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Rine S, Lara ST, Bikomeye JC, Beltrán-Ponce S, Kibudde S, Niyonzima N, Lawal OO, Mulamira P, Beyer KMM. The impact of the COVID-19 pandemic on cancer care including innovations implemented in Sub-Saharan Africa: A systematic review. J Glob Health 2023; 13:06048. [PMID: 37976409 PMCID: PMC10656081 DOI: 10.7189/jogh.13.06048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background The coronavirus 2019 (COVID-19) pandemic has caused disruptions in the delivery and utilisation of cancer services. The impact of these interruptions is disproportionately borne by low- and middle-income countries in Sub-Saharan Africa (SSA). There are speculations of increased late-stage presentation and mortality as services are returning to the pre-pandemic state. This review aims to explore the extent to which the COVID-19 pandemic impacted cancer services across SSA and to identify innovations implemented across SSA to mitigate the impacts. Methods Using database-specific search strategies, a systematic literature search was conducted in PubMed, Ovid (MedLine), Web of Science, and African Index Medicus. Eligible studies included original research, reports, perspectives and summaries of national or regional outcomes published in the English language. The primary outcome was changes in the delivery and utilisation of cancer prevention and screening, diagnosis, treatment and follow-up services. The secondary outcome was to identify implemented innovations to mitigate the impact of the pandemic on service delivery. Results Out of the 167 articles identified in the literature search, 46 were included in the synthesis. A majority (95.7%) of the included articles described suspension and/or delay of screening, diagnosis, and treatment services, although two studies (4.3%) described the continuation of services despite the lockdown. Care was additionally impacted by transportation limitations, shortages of staff and personal protective equipment, disruption of the medication supply chain and patients' fears and stigma associated with contracting COVID-19. A major innovation was the use of telemedicine and virtual platforms for patient consultation and follow-up during the pandemic in SSA. Furthermore, drones and mobile applications were used for sample collection, medication delivery and scheduling of treatment. In some instances, medication routes and treatment protocols were changed. Conclusions The delivery and utilisation of cancer services decreased substantially during the pandemic. Cancer centres initiated innovative methods of care delivery, including telehealth and drone use, with long-term potential to mitigate the impact of the pandemic on service delivery. Cancer centres in SSA must explore sustainable, facility or country-specific innovations as services return to the pre-pandemic state. Registration The review was registered in PROSPERO with registration number CRD42022351455.
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Affiliation(s)
- Sarah Rine
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shana T Lara
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jean C Bikomeye
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sara Beltrán-Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | - Olatunji O Lawal
- Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria
| | | | - Kirsten MM Beyer
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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2
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Ojo C, Orji C, Adedeji A, Nwachukwu C, Fagbemi O. Cancer Care During the COVID-19 Pandemic: The African Narrative and Prospects. Cureus 2023; 15:e43803. [PMID: 37731407 PMCID: PMC10508643 DOI: 10.7759/cureus.43803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on healthcare services globally. Whilst it has been particularly disruptive for cancer care in low-resource settings, a few African countries have been able to adapt strategies to enable continued delivery of medical care to persons with cancer. This study seeks to highlight how much effect the coronavirus pandemic has had on oncological care in Africa and to indicate the way forward. For this narrative review, PubMed and Google Scholar were used to search for literature addressing the effect of the coronavirus pandemic on the care of patients with cancer in Africa with ensuing coping strategies. Selection criteria were manuscripts published since the onset of the pandemic in 2019 and written in the English language with Africa being the focus. In total, 52 research papers involving up to 21 African nations were found and reviewed. Across the board, the COVID-19 pandemic resulted in the deferral of oncological screening programs and a halt in immunization activities routinely scheduled for preventable cancers. It caused a colossal shortage in the availability of appropriately trained medical personnel, reduced frequency and duration of outpatient consultations, and a delay in cancer investigations and diagnosis. It also stirred up the substandard modification of chemotherapy regimens and radiotherapy due to the scarcity of anticancer medications and radioisotopes and engendered the cancellation of cancer surgical procedures. Palliative care for patients with locally advanced and metastatic disease was in many cases interrupted and cancer research activities were abruptly deferred. Ultimately, these led to poor patient outcomes and increased cancer-related fatalities. However, a few African countries - Rwanda, Ghana, and Tunisia - have continued to adapt telemedicine, small unmanned aircraft systems (sUAS), and home therapy to facilitate cancer care. To date, there is a paucity of data concerning the successes and cost-effectiveness of these relatively new methods recently adapted to cater to the medical needs of cancer patients in Africa. The pandemic has presented the African community an opportunity to advance her healthcare systems, especially as it pertains to the delivery of medical care to persons with cancer. The need of the hour is to study further the alternative cancer care delivery systems initiated during the pandemic in order to determine their sustainability in Africa at large.
