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Piubelli C, Valerio M, Verzè M, Nicolis F, Mantoan C, Zamboni S, Perandin F, Rizzi E, Tais S, Degani M, Caldrer S, Gobbi FG, Bisoffi Z, Gori S. Humoral Effect of SARS-CoV-2 mRNA vaccination with booster dose in solid tumor patients with different anticancer treatments. Front Oncol 2023; 13:1089944. [PMID: 36910621 PMCID: PMC9992722 DOI: 10.3389/fonc.2023.1089944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Introduction Cancer patients are at risk for serious complications in case of SARS-CoV-2 infection. In these patients SARS-CoV-2 vaccination is strongly recommended, with the preferential use of mRNA vaccines. The antibody response in cancer patients is variable, depending on the type of cancer and antitumoral treatment. In solid tumor patients an antibody response similar to healthy subjects has been confirmed after the second dose. Only few studies explored the duration of immunization after the two doses and the effect of the third dose. Methods In our study we explored a cohort of 273 solid tumor patients at different stages and treated with different anticancer therapies. Results and Discussion Our analysis demonstrated that the persistence of the neutralizing antibody and the humoral response after the booster dose of vaccine was not dependent on either the tumor type, the stage or type of anticancer treatment.
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Affiliation(s)
- Chiara Piubelli
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Matteo Valerio
- Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Matteo Verzè
- Medical Direction Unit, Medical Direction, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Fabrizio Nicolis
- Medical Direction Unit, Medical Direction, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Carlotta Mantoan
- Nurse Direction Unit, Nurse Direction, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Sonia Zamboni
- Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Francesca Perandin
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Eleonora Rizzi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Stefano Tais
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Monica Degani
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Sara Caldrer
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Federico Giovanni Gobbi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Zeno Bisoffi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
| | - Stefania Gori
- Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Vr, Italy
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Caccese M, Saieva AM, Guarneri V, Lonardi S, Cacco M, Sileni VC, Gottardi M, Mioranza E, Bergamo F, Brunello A, Zagonel V, Benini P. Antigen rapid diagnostic test monitoring for SARS-CoV-2 in asymptomatic and fully vaccinated cancer patients: Is it cost-effective? Cancer Med 2022; 12:7795-7800. [PMID: 36583551 PMCID: PMC9880617 DOI: 10.1002/cam4.5537] [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: 08/18/2022] [Revised: 11/17/2022] [Accepted: 11/29/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Routine testing for cancer patients not presenting COVID-19-related symptoms and fully vaccinated for SARS-CoV-2 prior to cancer treatment is controversial. METHODS In this retrospective study we evaluated whether antigen-rapid-diagnostic-test (Ag-RDT) monitoring for SARS-CoV-2 in a large cohort of consecutive asymptomatic (absence of SARS-CoV-2-related symptoms such as fever, cough, sore throat or nasal congestion) and fully vaccinated cancer patients enrolled in a short period during cancer treatment has an impact on the therapeutic path of cancer patients. RESULTS From December 27, 2021, to February 11, 2022, 2439 cancer patients were screened through Ag-RDT for SARS-CoV-2 before entering the hospital for systemic treatment. Fifty-three patients (2.17%) tested positive, of whom 7 (13.2%) subsequently developed COVID-related symptoms, generally mild. Cancer treatment was discontinued, as a precaution, in 49 patients (92.5%) due to the test positivity. CONCLUSION SARS-CoV-2 screening in asymptomatic and fully vaccinated cancer patients during systemic treatment appeared to be not cost-effective: the low rate of SARS-CoV-2 positive patients and the low percentage of overt associated infection do not seem proportional to the direct costs (nursing work for swabs, costs of materials and patient monitoring) and indirect costs (dedicated rooms, extension of waiting times for patients and oncologists in delivering therapy as well as its discontinuation in the positive ones). It can, on the other hand, be detrimental when systemic cancer treatment is suspended as a precaution. Given the small number of patients testing positive and the rapid and favorable trend of the infection, it is recommended to always consider continuing systemic oncological treatment, especially when this impacts patient survival as in the adjuvant or neoadjuvant setting.
