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Ashique S, Mishra N, Mohanto S, Garg A, Taghizadeh-Hesary F, Gowda BJ, Chellappan DK. Application of artificial intelligence (AI) to control COVID-19 pandemic: Current status and future prospects. Heliyon 2024; 10:e25754. [PMID: 38370192 PMCID: PMC10869876 DOI: 10.1016/j.heliyon.2024.e25754] [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: 08/12/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
The impact of the coronavirus disease 2019 (COVID-19) pandemic on the everyday livelihood of people has been monumental and unparalleled. Although the pandemic has vastly affected the global healthcare system, it has also been a platform to promote and develop pioneering applications based on autonomic artificial intelligence (AI) technology with therapeutic significance in combating the pandemic. Artificial intelligence has successfully demonstrated that it can reduce the probability of human-to-human infectivity of the virus through evaluation, analysis, and triangulation of existing data on the infectivity and spread of the virus. This review talks about the applications and significance of modern robotic and automated systems that may assist in spreading a pandemic. In addition, this study discusses intelligent wearable devices and how they could be helpful throughout the COVID-19 pandemic.
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Affiliation(s)
- Sumel Ashique
- Department of Pharmaceutical Sciences, Bengal College of Pharmaceutical Sciences & Research, Durgapur, 713212, West Bengal, India
| | - Neeraj Mishra
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University, Gwalior, 474005, Madhya Pradesh, India
| | - Sourav Mohanto
- Department of Pharmaceutics, Yenepoya Pharmacy College & Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, 575018, India
| | - Ashish Garg
- Guru Ramdas Khalsa Institute of Science and Technology, Pharmacy, Jabalpur, M.P, 483001, India
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Clinical Oncology Department, Iran University of Medical Sciences, Tehran, Iran
| | - B.H. Jaswanth Gowda
- Department of Pharmaceutics, Yenepoya Pharmacy College & Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, 575018, India
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, Belfast, BT9 7BL, UK
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
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Gil C, Beyer-Bergeot L, Sabbagh C, Zerbib P, Bridoux V, Manceau G, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Godet C, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Defourneaux V, Maggiori L, Rebibo L, Christou N, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Giger U, Alves A, Ouaissi M. Impact of the first wave of COVID-19 epidemy on the surgical management of sigmoid diverticular disease in France: National French retrospective study. Int J Colorectal Dis 2023; 38:276. [PMID: 38040936 DOI: 10.1007/s00384-023-04564-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To analyze the surgical management of sigmoid diverticular disease (SDD) before, during, and after the first containment rules (CR) for the first wave of COVID-19. METHODS From the French Surgical Association multicenter series, this study included all patients operated on between January 2018 and September 2021. Three groups were compared: A (before CR period: 01/01/18-03/16/20), B (CR period: 03/17/20-05/03/20), and C (post CR period: 05/04/20-09/30/21). RESULTS A total of 1965 patients (A n = 1517, B n = 52, C n = 396) were included. The A group had significantly more previous SDD compared to the two other groups (p = 0.007), especially complicated (p = 0.0004). The rate of peritonitis was significantly higher in the B (46.1%) and C (38.4%) groups compared to the A group (31.7%) (p = 0.034 and p = 0.014). As regards surgical treatment, Hartmann's procedure was more often performed in the B group (44.2%, vs A 25.5% and C 26.8%, p = 0.01). Mortality at 90 days was significantly higher in the B group (9.6%, vs A 4% and C 6.3%, p = 0.034). This difference was also significant between the A and B groups (p = 0.048), as well as between the A and C groups (p = 0.05). There was no significant difference between the three groups in terms of postoperative morbidity. CONCLUSION This study shows that the management of SDD was impacted by COVID-19 at CR, but also after and until September 2021, both on the initial clinical presentation and on postoperative mortality.
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Affiliation(s)
- Camille Gil
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France
| | - Laura Beyer-Bergeot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - Charles Sabbagh
- Department of Surgery Department, Amiens University Hospital, Amiens, France
| | - Philippe Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, Lille, France
| | - Valérie Bridoux
- Department of Digestive Surgery, University Hospital of Rouen, Rouen, France
| | - Gilles Manceau
- Department of digestive Surgery, Assistance Publique Hôpitaux de Paris, Georges Pompidou University Hospital, univeristy Paris Cité, Paris, France
| | - Yves Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly/Seine, France
| | - Etienne Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - Aurélien Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - Iman Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - Martin Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - Manon Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - Alexandre Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | - Benjamin Menahem
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Clarisse Eveno
- Department of Digestive Surgery, University Hospital of Lille, Lille, France
| | - Catherine Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - Bodgan Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - Camille Godet
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, Saint-Lô, France
| | - Yassine Eid
- Department of Digestive Surgery, Polyclinique de Lisieux, Lisieux, France
| | - Emilie Duchalais
- Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, Nantes, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hôpital Lyon Sud, Lyon, France
| | - Anais Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | | | - Léon Maggiori
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, Paris, France
| | - Lionel Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Niki Christou
- Department of Digestive Surgery, Limoges Hospital, Limoges, France
| | - Ali Talal
- Department of Digestive Surgery, Argentan Hospital, Argentan, France
| | - Diane Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - Cécile Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, Bayeux, France
| | | | - François Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - Christophe Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Sorbonne Paris Nord University, Paris, France
| | - Jean Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - Alexis Laurent
- Department of Digestive Surgery, Créteil Hospital, Créteil, France
| | - Bertrand Trilling
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - Martin Bertrand
- Department of Digestive Surgery, Universitary Hospital of Nîmes, Nîmes, France
| | - Damien Massalou
- Department of Digestive Surgery, Hôpital L'Archet, Nice University, Nice, France
| | - Benoit Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | - Urs Giger
- Fliedner Fachhochschule, University of Applied Sciences, Düsseldorf, Germany
| | - Arnaud Alves
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France.
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Brustia R, Bouattour M, Allaire M, Lequoy M, Hollande C, Regnault H, Blaise L, Ganne-Carrié N, Vilgrain V, Larrey E, Lim C, Scatton O, Mouhadi SE, Ozenne V, Paye F, Balladur P, Dohan A, Massault PP, Pol S, Dioguardi Burgio M, Sepulveda A, Cauchy F, Luciani A, Sommacale D, Leroy V, Calderaro J, Roudot-Thoraval F, Nault JC, Amaddeo G. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area: What's new 12 months later? Ann Hepatol 2023; 28:101141. [PMID: 37468096 DOI: 10.1016/j.aohep.2023.101141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of Paris. MATERIALS AND METHODS We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Overall survival were compared between the groups. Predictors of mortality were analysed with Cox regression. RESULTS From the initial cohort, 575 patients were included (n = 263 Exposed_COVID, n = 312 Unexposed_COVID). Overall and disease free survival at 12 months were 59.9 ± 3.2% vs. 74.3 ± 2.5% (p<0.001) and 40.2 ± 3.5% vs. 63.5 ± 3.1% (p<0.001) according to the period of exposure (Exposed_COVID vs. Unexposed_COVID, respectively). Adjusted Cox regression revealed that the period of exposure (Exposed_COVID HR: 1.79, 95%CI (1.36, 2.35) p<0.001) and BCLC stage B, C and D (BCLC B HR: 1.82, 95%CI (1.07, 3.08) p = 0.027 - BCLC C HR: 1.96, 95%CI (1.14, 3.38) p = 0.015 - BCLC D HR: 3.21, 95%CI (1.76, 5.85) p<0.001) were predictors of death. CONCLUSIONS Disruption of routine healthcare services because of the pandemic translated to reduced 1 year overall and disease-free survival among patients affected by HCC, in the metropolitan area of Paris, France.
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Affiliation(s)
- Raffaele Brustia
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France.
| | - Mohamed Bouattour
- Département d'Oncologie Hépatique, AP-HP, Hôpital Beaujon, F-92110 Clichy, France
| | - Manon Allaire
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Marie Lequoy
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Clémence Hollande
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Hélène Regnault
- Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France
| | - Lorraine Blaise
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
| | - Nathalie Ganne-Carrié
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Edouard Larrey
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Chetana Lim
- Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Olivier Scatton
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France; Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Sanaa El Mouhadi
- Department of Radiology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Violaine Ozenne
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - François Paye
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Pierre Balladur
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Anthony Dohan
- Department of Radiology, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Pierre-Philippe Massault
- Department of Digestive Surgery, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Stanislas Pol
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Ailton Sepulveda
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Francois Cauchy
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Alain Luciani
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Radiology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Daniele Sommacale
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Vincent Leroy
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Julien Calderaro
- Université Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France; Assistance Publique-Hôpitaux de Paris, Henri Mondor-Albert Chenevier University Hospital, Department of Pathology, Créteil, France; Inserm, U955, Team 18, Créteil, France; European Reference Network (ERN) RARE-LIVER, France
| | | | - Jean-Charles Nault
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Giuliana Amaddeo
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France.
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Piel J, Hörold M, Brandstetter S, Drewitz KP, Hrudey I, Schmitt R, Apfelbacher C. COVID-19 crisis management of German ICU clinicians in leadership - a metaphor analysis. Front Public Health 2023; 11:1160094. [PMID: 37663843 PMCID: PMC10470881 DOI: 10.3389/fpubh.2023.1160094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/19/2023] [Indexed: 09/05/2023] Open
Abstract
The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. "Crisis" became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier ("to unite everyone behind this flag"), the distributor ("sometimes it is a crazy patchwork [wahnsinniges Gestückel]") or the critic ("we are the fool for everything"). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders' self-image.
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Affiliation(s)
- Julia Piel
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Karl-Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ilona Hrudey
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Rudolf Schmitt
- Faculty of Social Sciences, University of Applied Sciences Zittau-Görlitz, Görlitz, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Boike S, Mir M, Olson H, Cole D, Rauf I, Surani S, Khan SA. Perioperative management of emergency and elective surgeries during the pandemic. Hosp Pract (1995) 2023; 51:12-17. [PMID: 36629125 DOI: 10.1080/21548331.2023.2166746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The effects of the 2019 novel coronavirus, SARS-CoV-2, and its associated pandemic are complex and widespread. It has permeated all aspects of daily life around the world. Unsurprisingly, it also had significant impacts on proceedings within hospitals around the world as well. Most notably, the multiple waves of the pandemic have each had untoward effects on surgical productivity within hospital systems. More specifically, the disruption of surgical procedures has impacted both emergent and elective cases. In the context of emergent procedures, hospital systems have had to reevaluate how they define 'emergent,' forcing them to determine which cases could not be rescheduled versus those that could. Elective procedures, on the other hand, were nearly halted altogether in the initial pandemic waves. If these were not completely stopped in some places, then they were greatly reduced. This paper will serve to describe the effect the pandemic has had on the proceedings of both elective and emergent surgeries. It will also describe how we have reevaluated and changed the way we define 'emergent' surgeries and describe the potential implications of this. We will also describe literature that speaks to the implications of the delay of elective procedures. Additionally, the cost implications of fewer surgical procedures performed will be discussed. Finally, we will describe literature that has established protocols for scheduling surgeries in waves of the pandemic, how these have evolved over time, and how they have created confusion for hospital systems navigating the pandemic.
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Affiliation(s)
- Sydney Boike
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mikael Mir
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Holly Olson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Delaney Cole
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ibtisam Rauf
- St. George's School of Medicine, University Centre Grenada, West Indies, Grenada
| | - Salim Surani
- College Station, Texas A&M University, TX, USA.,Research Collaborator, Mayo Clinic, Rochester, MN, USA
| | - Syed Anjum Khan
- Critical Care Medicine, Mayo Clinic Health System, Mankato, MN, USA
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Kashiwagura N, Motoi F, Cooray U, Fukase R, Katayama Y, Osaka K, Murakami M, Ikeda T. Effects of the different periods and magnitude of COVID-19 infection spread on cancer operations: Interrupted time series analysis of medical claims data. Cancer Med 2023; 12:4707-4714. [PMID: 36127816 PMCID: PMC9538599 DOI: 10.1002/cam4.5259] [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: 02/03/2022] [Revised: 07/14/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND No clear evidence exists regarding the effects of the different periods and magnitude of spread of the COVID-19 infection on cancer treatments. This study investigated the effects of the different periods and magnitude of COVID-19 infection spread on in-hospital cancer operations. METHODS Medical claims data from 17 hospitals where in-hospital operations for patients with malignant neoplasms were performed between 1 April 2017 and 31 March 2021 in Yamagata were extracted and analyzed. The critical time points as exposure used to evaluate the impact of different COVID-19 infection spread periods on cancer operations were (1) April 2020 (emergency declaration introduced by the government) and (2) December 2020 (the second wave). From April to November 2020 and December 2020 to March 21, the number of confirmed COVID-19 cases was 130 and 840, respectively. The 17 hospitals were classified into intervention or control groups based on whether in-hospital treatments for patients with COVID-19 were provided. RESULTS The interrupted time series analysis reported that the difference in the trend of pre-COVID-19 and postsecond wave (March 2020 to December 2020) periods was statistically significant between groups, with 50.67 fewer operations (95% confidence interval [CI] = 12.19-89.15) performed per month in the intervention group compared with the control group. Moreover, the immediate change in the number of operations in April 2020 (beginning of the first wave) was statistically significant between groups, with 80.14 operations (95% CI = 39.62-120.67) less immediately after the first wave in the intervention group compared with the control group. CONCLUSION Our findings suggest that a statement of emergency by the government and the COVID-19 infection spread are both associated with the number of cancer operations performed in the Yamagata prefecture during the COVID-19 pandemic.