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Affiliation(s)
- Charles Ojo
- Emergency Department, United Lincolnshire Hospitals NHS Trust, Boston, GBR
| | - Chijioke Orji
- Trauma and Orthopaedics, Betsi Cadwaladr University Health Board, Wrexham, GBR
| | - Ayodeji Adedeji
- Emergency Department, Darlington Memorial Hospital, Durham, GBR
| | - Chibuike Nwachukwu
- Breast Surgery, St George's University Hospitals NHS Foundation Trust, London, GBR
| | - Ona Fagbemi
- General Surgery, University Hospital North Midlands, Stoke-on-Trent, GBR
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3
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Singh B, Palmer S, Maher C. Evaluation of a supportive care app for coordinating caring networks: an analysis of the first 19,000 users. Front Digit Health 2023; 5:1063277. [PMID: 37266027 PMCID: PMC10229897 DOI: 10.3389/fdgth.2023.1063277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/26/2023] [Indexed: 06/03/2023] Open
Abstract
Background Major illnesses such as cancer, and other traumatic life events, can lead to sudden increases in supportive care needs. This study aimed to describe engagement, acceptability and satisfaction with a supportive care networking app under real-world conditions. Methods A total of 10,952 individuals used the app during the study period (2018-2022). The app is designed to enable "captains" to assemble a network of friends and family members to provide timely, and individually tailored, supportive care (including assistance with tasks such as taking children to school, cooking meals, grocery shopping, and transport to appointments). Engagement was determined from server data, whilst acceptability and satisfaction were captured using purposed-designed surveys. Results Users were mostly female (76%) and aged between 30 and 49 years (61%). The most common reason for using the app was sudden illness (web: 81%; mobile: 64%). An average of 42 tasks were requested per network, with a 32% acceptance rate. Significantly more tasks were requested (web: 52.2 tasks per network; mobile: 31.7 tasks per network; p < 0.001) and accepted (web: 43.2%; mobile: 20.2%; p < 0.001) in the web app vs. the mobile app. Task requests in the web app most commonly related to food (43% of requested tasks), social (15% of requested tasks) and children (13% of requested tasks). The task acceptance rate differed by task categories (p < 0.001), with tasks relating to transport, medical appointments and children accepted at the highest rates (56%, 52% and 49%, respectively). Acceptability and satisfaction data suggested that the app was well received and overall, participants were satisfied with the app. Conclusion Findings suggested that this support care networking app achieved widespread uptake for a wide variety of supportive care tasks. Future research focused on optimizing engagement with the mobile app and examining the effectiveness of the app for improving patient and hospital outcomes is warranted.
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Affiliation(s)
- Ben Singh
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Susan Palmer
- Research and Development Department, The Gather Group Co, Gather Group, Elsternwick VIC, Australia
| | - Carol Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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4
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Obiefuna EC, Ojonta OI, Ogbuabor JE. The influence of COVID-19 pandemic and coping strategies on work operation of nonfarm household enterprises in Nigeria. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2023:1-16. [PMID: 37363036 PMCID: PMC10066960 DOI: 10.1007/s10668-023-03185-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 03/20/2023] [Indexed: 06/28/2023]
Abstract
The purpose of this study is to investigate how COVID-19 pandemic including some coping strategies such as hand wash with soap and food consumption influences work operation or performance of nonfarm household enterprises (NHEs) in Nigeria using 2020 Living Standard Measurement Survey data of 1728 sample size. This study departs from existing study in two ways: first, the study employs multinomial logistic regression technique to ascertain the determinants of work performance of nonfarm household enterprises in Nigeria. Second, the study focuses on nonfarm enterprises such as petty trade, road side automobile and cab drivers. The results show that COVID-19 pandemic is significant with negative influence on the work operation of NHEs in Nigeria. The result of the study also reveals that coping strategy such as hand wash with soap during the pandemic is an important driver of work performance or operation of NHEs in Nigeria. Another coping strategy like food consumption by nonfarm household enterprises shows insignificant influence on work operation which implies that there is no relationship between food consumption and work operation by NHEs in Nigeria. The policy recommendation of this study, among others, is that policies should focus on procurement of sanitary material for public use. This can be achieved through public sensitisation in terms of organising workshops and conferences.
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Affiliation(s)
| | - Obed I. Ojonta
- Department of Economics, University of Nigeria, Nsukka, Nigeria
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5
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Wright H, Turner A, Ennis S, Percy C, Loftus G, Clyne W, Matouskova G, Martin F. Digital peer-supported self-management, co-designed by people living with Long COVID: a mixed methods proof-of-concept study (Preprint). JMIR Form Res 2022; 6:e41410. [PMID: 36166651 PMCID: PMC9578526 DOI: 10.2196/41410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background There are around 1.3 million people in the United Kingdom with the devastating psychological, physical, and cognitive consequences of long COVID (LC). UK guidelines recommend that LC symptoms be managed pragmatically with holistic support for patients’ biopsychosocial needs, including psychological, emotional, and physical health. Self-management strategies, such as pacing, prioritization, and goal setting, are vital for the self-management of many LC symptoms. Objective This paper describes the codevelopment and initial testing of a digital intervention combining peer support with positive psychology approaches for self-managing the physical, emotional, psychological, and cognitive challenges associated with LC. The objectives of this study were to (1) codesign an intervention with and for people with LC; (2) test the intervention and study methods; (3) measure changes in participant well-being, self-efficacy, fatigue, and loneliness; and (4) understand the types of self-management goals and strategies used by people with LC. Methods The study used a pre-post, mixed methods, pragmatic, uncontrolled design. Digital intervention content was codeveloped with a lived-experience group to meet the needs uncovered during the intervention development and logic mapping phase. The resulting 8-week digital intervention, Hope Programme for Long COVID, was attended by 47 participants, who completed pre- and postprogram measures of well-being, self-efficacy, fatigue, and loneliness. Goal-setting data were extracted from the digital platform at the end of the intervention. Results The recruitment rate (n=47, 83.9%) and follow-up rate (n=28, 59.6%) were encouraging. Positive mental well-being (mean difference 6.5, P<.001) and self-efficacy (mean difference 1.1, P=.009) improved from baseline to postcourse. All goals set by participants mapped onto the 5 goal-oriented domains in the taxonomy of everyday self-management strategies (TEDSS). The most frequent type of goals was related to activity strategies, followed by health behavior and internal strategies. Conclusions The bespoke self-management intervention, Hope Programme for Long COVID, was well attended, and follow-up was encouraging. The sample characteristics largely mirrored those of the wider UK population with LC. Although not powered to detect statistically significant changes, the preliminary data show improvements in self-efficacy and positive mental well-being. Our next trial (ISRCTN: 11868601) will use a nonrandomized waitlist control design to further examine intervention efficacy.