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Affiliation(s)
- Mario Caccese
- Department of Oncology, Oncology 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Anna Maria Saieva
- Medical Direction UnitVeneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Valentina Guarneri
- Department of Oncology, Oncology 2Veneto Institute of Oncology IOV‐IRCCSPaduaItaly,Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
| | - Sara Lonardi
- Department of Oncology, Oncology 3Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Massimo Cacco
- Hospital Health Professions UnitVeneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | | | - Michele Gottardi
- Onco‐Hematology UnitVeneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Eleonora Mioranza
- Department of Oncology, Oncology 2Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Francesca Bergamo
- Department of Oncology, Oncology 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Antonella Brunello
- Department of Oncology, Oncology 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1Veneto Institute of Oncology IOV‐IRCCSPaduaItaly
| | - Patrizia Benini
- General DirectorateVeneto Institute of Oncology IOV‐IRCCSPaduaItaly
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Lasalvia P, Trama A, Botta L, Franchi M, Bernasconi A. Developing a comorbidity score in cancer patients using healthcare utilization databases during the COVID-19 pandemic: An experience from Italy. Cancer Med 2022; 12:9849-9856. [PMID: 36540941 PMCID: PMC9877744 DOI: 10.1002/cam4.5540] [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: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A strong relationship has been observed between comorbidities and the risk of severe/fatal COVID-19 manifestations, but no score is available to evaluate their association in cancer patients. To make up for this lacuna, we aimed to develop a comorbidity score for cancer patients, based on the Lombardy Region healthcare databases. METHODS We used hospital discharge records to identify patients with a new diagnosis of solid cancer between February and December 2019; 61 comorbidities were retrieved within 2 years before cancer diagnosis. This cohort was split into training and validation sets. In the training set, we used a LASSO-logistic model to identify comorbidities associated with the risk of developing a severe/fatal form of COVID-19 during the first pandemic wave (March-May 2020). We used a logistic model to estimate comorbidity score weights and then we divided the score into five classes (<=-1, 0, 1, 2-4, >=5). In the validation set, we assessed score performance by areas under the receiver operating characteristic curve (AUC) and calibration plots. We repeated the process on second pandemic wave (October-December 2020) data. RESULTS We identified 55,425 patients with an incident solid cancer. We selected 21 comorbidities as independent predictors. The first four score classes showed similar probability of experiencing the outcome (0.2% to 0.5%), while the last showed a probability equal to 5.8%. The score performed well in both the first and second pandemic waves: AUC 0.85 and 0.82, respectively. Our results were robust for major cancer sites too (i.e., colorectal, lung, female breast, and prostate). CONCLUSIONS We developed a high performance comorbidity score for cancer patients and COVID-19. Being based on administrative databases, this score will be useful for adjusting for comorbidity confounding in epidemiological studies on COVID-19 and cancer impact.