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Affiliation(s)
- Natsue Kashiwagura
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan.,Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Fuyuhiko Motoi
- Department of Surgery I, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ryu Fukase
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | | | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayasu Murakami
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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7
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González-Suárez S, Barbara Ferreras A, Caicedo Toro M, Aznar de Legarra M. Detection of residual pulmonary alterations with lung ultrasound and effects on postoperative pulmonary complications for patients with asymptomatic SARS-CoV-2 infection undergoing surgeries. BMC Anesthesiol 2022; 22:186. [PMID: 35710326 PMCID: PMC9200944 DOI: 10.1186/s12871-022-01715-4] [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: 01/09/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For patients with a clinical course of active SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, there may be a higher risk of perioperative complications. Our main objective is to detect the residual pulmonary alterations in asymptomatic patients after SARS-CoV-2 infection undergoing surgery and determine their relationship with the clinical course of SARS-CoV-2 infection. The secondary aim is to investigate whether the presence of residual pulmonary alterations have any affects on the severity of postoperative pulmonary complications. METHODS After approval by the Hospital's Ethical Committee, this prospective observational study included consecutive patients (n=103) undergoing various surgical procedures and anesthetic techniques with a history of past SARS-CoV-2 infection. On the day of surgery these patients remained asymptomatic and the polymerase chain reaction (PCR) test for SARS-CoV-2 was negative. The history, physical findings, and clinical course of SARS-CoV-2 infection were recorded. Lung ultrasound was performed before surgery to evaluate the possible residual pulmonary alterations (≥ 3 B-lines and pleural thickening), along with determitation of pulmonary static compliance values during surgery. Postoperative pulmonary complications were collected during hospital stay. RESULTS 24.27% (n=25) patients presented ≥ 3 B-lines, and 28% (n=29) patients presented pleural thickening. For 15 patients (21.7%) the pulmonary compliance was < 40 mL/cm H2O. Patients with pleural thickening had a higher incidence of pneumonia, acute respiratory syndrome distress, a need for vasoactive drugs and required more days of hospitalization during SARS-CoV-2 infection (p= 0.004, 0.001, 0.03, 0.00 respectively). Patients with ≥ 3 B-lines needed more days in an intensive care unit and vasoactive drugs during SARS-CoV2 infection (p= 0.04, 0.004 respectively). Postoperative pulmonary complications were observed in 5.8% (n=6) of the patients, and were more frequent in the presence of both, ≥ 3 B-lines and pleural thickening (p= 0.01). CONCLUSIONS In asymptomatic post-COVID-19 patients, pathological findings detected by lung ultrasound before surgery are associated with the severity of the SARS-CoV2 infection and resulted in more postoperative pulmonary complications. In these patients, the incidence of postoperative pulmonary complications appears similar to that described in the surgical population before the pandemic. TRIAL REGISTRATION clinicaltrials.gov (NCT04922931). June 21, 2021. "Retrospectively registered".
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Affiliation(s)
- Susana González-Suárez
- Department of Anesthesiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain. .,Universitat Autònoma de Barcelona, UAB, Barcelona, Spain.
| | - Antonio Barbara Ferreras
- Department of Anesthesiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Melissa Caicedo Toro
- Department of Anesthesiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Macarena Aznar de Legarra
- Department of Anesthesiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain
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Brugel M, Letrillart L, Evrard C, Thierry A, Tougeron D, El Amrani M, Piessen G, Truant S, Turpin A, d'Engremont C, Roth G, Hautefeuille V, Regimbeau JM, Williet N, Schwarz L, Di Fiore F, Borg C, Doussot A, Lambert A, Moulin V, Trelohan H, Bolliet M, Topolscki A, Ayav A, Lopez A, Botsen D, Piardi T, Carlier C, Bouché O. Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID). Eur J Cancer 2022; 166:8-20. [PMID: 35259629 PMCID: PMC8828421 DOI: 10.1016/j.ejca.2022.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) - from diagnosis to treatment - of the reorganisation of the health care system during the first lockdown. METHODS This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. RESULTS During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, -18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, -1.7%; p = 0.97). The number of borderline tumours increased (13.6%-21.7%), whereas the rate of metastatic diseases rate dropped (47.1%-40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%-32.6%) compared with upfront surgery (13%-7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%-69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%-9.6%) and advanced diseases increased (59.7%-69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). CONCLUSION This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. TRIAL REGISTRATION Clinicaltrials.gov NCT04406571.
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Affiliation(s)
- Mathias Brugel
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France.
| | - Léa Letrillart
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
| | - Camille Evrard
- Medical Oncology Department, CHU Poitiers, Poitiers, France
| | - Aurore Thierry
- Department of Research and Public Health, CHU Reims, Reims, France
| | - David Tougeron
- University of Poitiers, Hepatogastroenterology Department, CHU Poitiers, Poitiers, France
| | - Mehdi El Amrani
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Guillaume Piessen
- Digestive and Oncological Surgery Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Stéphanie Truant
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Anthony Turpin
- Medical Oncology Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Christelle d'Engremont
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Gaël Roth
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Vincent Hautefeuille
- Digestive Oncology and Gastroenterology Department, CHU Amiens-Picardie, Amiens, France
| | - Jean M Regimbeau
- Digestive Surgery Department, CHU Amiens-Picardie, SSPC (Simplification of Complex Patient Care) UR UPJV 7518, University of Picardie-Jules Verne, Amiens, France
| | - Nicolas Williet
- Hepatogastroenterology Department, CHU Saint Etienne, Saint-Priest-en-Jarez, France
| | - Lilian Schwarz
- Digestive Surgery Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Frédéric Di Fiore
- Hepatogastroenterology Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Christophe Borg
- Medical Oncology Department, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Alexandre Doussot
- Digestive Surgical Oncology and Liver Transplantation Department, CHU Besançon, Besançon, France
| | - Aurélien Lambert
- Medical Oncology Department, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - Valérie Moulin
- Oncology Department, GH La Rochelle, La Rochelle, France
| | | | - Marion Bolliet
- Hepatogastroenterology Department, CH Colmar, Colmar, France
| | | | - Ahmet Ayav
- Hepatobiliary and Pancreatic Surgery Departement, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Anthony Lopez
- Gastroenterology and Digestive Oncology, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Damien Botsen
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Tulio Piardi
- General, Digestive and Endocrine Surgery Department, CHU Reims, Research Unit EA 3797 (VieFra) University of Reims Champagne-Ardenne (URCA), Reims, France
| | - Claire Carlier
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Olivier Bouché
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
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Ortenzi M, Balla A, Botteri E, Lepiane P, Guerrieri M, Arezzo A, Sartori A. COVID-19 pandemic: is it time for shared surgical guidelines? A systematic review of the literature. Minerva Surg 2022; 77:171-179. [PMID: 35416005 DOI: 10.23736/s2724-5691.21.09166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting requests of healthcare resources. The aim of this paper is to offer a comprehensive overview of the most important recommendations by the International Guidelines about general surgery, and possibly to invite building common shared guidelines to preserve the potential to provide surgical assistance despite the pandemic. EVIDENCE ACQUISITION This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. PubMed, Embase, Cochrane and Web of Science databases were searched. EVIDENCE SYNTHESIS The searches revealed a total of 18579 articles published up to the end of February 2021. Five articles published between March and May 2020, were included in the present study: Guidelines from The European Society of Trauma and Emergency Surgery (ESTES), The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and The European Association for Endoscopic Surgeons (EAES), The Endoscopic and Laparoscopic Surgeons of Asia (ELSA), The European Hernia Society (EHS) and The International Organization for the Study of Inflammatory Bowel Disease (IOS-IBD). CONCLUSIONS In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.
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Affiliation(s)
- Monica Ortenzi
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy -
| | - Andrea Balla
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Emanuele Botteri
- General Surgery Unit, ASST Spedali Civili, Montichiari Hospital, Montichiari, Brescia, Italy
| | - Pasquale Lepiane
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Mario Guerrieri
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alberto Sartori
- Department of General Surgery, Montebelluna Hospital, Montebelluna, Treviso, Italy
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10
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Chang YJ, Chen LJ, Chang YJ. Did the severity of appendicitis increase during the COVID-19 pandemic? PLoS One 2022; 17:e0263814. [PMID: 35143582 PMCID: PMC8830628 DOI: 10.1371/journal.pone.0263814] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 01/23/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aimed to assess the severity of appendicitis during the coronavirus disease 2019 (COVID-19) pandemic, as patients with appendicitis may procrastinate seeking medical attention during the pandemic. METHODS Information on patients with appendicitis who were treated at the Taipei City Hospital during the COVID-19 pandemic (January 1, 2020 to June 30, 2020) was retrieved. Patients who were diagnosed with appendicitis and treated at the same hospital from January 1, 2019 to July 1, 2019 were designated as the control group. Multivariate logistic regression analysis was conducted to assess changes in the severity of appendicitis (at a 2-week interval) between the two groups. RESULTS We identified 307 (study group: 149; control group: 158) consecutive patients with appendicitis. The mean age was 46.2 +- 19.8 years. Between the two groups, there were no significant differences in age, sex, comorbidity, surgery type (laparoscopic or open appendectomy) or surgery time. The number of patients in the study group decreased between January 29, 2020 and April 21, 2020, which paralleled the period of spikes in the confirmed COVID-19 cases and restricted daily activities. The percentage of uncomplicated and complicated appendicitis (excluding mild appendicitis or normal appendix) in the study group increased between February 26 and March 10, as well as between April 8 and April 21. In the multivariate regression analysis, the odds of uncomplicated and complicated appendicitis increased in three bi-weeks for the study group but not in the control group. CONCLUSION The severity of acute appendicitis might increase during the COVID-19 pandemic, because patients with mild appendicitis (or abdominal pain) may hesitate to seek help.
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Affiliation(s)
- Yao-Jen Chang
- Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Li-Ju Chen
- University of Taipei, Taipei, Taiwan
- Department of Ophthalmology, HepingFuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yun-Jau Chang
- Department of General Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Department of General Surgery, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan
- * E-mail:
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11
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The effect of Covid-19 pandemic on gastric cancer surgery. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.1033128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Ishibashi Y, Tsujimoto H, Sugasawa H, Mochizuki S, Okamoto K, Kajiwara Y, Shinto E, Takahata R, Kobayashi M, Fujikura Y, Hase K, Kishi Y, Ueno H. How has the COVID-19 pandemic affected gastrointestinal surgery for malignancies and surgical infections? NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 83:715-725. [PMID: 34916716 PMCID: PMC8648525 DOI: 10.18999/nagjms.83.4.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected infection control and prevention measures. We investigated the impact of the COVID-19 pandemic on postoperative infections and infection control measures in patients underwent gastrointestinal surgery for malignancies. We retrospectively evaluated changes in clinicopathological features, frequency of alcohol-based hand sanitizer use, frequency of postoperative complications, and microbial findings among our patients in February-May in 2019 (Control group) and 2020 (Pandemic group), respectively. Surgical resection in pathological stage III or IV patients was more frequently performed in the Pandemic group than in the Control group (P = 0.02). The total length of hospitalization and preoperative hospitalization was significantly shorter in the Pandemic group (P = 0.01 and P = 0.008, respectively). During the pandemic, hand sanitizer was used by a patients for an average of 14.9±3.0 times/day during the pandemic as opposed to 9.6±3.0 times/day in 2019 (p<0.0001). Superficial surgical site infection and infectious colitis occurred less frequently during the pandemic (P = 0.04 and P = 0.0002, respectively). In Pandemic group, Enterobacter, Haemophilus, and Candida were significantly decreased in microbiological cultures (P < 0.05, P < 0.05, P = 0.02, respectively) compared with Control group. Furthermore, a significant decrease in Streptococcus from drainage cultures was observed in the Pandemic group (P < 0.05). During the COVID-19 pandemic, a decrease in nosocomial infections was observed in the presence of an increase in alcohol-based hand sanitizer use.