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Affiliation(s)
- Hayley Wright
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Stuart Ennis
- Department of Cardiac Rehabilitation, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Atrium Health, Centre for Exercise and Health, Coventry, United Kingdom
| | - Carol Percy
- School of Psychological, Social and Behavioural Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Garry Loftus
- Hope For The Community Community Interest Company, Enterprise Hub, Coventry, United Kingdom
| | - Wendy Clyne
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Gabriela Matouskova
- Hope For The Community Community Interest Company, Enterprise Hub, Coventry, United Kingdom
| | - Faith Martin
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
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Social Entrepreneurship Opportunities via Distant Socialization and Social Value Creation. SUSTAINABILITY 2022. [DOI: 10.3390/su14063170] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Social entrepreneurs are catalysts for social change on account of social value creation and opportunity identification, thereby improving the quality of life. Their contribution to society is particularly significant in times of crises and pandemics. Hence, the world health crisis caused by the COVID-19 pandemic has increased the need for social entrepreneurship across the globe. Despite social entrepreneurship’s relevance in social value creation, the studies regarding opportunity identification in times of social distancing are particularly rare. This constructivist-qualitative research fills the gap by employing the EDraw Mind Map tool to explore how the COVID-19 pandemic in general, and social distancing in particular, have shaped entrepreneurial opportunities for social innovation. The findings from content analysis reveal that ICT-based services and industry 4.0 hold a promising future during and post-COVID-19 scenario. They can facilitate a transformation of the threats of social distancing into distant socialization benefits and demand fulfillment. Furthermore, the study contributes to providing a comprehensive depiction of the myriad of opportunities created by social entrepreneurs worldwide. It also guides aspiring social entrepreneurs to adopt such technologies and aim for social integration to ensure quality mental health, education, employment, and manufacturing services in low-resource and developing countries’ contexts, as they are severely impacted by the pandemic.
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Joseph A, Olatosi B, Haider MR, Adegboyega BC, Lasebikan NN, Aliyu UM, Ali-Gombe M, Jimoh MA, Biyi-Olutunde OA, Awofeso O, Fatiregun OA, Oboh EO, Nwachukwu E, Zubairu IH, Otene SA, Iyare OI, Andero T, Musbau AB, Ajose A, Onitilo AA. Patient's Perspective on the Impact of COVID-19 on Cancer Treatment in Nigeria. JCO Glob Oncol 2022; 8:e2100244. [PMID: 35157511 PMCID: PMC8853626 DOI: 10.1200/go.21.00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Because of the global COVID-19 pandemic, health care organizations introduced guidelines for modifications to health and cancer medical care delivery to mitigate transmission and ensure quality health outcomes. To examine the extent and impact of these modifications on oncology service disruptions in Nigeria, we surveyed oncology patients across selected public and private cancer treatment centers. Service interruptions because of the COVID-19 pandemic—Nigerian cancer patients' experience.![]()
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Affiliation(s)
- Adedayo Joseph
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Bankole Olatosi
- Health Services, Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA
| | | | | | - Usman M Aliyu
- Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Mutiu A Jimoh
- University College Hospital, Ibadan, Oyo, Nigeria.,Lakeshore Cancer Center, Lagos, Nigeria
| | | | - Opeyemi Awofeso
- Lagos University Teaching Hospital, Idiaraba, Lagos, Nigeria
| | | | | | | | | | | | | | | | | | - Azeezat Ajose
- Lagos University Teaching Hospital, Idiaraba, Lagos, Nigeria
| | - Adedayo A Onitilo
- Department of Oncology, Marshfield Clinic Health System, Marshfield, WI
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8
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Teixeira TOA, Carvalho LG, Camargo GG, De Domenico EBL. Cancer care in the COVID-19 era and psychosocial impacts on oncology nursing in Brazil. Ecancermedicalscience 2021; 15:1331. [PMID: 35211200 PMCID: PMC8816500 DOI: 10.3332/ecancer.2021.1331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Globally, Brazil has the third highest number of confirmed COVID-19 cases and the second highest number of deaths related to COVID-19 at the time of writing. Maintaining cancer care has been a challenge for patient safety and for the physical and mental health of oncology nurses. OBJECTIVES To describe which effects of the COVID-19 pandemic on cancer care could already be evaluated and to identify the psychosocial impact on cancer nurses in Brazil. METHOD Reflective, analytical, qualitative study. RESULTS Although the Brazilian cancer care policy has reached important achievements in overcoming access barriers to cancer diagnosis and treatment over the past decade, the COVID-19 pandemic has caused losses of timely access to health services for patients with cancer, which has compromised screening, early diagnosis and treatment, and patient follow-up. Oncology nurses have actively participated in the management and assistance strategies during the pandemic. This path has generated an increase in oncology nurses' workload, leading to physical and mental stress and anxiety related to the fear of contagion for themselves and their family. CONCLUSION The pandemic has affected the care of cancer patients, with the potential to suffer greater losses because of reductions in screening, early diagnosis and treatment, and patient follow-up. In addition to the worsening of the cancer setting, the COVID-19 pandemic has overwhelmed Brazilian oncology nurses, physically and mentally.