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Affiliation(s)
- Paolo Lasalvia
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Matteo Franchi
- National Centre for Healthcare Research and PharmacoepidemiologyUniversity of Milano‐BicoccaMilanItaly,Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative MethodsUniversity of Milano‐BicoccaMilanItaly
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Epidemiology and Data ScienceFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
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Crispo A, Rivieccio G, Cataldo L, Coluccia S, Luongo A, Coppola E, Grimaldi M, Montagnese C, Nocerino F, Celentano E, Saviano R, Bastone A, Baglio G, De Angelis C, Ciardiello F, Avallone A, Cassata A, Costanzo R, Morabito A, Maione P, Gridelli C, Cigolari S, Borrelli A, De Placido S, Schiavone F, Bianchi AAM, Pignata S, Aquino A, Bonito C, Buonerba C, Caccavallo F, Carlomagno C, Cavaliere M, Centonze S, Damiano S, De Divitiis C, De Nardo R, Del Deo Vito A, D'Errico D, Esposito G, Esposito L, Famiglietti V, Formisano L, Formisano L, Franzese E, Gaeta V, Gragnano E, Grimaldi R, Iovane G, Lauria R, Migliore G, Mirto M, Napoletano A, Napoli D, Vitale P, Pepe S, Rambaldo MP, Renato M, Rescigno M, Rossi E, Santabarbara G, Stanzione C. New approach to implement cancer patient care: The valutazione percorso rete oncologica campana (ValPeROC)‐experience from an Italian oncology network. Eur J Cancer Care (Engl) 2022; 31:e13736. [PMID: 37039607 DOI: 10.1111/ecc.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary goal of the Campania Oncology Network (ROC) was to reduce cancer delay and care fragmentation through the establishment of cancer-specific multidisciplinary oncologic groups (GOMs) and diagnostic and therapeutic assistance paths (PDTAs). METHODS Five cancer centres of the ROC, with their own cancer specific GOM, were selected. In our analysis, we have focused on four neoplasms: lung, colon, ovarian and prostate cancers. The median time for pre-GOM and GOM Times was calculated for each tumour site. Univariate and multivariate logistic regressions were performed to individuate risk factors for pre-GOM and GOM Time. RESULTS Significant differences were observed for prostate cancer compared to other patients either for pre-GOM or GOM Times. Significant risks were found for ovarian and prostate cancers in pre-GOM time and for prostate cancer in GOM-Time. CONCLUSIONS This experience will produce knowledge and data to guide decision-making and to manage more effectively the challenges of fighting cancer in Campania region. The Valutazione Percorso Rete Oncologica Campana (ValPeROC) study evaluates, for the first time, the ROC activity, through the analysis of key performance indices. Pre-GOM and GOM Time represent the quality of the entire regional health system and are useful to define models, which can evaluate the performance of the ROC over time.
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Affiliation(s)
- Anna Crispo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Giorgia Rivieccio
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Luca Cataldo
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Elisabetta Coppola
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Flavia Nocerino
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Rocco Saviano
- National Cancer Institute IRCCS Pascale Foundation Naples Italy
| | - Anna Bastone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Giovanni Baglio
- AGENAS ‐ Italian National Agency for Regional Healthcare Services Rome Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento di Medicina di Precisione Università degli Studi della Campania ‘L. Vanvitelli’ Naples Italy
| | - Antonio Avallone
- Experimental Clinical Abdominal Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Antonino Cassata
- Medical Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Raffaele Costanzo
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Alessandro Morabito
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Paolo Maione
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Cesare Gridelli
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Silvio Cigolari
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Anna Borrelli
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Francesco Schiavone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Attilio A. M. Bianchi
- Directorate‐General for Management Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Sandro Pignata
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
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Yang S, Zhao H, Cui R, Ma L, Ge X, Fu Q, Yu D, Niu X. Comparison of clinical outcomes and risk factors for COVID-19 infection in cancer patients without anticancer treatment and noncancer patients. Front Public Health 2022; 10:925519. [PMID: 36033814 PMCID: PMC9411742 DOI: 10.3389/fpubh.2022.925519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies have shown that cancer patients have higher rates of coronavirus disease 2019 (COVID-19) infection and mortality than noncancer patients. However, the differences between cancer patients undergoing regular follow-up without anticancer treatment and noncancer patients with COVID-19 have remained insufficiently investigated. Methods A retrospective case-control study of 52 patients with COVID-19 infection was performed with a 1:3 matched proportion of cancer patients undergoing regular follow-up without anticancer treatment and noncancer patients. The demographic characteristics, clinical data, laboratory tests, treatment, and complications of patients were collected from medical records. Chi-square tests and univariate and multivariate regressions were performed to assess the differences between these two cohorts of COVID-19 patients with and without cancer and risk factors for severe events in COVID-19 patients. Results Increased C-reactive protein (CRP) (>4 mg/L) (p = 0.015) and lactate dehydrogenase (LDH) (>243 IU/L) (p = 0.038) were identified as risk factors for severe events in all enrolled COVID-19 patients based on multivariate analysis, but cancer as a chronic disease (p = 1.000) was not identified as an independent risk factor for severe events in COVID-19 patients. Compared with noncancer patients, cancer patients had a significantly longer median hospitalization time (29 days vs. 19 days, p = 0.048) and a higher incidence of hypoalbuminemia complications (84.6 vs. 46.2%, p = 0.016). Conclusions Increased CRP and LDH were risk factors for severe events in all enrolled COVID-19 patients, and an increased incidence of hypoalbuminemia complications and longer hospitalization were noted in COVID-19 cancer patients undergoing regular follow-up without anticancer treatment compared with noncancer patients.