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Affiliation(s)
- Yusuke Ishibashi
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Hironori Tsujimoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
,Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Hidekazu Sugasawa
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Satsuki Mochizuki
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Koichi Okamoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Yoshiki Kajiwara
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Eiji Shinto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Risa Takahata
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
,Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Minako Kobayashi
- Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Yuji Fujikura
- Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Kazuo Hase
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Yoji Kishi
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
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13
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Gupta R, Mouawad NJ, Yi JA. The impact of the COVID-19 pandemic on vascular surgery: Health care systems, economic, and clinical implications. Semin Vasc Surg 2021; 34:74-81. [PMID: 34642039 PMCID: PMC8285216 DOI: 10.1053/j.semvascsurg.2021.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (coronavirus disease 2019 [COVID-19]) pandemic is responsible for more than 500,000 deaths in the United States and nearly 3 million worldwide, profoundly altering the landscape of health care delivery. Aggressive public health measures were instituted and hospital efforts became directed at COVID-19–related concerns. Consequently, routine surgical practice was virtually halted, resulting in billions of dollars in hospital losses as pandemic costs escalated. Navigating an uncertain new landscape of scarce resource allocation, exposure risk, role redeployment, and significant practice pattern changes has been challenging. Furthermore, the overall effect on the financial viability of the health care system and vascular surgical practices is yet to be elucidated. This review explores the economic and clinical implications of COVID-19 on the practice of vascular surgery in addition to the health care system as a whole.
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Affiliation(s)
- Ryan Gupta
- Division of Vascular Surgery and Endovascular Therapy, University of Colorado Anschutz School of Medicine, 12631 E. 16(th) Avenue, Room 5405 MC C312, Aurora, CO, 80045
| | - Nicolas J Mouawad
- Division of Vascular and Endovascular Surgery, McLaren Health System-Bay Region, Auburn Hills, MI; Department of Surgery, Michigan State University, East Lansing, MI
| | - Jeniann A Yi
- Division of Vascular Surgery and Endovascular Therapy, University of Colorado Anschutz School of Medicine, 12631 E. 16(th) Avenue, Room 5405 MC C312, Aurora, CO, 80045.
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14
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Khan MNH, Jamal AB, Faraz A, Shafique H, Rasool MU, Ilyas MW, Jamshed MH, Riaz W, Usman M. Management of Acute Appendicitis During the COVID-19 Pandemic is Significantly Different: A Retrospective Single UK Hospital Study. J Multidiscip Healthc 2021; 14:2415-2420. [PMID: 34511924 PMCID: PMC8421328 DOI: 10.2147/jmdh.s327568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction The COVID-19 pandemic has led to a change in the delivery of acute and emergency surgical services. With emphasis on reducing unnecessary operative intervention and performing more CT scans, there has been a shift in managing acute appendicitis conservatively. We evaluate the impact of this shift on the management of acute appendicitis. Methods A single UK centre retrospective study evaluating patients with suspected acute appendicitis pre-COVID-19 rota (18 March 2020) and post-COVID rota implementation. Data including demographics, inflammatory markers, imaging, mode of management and operative findings were collected. Logistic regression with SPSS was used to determine which factors were associated with conservative management and treated with antibiotics. Results A total of 161 patients were analysed, 82 pre-COVID19 and 79 post-COVID19. Of the pre-COVID-19 patients, 67.07% underwent appendicectomy while the rest were conservatively managed; 24.3% of these patients underwent a CT scan only. Post-COVID-19, 22.78% of patients underwent appendicectomy with a higher percentage of diagnostic CT scans performed, 43/79 (54.4%, p <0.001). The proportion of histologically normal appendicectomies was significantly reduced in the post-COVID-19 era (12.78% vs 0.00%; p-value 0.001). Logistic regression analysis showed a normal WCC to be associated with greater likelihood of conservative management. No conservatively managed patients returned to theatre in the 30-day follow-up period. Conclusion Due to the restrictions imposed by the post-COVID-19 rota, a greater proportion of patients were managed conservatively with comparable patient outcomes. The approach also led to fewer negative appendicectomies owing to greater reliance on imaging.
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Affiliation(s)
| | - Abdul Basit Jamal
- Trauma and Orthopedic Surgery, Ittefaq Hospital Trust, Lahore, Pakistan
| | - Ahmad Faraz
- Department of General Surgery, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Hassan Shafique
- Trauma and Orthopedic Surgery, Royal London Hospital, London, UK
| | - Muhammad Umar Rasool
- Trauma and Orthopedic Surgery, North Manchester General Hospital, Manchester, UK
| | - Muhammad Waqas Ilyas
- Trauma and Orthopaedics University Hospital Southampton, Southampton Hampshire, UK
| | | | - Waleed Riaz
- General Surgery Royal Victoria Hospital, Belfast, Northern Ireland
| | - Mehwish Usman
- Trauma and Orthopedics, Manchester Royal Infirmary, Manchester, UK
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15
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Impacts de l’épidémie COVID 19 sur la chirurgie digestive en France et perspectives : une enquête de la FCVD. LA PRESSE MÉDICALE FORMATION 2021; 2:225-228. [PMCID: PMC8175101 DOI: 10.1016/j.lpmfor.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/26/2021] [Indexed: 12/03/2023]
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16
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Bisceglia I, Gabrielli D, Canale ML, Gallucci G, Parrini I, Turazza FM, Russo G, Maurea N, Quagliariello V, Lestuzzi C, Oliva S, Di Fusco SA, Lucà F, Tarantini L, Trambaiolo P, Gulizia MM, Colivicchi F. ANMCO POSITION PAPER: cardio-oncology in the COVID era (CO and CO). Eur Heart J Suppl 2021; 23:C128-C153. [PMID: 34456641 PMCID: PMC8388610 DOI: 10.1093/eurheartj/suab067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic and its impact on patients with cancer and cardiovascular disease have confirmed the particular vulnerability of these populations. Indeed, not only a higher risk of contracting the infection has been reported but also an increased occurrence of a more severe course and unfavourable outcome. Beyond the direct consequences of COVID-19 infection, the pandemic has an enormous impact on global health systems. Screening programmes and non-urgent tests have been postponed; clinical trials have suffered a setback. Similarly, in the area of cardiology care, a significant decline in STEMI accesses and an increase in cases of late presenting heart attacks with increased mortality and complication rates have been reported. Health care systems must therefore get ready to tackle the 'rebound effect' that will likely show a relative increase in the short- and medium-term incidence of diseases such as heart failure, myocardial infarction, arrhythmias, and cardio- and cerebrovascular complications. Scientific societies are taking action to provide general guidance and recommendations aimed at mitigating the unfavourable outcomes of this pandemic emergency. Cardio-oncology, as an emerging discipline, is more flexible in modulating care pathways and represents a beacon of innovation in the development of multi-specialty patient management. In the era of the COVID-19 pandemic, cardio-oncology has rapidly modified its clinical care pathways and implemented flexible monitoring protocols that include targeted use of cardiac imaging, increased use of biomarkers, and telemedicine systems. The goal of these strategic adjustments is to minimize the risk of infection for providers and patients while maintaining standards of care for the treatment of oncologic and cardiovascular diseases. The aim of this document is to evaluate the impact of the pandemic on the management of cardio-oncologic patients with the-state-of-the-art knowledge about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19) in order to optimize medical strategies during and after the pandemic.
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Affiliation(s)
- Irma Bisceglia
- Integrated Cardiology Services, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Domenico Gabrielli
- Cardiology Unit, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Maria Laura Canale
- Cardiology Department, Nuovo Ospedale Versilia Lido Di Camaiore, LU, Italy
| | | | - Iris Parrini
- Cardiology Department, Ospedale Mauriziano Umberto I, Torino, Italy
| | | | - Giulia Russo
- Cardiovascular and Sports Medicine Department, ASUGI Trieste, Trieste, Italy
| | - Nicola Maurea
- Cardiology Department, Fondazione Pascale, Napoli, Italy
| | | | - Chiara Lestuzzi
- Cardiology Department, Centro di Riferimento Oncologico (CRO), Aviano, PN, Italy
| | - Stefano Oliva
- Cardio-Oncology Department, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Stefania Angela Di Fusco
- Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma, Italy
| | - Fabiana Lucà
- Cardiology Department, Grande Osp. Metropol-Bianchi Melacrino-Morelli, Reggio Calabria, Italy
| | - Luigi Tarantini
- Cardiology Department, Presidio Ospedaliero. Santa Maria Nuova—AUSL RE IRCCS, Reggio Emilia, Italy
| | | | - Michele Massimo Gulizia
- Cardiology Department, Azienda di Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy
- Fondazione per il Tuo cuore—Heart Care Foundation, Firenze, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma, Italy
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Tommaselli GA, Grange P, Ricketts CD, Clymer JW, Fryrear RS. Intraoperative Measures to Reduce the Risk of COVID-19 Transmission During Minimally Invasive Procedures: A Systematic Review and Critical Appraisal of Societies' Recommendations. Surg Laparosc Endosc Percutan Tech 2021; 31:765-777. [PMID: 34320592 PMCID: PMC8635252 DOI: 10.1097/sle.0000000000000972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The coronavirus 2019 pandemic and the hypothetical risk of virus transmission through aerosolized CO2 or surgical smoke produced during minimally invasive surgery (MIS) procedures have prompted societies to issue recommendations on measures to reduce this risk. The aim of this systematic review is to identify, summarize and critically appraise recommendations from surgical societies on intraoperative measures to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to the operative room (OR) staff during MIS. METHODS Medline, Embase, and Google Scholar databases were searched using a search strategy or free terms. The search was supplemented with searches of additional relevant records on coronavirus 2019 resource websites from Surgical Associations and Societies. Recommendations published by surgical societies that reported on the intraoperative methods to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to the OR staff during MIS were also reviewed for inclusion. Expert opinion articles were excluded. A preliminary synthesis was performed of the extracted data to categorize and itemize the different types of recommendations. The results were then summarized in a narrative synthesis. RESULTS Thirty-three recommendation were included in the study. Most recommendations were targeted to general surgery (13) and gynecology (8). Areas covered by the documents were recommendations on performance of laparoscopic/robotic surgery versus open approach (28 documents), selection of surgical staff (13), management of pneumoperitoneum (33), use of energy devices (20), and management of surgical smoke and pneumoperitoneum desufflation (33) with varying degree of consensus on the specific recommendations among the documents. CONCLUSIONS While some of the early recommendations advised against the use of MIS, they were not strictly based on the available scientific evidence. After further consideration of the literature and of the well-known benefits of laparoscopy to the patient, later recommendations shifted to encouraging the use of MIS as long as adequate precautions could be taken to protect the safety of the OR staff. The release and implementation of recommendations should be based on evidence-based practices that allows health care systems to provide safe surgical and medical assistance.
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18
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Nugroho A, Arifin F, Wibowo AA, Handaya AY, Rivai MI, Mulyawan M, Niam M, Budiono P, Kristian I, Putro MD, Widianto P, Warsinggih W. Delivery of digestive surgery services during the COVID-19 pandemic: Indonesian Society of Digestive Surgeons online survey. Asian J Endosc Surg 2021; 14:540-547. [PMID: 33401334 DOI: 10.1111/ases.12913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/12/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, digestive surgery potentially exposes both health-care professionals and vulnerable patients to COVID-19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID-19 pandemic, optimize safety for patients and clinicians, and safeguard health-care services. METHODS An online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID-19 pandemic. RESULTS Early in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3-100 cases) to 1 case (range. 0-10 cases) (P < .001; Wilcoxon signed-rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of screening for COVID-19 with polymerase chain reaction has increased over time, and a more comprehensive screening methodology incorporating real-time polymerase chain reaction, chest CT, and rapid antibody test were evident in 31.37% of July 2020 responses. CONCLUSION Our survey has shown that surgeons adapted to the evolving pandemic and continue to do so only with appropriate safety assurances.