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Affiliation(s)
- Tamara Otsuru Augustinho Teixeira
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0002-3588-653X
| | - Leticia Gomes Carvalho
- Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0003-1719-6014
| | - Guilherme Gasparini Camargo
- Universidade Federal de São Carlos, Washington Luiz, s/n – São Carlos, SP 13565-905, Brazil,https://orcid.org/0000-0003-4310-892X
| | - Edvane Birelo Lopes De Domenico
- Department of Clinical and Surgical Nursing, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, 754, Napoleão de Barros Street, Vila Clementino, São Paulo, SP 04023-062, Brazil,https://orcid.org/0000-0001-7455-1727
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Murugan AK, Alzahrani AS. SARS-CoV-2: Emerging Role in the Pathogenesis of Various Thyroid Diseases. J Inflamm Res 2021; 14:6191-6221. [PMID: 34853527 PMCID: PMC8628126 DOI: 10.2147/jir.s332705] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) is asymptomatic in most cases, but it is impartible and fatal in fragile and elderly people. Heretofore, more than four million people succumbed to COVID-19, while it spreads to every part of the globe. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) induces various dysfunctions in many vital organs including the thyroid by utilizing ACE2 as a receptor for cellular entry. Emerging reports clearly show the involvement of SARS-CoV-2 in diverse thyroid disorders. Thus, this review article aims to review comprehensively all the recent developments in SARS-CoV-2-induced pathogenesis of thyroid diseases. The review briefly summarizes the recent key findings on the mechanism of SARS-CoV-2 infection, the role of ACE2 receptor in viral entry, SARS-CoV-2-activated molecular signaling in host cells, ACE2 expression in the thyroid, cytokine storm, and its vital role in thyroid dysfunction and long-COVID in relation to thyroid and autoimmunity. Further, it extensively discusses rapidly evolving knowledge on the potential part of SARS-CoV-2 in emerging various thyroid dysfunctions during and post-COVID-19 conditions which include subacute thyroiditis, Graves' diseases, Hashimoto’s thyroiditis, thyrotoxicosis, and other recent advances in further discerning the implications of this virus within thyroid dysfunction. Unraveling the pathophysiology of SARS-CoV-2-triggered thyroid dysfunctions may aid pertinent therapeutic options and management of these patients in both during and post-COVID-19 scenarios.
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Affiliation(s)
- Avaniyapuram Kannan Murugan
- Division of Molecular Endocrinology, Department of Molecular Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Ali S Alzahrani
- Division of Molecular Endocrinology, Department of Molecular Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia.,Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
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10
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Eysenbach G, Martin F, Clyne W, Clark CCT, Matouskova G, McGillion M, Turner A. A Digital Self-management Program (Help to Overcome Problems Effectively) for People Living With Cancer: Feasibility Randomized Controlled Trial. J Med Internet Res 2021; 23:e28322. [PMID: 34738912 PMCID: PMC8726569 DOI: 10.2196/28322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/25/2021] [Accepted: 08/02/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We present the results of a feasibility, randomized waitlist control group (CG) parallel design study with a 1:1 allocation ratio. Participants were randomized into an intervention group (IG) or a waitlist CG. The intervention was a 6-week digital self-management program, Help to Overcome Problems Effectively (HOPE), for people with cancer. OBJECTIVE This study aims to test the feasibility of a digitally delivered self-management program for people with cancer. This will inform the design of a definitive randomized controlled trial. In addition, a preliminary assessment of the impact of the HOPE program via secondary outcomes will be used to assess signals of efficacy in a trial context. METHODS Participants were drawn from an opportunity sample, referred by Macmillan Cancer Support, and were invited via email to participate in the study (N=61). Primary outcomes were rates of recruitment, retention, follow-up, completion and adherence, sample size and effect size estimation, and assessment of progression criteria for a definitive trial. Secondary outcomes were self-report measures of participants' positive mental well-being, depression, anxiety, and patient activation (ie, confidence in managing their cancer). The intervention and data collection took place on the web. RESULTS The recruitment rate was 77% (47/61). A total of 41 participants completed the baseline questionnaires and were randomized to either the IG (n=21) or the waitlist CG (n=20). The retention rate (attending all program sessions) was greater than 50% (all: 21/41, 51%, IG: 10/21, 48%; and CG: 11/20, 55%). The follow-up rate (completing all questionnaires) was greater than 80% (all: 33/41, 80%; IG: 16/21, 76%; and CG: 17/20, 85%). The completion rate (attending ≥3 sessions and completing all questionnaires) was greater than 60% (all: 25/41, 61%; IG: 13/21, 62%; and CG: 12/20, 60%). Engagement data showed that participants viewed between half (5.1/10, 51%) and three-quarters (12.2/16, 76%) of the pages in each session. CONCLUSIONS All progression criteria for a definitive trial were met, as supported by the primary outcome data. The IG showed improved postprogram scores on measures of positive mental well-being, depression, anxiety, and patient activation. A full-scale trial of the digital HOPE program for people with cancer will allow us to fully evaluate the efficacy of the intervention relative to a CG. TRIAL REGISTRATION ISRCTN Registry ISRCTN79623250; http://www.isrctn.com/ISRCTN79623250. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/24264.