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Affiliation(s)
- Sen Yang
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huaxin Zhao
- Department of Oncology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ran Cui
- Department of Rheumatology and Immunology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Le Ma
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuhua Ge
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | | | - Dehua Yu
- Yangpu Hospital, Tongji University, Shanghai, China,Dehua Yu
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Xiaomin Niu
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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Dieci MV, Azzarello G, Zagonel V, Bassan F, Gori S, Aprile G, Chiarion-Sileni V, Lonardi S, Oliani C, Zaninelli M, Chiari R, Favaretto A, Pavan A, Di Liso E, Mioranza E, Baldoni A, Bergamo F, Maruzzo M, Ziampiri S, Inno A, Graziani F, Sinigaglia G, Celestino M, Conte P, Guarneri V. Clinical profile and mortality of Sars-Cov-2 infection in cancer patients across two pandemic time periods (Feb 2020-Sep 2020; Sep2020- May 2021) in the Veneto Oncology Network: the ROVID study. Eur J Cancer 2022; 167:81-91. [PMID: 35398759 PMCID: PMC8930432 DOI: 10.1016/j.ejca.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022]
Abstract
Introduction We analyzed a cohort of patients with cancer and Sars-Cov-2 infection from the Veneto Oncology Network registry across two pandemic time periods. Materials and methods 761 patients with cancer and SARS-CoV-2 infection were included. Results 198 patients were diagnosed during the first pandemic time period (TP1; February 2020 September 2020), 494 during TP2 before the vaccination campaign (TP2/pre-vaccination; September 2020-21 February 2021) and 69 in TP2/post-vaccination (22 February 2021-15 May 2021). TP2 vs TP1 patients were younger (p = 0.004), showed more frequently a good performance status (p < 0.001) and <2 comorbidities (p = 0.002), were more likely to be on active anticancer therapy (p = 0.006). Significantly fewer patients in TP2 (3-4%) vs TP1 (22%) had an in-hospital potential source of infection (p < 0.001). TP2 patients were more frequently asymptomatic (p = 0.003). Significantly fewer patients from TP2 were hospitalized (p < 0.001) or admitted to intensive care unit (p = 0.006). All-cause mortality decreased from 30.3% in TP1, to 8.9% and 8.7% in the two TP2 periods (p < 0.001), reflected by a significant reduction in Sars-Cov-2-related mortality (15.2%, 7.5% and 5.8% in the three consecutive time periods, p = 0.004). Conclusions Differences in clinical characteristics and features of Sars-Cov-2 infection between TP1 and TP2 reflect the effects of protective measures and increased testing capacity. The lower mortality in TP2 is in line with a less frail population. However, the vast majority of death events in TP2 were related to COVID-19, reinforcing the priority to protect cancer patients.