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Affiliation(s)
- Adianto Nugroho
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Fatmawati Central General Hospital, Jakarta, Indonesia
| | - Fransicus Arifin
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, M. Soewandhi District Hospital, Surabaya, Indonesia
| | - Agung Ary Wibowo
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Ulin District Hospital, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - A Yuda Handaya
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Dr. Sardjito Central General Hospital, Faculty of Medicine, Gajah Mada University, Yogyakarta, Indonesia
| | - M Iqbal Rivai
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, M. Djamil Central General Hospital, Faculty of Medicine, Andalas University, Padang, Indonesia
| | - Made Mulyawan
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Sanglah Central General Hospital, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Muhammad Niam
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Syaiful Anwar District Hospital. Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Parish Budiono
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Dr. Karyadi Central General Hospital, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Iwan Kristian
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Dr. Soetomo Central General Hospital, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Mamiek Dwi Putro
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Dr. Soetomo Central General Hospital, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Perwira Widianto
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Persahabatan Central General Hospital, Jakarta, Indonesia
| | - Warsinggih Warsinggih
- Indonesian Society of Digestive Surgeons, Jakarta, Indonesia.,Department of Surgery, Dr. Wahidin Sudirohusodo Central General Hospital, Faculty of Medicine, Hasanudin University, Makasar, Indonesia
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19
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Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus. J Clin Med 2021; 10:jcm10132769. [PMID: 34202563 PMCID: PMC8269029 DOI: 10.3390/jcm10132769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 01/16/2023] Open
Abstract
The COVID-19 pandemic challenges international and national healthcare systems. In the field of thoracic surgery, procedures may be deferred due to mandatory constraints of the access to diagnostics, staff and follow-up facilities. There is a lack of prospective data on the management of benign and malignant thoracic conditions in the pandemic. Therefore, we derived recommendations from 14 thoracic societies to address key questions on the topic of COVID-19 in the field of thoracic surgery. Respective recommendations were extracted and the degree of consensus among different organizations was calculated. A high degree of consensus was found to temporarily suspend non-critical elective procedures or procedures for benign conditions and to prioritize patients with symptomatic or advanced cancer. Prior to hospitalization, patients should be screened for respiratory symptoms indicating possible COVID-19 infection and most societies recommended to screen all patients for COVID-19 prior to admission. There was a weak consensus on the usage of serology tests and CT scans for COVID-19 diagnostics. Nearly all societies suggested to postpone elective procedures in patients with suspected or confirmed COVID-19 and recommended constant reevaluation of these patients. Additionally, we summarized recommendations focusing on precautions in the theater and the management of chest drains. This study provides a novel approach to informed guidance for thoracic surgeons during the COVID-19 pandemic in the absence of scientific evidence-based data.
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20
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Panzuto F, Maccauro M, Campana D, Faggiano A, Massironi S, Pusceddu S, Spada F, Ferone D, Modica R, Grana CM, Ferolla P, Rinzivillo M, Badalamenti G, Zatelli MC, Gelsomino F, De Carlo E, Bartolomei M, Brizzi MP, Cingarlini S, Versari A, Fanciulli G, Arvat E, Merola E, Cives M, Tafuto S, Baldari S, Falconi M. Impact of the SARS-CoV2 pandemic dissemination on the management of neuroendocrine neoplasia in Italy: a report from the Italian Association for Neuroendocrine Tumors (Itanet). J Endocrinol Invest 2021; 44:989-994. [PMID: 32803662 PMCID: PMC7429140 DOI: 10.1007/s40618-020-01393-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/09/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The organization of the healthcare system has significantly changed after the recent COVID-19 outbreak, with a negative impact on the management of oncological patients. The present survey reports data collected by the Italian Association for Neuroendocrine Tumors on the management of patients with neuroendocrine neoplasia (NEN) during the pandemic dissemination. METHODS A survey with 57 questions was sent to NEN-dedicated Italian centers regarding the management of patients in the period March 9, 2020, to May 9, 2020 RESULTS: The main modification in the centers' activity consisted of decreases in newly diagnosed NEN patients (- 76.8%), decreases in performed surgical procedures (- 58%), delays to starting peptide receptor radionuclide therapy (45.5%), postponed/canceled follow-up examinations (26%), and canceled multidisciplinary teams' activity (20.8%). A low proportion of centers (< 10%) reported having to withdraw systemic anti-tumor medical treatment due to concerns about the pandemic situation, whereas PRRT was withdrawn from no patients. CONCLUSION Although the COVID-19 outbreak induced the centers to reduce some important activities in the management of NEN patients, the Italian network was able to provide continuity in care without withdrawing anti-tumor treatment for the majority of patients.
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Affiliation(s)
- F Panzuto
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy.
| | - M Maccauro
- Nuclear Medicine Unit, ENETS Center of Excellence, IRRCS National Cancer Institute (INT), Milan, Italy
| | - D Campana
- Division of Oncology, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - A Faggiano
- Endocrinology Unit, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - S Massironi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - S Pusceddu
- Oncology Unit, ENETS Center of Excellence, IRRCS National Cancer Institute (INT), Milan, Italy
| | - F Spada
- Oncology Unit, ENETS Center of Excellence, European Cancer Institute (IEO), Milan, Italy
| | - D Ferone
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino; Endocrinology, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - R Modica
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - C M Grana
- Nuclear Medicine Division, IRCCS European Institute of Oncology, Milan, Italy
| | - P Ferolla
- Multidisciplinary Group for Diagnosis and Treatment of Neuroendocrine Tumors Umbria Regional Cancer Network, Perugia, Italy
| | - M Rinzivillo
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy
| | - G Badalamenti
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - M C Zatelli
- Section of Endocrinology and Internal Medicine,, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - F Gelsomino
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - E De Carlo
- Department of Medicine, Internal Medicine III, University of Padova, Padua, Italy
| | - M Bartolomei
- Nuclear Medicine Department, Sant'Anna Hospital, Ferrara, Italy
| | - M P Brizzi
- Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - S Cingarlini
- Oncology Unit, ENETS Center of Excellence, University Hospital of Verona, Verona, Italy
| | - A Versari
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - G Fanciulli
- NET Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari - Endocrine Unit, AOU Sassari, Sassari, Italy
| | - E Arvat
- Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Merola
- Department of Gastroenterology, Azienda Provinciale per i Servizi Sanitari di Trento (APSS), Trento, Italy
| | - M Cives
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - S Tafuto
- S.C. Sarcomi e Tumori Rari, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Napoli, Italy
| | - S Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and of Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - M Falconi
- Pancreatic Surgery, ENETS Center of Excellence, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Abadi MQH, Rahmati S, Sharifi A, Ahmadi M. HSSAGA: Designation and scheduling of nurses for taking care of COVID-19 patients using novel method of Hybrid Salp Swarm Algorithm and Genetic Algorithm. Appl Soft Comput 2021; 108:107449. [PMID: 33967657 PMCID: PMC8086267 DOI: 10.1016/j.asoc.2021.107449] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic is viewed as the most basic worldwide disaster that humankind has observed since the second World War. There is no report of any clinically endorsed antiviral medications or antibodies that are successful against COVID-19. It has quickly spread everywhere, presenting tremendous well-being, financial, ecological, and social difficulties to the whole human populace. The COVID flare-up is seriously disturbing the worldwide economy. Practically all the countries are battling to hinder the transmission of the malady by testing and treating patients, isolating speculated people through contact following, confining huge social affairs, keeping up total or incomplete lockdown, etc. Proper scheduling of nursing workers and optimal designation of nurses may significantly affect the quality of clinical facilities. It is delivered by eliminating unbalanced workloads or undue stress, which could lead to decreased nurse performance and potential human errors., Nurses are frequently asked to leave while caring for all sick patients. However, regular scheduling formulas are not thought to consider this possibility because they are out of scheduling control in typical scenarios. In this paper, a novel model of the Hybrid Salp Swarm Algorithm and Genetic Algorithm (HSSAGA) is proposed to solve nurses’ scheduling and designation. The findings of the suggested test function algorithm demonstrate that this algorithm has outperformed state-of-the-art approaches.
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Affiliation(s)
- Moein Qaisari Hasan Abadi
- Department of Industrial Engineering, K. N. Toosi University of Technology, P.O. Box: 15875-4416, Tehran, Iran
| | - Sara Rahmati
- Department of Industrial Engineering, Islamic Azad University Najaf-Abad Branch, P.O. Box: 8514143131, Isfahan, Iran
| | - Abbas Sharifi
- Department of Mechanical Engineering, Urmia University of Technology (UUT), P.O. Box: 57166-419, Urmia, Iran
| | - Mohsen Ahmadi
- Department of Industrial Engineering, Urmia University of Technology (UUT), P.O. Box: 57166-419, Urmia, Iran
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22
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Agcaoglu O, Sezer A, Makay O, Erdogan MF, Bayram F, Guldiken S, Raffaelli M, Sonmez YA, Lee YS, Vamvakidis K, Mihai R, Duh QY, Akinci B, Alagol F, Almquist M, Barczynski M, Bayraktaroglu T, Berber E, Bukey Y, Cakmak GK, Canturk NZ, Canturk Z, Celik M, Celik O, Ceyhan BO, Cherenko S, Clerici T, Coombes DS, Demircan O, Deyneli O, Dionigi G, Emre AU, Erbil Y, Filiz AI, Gozu HI, Gurdal SO, Gurleyik G, Haciyanli M, Kebudi A, Kim S, Koutelidakis G, Kuru B, Mert M, Oruk GG, Ozbas S, Palazzo F, Pandev R, Riss P, Sabuncu T, Sahin I, Sakman G, Saygili F, Senyurek YG, Sleptsov I, Van Slycke S, Teksoz S, Terzioglu T, Tezelman S, Tunca F, Ugurlu MU, Uludag M, Villar-Del-Moral J, Vriens M, Yazici D. Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options. Updates Surg 2021; 74:325-335. [PMID: 33840069 PMCID: PMC8036242 DOI: 10.1007/s13304-021-00979-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/12/2021] [Indexed: 12/03/2022]
Abstract
Purpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± β-blocker combination for Graves’ disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3–4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.
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Affiliation(s)
- Orhan Agcaoglu
- Department of General Surgery, School of Medicine, Koc University, Istanbul, Turkey
| | - Atakan Sezer
- Department of General Surgery, School of Medicine, Trakya University, Balkan Yerleskesi, 22030, Edirne, Turkey.
