, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Guillaume Pamart
- Department of Chest Diseases, Strasbourg, University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Jean-Marc Limacher
- Department of Medical Oncology and Clinical Hematology, Hôpital Louis Pasteur, Colmar, France
| | - Olivier Clerc
- Rehabilitation Center, Maison de Santé Béthel, Oberhausbergen, France
| | - Elise Dicop
- Department of Medical Oncology, ICANS, Strasbourg, France
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5
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Davin-Casalena B, Jardin M, Guerrera H, J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. [The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data]. Rev Epidemiol Sante Publique 2021; 69:105-115. [PMID: 33992499 PMCID: PMC8075812 DOI: 10.1016/j.respe.2021.04.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Position du problème L’épidémie de COVID-19 du printemps 2020 a fortement affecté le système de soins. Le confinement et les risques d’exposition au coronavirus ont incité les patients à modifier leur recours aux soins. L’objectif était de partager un retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel de l’activité des médecins libéraux de la région Provence-Alpes-Côte d’Azur, et de l’évolution des remboursements de médicaments prescrits aux assurés du régime général pour le diabète, pour des troubles de la santé mentale et pour certains vaccins. Méthodes Les données ont été extraites à partir des bases régionales de l’Assurance maladie pour les années 2019 et 2020. Elles ont permis de construire des indicateurs en date de soins pour le régime général stricto sensu, calculés de façon hebdomadaire, à partir de la semaine 2. Résultats On constate une chute d’activité des médecins libéraux lors du confinement (−23 % pour les médecins généralistes ; −46 % pour les spécialistes), suivie d’un quasi retour à la normale par la suite. Dans le même temps, les téléconsultations ont connu un véritable essor : elles ont constitué 30 % des actes des médecins libéraux au plus fort de la crise. Le début du confinement a été marqué par un pic d’approvisionnement en médicaments, tandis que la vaccination a fortement diminué (−39 % concernant le vaccin contre la rougeole, les oreillons et la rubéole chez les enfants âgés de moins de 5 ans ; −54 % pour le vaccin contre les papillomavirus humains chez les filles âgées de 10–14 ans). Conclusion L’épidémie de COVID-19 risque d’entraîner d’autres conséquences sanitaires que celles directement imputables à la COVID-19 elle-même. Le renoncement aux soins pourrait causer des retards de soins fortement préjudiciables aux individus et à la collectivité. Ces questions inquiètent les autorités publiques, qui mettent en place des actions visant à inciter les patients à se soigner sans tarder. Mais la crise liée à la COVID-19 a aussi créé des opportunités, telles que le déploiement de la téléconsultation et de la télé-expertise. Bien que partiels, les indicateurs mis en œuvre peuvent permettre aux décideurs publics d’être réactifs et de mettre en place certaines actions afin de répondre aux besoins de santé des populations.
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Affiliation(s)
- B Davin-Casalena
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - M Jardin
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - H Guerrera
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - J Mabille
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - H Tréhard
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - D Lapalus
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - C Ménager
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - S Nauleau
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - V Cassaro
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - P Verger
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - V Guagliardo
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
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6
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Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol 2021; 7:311-323. [PMID: 33617304 PMCID: PMC8081532 DOI: 10.1200/go.20.00639] [Citation(s) in RCA: 253] [Impact Index Per Article: 84.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.
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Affiliation(s)
- Rachel Riera
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil
| | | | - Rafael Leite Pacheco
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil.,Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Felipe Roitberg
- Instituto do Câncer do Estado de São Paulo/HCFMUSP, São Paulo, Brazil.,Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland.,European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
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7
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Basse C, Diakite S, Servois V, Frelaut M, Noret A, Bellesoeur A, Moreau P, Massiani MA, Bouyer AS, Vuagnat P, Malak S, Bidard FC, Vanjak D, Kriegel I, Burnod A, Bilger G, Ramtohul T, Dhonneur G, Bouleuc C, Cassoux N, Paoletti X, Bozec L, Cottu P. Characteristics and Outcome of SARS-CoV-2 Infection in Cancer Patients. JNCI Cancer Spectr 2021; 5:pkaa090. [PMID: 33604509 PMCID: PMC7665636 DOI: 10.1093/jncics/pkaa090] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/10/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022] Open
Abstract
Background Concerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, we review the experience of a comprehensive cancer center. Methods A prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days. Results Among 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography scan. In line with our case mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19–related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O2 saturation. Conclusions COVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.
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Affiliation(s)
- Clémence Basse
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - Sarah Diakite
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | | | - Maxime Frelaut
- Department of Drug Development and Innovation, Institut Curie, Paris & Saint Cloud, France
| | - Aurélien Noret
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - Audrey Bellesoeur
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - Pauline Moreau
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | | | - Anne-Sophie Bouyer
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - Perrine Vuagnat
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France.,Université Versailles Saint-Quentin, Université Paris-Saclay, Saint Cloud, France
| | - Sandra Malak
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - François-Clément Bidard
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France.,Université Versailles Saint-Quentin, Université Paris-Saclay, Saint Cloud, France
| | - Dominique Vanjak
- Infectious Diseases Unit, Institut Curie, Paris & Saint Cloud, France
| | - Irène Kriegel
- Department of Anesthesia, Intensive Care and Pain Medicine, Institut Curie, Paris & Saint Cloud, France
| | - Alexis Burnod
- Supportive and Palliative Care Department, Institut Curie, Paris & Saint-Cloud, France
| | - Geoffroy Bilger
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | | | - Gilles Dhonneur
- Department of Anesthesia, Intensive Care and Pain Medicine, Institut Curie, Paris & Saint Cloud, France
| | - Carole Bouleuc
- Supportive and Palliative Care Department, Institut Curie, Paris & Saint-Cloud, France
| | - Nathalie Cassoux
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France.,Université de Paris, Paris, France
| | | | - Xavier Paoletti
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France.,Université Versailles Saint-Quentin, Université Paris-Saclay, Saint Cloud, France
| | - Laurence Bozec
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France
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Abstract
BACKGROUND Although COVID-19 is a major worldwide health threat, there is another global public health emergency that is becoming a growing challenge. Domestic violence is a public health and human rights issue that primarily affects women and children worldwide. Several countries have reported a significant increase in domestic violence cases since the COVID-19-induced lockdowns and physical distancing measures were implemented. The COVID-19 health crisis is exacerbating another pre-existing public health problem by increasing the severity and frequency of domestic violence, thus demonstrating the need to adopt significant and long-term measures. OBJECTIVE Therefore, it is urgently necessary to promote and increase actions and policies to guarantee the safety and dignity of all victims of domestic violence worldwide. METHODS This paper describes preventive measures and action plans to combat violence against women and children during the COVID-19 pandemic. CONCLUSION The prevention of domestic violence must indeed be every government's priority and every citizen's responsibility.
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Affiliation(s)
- Deniz Ertan
- La Teppe, Tain l'Hermitage, France.,Département de Neurologie, CHRU de Nancy, Nancy, France
| | - Wissam El-Hage
- Centre Régional de Psychotraumatologie CVL, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Sarah Thierrée
- Centre Régional de Psychotraumatologie CVL, CHRU de Tours, Tours, France
| | - Hervé Javelot
- Laboratoire de Toxicologie et Pharmacologie Neuro Cardiovasculaire, Université de Strasbourg, Strasbourg, France
| | - Coraline Hingray
- Département de Neurologie, CHRU de Nancy, Nancy, France.,Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
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