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Caccese M, Imbevaro S, Feltrin A, Costardi D, Giordano N, Maran M, Martino R, Ottolitri K, Shams M, Vascon F, Roma A, Galiano A, Maruzzo M, Marino D, Lombardi G, Lonardi S, Brunello A, Zagonel V. Cancer Patient-Reported Experience Measures (PREMs) Regarding the Policies Implemented to Contain the Spread of Sars-CoV-2 and Vaccination Campaign at Veneto Institute of Oncology. Patient Prefer Adherence 2022; 16:353-362. [PMID: 35173420 PMCID: PMC8841696 DOI: 10.2147/ppa.s351771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/24/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The SARS-CoV-2 spread has impacted Healthcare systems. COVID-19 pandemic has had consequences for patients with cancer, being associated with delays in diagnosis, in treatment And follow-up care, increase in overall infection rates and higher mortality. A survey on COVID-19 and a vaccination-questionnaire were developed at different times of the outbreak, to evaluate cancer patient-reported experience measures (PREMs) on the policies implemented to reduce the infection from SARS-CoV-2 and on the timing and methods of COVID-19 vaccination. PATIENTS AND METHODS The survey was distributed to all patients accessing the Institute during the "first-wave" Of the pandemic, evaluating patients' concerns about the pandemic, the pandemics' consequences on their cancer care, and their perception Of the measures adopted to limit the infection spread. The vaccination-questionnaire was proposed to 10% of the first 5297 cancer patients vaccinated with two doses of the Pfizer-BioNTechCOVID-19 vaccine. This questionnaire aimed at assessing the degree Of satisfaction with the Institutional vaccination campaign and vaccination-related adverse events. RESULTS From May 18th 2020 to June 15th 2020 the survey was completed by 3238 patients. Most of the responders expressed concern on the pandemic yet acknowledging their oncological disease as a priority. Measures implemented were appreciated by patients. Telemedicine was positively evaluated and the absence of the caregiver during the visit did not determine discomfort for two thirds of patients. From March 6th 2021 to May 8th 2021 the vaccination-questionnaire was completed by 357 patients. The 98.8% were satisfied with the vaccination campaign. No serious vaccination-correlated adverse events were reported. No patient had to delay/discontinue chemotherapy due to vaccination. CONCLUSION PREMs during COVID-19 pandemic and related vaccination can provide important information to help reorganization of the health care systems for cancer care. Patients' feedback on the organizational changes implemented in the emergency period are essential for healthcare improvement and to help informed choices that are consistent with patients' needs.
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Affiliation(s)
- Mario Caccese
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
- Correspondence: Mario Caccese, Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, Padua, 35128, Italy, Email
| | - Silvia Imbevaro
- General Directorate, Accreditation and Acknowledgment Unit, Veneto Institute of Oncolog IOV - IRCCS, Padua, Italy
| | - Alessandra Feltrin
- Health Department, Psycho-Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Daniela Costardi
- Scientific Directorate, Patient Education and Empowerment, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Nadia Giordano
- Department of Oncology, Oncology 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Maristella Maran
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Rosalba Martino
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Ketti Ottolitri
- Health Department, Clinical Risk Office, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Malihe Shams
- Health Department, Psycho-Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Federica Vascon
- Department of Imaging and Health Physics, Radiotherapy Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Anna Roma
- Department of Oncology, Oncology 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonella Galiano
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Marco Maruzzo
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Dario Marino
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Sara Lonardi
- Department of Oncology, Oncology 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonella Brunello
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
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9
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Brunello A, Guarneri V, Coppola M, Bernardi M, Ottolitri K, Ghi MG, Mioranza E, Vianello F, Gottardi M, Lonardi S, Zagonel V. OUP accepted manuscript. Oncologist 2022; 27:e203-e205. [PMID: 35641217 PMCID: PMC8895736 DOI: 10.1093/oncolo/oyab037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
Background Few data are available on the safety of COVID-19 vaccines in cancer patients undergoing active cancer-directed treatment. Patients and Methods This case series analyzes outcomes in terms of adverse events in 5297 patients undergoing anti-cancer treatment who were vaccinated with anti-SARS-CoV-2 Pfizer-BioNTech vaccine at a single cancer center from March 6, 2021 to May 9, 2021. Adverse events were retrieved from the national Italian pharmacovigilance platform (http://www.vigicovid.it). Results Of the 5297 patients treated for either solid tumors (87%) or onco-hematologic malignancies (13%) who were vaccinated, 8 adverse drug reactions (ADRs) were reported. One was a severe ADR and 7 were non-severe ADRs. Non-severe ADRs resolved within 48 hours. Conclusion BNT162b2 Pfizer-BioNTech vaccine was safely administered in the largest cohort of cancer patients reported to date.