| | - Ozer Makay
- Department of General Surgery, School of Medicine, Ege University, Bornova, Turkey
| | - Murat Faik Erdogan
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Sibel Guldiken
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, Edirne, Turkey
| | - Marco Raffaelli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Yusuf Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Yong-Sang Lee
- Department of General Surgery, Gangnam Severance Thyroid Center, Yonsei University, Seoul, South Korea
| | | | - Radu Mihai
- Department of General Surgery, Churchill Cancer Center, Oxford University, Oxford, UK
| | - Quan-Yang Duh
- Department of General Surgery, University of California, San Francisco, USA
| | - Baris Akinci
- Department of Endocrinology and Metabolism, School of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Faruk Alagol
- Department of Endocrinology and Metabolism, School of Medicine, Koc University, Istanbul, Turkey
| | - Martin Almquist
- Department of General Surgery, Skåne University Hospital, Malmö, Sweden
| | - Marcin Barczynski
- Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
| | - Taner Bayraktaroglu
- Department of Endocrinology and Metabolism, School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Eren Berber
- Division of Endocrine Surgery, Department of General Surgery, Cleveland Clinic Foundation, Cleveland, USA
| | - Yusuf Bukey
- Department of General Surgery, School of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Guldeniz Karadeniz Cakmak
- Department of General Surgery, School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Nuh Zafer Canturk
- Department of General Surgery, School of Medicine, Kocaeli University, İzmit, Turkey
| | - Zeynep Canturk
- Department of Endocrinology and Metabolism, School of Medicine, Kocaeli University, İzmit, Turkey
| | - Mehmet Celik
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, Edirne, Turkey
| | - Ozlem Celik
- Department of Endocrinology and Metabolism, School of Medicine, Acibadem University, Istanbul, Turkey
| | | | - Sergii Cherenko
- Department of General Surgery, International Medical Center, Kyiv, Ukraine
| | - Thomas Clerici
- Department of Endocrinology and Metabolism, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Orhan Demircan
- Department of General Surgery, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Oguzhan Deyneli
- Department of Endocrinology and Metabolism, School of Medicine, Koc University, Istanbul, Turkey
| | - Gianlorenzo Dionigi
- Department of General Surgery, School of Medicine, Messina University, Messina, Italy
| | - Ali Ugur Emre
- Department of General Surgery, School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | | | - Ali Ilker Filiz
- Department of General Surgery, School of Medicine, Okan University, Istanbul, Turkey
| | - Hulya Ilıksu Gozu
- Department of Endocrinology and Metabolism, School of Medicine, Marmara University, Istanbul, Turkey
| | - Sibel Ozkan Gurdal
- Department of General Surgery, Namik Kemal University, Zonguldak, Turkey
| | - Gunay Gurleyik
- Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Haciyanli
- Department of General Surgery, İzmir Ataturk Training and Research Hospital, İzmir, Turkey
| | - Abut Kebudi
- Department of General Surgery, School of Medicine, Okan University, Istanbul, Turkey
| | - Seokmo Kim
- Department of General Surgery, Gangnam Severance Thyroid Center, Yonsei University, Seoul, South Korea
| | - Giannis Koutelidakis
- Department of General Surgery, Aristoteleio University of Thessaloniki, Thessaloniki, Greece
| | - Bekir Kuru
- Department of General Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Meral Mert
- Department of Endocrinology and Metabolism, Bakirkoy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Guzide Gonca Oruk
- Department of Endocrinology and Metabolism, Ataturk Training and Research Hospital, Katip Celebi University, İzmir, Turkey
| | | | - Fausto Palazzo
- Department of Endocrinology and Metabolism, Imperial College, Hammersmith Hospital, London, UK
| | - Rumen Pandev
- Department of General Surgery, School of Medicine, Medical University Sofia, Sofia, Bulgaria
| | - Phillip Riss
- Department of General Surgery, School of Medicine, Medical University of Vienna, Vienna, Austria
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, School of Medicine, Harran University, Şanlıurfa, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya University, Malatya, Turkey
| | - Gurhan Sakman
- Department of General Surgery, School of Medicine, Cukurova University, Adana, Turkey
| | - Fusun Saygili
- Department of Endocrinology and Metabolism, School of Medicine, Ege University, Bornova, Turkey
| | - Yasemin Giles Senyurek
- Department of General Surgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilya Sleptsov
- North-West Center of Endocrinology and Metabolism, St. Petersburg State University, St. Petersburg, Russia
| | - Sam Van Slycke
- Department of General Surgery, Vattikutti Foundation, OLV Hospital, Aalst, Belgium
| | - Serkan Teksoz
- Department of General Surgery, School of Medicine, Cerrahpasa University, Istanbul, Turkey
| | - Tarik Terzioglu
- Department of General Surgery, VKV American Hospital, Istanbul, Turkey
| | - Serdar Tezelman
- Department of General Surgery, School of Medicine, Koc University, Istanbul, Turkey
| | - Fatih Tunca
- Department of General Surgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Umit Ugurlu
- Department of General Surgery, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mehmet Uludag
- Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Menno Vriens
- Department of General Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, School of Medicine, Koc University, Istanbul, Turkey
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Successful maintenance of process and outcomes for oesophageal cancer surgery in Ireland during the first wave of the COVID-19 pandemic. Ir J Med Sci 2021; 191:831-837. [PMID: 33728528 PMCID: PMC7963466 DOI: 10.1007/s11845-021-02597-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/09/2021] [Indexed: 11/21/2022]
Abstract
Introduction The emergence of the novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the coronavirus disease COVID-19 has impacted enormously on non-COVID-19-related hospital care. Curtailment of intensive care unit (ICU) access threatens complex surgery, particularly impacting on outcomes for time-sensitive cancer surgery. Oesophageal cancer surgery is a good example. This study explored the impact of the pandemic on process and short-term surgical outcomes, comparing the first wave of the pandemic from April to June in 2020 with the same period in 2019. Methods Data from all four Irish oesophageal cancer centres were reviewed. All patients undergoing resection for oesophageal malignancy from 1 April to 30 June inclusive in 2020 and 2019 were included. Patient, disease, and peri-operative outcomes (including COVID-19 infection) were compared. Results In 2020, 45 patients underwent oesophagectomy, and 53 in the equivalent period in 2019. There were no differences in patient demographics, co-morbidities, or use of neoadjuvant therapy. The median time to surgery from neoadjuvant therapy was 8 weeks in both 2020 and 2019. There were no significant differences in operative interventions between the two time periods. There was no difference in operative morbidity in 2020 and 2019 (28% vs 40%, p = 0.28). There was no in-hospital mortality in either period. No patient contracted COVID-19 in the perioperative period. Conclusions Continuing surgical resection for oesophageal cancer was feasible and safe during the COVID-19 pandemic in Ireland. The national response to this threat was therefore successful by these criteria in the curative management of oesophageal cancer.
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Drissi F, Frey S, Abet E. Re: "Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation". As regards the detection of coronavirus in peritoneal fluid. J Visc Surg 2021; 158:96-97. [PMID: 33268321 PMCID: PMC7566814 DOI: 10.1016/j.jviscsurg.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- F Drissi
- Department of digestive surgery, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La-Roche-sur-Yon, France.
| | - S Frey
- Department of digestive surgery, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La-Roche-sur-Yon, France
| | - E Abet
- Department of digestive surgery, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La-Roche-sur-Yon, France
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Leow L, Ramanathan K, Kofidis T, Tam JKC, Mithiran H. Organization of thoracic surgical services during the COVID pandemic. Surgeon 2021; 19:e1-e8. [PMID: 32778525 PMCID: PMC7413094 DOI: 10.1016/j.surge.2020.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/28/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION COVID-19 presented an unprecedented challenge for healthcare workers and systems around the world. Healthcare systems have adapted differently in terms of pandemic planning of regular services, adopting infection control measures and prioritising essential hospital services in the context of a burgeoning COVID-19 patient load and inevitable surge. METHODS We performed a review on current evidence and share our practices at a teaching hospital in Singapore. RESULTS We outline principles and make recommendations for continuity of delivering essential thoracic surgical services during this current outbreak. CONCLUSIONS The maintenance and provision of thoracic surgery services in this context requires good preplanning and vigilance to infection control measures across all levels.
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Affiliation(s)
- Lowell Leow
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
| | - Kollengode Ramanathan
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
| | - Theo Kofidis
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, MD9, National University of Singapore, 2 Medical Drive, Singapore 117593, Singapore.
| | - John Kit Chung Tam
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, MD9, National University of Singapore, 2 Medical Drive, Singapore 117593, Singapore.
| | - Harish Mithiran
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, National University Hospital Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
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Cavaliere D, Parini D, Marano L, Cipriani F, Di Marzo F, Macrì A, D'Ugo D, Roviello F, Gronchi A. Surgical management of oncologic patient during and after the COVID-19 outbreak: practical recommendations from the Italian society of Surgical Oncology. Updates Surg 2021; 73:321-329. [PMID: 33184782 PMCID: PMC7660129 DOI: 10.1007/s13304-020-00921-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/28/2020] [Indexed: 12/21/2022]
Abstract
The recent outbreak of COVID-19 in Italy caused a limitation of the resources of the health system, which necessarily led to their rationalization in the critical phase (phase 1) and a reorganization of the system in the following phase (phase 2). The Italian Society of Oncological Surgery-SICO has drafted these practical recommendations, calibrated on the most recent scientific literature and taking into account current health regulations and common sense. Surgical activity during phase 1 and 2 should follow a dynamic model, considering architectural structures, hospital mission, organizational models. Surgical delay should not affect oncological prognosis. However, COVID-19-positive cancer patients should be postponed until the infection is cured. The patients to consider more carefully before delaying surgery are those who have completed neoadjuvant therapy, patients with high biological aggressiveness tumors or without therapeutic alternatives. The multidisciplinary discussions are fundamental for sharing clinical decisions; videoconference meetings are preferable and use of telemedicine for follow-up is recommended. Especially in phase 1, maximum effort must be made to reduce the spread of the pandemic. Prefer intra-corporeal rather than open anastomosis during laparoscopy and mechanical rather than hand-sewn anastomosis in open surgery. Consider PPE for caregivers during stoma management. Minimal invasive surgery is not discouraged, because there is little evidence for augmented risk. Specific procedures have to be followed and use of energy devices has to be limited. Training programs with COVID-19 + patients are not recommended. All staff in OR should be trained with specific courses on specific PPE use. Differentiate recommendations are presented for every district cancer. Surgical oncology during phase 2 should be guaranteed by individual and distinct protocols and pathways between cancer patients and COVID-19 + patients with resources specifically addressed to the two distinct kind of patients to limit diagnostic/therapeutic interferences or slowdowns. These recommendations are based on currently available evidence about management of oncologic patients during COVID-19 pandemic, were endorsed by the SICO Executive Board, and are considered suitable for nationwide diffusion. They will be subject to updates and revisions in case of new and relevant scientific acquisitions.
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Affiliation(s)
- Davide Cavaliere
- General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy
| | - Dario Parini
- General Surgery Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Luigi Marano
- Department of Medicine, Surgery, and Neurosciences, General Surgery and Surgical Oncology, University of Siena, Viale Bracci 3, 53100, Siena, Italy.
| | - Federica Cipriani
- Hepatobiliary Surgery Division, Ospedale San Raffaele, Via Olgettina 60, Milano, Italy
| | - Francesco Di Marzo
- UOC Chirurgia Generale, Usl Toscana Sud-Est, Ospedale Valtiberina, Sansepolcro, Arezzo, Italy
| | - Antonio Macrì
- Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital, Messina, Italy
| | - Domenico D'Ugo
- Dipartimento Scienze Mediche e Chirurgiche, UOC di Chirurgia Generale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Franco Roviello
- Department of Medicine, Surgery, and Neurosciences, General Surgery and Surgical Oncology, University of Siena, Viale Bracci 3, 53100, Siena, Italy
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Team V, Team L, Jones A, Teede H, Weller CD. Pressure Injury Prevention in COVID-19 Patients With Acute Respiratory Distress Syndrome. Front Med (Lausanne) 2021; 7:558696. [PMID: 33553194 PMCID: PMC7862742 DOI: 10.3389/fmed.2020.558696] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/02/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019 and became a pandemic in a short period of time. While most infected people might have mild symptoms, older people and people with chronic illnesses may develop acute respiratory distress syndrome (ARDS). Patients with ARDS with worsening hypoxemia require prone positioning to improve the respiratory mechanics and oxygenation. Intubated patients may stay in a prone position up to 12–16 h, increasing the risk of pressure injury (PI). Frequent skin inspections and PI risk assessment in COVID-19 patients will be challenging due to hospital infection control measures aimed to reduce the risk for health professionals. In this perspective article, we summarize the best practice recommendations for prevention of PI in SARS-CoV-2-infected ARDS patients in prone positioning. Prior to positioning patients in prone position, the main recommendations are to (1) conduct a skin assessment, (2) use pressure redistribution devices, (3) select an appropriate mattress or an overlay, (4) ensure that the endotracheal tube securing device is removed and the endotracheal tube is secured with tapes, (5) use a liquid film-forming protective dressing, and (6) lubricate the eyes and tape them closed. Once a patient is in prone position, it is recommended to (1) use the swimmer's position, (2) reposition the patient every 2 h, and (3) keep the skin clean. When the patient is repositioned to supine position, healthcare professionals are advised to (1) assess the pressure points and (2) promote early mobilization.
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Affiliation(s)
- Victoria Team
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Monash Partners Academic Health Science Centre, Clayton, VIC, Australia
| | - Lydia Team
- Monash Health, Clayton, VIC, Australia.,School of Nursing and Midwifery, Deakin University, Melbourne, VIC, Australia
| | - Angela Jones
- Monash Partners Academic Health Science Centre, Clayton, VIC, Australia
| | - Helena Teede
- Monash Partners Academic Health Science Centre, Clayton, VIC, Australia
| | - Carolina D Weller
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Challine A, Dousset B, de'Angelis N, Lefèvre JH, Parc Y, Katsahian S, Lazzati A. Impact of coronavirus disease 2019 (COVID-19) lockdown on in-hospital mortality and surgical activity in elective digestive resections: A nationwide cohort analysis. Surgery 2021; 170:1644-1649. [PMID: 33597086 PMCID: PMC7834914 DOI: 10.1016/j.surg.2020.12.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
Background The outbreak of coronavirus disease 2019 (COVID-19) infection has led to the reorganization of hospital care in several countries. The objective was to report the postoperative mortality after elective digestive resections in a nationwide cohort during the lockdown period. Methods This analytic study was performed using a national billing database (the Programme de Médicalisation des Systèmes d’Informations). Patients who underwent elective digestive resections were divided in 2 groups: the lockdown group defined by hospital admissions between March 17 and May 11, 2020; and the control group, defined by hospital admissions during the corresponding period in 2019. Groups were matched on propensity score, geographical region, and surgical procedure. The primary outcome was the postoperative mortality. Results The overall population included 15,217 patients: 9,325 patients in the control group and 5,892 in the lockdown group. The overall surgical activity was decreased by 37% during the lockdown period. The overall in-hospital mortality during the hospital stay was 2.7%. After matching and adjustment, no difference in mortality between groups was reported (OR = 1.05; 95% CI: 0.83–1.34; P = .669). An asymptomatic COVID-19 infection was a risk factor for a 2-fold increased mortality, whereas a symptomatic COVID-19 infection was associated with a 10-fold increased mortality. Conclusion Despite a considerable reduction in the surgical activity for elective digestive resections during the lockdown period, mortality remained stable on a nationwide scale in COVID-free patients. These findings support that systematic COVID-19 screening should be advocated before elective gastrointestinal surgery and that all efforts should be made to maintain elective surgical resection for cancer during the second wave in COVID-free patients.