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Affiliation(s)
| | - Faith Martin
- Centre for Intelligent Healthcare, Research Institute for Health and Wellbeing, Coventry University, Coventry, United Kingdom
| | - Wendy Clyne
- National Institute for Health Research, Research Design Service South West, Peninsula Medical School, University of Plymouth, Devon, United Kingdom
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Research Institute for Health and Wellbeing, Coventry University, Coventry, United Kingdom
| | - Gabriela Matouskova
- Hope For The Community, Community Interest Company, The Enterprise Hub, Coventry, United Kingdom
| | | | - Andrew Turner
- Centre for Intelligent Healthcare, Research Institute for Health and Wellbeing, Coventry University, Coventry, United Kingdom
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11
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Marthick M, McGregor D, Alison J, Cheema B, Dhillon H, Shaw T. Supportive Care Interventions for People With Cancer Assisted by Digital Technology: Systematic Review. J Med Internet Res 2021; 23:e24722. [PMID: 34714246 PMCID: PMC8590193 DOI: 10.2196/24722] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/01/2020] [Accepted: 09/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although relatively new, digital health interventions are demonstrating rapid growth because of their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision of supportive cancer care. OBJECTIVE This systematic review aims to evaluate digital health interventions for supportive cancer care. METHODS Published literature between 2000 and 2020 was systematically searched in MEDLINE, PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, and Scopus. Eligible publications were randomized controlled trials of clinician-led digital health interventions to support adult cancer patients. The interventions included were determined by applying a digital health conceptual model. Studies were appraised for quality using the revised Cochrane risk of bias tool. RESULTS Twenty randomized controlled trials met the inclusion criteria for the analysis. Interventions varied by duration, frequency, degree of technology use, and applied outcome measures. Interventions targeting a single tumor stream, predominantly breast cancer, and studies involving the implementation of remote symptom monitoring have dominated the results. In most studies, digital intervention resulted in significant positive outcomes in patient-reported symptoms, levels of fatigue and pain, health-related quality of life, functional capacity, and depression levels compared with the control. CONCLUSIONS Digital health interventions are helpful and effective for supportive care of patients with cancer. There is a need for high-quality research. Future endeavors could focus on the use of valid, standardized outcome measures, maintenance of methodological rigor, and strategies to improve patient and health professional engagement in the design and delivery of supportive digital health interventions. TRIAL REGISTRATION PROSPERO CRD42020149730; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=149730.
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Affiliation(s)
- Michael Marthick
- Research in Implementation Science and eHealth Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Deborah McGregor
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Jennifer Alison
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Sydney Local Health District, Sydney, Australia
| | - Birinder Cheema
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Haryana Dhillon
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, University of Sydney, Sydney, Australia
| | - Tim Shaw
- Research in Implementation Science and eHealth Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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12
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Marshall VK, Chavez M, Mason TM, Martinez‐Tyson D. Emergency preparedness during the COVID-19 pandemic: Perceptions of oncology professionals and implications for nursing management from a qualitative study. J Nurs Manag 2021; 29:1375-1384. [PMID: 34174005 PMCID: PMC8420290 DOI: 10.1111/jonm.13399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/05/2021] [Accepted: 06/22/2021] [Indexed: 01/09/2023]
Abstract
AIM To explore oncology health care professionals' perceptions of the COVID-19 pandemic response. BACKGROUND The pandemic has created health care delivery challenges globally and many countries have exhibited low readiness and emergency preparedness. METHODS A descriptive design using a qualitative approach was employed. Semi-structured interviews, which were completed via telephone, were audio recorded and transcribed verbatim. A thematic analysis was conducted. RESULTS Participants (N = 30) were mostly registered nurses (70%). Three themes emerged: (1) ability to adapt and operationalize disaster planning, training and restructure nursing models (subtheme: reactive vs. proactive approach to emergency preparedness); (2) COVID-19 task forces and professional organisations were critical for valid information surrounding the pandemic; and (3) recommendations for emergency preparedness/planning for future pandemics. CONCLUSION Oncology organisations adapted during the pandemic, but policies and procedures were perceived as reactive and not proactive. Recommendations for planning for future pandemics included (1) adequate personal protective equipment, (2) developing cancer-specific guidelines/algorithms and (3) telehealth training related to billing/reimbursement. Professional organisations were reliable resources of information during the pandemic, but oncology professionals ultimately trusted employers and administration to distribute information needed for safe patient care. IMPLICATIONS FOR NURSING MANAGEMENT Frontline nurses should hold positions on task forces to develop future emergency preparedness.