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Affiliation(s)
- Antonella Brunello
- Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
- Corresponding author: Antonella Brunello, MD PhD, UOC Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto, IOV, IRCCS, via Gattamelata 64, 35128 Padova, Italy. Tel: +39 0498215953; Email
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Marina Coppola
- Pharmacy, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Matteo Bernardi
- Healthcare Professions, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Ketti Ottolitri
- Risk Management, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Maria Grazia Ghi
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Eleonora Mioranza
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Federica Vianello
- Radiotherapy, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Michele Gottardi
- Onco Hematology, Veneto Institute of Oncology IOV – IRCCS, Castelfranco Veneto, Italy
| | - Sara Lonardi
- Medical Oncology 3, Veneto Institute of Oncology IOV – IRCCS, Castelfranco Veneto, Italy
| | - Vittorina Zagonel
- Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
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Risk stratification by anamnesis increases SARS-CoV-2 test efficiency in cancer patients. Strahlenther Onkol 2021; 198:354-360. [PMID: 34618171 PMCID: PMC8494759 DOI: 10.1007/s00066-021-01853-7] [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: 06/06/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To evaluate the impact of testing asymptomatic cancer patients, we analyzed all tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) before and during radiotherapy at a tertiary cancer center throughout the second wave of the pandemic in Germany. Methods Results of all real-time polymerase chain reaction (RT-PCR) tests for SARS-CoV‑2 performed at our radio-oncology department between 13 October 2020 and 11 March 2021 were included. Clinical data and anamnestic information at the time of testing were documented and examined for (i) the presence of COVID-19-related symptoms and (ii) virus-related anamnesis (high-risk [prior positive test or contact to a positive tested person within the last 14 days] or low-risk [inconspicuous anamnesis within the last 14 days]). Results A total of 1056 SARS-CoV‑2 tests in 543 patients were analyzed. Of those, 1015 tests were performed in asymptomatic patients and 41 tests in patients with COVID-19-associated symptoms. Two of 940 (0.2%) tests in asymptomatic patients with low-risk anamnesis and three of 75 (4.0%) tests in asymptomatic patients with high-risk anamnesis showed a positive result. For symptomatic patients, SARS-CoV‑2 was detected in three of 36 (8.3%) low-risk and three of five (60.0%) high-risk tests. Conclusion To the best of our knowledge, this is the first study evaluating the correlation between individual risk factors and positivity rates of SARS-CoV‑2 tests in cancer patients. The data demonstrate that clinical and anamnestic assessment is a simple and effective measure to distinctly increase SARS-CoV‑2 test efficiency. This might enable cancer centers to adjust test strategies in asymptomatic patients, especially when test resources are scarce. Supplementary Information The online version of this article (10.1007/s00066-021-01853-7) contains supplementary material, which is available to authorized users.