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Affiliation(s)
- Alexandre Challine
- Department of Digestive, Hepato-biliary, and Endocrine Surgery, University of Paris, Cochin Hospital, Paris, France; University of Paris, Centre de Recherche des Cordeliers, Paris, France.
| | - Bertrand Dousset
- Department of Digestive, Hepato-biliary, and Endocrine Surgery, University of Paris, Cochin Hospital, Paris, France
| | - Nicola de'Angelis
- Department of Digestive Surgery, University Paris Est-UPEC, Henri Mondor University Hospital, Créteil, France
| | - Jérémie H Lefèvre
- Department of Digestive and General Surgery, Sorbonne University, Saint-Antoine Hospital, Paris, France. https://twitter.com/jeremielefevre
| | - Yann Parc
- Department of Digestive and General Surgery, Sorbonne University, Saint-Antoine Hospital, Paris, France
| | - Sandrine Katsahian
- Epidemiology Department, University of Paris, European Hospital Georges Pompidou, Paris, France
| | - Andrea Lazzati
- Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, Créteil, France; University Paris Est-UPEC, Créteil, France
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Tuech JJ, Manceau G, Ouaissi M, Denet C, Chau A, Kartheuser A, Desfourneaux V, Duchalais E, Bertrand M, Badic B, Alves A, Ceribelli C, Venara A, Mege D, Mauvais F, Dumont F, Mabrut JY, Lakkis Z, Cotte E, Meillat H. Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study. Int J Colorectal Dis 2021; 36:611-615. [PMID: 33495872 PMCID: PMC7835106 DOI: 10.1007/s00384-021-03847-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating. MATERIALS AND METHODS This French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020. RESULTS This study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19-95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12-42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died. CONCLUSION The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.
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Affiliation(s)
- Jean-Jacques Tuech
- grid.41724.34Department of Digestive Surgery, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen cedex, France
| | - Gilles Manceau
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne University, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Mehdi Ouaissi
- grid.411167.40000 0004 1765 1600Department of Digestive, Oncological, Endocrine, and Hepatic Surgery, and Hepatic Transplantation, Trousseau Hospital, CHRU Trouseau, Tours, France
| | - Christine Denet
- grid.418120.e0000 0001 0626 5681Service de Chirurgie Digestive, Institut Mutualiste Montsouris, Paris, France
| | - Amélie Chau
- Polyclinique d’Hénin-Beaumont, Route de Courrières, 62110 Hénin-Beaumont, France
| | - Alex Kartheuser
- grid.7942.80000 0001 2294 713XColorectal Surgery Unit, Department of Abdominal Surgery and Transplantation Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Véronique Desfourneaux
- grid.411154.40000 0001 2175 0984Department of Hepatobiliary and Digestive Surgery, CHU Rennes, 2 rue Henri Le Guilloux, Rennes, France
| | - Emilie Duchalais
- grid.277151.70000 0004 0472 0371Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l’Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093 Nantes, France
| | - Martin Bertrand
- grid.121334.60000 0001 2097 0141Digestive surgery & digestive cancerology, CHU Carémeau, université de Montpellier, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France
| | - Bogdan Badic
- grid.411766.30000 0004 0472 3249CHRU de Brest, Brest, France
| | - Arnaud Alves
- grid.411149.80000 0004 0472 0160Service de chirurgie digestive CHU Caen, registre des tumeurs digestive du calvados, Inserm U1086 ANTICIPE, 14000 Caen, France
| | - Cecilia Ceribelli
- grid.29172.3f0000 0001 2194 6418Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Université de Lorraine, 54519 Vandoeuvre-lès-Nancy, France
| | - Aurelien Venara
- grid.411147.60000 0004 0472 0283Department of Endocrinal and Visceral Surgery, Angers University Hospital, 49933 Angers, France
| | - Diane Mege
- grid.411266.60000 0001 0404 1115Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - François Mauvais
- Digestive Surgery Department, Beauvais Hospital, Beauvais, France
| | - Fréderic Dumont
- grid.418191.40000 0000 9437 3027Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Jean-Yves Mabrut
- grid.25697.3f0000 0001 2172 4233Department of Digestive Surgery and Transplantation, University Hospital Croix Rousse, Hospices Civils de Lyon, University of Lyon I, Lyon, France
| | - Zaher Lakkis
- grid.411158.80000 0004 0638 9213Department of Surgical Oncology, University Hospital Jean Minjoz, Besançon, France
| | - Eddy Cotte
- Department of Gastrointestinal Surgery, Hospices Civils de Lyon, Université de Lyon, Centre Hospitalier Lyon-Sud, 165 chemin du grand Revoyet, 69495 Pierre Bénite, France
| | - Helene Meillat
- grid.418443.e0000 0004 0598 4440Department of Digestive Surgical Oncology, Department of Mini Invasive Interventions (DIMI), Paoli Calmettes Institute, Marseille, France
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Wang Y, Liu Z, Shan F, Ying X, Zhang Y, Li S, Jia Y, Li Z, Ji J. Optimal Timing to Surgery After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer. Front Oncol 2020; 10:613988. [PMID: 33392098 PMCID: PMC7773852 DOI: 10.3389/fonc.2020.613988] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relationship between time to surgery (TTS) and survival benefit is not sufficiently demonstrated by previous studies in locally advanced gastric cancer (LAGC). This study aims to assess the impact of TTS after neoadjuvant chemotherapy (NACT) on long-term and short-term outcomes in LAGC patients. METHODS Data were collected from patients with LAGC who underwent NACT between January 2007 and January 2018 at our institution. Outcomes assessed were long-term survival, pathologic complete response (pCR) rate, and postoperative complications. RESULTS This cohort of 426 patients was divided into five groups by weeks of TTS. Under cox regression, compared to other groups, the 22-28 days and 29-35 days groups revealed a better OS (≤21 vs. 22-28 days: HR 1.54, 95% CI = 0.81-2.93, P = 0.185; 36-42 vs. 22-28 days: HR 2.20, 95% CI = 1.28-3.79, P = 0.004; 43-84 vs. 22-28 days: HR 1.83, 95% CI = 1.09-3.06, P = 0.022) and PFS (≤21 vs. 22-28 days: HR 1.54, 95% CI = 0.81-2.93, P = 0.256; 36-42 vs. 22-28 days: HR 2.20, 95% CI = 1.28-3.79, P = 0.111; 43-84 vs. 22-28 days: HR 1.83, 95% CI = 1.09-3.06, P = 0.047). Further analysis revealed a better prognosis in patients with TTS within 22-35 days (OS: HR 1.78 95% CI = 1.25-2.54, P = 0.001; PFS: HR 1.49, 95% CI = 1.07-2.08, P = 0.017). Postoperative stay was significantly higher in the ≤21 days group, while other parameters revealed no statistical significance (P > 0.05). Restricted cubic spline depicted the nonlinear relationship between TTS and OS/PFS. CONCLUSION Patients who received surgery within 3-5 weeks experienced the maximal survival benefit without an increase in postoperative complications or lowering the rate of pCR. Further investigations are warranted.
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Affiliation(s)
| | | | | | | | | | | | | | - Ziyu Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing, China
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Shrikhande SV, Chaudhary A, Krishnamurthy A, Rao GV, Chaturvedi H, Kar M, Deo SVS, Chaudhari V, Somashekhar S. Surgical Oncology Practice in the Wake of COVID-19 Crisis. Indian J Surg Oncol 2020; 11:762-768. [PMID: 33191994 PMCID: PMC7648662 DOI: 10.1007/s13193-020-01240-1] [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: 06/11/2020] [Accepted: 09/21/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome (SARS-CoV-2) outbreak has placed unprecedented challenges globally dismantling healthcare systems and forcing rapid transformations of healthcare services. In patients with cancer, these changes are having profound effects on vital aspects of their care. It has been advised that hospitals discontinue elective surgery and work on triage of nonemergent surgical procedures during the pandemic. The purpose of this article is to highlight the recommendations and adapted workflow from the private and public tertiary level hospitals in India advising on the best practices and views on better patient management, redesigning of SOPs for OR, surgeon, and staff safety and resumption of cancer care especially from surgical perspective. Different concerns are addressed that are necessary to optimize the quality of care provided to COVID-19 patients and to reduce the risk of viral transmission to other patients or healthcare workers.
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Affiliation(s)
- Shailesh V. Shrikhande
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Adarsh Chaudhary
- Institute of Digestive and Hepatobiliary Sciences, Medanta-The Medcity, Delhi, India
| | | | - G. V. Rao
- Asian Institute of Gastroenterology, Hyderabad, Telangana India
| | - Harit Chaturvedi
- Max Institute of Cancer Care, Max Group of Hospitals, Delhi, India
| | | | - S. V. S. Deo
- Department of Surgical Oncology, AIIMS (ICRH and NCI), Delhi, India
| | - Vikram Chaudhari
- Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra India
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Wang K, Wu C, Xu J, Zhang B, Zhang X, Gao Z, Xia Z. Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis. EClinicalMedicine 2020; 29:100612. [PMID: 33169112 PMCID: PMC7641595 DOI: 10.1016/j.eclinm.2020.100612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. METHODS We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms "COVID-19″ or "SARS-CoV-2″ and "Surgery" or "Operation" for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. FINDINGS A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality (r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality (r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. INTERPRETATION COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). FUNDING Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.
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Affiliation(s)
- Kun Wang
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Changshuai Wu
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Jian Xu
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Baohui Zhang
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Xiaowang Zhang
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Zhenglian Gao
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, 6 Baojian Road, Nangang District, Harbin 150081, Heilongjiang, China
| | - Zhengyuan Xia
- Department of Anesthesiology, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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33
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Tuech JJ, Schwarz L, Pocard M. [RE: Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation]. ACTA ACUST UNITED AC 2020; 158:101-102. [PMID: 33250944 PMCID: PMC7678451 DOI: 10.1016/j.jchirv.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- J-J Tuech
- Rouen university hospital, department of digestive surgery, 1, rue de Germont, 76031 Rouen cedex, France.,Normandie university, UNIROUEN, UMR 1245 Inserm, Rouen university Hospital, Department of genomic and personalized medicine in cancer and neurological Disorders, 76000 Rouen, France.,Université de Paris, UMR 1275 CAP Paris-Tech, 75010 Paris, France
| | - L Schwarz
- Rouen university hospital, department of digestive surgery, 1, rue de Germont, 76031 Rouen cedex, France.,Normandie university, UNIROUEN, UMR 1245 Inserm, Rouen university Hospital, Department of genomic and personalized medicine in cancer and neurological Disorders, 76000 Rouen, France.,Université de Paris, UMR 1275 CAP Paris-Tech, 75010 Paris, France
| | - M Pocard
- Service de chirurgie digestive et cancérologique Hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France
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Sadler D, DeCara JM, Herrmann J, Arnold A, Ghosh AK, Abdel-Qadir H, Yang EH, Szmit S, Akhter N, Leja M, Silva CMPDC, Raikhelkar J, Brown SA, Dent S, O'Quinn R, Thuny F, Moudgil R, Raez LE, Okwuosa T, Daniele A, Bauer B, Kondapalli L, Ismail-Khan R, Lax J, Blaes A, Nahleh Z, Elson L, Baldassarre LA, Zaha V, Rao V, Lara DS, Skurka K. Perspectives on the COVID-19 pandemic impact on cardio-oncology: results from the COVID-19 International Collaborative Network survey. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2020; 6:28. [PMID: 33292763 PMCID: PMC7691954 DOI: 10.1186/s40959-020-00085-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/19/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Re-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated. OBJECTIVES To assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers' opinions on healthcare policies among oncology and cardiology practitioners. METHODS An electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology, American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty. RESULTS One thousand four hundred fifteen providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p = 0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p = < 0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p = 0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1097) (p = < 0.001). 95% of all groups supported more active leadership from medical professional societies. CONCLUSIONS These results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.