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Affiliation(s)
| | - Melody Chavez
- College of Public HealthUniversity of South FloridaTampaFloridaUSA
| | - Tina M. Mason
- H. Lee Moffitt Cancer Center and Research InstituteTampaFloridaUSA
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13
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Spartalis E, Plakopitis N, Theodori MA, Karagiannis SP, Athanasiadis DI, Spartalis M, Boutzios G, Paschou SA, Nikiteas N, Troupis T. Thyroid cancer surgery during the coronavirus disease 2019 pandemic: perioperative management and oncological and anatomical considerations. Future Oncol 2021; 17:4389-4395. [PMID: 34431326 PMCID: PMC8386469 DOI: 10.2217/fon-2021-0585] [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] [Indexed: 12/28/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has changed many aspects of our everyday lives and medical practice, including oncology treatment; thyroid cancer surgery is not an exception. The reported number of fine-needle aspirations performed during the first semester of 2020 was significantly reduced. Poorly differentiated, medullary and anaplastic thyroid tumors are considered important indications for immediate surgical intervention. By contrast, most well-differentiated carcinomas present slow growth, and thus surgery can be deferred for a short period of time during which patients are under active surveillance. Thyroid surgeries have decreased during the COVID-19 pandemic. Furthermore, prior to any intervention, negative COVID-19 status - with the use of a nasopharyngeal swab and reverse transcription PCR assay as the gold standard and chest CT scan as a complementary modality in some cases - must be confirmed to achieve a COVID-free pathway. Thorough preoperative assessment regarding both oncological and anatomical aspects should be performed to identify optimal timing for safe management.
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Affiliation(s)
- Eleftherios Spartalis
- Laboratory of Experimental Surgery & Surgical Research 'N S Christeas', Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece.,Department of Anatomy, Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Nikolaos Plakopitis
- Laboratory of Experimental Surgery & Surgical Research 'N S Christeas', Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Maria Anna Theodori
- Laboratory of Experimental Surgery & Surgical Research 'N S Christeas', Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Sotirios P Karagiannis
- Laboratory of Experimental Surgery & Surgical Research 'N S Christeas', Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | | | - Michael Spartalis
- Laboratory of Experimental Surgery & Surgical Research 'N S Christeas', Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Georgios Boutzios
- Department of Pathophysiology, Endocrine Unit, Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Stavroula A Paschou
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National & Kapodistrian University of Athens, Athens, 11528, Greece
| | - Nikolaos Nikiteas
- Second Department of Propaedeutic Surgery, Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Theodore Troupis
- Department of Anatomy, Medical School, National & Kapodistrian University of Athens, Athens, 11527, Greece
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14
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Beukes EW, Lourenco MPCG, Biot L, Andersson G, Kaldo V, Manchaiah V, Jacquemin L. Suggestions for shaping tinnitus service provision in Western Europe: Lessons from the COVID-19 pandemic. Int J Clin Pract 2021; 75:e14196. [PMID: 33837639 PMCID: PMC8250123 DOI: 10.1111/ijcp.14196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/27/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tinnitus severity has been exacerbated because of the COVID-19 pandemic and those with tinnitus require additional support. Such support should be informed by patient preferences and needs. The objective of this study was to gather information from individuals with tinnitus living in Europe to inform stakeholders of the (a) support they needed in relation to changes associated with the COVID-19 pandemic and (b) suggestions regarding tinnitus care for the future. METHODS A cross-sectional mixed method study design was used using closed and open-ended questions via an online survey. Data were gathered from 710 adults experiencing tinnitus in Western Europe, with the majority living in The Netherlands, Belgium and Sweden. Data were analysed using qualitative content analysis and descriptive statistics. RESULTS Those with tinnitus indicated the following support needs during the pandemic (a) support for tinnitus, (b) support for hearing-related difficulties, (c) social support and (d) pandemic-related support. Five directions for future tinnitus care were provided, namely, (a) need for understanding professional support and access to multidisciplinary experts, (b) greater range of therapies and resources, (c) access to more information about tinnitus, (d) prioritising tinnitus research and (e) more support for hearing protection and hearing loss prevention. CONCLUSIONS The findings point to the need for accessible (remote), patient-centred, suitable and evidence-based tinnitus care. Insights from the current study can be used by various stakeholders including clinical practitioners and tinnitus support services to ensure those with tinnitus have access to the help and support required in order to reduce service provision insufficiencies.
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Affiliation(s)
- Eldré W. Beukes
- Department of Speech and Hearing SciencesLamar UniversityBeaumontTXUSA
- Department of Vision and Hearing SciencesAnglia Ruskin UniversityCambridgeUK
| | - Matheus P. C. G. Lourenco
- Experimental Health PsychologyMaastricht UniversityMaastrichtThe Netherlands
- Research Group Health PsychologyKU Leuven UniversityLeuvenBelgium
| | - Lana Biot
- Faculty of BiomedicalPharmaceuticals and Veterinary SciencesUniversity of AntwerpAntwerpBelgium
| | - Gerhard Andersson
- Department of Behavioral Sciences and LearningDepartment of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Viktor Kaldo
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of PsychologyFaculty of Health and Life SciencesLinnaeus UniversityVäxjöSweden
| | - Vinaya Manchaiah
- Department of Speech and Hearing SciencesLamar UniversityBeaumontTXUSA
- Department of Speech and HearingSchool of Allied Health SciencesManipal UniversityManipalKarnatakaIndia
| | - Laure Jacquemin
- Department of Translational NeurosciencesFaculty of Medicine and Health SciencesUniversity of AntwerpWilrijkBelgium
- Department of Otorhinolaryngology and Head and Neck SurgeryAntwerp University HospitalEdegemBelgium
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15
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COVID-19 in Patients with Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:315-331. [PMID: 33973186 DOI: 10.1007/978-3-030-63761-3_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With more than 5 million cases and 333,212 deaths, COVID-19 (or SARS-CoV-2) continues to spread. General symptoms of this disease are similar to that of many other viral respiratory diseases, including fever, cough, dyspnea, and fatigue, with a chance of progression to more severe complications. However, the virus does not affect all people equally, and cases with comorbidities such as malignancies, cardiovascular diseases, respiratory diseases, and kidney diseases are at higher risk of developing severe events, including requiring intensive ventilation, intensive care unit (ICU) admission, and death. Patients with cancer are more likely to be infected with COVID-19, which is possibly due to their immunological dysfunction or frequent clinic visits. Also, there is a higher chance that these patients experience severe events because of the medication they receive. In this chapter, we will review the main clinical manifestations of COVID-19 in patients with cancer. Recommendations and challenges for managing resources, organizing cancer centers, treatment of COVID-19-infected cancer patients, and performing cancer research during this pandemic will also be discussed.