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11
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Yaneske E, Zampieri G, Bertoldi L, Benvenuto G, Angione C. Genome-scale metabolic modelling of SARS-CoV-2 in cancer cells reveals an increased shift to glycolytic energy production. FEBS Lett 2021; 595:2350-2365. [PMID: 34409594 PMCID: PMC8427129 DOI: 10.1002/1873-3468.14180] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/02/2021] [Accepted: 08/15/2021] [Indexed: 01/08/2023]
Abstract
Cancer is considered a high‐risk condition for severe illness resulting from COVID‐19. The interaction between severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) and human metabolism is key to elucidating the risk posed by COVID‐19 for cancer patients and identifying effective treatments, yet it is largely uncharacterised on a mechanistic level. We present a genome‐scale map of short‐term metabolic alterations triggered by SARS‐CoV‐2 infection of cancer cells. Through transcriptomic‐ and proteomic‐informed genome‐scale metabolic modelling, we characterise the role of RNA and fatty acid biosynthesis in conjunction with a rewiring in energy production pathways and enhanced cytokine secretion. These findings link together complementary aspects of viral invasion of cancer cells, while providing mechanistic insights that can inform the development of treatment strategies.
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Affiliation(s)
- Elisabeth Yaneske
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK
| | - Guido Zampieri
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK.,Department of Biology, University of Padua, Italy
| | | | | | - Claudio Angione
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK.,Healthcare Innovation Centre, Teesside University, Middlesbrough, UK.,Centre for Digital Innovation, Teesside University, Middlesbrough, UK
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12
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Safari M, Faradmal J, Bashirian S, Soltanian AR, Khazaei S, Roshanaei G. Identifying the Risk Factors for Mortality in Patients with Cancer and COVID-19 in Hamadan, the West of Iran. J Gastrointest Cancer 2021; 53:614-622. [PMID: 34347248 PMCID: PMC8333151 DOI: 10.1007/s12029-021-00677-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 01/08/2023]
Abstract
Purpose Since cancer patients are at higher risk of COVID-19, the present study was conducted to investigate the epidemiology of these patients and identify the affecting risk factors on their mortality. Methods The present retrospective cohort study was conducted on 66 hospitalized patients with cancer and COVID-19 in Hamadan in 2020. In the present study, demographic, clinical, and laboratory information and patients’ outcome were collected through a checklist and its impact on death was assessed. Data were analyzed in SPSS-24 software and the significance level of the tests was considered at 5%. Results The mean (standard deviation (SD)) age of patients was 61.6 (13.5) years. Forty patients (60.6%) were male. Twenty and five patients (37.9%) died at the end of study. The results of logistic regression model revealed that the nausea, mechanical ventilation, admission to ICU, and length of hospital stay in the ward had a significant impact on the odds of death among cancer patients with COVID-19 (p < 0.05). Conclusion Owing to high mortality rate in cancer patients with COVID-19 and due to underlying diseases and more severe clinical symptoms than other patients with coronavirus, these patients need intensive care and specific treatments. However, screening these patients and early identifying and vaccinating of them can reduce the mortality rate in these patients.
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Affiliation(s)
- Malihe Safari
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Javad Faradmal
- Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics, School of Public Health, Modeling of Noncommunicable Diseases Research Canter, Hamadan University of Medical Sciences, Hamadan, Iran.
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13
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Thorat N, Pricl S, Parchur AK, Somvanshi SB, Li Q, Umrao S, Townley H. Safeguarding COVID-19 and cancer management: drug design and therapeutic approach. OPEN RESEARCH EUROPE 2021; 1:77. [PMID: 37645153 PMCID: PMC10445946 DOI: 10.12688/openreseurope.13841.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 08/31/2023]
Abstract
Recent clinical cohort studies have highlighted that there is a three-fold greater SARS-Cov-2 infection risk in cancer patients, and overall mortality in individuals with tumours is increased by 41% with respect to general COVID-19 patients. Thus, access to therapeutics and intensive care is compromised for people with both diseases (comorbidity) and there is risk of delayed access to diagnosis. This comorbidity has resulted in extensive burden on the treatment of patients and health care system across the globe; moreover, mortality of hospitalized patients with comorbidity is reported to be 30% higher than for individuals affected by either disease. In this data-driven review, we aim specifically to address drug discoveries and clinical data of cancer management during the COVID-19 pandemic. The review will extensively address the treatment of COVID-19/cancer comorbidity; treatment protocols and new drug discoveries, including the description of drugs currently available in clinical settings; demographic features; and COVID-19 outcomes in cancer patients worldwide.