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Affiliation(s)
- Diego Sadler
- Heart and Vascular Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
| | | | | | | | - Arjun K Ghosh
- Barts Heart Centre, St Bartholomew's Hospital, and University College London's Hospital, London, UK
| | - Husam Abdel-Qadir
- Women's College Hospital and Peter Munk Cardiac Centre, University of Toronto, Toronto, Canada
| | - Eric H Yang
- UCLA Cardio-Oncology Program, University of California, Los Angeles, USA
| | | | | | | | | | | | | | | | | | | | | | - Luis E Raez
- Memorial Health Care, Florida International University, Miami, FL, USA
| | | | | | | | | | | | - Jorge Lax
- Hospital Cosme Argerich, Buenos Aires, Argentina
| | - Anne Blaes
- University of Minnesota, Minneapolis, MN, USA
| | - Zeina Nahleh
- Heart and Vascular Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Leah Elson
- Heart and Vascular Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | | | | | - Vijay Rao
- Franciscan Health, Indianapolis, IN, USA
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Rebecchi F, Arolfo S, Ugliono E, Morino M, Asti E, Bonavina L, Borghi F, Coratti A, Cossu A, De Manzoni G, De Pascale S, Ferrari GC, Fumagalli Romario U, Giacopuzzi S, Gualtierotti M, Guglielmetti M, Merigliano S, Pallabazzer G, Parise P, Peri A, Pietrabissa A, Rosati R, Santi S, Tribuzi A, Valmasoni M, Viganò J, Weindelmayer J. Impact of COVID-19 outbreak on esophageal cancer surgery in Northern Italy: lessons learned from a multicentric snapshot. Dis Esophagus 2020; 34:6007422. [PMID: 33245104 PMCID: PMC7717178 DOI: 10.1093/dote/doaa124] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/10/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
Abstract
Coronavirus Disease-19 (COVID-19) outbreak has significantly burdened healthcare systems worldwide, leading to reorganization of healthcare services and reallocation of resources. The Italian Society for Study of Esophageal Diseases (SISME) conducted a national survey to evaluate changes in esophageal cancer management in a region severely struck by COVID-19 pandemic. A web-based questionnaire (26 items) was sent to 12 SISME units. Short-term outcomes of esophageal resections performed during the lockdown were compared with those achieved in the same period of 2019. Six (50%) centers had significant restrictions in their activity. However, overall number of resections did not decrease compared to 2019, while a higher rate of open esophageal resections was observed (40 vs. 21.7%; P = 0.034). Surgery was delayed in 24 (36.9%) patients in 6 (50%) centers, mostly due to shortage of anesthesiologists, and occupation of intensive care unit beds from intubated COVID-19 patients. Indications for neoadjuvant chemo (radio) therapy were extended in 14% of patients. Separate COVID-19 hospital pathways were active in 11 (91.7%) units. COVID-19 screening protocols included nasopharyngeal swab in 91.7%, chest computed tomography scan in 8.3% and selective use of lung ultrasound in 75% of units. Postoperative interstitial pneumonia occurred in 1 (1.5%) patient. Recovery from COVID-19 pandemic was characterized by screening of patients in all units, and follow-up outpatient visits in only 33% of units. This survey shows that clinical strategies differed considerably among the 12 SISME centers. Evidence-based guidelines are needed to support the surgical esophageal community and to standardize clinical practice in case of further pandemics.
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Affiliation(s)
- Fabrizio Rebecchi
- Address correspondence to: Fabrizio Rebecchi, MD, Department of Surgical Sciences, University of Turin, Turin, Italy, 14 c/so AM Dogliotti, 10126 Turin, Italy.
| | - Simone Arolfo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Elettra Ugliono
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mario Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Emanuele Asti
- Department of General and Foregut Surgery, University of Milan, IRCCS, Policlinico San Donato, Milan, Italy
| | - Luigi Bonavina
- Department of General and Foregut Surgery, University of Milan, IRCCS, Policlinico San Donato, Milan, Italy
| | - Felice Borghi
- General and Oncologic Surgery Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Andrea Coratti
- Division of Oncological and Robotic Surgery, Careggi University Hospital of Florence, Florence, Italy
| | - Andrea Cossu
- Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy
| | - Giovanni De Manzoni
- General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy
| | | | | | | | - Simone Giacopuzzi
- General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy
| | - Monica Gualtierotti
- Mini-Invasive Oncological Surgical Department, Niguarda Hospital, Milan, Italy
| | | | - Stefano Merigliano
- Center for Esophageal Disease, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padua, Italy
| | | | - Paolo Parise
- Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy
| | - Andrea Peri
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Andrea Pietrabissa
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Riccardo Rosati
- Gastrointestinal Surgery Unit, San Raffaele Hospital, Milan, Italy
| | - Stefano Santi
- Esophageal Surgery Unit, University Hospital of Pisa, Pisa, Italy
| | - Angela Tribuzi
- Division of Oncological and Robotic Surgery, Careggi University Hospital of Florence, Florence, Italy
| | - Michele Valmasoni
- Center for Esophageal Disease, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova, Padua, Italy
| | - Jacopo Viganò
- Department of Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Jacopo Weindelmayer
- General, Esophageal and Gastric Surgery Unit, University Hospital of Verona, Verona, Italy
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RE: RE: Strategy for the practice of digestive and oncologic surgery in the COVID-19 epidemic situation. J Visc Surg 2020; 158:98-99. [PMID: 33272818 PMCID: PMC7680036 DOI: 10.1016/j.jviscsurg.2020.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Elective Surgery During the SARS-CoV-2 Pandemic (COVID-19): A Morbimortality Analysis and Recommendations on Patient Prioritisation and Security Measures. CIRUGÍA ESPAÑOLA (ENGLISH EDITION) 2020. [PMCID: PMC7305868 DOI: 10.1016/j.cireng.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction The spread of the SARS-CoV-2 infection (COVID-19) has required adaptation by hospitals affected by the pandemic, which has caused a reduction in elective surgical activity. Methods Retrospective study of patients operated on in the previous month and during the peak of the pandemic. We analysed the COVID-19 infection rate, the severity of respiratory infection according to the Brescia respiratory COVID-19 severity scale, the adopted therapeutic measures and the overall postoperative complications. Results From 17th February to 31st March 2020, there was a progressive decrease in surgical activity, with only 213 patients operated on. This comprised 59 (27.8%) elective operations for oncological diseases, 97 (45.5%) elective operations for benign diseases and 57 (26.7%) as urgent procedures. There was a progressive increase in the rate of infection by COVID-19, with a total of 15 cases (7%). This included 10 patients (16.9%) in the elective group for oncological disease, 1 (1%) in the elective surgery group for benign disease and 4 (7%) in the urgent surgery group (P<.001). Five patients presented with a severe respiratory infection, of which 4 were affected by oncological disease. There were 3 deaths (1.4%), which were all due to the worsening of a respiratory infection. Conclusions The patients undergoing the surgical procedures showed high rates of COVID-19 infection and postoperative complications, especially the patients with oncological diseases. Local resumption of surgical activity must be based on the prioritisation of the cases to be operated on, respecting certain premises of security and optimisation of the available resources.
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Di Martino M, García Septiem J, Maqueda González R, Muñoz de Nova JL, de la Hoz Rodríguez Á, Correa Bonito A, Martín-Pérez E. [Elective surgery during the SARS-CoV-2 pandemic (COVID-19): a morbimortality analysis and recommendations on patient prioritisation and security measures]. Cir Esp 2020; 98:525-532. [PMID: 32408995 PMCID: PMC7188649 DOI: 10.1016/j.ciresp.2020.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The spread of the SARS-CoV-2 infection (COVID-19) has required adaptation by hospitals affected by the pandemic, which has caused a reduction in elective surgical activity. METHODS Retrospective study of patients operated on in the previous month and during the peak of the pandemic. We analysed the COVID-19 infection rate, the severity of respiratory infection according to the Brescia respiratory COVID-19 severity scale, the adopted therapeutic measures and the overall postoperative complications. RESULTS From 17th February to 31st March 2020, there was a progressive decrease in surgical activity, with only 213 patients operated on. This comprised 59 (27.8%) elective operations for oncological diseases, 97 (45.5%) elective operations for benign diseases and 57 (26.7%) as urgent procedures.There was a progressive increase in the rate of infection by COVID-19, with a total of 15 cases (7%). This included 10 patients (16.9%) in the elective group for oncological disease, 1 (1%) in the elective surgery group for benign disease and 4 (7%) in the urgent surgery group (p < 0.001). Five patients presented with a severe respiratory infection, of which 4 were affected by oncological disease. There were 3 deaths (1.4%), which were all due to the worsening of a respiratory infection. CONCLUSIONS The patients undergoing the surgical procedures showed high rates of COVID-19 infection and postoperative complications, especially the patients with oncological diseases. Local resumption of surgical activity must be based on the prioritisation of the cases to be operated on, respecting certain premises of security and optimisation of the available resources.
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Affiliation(s)
- Marcello Di Martino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España.
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Rocío Maqueda González
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Jose Luis Muñoz de Nova
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | | | - Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Princesa, Madrid, España
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Behrens E, Poggi L, Aparicio S, Martínez Duartez P, Rodríguez N, Zundel N, Ramos Cardoso A, Camacho D, López-Corvalá JA, Vilas-Bôas ML, Laynez J. COVID-19: IFSO LAC Recommendations for the Resumption of Elective Bariatric Surgery. Obes Surg 2020; 30:4519-4528. [PMID: 32827292 PMCID: PMC7442889 DOI: 10.1007/s11695-020-04910-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND COVID-19 pandemic varies greatly and has different dynamics in every country, city, and hospital in Latin America. Obesity increases the risk of SARS-CoV-2 infection, and it is one of the independent risk factors for the most severe cases of COVID-19. Currently, the most effective treatment against obesity available is bariatric and metabolic surgery (BMS), which further resolves or improves other independent risk factors like diabetes and hypertension. OBJECTIVE Provide recommendations for the resumption of elective BMS during COVID-19 pandemic. METHOD This document was created by the IFSO-LAC Executive Board and a task force. Based on data collected from a survey distributed to all IFSO-LAC members that obtained 540 responses, current evidence available, and consensus reached by other scientific societies. RESULTS The resumption of elective BMS must be a priority maybe similar to oncological surgery, when hospitals reach phase I or II, treating obesity patients in a NON-COVID area, avoiding inadvertent intrahospital contagion from healthcare provider, patients, and relatives. Same BMS indication and types of procedures as before the pandemic. Discard the presence of SARS-CoV-2 within 72 h prior to surgery. Continues laparoscopic approach. The entire team use N95 mask. Minimum hospital stays. Implement remote visits for the follow-up. CONCLUSION Resumption of elective BMS is crucial because it is not only a weight loss operation but also resolves or improves comorbidities and appears to be an immune restorative procedure of obese patients in the medium term, offering them the same probability of contracting COVID-19 as the regular population.
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Affiliation(s)
- Estuardo Behrens
- NEW LIFE CENTER, 10 calle 2-45 zona 14. Of. 1202, Guatemala City, Guatemala
- Bariatric and Metabolic Institute of Guatemala, Guatemala City, Guatemala
| | - Luis Poggi
- Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Peruvian Academy of Surgery, Lima, Peru
| | | | | | - Nelson Rodríguez
- Department of Bariatric Surgery, Hospital Puerta de Hierro Andares, Guadalajara, Mexico
| | | | | | - Diego Camacho
- Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467 USA
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Drissi F, Frey S, Abet E. [Re: "Strategy for the practice of digestive and oncologic surgery in COVID-19 epidemic situation". As regards the detection of coronavirus in peritoneal fluid]. ACTA ACUST UNITED AC 2020; 158:100-101. [PMID: 33101553 PMCID: PMC7566759 DOI: 10.1016/j.jchirv.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- F Drissi
- Service de chirurgie digestive, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La Roche-sur-Yon, France
| | - S Frey
- Service de chirurgie digestive, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La Roche-sur-Yon, France
| | - E Abet
- Service de chirurgie digestive, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85000 La Roche-sur-Yon, France
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Ghazali WAHW, Nallaluthan P, Hasan RZ, Adlan AS, Boon NK. Gynecological Endoscopic Society of Malaysia Statement and Recommendations on Gynecological Laparoscopic Surgery during COVID-19 Pandemic. Gynecol Minim Invasive Ther 2020; 9:185-189. [PMID: 33312860 PMCID: PMC7713654 DOI: 10.4103/gmit.gmit_109_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives: While the issue of aerosolization of virus from the blood occurs during usage of energy sources scare practitioners, there have been no reported instances of healthcare workers (HCWs) being infected. COVID-19 virus is primarily transmitted via respiratory droplets and contact routes. Therefore, the ultimate decision for surgery, should be based on which is the safest, quickest route and concurrently ensuring that HCWs are protected during these surgeries. During the time of crisis, HCWs need to concentrate and channel resources to the care of those affected by the coronavirus hence judicious allocation of resources is mandatory. We present the guidelines and recommendations on gynecological laparoscopic surgery during this COVID-19 outbreak in Malaysia. Materials and Methods: Thorough search of articles and recommendations were done to look into the characteristics of the virus in terms of transmission and risks during surgery. Smoke plume characteristics, composition and risk of viral transmission were also studied. Search includes The WHO Library, Cochrane Library and electronic databases (PubMed, Google scholar and Science Direct). Conclusion: We concluded that there is no scientific basis of shunning laparoscopic approach in surgical intervention. Ultimately, the guiding principles would be of reducing the anesthetic and surgical duration, the availability of full protective gear for HCWs during the surgery and the status of the patient. It is mandatory for viral swab tests to be done within the shortest window period possible, for all cases planned for surgery.