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16
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Kaiser FK, Wiens M, Schultmann F. Use of digital healthcare solutions for care delivery during a pandemic-chances and (cyber) risks referring to the example of the COVID-19 pandemic. HEALTH AND TECHNOLOGY 2021; 11:1125-1137. [PMID: 33875933 PMCID: PMC8046498 DOI: 10.1007/s12553-021-00541-x] [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: 12/02/2020] [Accepted: 03/07/2021] [Indexed: 12/12/2022]
Abstract
During pandemics, regular service provisioning processes in medical care may be disrupted. Digital health promises many opportunities for service provisioning during a pandemic. However, a broad penetration of medical processes with information technology also has drawbacks. Within this work, the authors use the COVID-19 pandemic to analyze the chances and the risks that may come with using digital health solutions for medical care during a pandemic. Therefore, a multi-methods approach is used. First we use a systematic literature review for reviewing the state of the art of digital health applications in healthcare. Furthermore, the usage of digital health applications is mapped to the different processes in care delivery. Here we provide an exemplary process model of oncological care delivery. The analysis shows that including digital health solutions may be helpful for care delivery in most processes of medical care provisioning. However, research on digital health solutions focuses strongly on some few processes and specific disciplines while other processes and medical disciplines are underrepresented in literature. Last, we highlight the necessity of a comprehensive risk-related debate around the effects that come with the use of digital healthcare solutions.
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Affiliation(s)
- Florian Klaus Kaiser
- Institute for Industrial Production (IIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Marcus Wiens
- Institute for Industrial Production (IIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Frank Schultmann
- Institute for Industrial Production (IIP), Karlsruhe Institute of Technology, Karlsruhe, Germany
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17
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Bandinelli L, Ornell F, von Diemen L, Kessler FHP. The Sum of Fears in Cancer Patients Inside the Context of the COVID-19. Front Psychiatry 2021; 12:557834. [PMID: 33897477 PMCID: PMC8058213 DOI: 10.3389/fpsyt.2021.557834] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/27/2021] [Indexed: 12/14/2022] Open
Abstract
The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies.
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Affiliation(s)
- Lucas Bandinelli
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Queen's University Department of Psychiatry, Providence Care Hospital, Kingston, ON, Canada
| | - Felix Henrique Paim Kessler
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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18
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Nahshon C, Segev Y, Schmidt M, Bar-Noy T, Ostrovsky L, Lavie O. Outcomes of diagnosed COVID-19 cancer patients: concerning results of a systematic review. J Chemother 2021; 33:528-538. [PMID: 33769233 DOI: 10.1080/1120009x.2021.1899442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Since the outbreak of coronavirus disease 2019 (COVID-19), malignancy was shown to be prevalent in COVID-19 patients. This systematic review's searches were conducted in MEDLINE(R), Embase, Web of Science, and Scopos. Considered for inclusion were all reports on outcomes of cancer patients diagnosed with COVID-19. A total of 1099 references were identified through database searching and manual search. Finally, 17 references comprising 88 cancer patients, diagnosed with COVID-19, were included. Prevalence of cancer patients with COVID-19 was shown to range from 0.9% to 3%. The evidence suggested a severe clinical course of 50.6% in COVID-19 diagnosed cancer patients and a mortality rate of 34.5%. Subgroup analysis according to recent anti-cancer treatment showed a similar pattern, with the most concerning results in patients receiving recent immunotherapy/immunosuppressive treatment. COVID-19 morbidity and mortality among cancer patients should be reduced by consideration of testing asymptomatic COVID-19 cancer patients, reduction of hospital visits, and consideration of anti-cancer treatment.
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Affiliation(s)
- C Nahshon
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
| | - Y Segev
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
| | - M Schmidt
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
| | - T Bar-Noy
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
| | - L Ostrovsky
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
| | - O Lavie
- Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel
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19
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Corso CR, Mulinari Turin de Oliveira N, Maria-Ferreira D. Susceptibility to SARS-CoV-2 infection in patients undergoing chemotherapy and radiation therapy. J Infect Public Health 2021; 14:766-771. [PMID: 34022735 PMCID: PMC7980522 DOI: 10.1016/j.jiph.2021.03.008] [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] [Received: 09/04/2020] [Revised: 02/22/2021] [Accepted: 03/14/2021] [Indexed: 01/08/2023] Open
Abstract
The outbreak of the new coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly become a public health emergency of international concern, especially affecting the elderly people and patients with chronic disease, such as hypertension and respiratory syndromes. Patients undergoing chemotherapy treatment (e.g., bleomycin, cyclophosphamide, methotrexate, monoclonal antibodies, and paclitaxel therapy) are vulnerable to the development of respiratory syndromes induced by chemotherapeutic agents and are also more susceptible to viral infections as they are immunosuppressed. Neutropenia is an important risk factor for increased vulnerability to infections, as a respiratory syndrome involves an array of immune cells maintaining the balance between pathogen clearance and immunopathology. However, the differential diagnosis of pulmonary symptoms in cancer patients is broad, with complications being related to the malignancy itself, treatment toxicity, and infections. The risk factors depend on the specific type of cancer, chemotherapy, patient characteristics, and comorbidities. Thus, this review discusses the main events implicated in immunosuppression caused by chemotherapy and radiation therapy and the association of immunosuppression and other factors with SARS-CoV-2 infection susceptibility in cancer patients; and, importantly, how to deal with this situation in face of the current pandemic scenario.