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Affiliation(s)
- Nanasaheb Thorat
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| | - Sabrina Pricl
- MolBNL@UniTS-DEA, University of Trieste, Piazzale Europa 1, Trieste, 34127, Italy
- Department of General Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, 90-136, Poland
| | - Abdul K. Parchur
- Radiation Oncology, Froedtert Hospital & Medical College of Wisconsin, Medical College of Wisconsin, Wisconsin, USA
| | - Sandeep B. Somvanshi
- School of Materials Engineering, Purdue University, West Stadium Avenue, West Lafayette, USA
| | - Qifei Li
- Division of Newborn Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Sachin Umrao
- Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, USA
| | - Helen Townley
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
- Department of Engineering Science, University of Oxford, Oxford, UK
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14
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Indini A, Pinotti G, Artioli F, Aschele C, Bernardi D, Butera A, Defraia E, Fasola G, Gamucci T, Giordano M, Iaria A, Leo S, Ribecco AS, Rossetti R, Savastano C, Schena M, Silva RR, Grossi F, Blasi L. Management of patients with cancer during the COVID-19 pandemic: The Italian perspective on the second wave. Eur J Cancer 2021; 148:112-116. [PMID: 33743478 PMCID: PMC7904514 DOI: 10.1016/j.ejca.2021.01.040] [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: 01/12/2021] [Revised: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic has been an overwhelming challenge for worldwide health systems. Since the beginning of year 2020, COVID-19 has represented a potential harm for cancer patients and has often hindered oncology care. The Collegio Italiano dei Primari Oncologi Medici (CIPOMO) is an Italian association of head physicians in oncology departments, which promotes working and research activities in oncology on a national basis. During the second wave of COVID-19 pandemic, the CIPOMO promoted a national survey aiming to evaluate the impact of COVID-19 on oncologists' clinical activity and what changes have been made compared with the Italian situation during the first wave of the pandemic. Overall, 138 heads of medical oncology departments participated in this survey: 75 (54%) from the North, 24 (17%) from the Centre and 39 (28%) from the South of Italy and islands. This survey provides an overview of Italian oncologists facing the second wave of COVID-19 pandemic. The lesson learned during the first wave of COVID-19 pandemic has led to a better organisation of clinical activities, and regular testing among healthcare practitioners, with better chances to grant patients' protection. However, the lack of standardised informatic platforms results in serious challenges in replacing frontal visits, often making a concrete reduction of patients' hospital accesses unfeasible. Oncologists need to keep preserving the continuum of care of patients. Standardisation of safety measures, together with the implementation of informatic platforms, can significantly improve oncology pathways during this second wave of COVID-19 pandemic.
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Affiliation(s)
- Alice Indini
- Medical Oncology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Carlo Aschele
- Medical Oncology Department, Ospedale Sant'Andrea, La Spezia, Italy
| | | | - Alfredo Butera
- Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento, Italy
| | | | - Gianpiero Fasola
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | | | | | - Antonino Iaria
- Oncology Unit, Azienda Sanitaria Provinciale, Presidio Ospedaliero Melito Porto Salvo, Reggio Calabria, Italy
| | - Silvana Leo
- Department of Medical Oncology, Vito Fazzi Hospital, Lecce, Italy
| | | | - Riccardo Rossetti
- Medical Oncology and Palliative Care Unit, Pantalla Hospital, Todi, Italy
| | | | - Marina Schena
- Medical Oncology, Azienda AUSL, Regional Hospital of Aosta, Aosta, Italy
| | - Rosa R Silva
- Medical Oncology, ASUR Marche, Area Vasta 2, Fabriano, Italy
| | - Francesco Grossi
- Medical Oncology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Livio Blasi
- Medical Oncology Unit, ARNAS Civico, Palermo, Italy
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