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Affiliation(s)
- Wan Ahmad Hazim Wan Ghazali
- Department of Obstetrics and Gynecology, Putrajaya Hospital, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
| | - Pavani Nallaluthan
- Department of Obstetrics and Gynecology, Putrajaya Hospital, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
| | - Raimi Zamriah Hasan
- Department of Obstetrics and Gynecology, Putrajaya Hospital, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
| | - Aizura Syafinaz Adlan
- Department of Obstetrics and Gynecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ng Kwee Boon
- Department of Obstetrics and Gynecology, Tung Shin Hospital, Kuala Lumpur, Malaysia
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Fedorov AV, Kurganov IA, Emelyanov SI. [Surgical care during the new coronavirus (Covid-19) pandemic]. Khirurgiia (Mosk) 2020:92-101. [PMID: 33030009 DOI: 10.17116/hirurgia202009192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Safe and reasonable surgical care in the context of COVID-19 pandemic is difficult task. The main current issues are selection of patients for surgical treatment, principles of surgical treatment in cancer patients, possibilities of endoscopic surgery, organization of surgical department and operating theatre, surgical strategy in infected patients. Own experience and rational implementation of the recommendations developed by international research and practical communities are extremely important for optimizing surgical treatment of patients in a pandemic, as well as for ensuring the safety of patients and medical staff.
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Affiliation(s)
- A V Fedorov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.,Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - I A Kurganov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - S I Emelyanov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Risk factors for Coronavirus Disease 2019 (COVID-19) severity and mortality among solid cancer patients and impact of the disease on anticancer treatment: A French nationwide cohort study (GCO-002 CACOVID-19). Eur J Cancer 2020; 141:62-81. [PMID: 33129039 PMCID: PMC7543792 DOI: 10.1016/j.ejca.2020.09.035] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/11/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022]
Abstract
Background Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated. Patients and methods In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and 11th June 2020. The primary end-point was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary end-points. Results From April 4 to 11th June 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18–2.52), The Eastern Cooperative Oncology Group Performance Scale (ECOG PS) ≥ 2 (OR 3.23, 95%CI: 2.27–4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01–1.16) and admission to ICU (OR 3.62, 95%CI 2.14–6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except for cytotoxic chemotherapy in the subgroup of patients with detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00–2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment (such as chemotherapy, targeted or immune therapy) interrupted or stopped following diagnosis of COVID-19. Conclusions Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.
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Li YX, He CZ, Liu YC, Zhao PY, Xu XL, Wang YF, Xia SY, Du XH. The impact of COVID-19 on gastric cancer surgery: a single-center retrospective study. BMC Surg 2020; 20:222. [PMID: 33008379 PMCID: PMC7530856 DOI: 10.1186/s12893-020-00885-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. Methods The ‘COVID-19’ period was defined as occurring between 2020 and 01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p = 0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p = 0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p < 0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p = 0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p < 0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p = 0.006). Conclusion This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.
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Affiliation(s)
- Yu-Xuan Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Chang-Zheng He
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Yi-Chen Liu
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Peng-Yue Zhao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Xiao-Lei Xu
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Yu-Feng Wang
- Department of Hospitalization management, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Shao-You Xia
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China.
| | - Xiao-Hui Du
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, PR China.
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Emergency surgery and trauma care during COVID-19 pandemic. Recommendations of the Spanish Association of Surgeons. CIRUGÍA ESPAÑOLA (ENGLISH EDITION) 2020. [PMCID: PMC7513833 DOI: 10.1016/j.cireng.2020.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Bresadola V, Biddau C, Puggioni A, Tel A, Robiony M, Hodgkinson J, Leo CA. General surgery and COVID-19: review of practical recommendations in the first pandemic phase. Surg Today 2020; 50:1159-1167. [PMID: 32720009 PMCID: PMC7383064 DOI: 10.1007/s00595-020-02086-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND In March, 2020, the World Health Organization declared COVID-19 a pandemic. The absence of previous knowledge of COVID-19 has made decision-making difficult for all in health care, including surgical departments. We reviewed the management recommendations for surgical activity and changes to surgical practice, identifying concordances and discrepancies, based on the literature published in the early phase of the pandemic. METHOD We searched the electronic datasets, PubMed Database, Google, and Google Scholar, using the keywords "SARS-CoV-2", "COVID-19", "surgery", "recommendations", "guideline", and "triage". The search was limited to the first 2 months after the pandemic began and was closed on May 6, 2020. RESULTS Twenty papers were included in the analysis and their recommendations are divided into the following categories: 1. general aspects, such as maintaining the safety of health personnel and indications for surgery. 2. The preoperative phase, with recommendations about activating different care pathways for COVID-19 positive patients. 3. The operative phase, with recommendations about activating safety measures for aerosol-generating procedures. 4. The postoperative phase, with recommendations for managing operating theatres and patient transfers. CONCLUSION The recommendations proposed in the revised documents are considered good practices aimed at keeping patients and healthcare professionals safe. However, these recommendations must be contextualized in each individual hospital.
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Affiliation(s)
- Vittorio Bresadola
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.
| | - Carlo Biddau
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Puggioni
- General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy
| | | | - Cosimo Alex Leo
- Department of General and Emergency Surgery, Northwick Park and St Mark's Hospital, London North West University Healthcare NHS Trust, Harrow, UK
- Department of Surgery & Cancer, Imperial College London, London, UK
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COVID-19 Outbreak and Oncological Surgery Practice. Indian J Surg Oncol 2020; 12:114-116. [PMID: 33013104 PMCID: PMC7519380 DOI: 10.1007/s13193-020-01239-8] [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] [Received: 06/01/2020] [Accepted: 09/21/2020] [Indexed: 01/08/2023] Open
Abstract
The emergence of COVID-19 has caused a global public health emergency. With the World Health Organization (WHO) reporting the novel coronavirus outbreak a pandemic, the focus is needed on the influence of this rapidly spreading viral infection on cancer patients. In this study, we aimed to address cancer-related operations during the COVID-19 outbreak. We retrospectively reviewed 26 patients who had undergone cancer surgeries admitted from March 13 to May 13, 2020, during the COVID-19 epidemic at Istanbul Bagcilar Training and Research Hospital, as a pandemic hospital. A total of 26 cases of COVID-19 were enrolled in the study. Seventeen (65%) were female, and 9 (35%) were male. The mean age was 52.4 (range 28–74). The mean body mass index (BMI) is 27.8 kg/m2 (range 17.6–34.0). Eight of them had comorbidities. 7 patients needed an intensive care unit (ICU). Only one patient was COVID-19 positive in the PCR test, while the others were negative. In addition to this patient, 3 other patients were COVID-19 positive on computed tomography (CT). The patients included in this study underwent various oncologic surgery procedures. While 24 patients were discharged without any problems, 2 patients developed complications. Due to respiratory problems, the patient could not get out of intensive care and died on the sixth postoperative day. It is the obligation of the institutions and the medical staff to reassure patients by creating safe postoperative surgical environments free of COVID-19. Surgeon leaders need to synthesize actual data to make the best decisions for their cancer patients.
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The Impact of COVID-19 pandemic on Spine Surgeons: An Asia Pacific Spine Society (APSS) Survey. Spine (Phila Pa 1976) 2020; 45:1285-1292. [PMID: 32756270 DOI: 10.1097/brs.0000000000003622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVE The aim of this study was to investigate the impact of COVID-19 pandemic on the clinical practices of spine surgeons within the Asia Pacific region. SUMMARY OF BACKGROUND DATA COVID-19 pandemic had changed spine surgeons' clinical practices and their concerns toward personal and family risk of infection. METHODS This cross-sectional survey was carried out from May 4, 2020 to June 4, 2020. The questionnaire was administered using REDCAP. The online questionnaire includes four sections. First section includes surgeon's demographics, background, type of clinical practice, and status of pandemic in their country. Second section includes volume and the type of spine surgery practice before the COVID pandemic. Third section includes changes of clinical practice during the pandemic and the last section was regarding their concern on COVID transmission. RESULTS Total of 222 respondents from 19 countries completed the questionnaire. During the pandemic, 92.3% of the respondents felt their clinical practice was affected. 58.5% respondents reported reduced outpatient clinic hours and 74.6% respondents reported reduced operation theatre hours due to the enforcement by the hospital administration. The mean reduction of clinic volume for all countries was 48.1%. There was a significant reduction in the number of surgeries performed in Japan, Malaysia, India, Philippines, and South Korea. This was due to reduced patient load. More than 60% of respondents were worried being infected by COVID-19 virus and >68% were worried of transmission to their family members. CONCLUSION COVID-19 pandemic has significantly affected the clinical and surgical practice of spine surgeons in the Asia Pacific region. Clinics were closed or the practice hours reduced. Similarly, surgical theaters were closed, reduced, or limited to semi-emergency and emergency surgeries. Spine surgeons were moderately concerned of contracting COVID-19 during their clinical practice but were extremely concerned to transmit this disease to their family members. LEVEL OF EVIDENCE 4.
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Santambrogio R, Galfrascoli E, Zappa MA. Five recommendations for loco-regional treatments of hepatocellular carcinoma during the COVID-19 pandemic. Dig Liver Dis 2020; 52:950-952. [PMID: 32561303 PMCID: PMC7297168 DOI: 10.1016/j.dld.2020.05.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/09/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Roberto Santambrogio
- UOC di Chirurgia Generale, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, Milano 20121, Italy.
| | - Elisa Galfrascoli
- UOC di Chirurgia Generale, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, Milano 20121, Italy
| | - Marco Antonio Zappa
- UOC di Chirurgia Generale, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, Milano 20121, Italy
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Campos FG, Fillmann HS. Potential impact of COVID-19 on colorectal disease management. JOURNAL OF COLOPROCTOLOGY 2020. [PMCID: PMC7303621 DOI: 10.1016/j.jcol.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractThe current recommendations for management of colorectal diseases are still evolving, due to the limited experience on this issue. As the new coronavirus can be transmitted through breath droplets, by contact and orofecally, there is no consensus of how this fact may affect the investigation and treatment of anorectal diseases. Thus, high-quality multicenter studies are urgently needed to provide better information to both patients and the multiprofessional team, in order to build an effective pandemic response plan in our specialty. As a greater operative risk for infected patients has already been demonstrated, the next step lies on the identification of new therapeutic strategies that could minimize this effect on an individual basis. There is a present understanding that the COVID-19 pandemic should change some traditional practices. Therefore, the surgical treatment of suspected or known COVID-19 case demands specific insights. This article analyses potential influences regarding the treatment of patients with Colorectal Cancer (CRC) and Inflammatory Bowel Diseases (IBD). At present, elective surgery must be avoided, and the colorectal surgeon must carefully evaluate the risks and benefits of such decision. Within this context, a change toward nonsurgical and less aggressive modalities of CRC treatment may help to postpone definitive treatment. We also discuss the concerns regarding the viral infection among the population, the influence on clinical symptoms and the proposed modifications on therapeutic schemes.
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Affiliation(s)
- Fábio Guilherme Campos
- Universidade de São Paulo, Hospital das Clínicas, Divisão de Cirurgia Colorretal, Departamento de Gastroenterologia em, São Paulo, SP, Brazil
- Corresponding author.
| | - Henrique Sarubbi Fillmann
- Division of Colorectal Surgery, Department of Surgery of Faculdade de Medicina, Universidade PUCRS, Porto Alegre, RS, Brazil
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