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Affiliation(s)
- Claudia Rita Corso
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil; Programa de Pós-graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil
| | - Natalia Mulinari Turin de Oliveira
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil; Programa de Pós-graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil
| | - Daniele Maria-Ferreira
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil; Programa de Pós-graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil.
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20
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Xie J, Zhong R, Wang W, Chen O, Zou Y. COVID-19 and Smoking: What Evidence Needs Our Attention? Front Physiol 2021; 12:603850. [PMID: 33815131 PMCID: PMC8012895 DOI: 10.3389/fphys.2021.603850] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/26/2021] [Indexed: 12/21/2022] Open
Abstract
The current COVID-19 pandemic has caused severe morbidity and mortality worldwide. Although relevant studies show that the smoking rate of COVID-19 patients is relatively low, the current smoking status of people with COVID-19 cannot be accurately measured for reasons. Thus, it is difficult to assess the relationship between smoking and COVID-19. Smoking can increase the risk of severe COVID-19 symptoms and aggravate the condition of patients with COVID-19. Nicotine upregulates the expression of ACE2, which can also increase susceptibility to COVID-19, aggravatiing the disease. Although nicotine has certain anti-inflammatory effects, there is no evidence that it is related to COVID-19 treatment; therefore, smoking cannot be considered a preventative measure. Furthermore, smokers gathering and sharing tobacco may promote the spread of viruses. Despite the COVID-19 epidemic, the findings suggested that COVID-19 has not encouraged smokers to quit. Additionally, there is evidence that isolation at home has contributed to increased smoking behavior and increased quantities. Therefore, it is recommended that governments increase smoking cessation messaging as part of public health measures to contain the COVID-19 pandemic. This review analyzes the existing research on smoking's impact on COVID-19 so that governments and medical institutions can develop evidence-based smoking-related prevention and control measures for COVID-19.
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Affiliation(s)
- Jianghua Xie
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Rui Zhong
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Wang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ouying Chen
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yanhui Zou
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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21
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Low JL, Huang Y, Sooi K, Ang Y, Chan ZY, Spencer K, Jeyasekharan AD, Sundar R, Goh BC, Soo R, Yong WP. Low-dose pembrolizumab in the treatment of advanced non-small cell lung cancer. Int J Cancer 2021; 149:169-176. [PMID: 33634869 PMCID: PMC9545741 DOI: 10.1002/ijc.33534] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/01/2021] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
A dose of 200 mg 3‐weekly of pembrolizumab was approved by the Food and Drug Administration (FDA) as treatment for advanced non‐small cell lung cancer (NSCLC) without oncogenic drivers. This is despite evidence showing no difference in efficacy with 2 mg/kg. Our study aimed to assess the efficacy of a lower fixed dose of 100 mg, which is closer to 2 mg/kg weight‐based dose in an average‐sized Asian patient. All patients receiving pembrolizumab for advanced NSCLC from January 2016 to March 2020 in National University Hospital, Singapore, were included in this retrospective observational study. The effect of pembrolizumab 100 mg (Pem100) vs 200 mg (Pem200) upon survival outcomes, toxicity and cost were examined. One hundred fourteen patients received pembrolizumab. Sixty‐five (57%) and 49 (43%) received Pem100 and Pem200, respectively. There was no difference in progression‐free survival (PFS) and overall survival (OS) between Pem100 vs Pem200 as a single agent (PFS: 6.8 vs 4.2 months, hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.36‐1.46, P = .36; 9 month OS: 58% vs 63%, HR 1.08, 95% CI 0.48‐2.41, P = .86) and when combined with chemotherapy (9‐month PFS: 60% vs 50%, HR0.84, 95% CI 0.34‐2.08, P = .71; 9‐month OS: 85% vs 58%, HR 0.27, 95% CI 0.062‐1.20, P = .09). No significant difference in response rate or ≥G3 immune‐related toxicities between Pem100 and Pem200 was observed. A cost minimisation analysis evaluating the degree of cost savings related to drug costs estimated a within study cost saving of SGD4,290,912 and cost saving per patient of SGD39,942 in the Pem100 group. A 100 mg of pembrolizumab appears to be effective with reduction in cost. A randomised trial should be done to investigate a lower dose of pembrolizumab.
What's new?
Pembrolizumab, a monoclonal antibody directed against the PD‐1 receptor, has received FDA approval for the treatment of lung cancer at a fixed dose of 200 mg every 3 weeks. However, doses above 2 mg/kg show a lack of benefit, calling for further evaluation in Asian populations. This retrospective observational study demonstrates the efficacy of a lower fixed dose of pembrolizumab (100 mg every 3 weeks) compared with standard‐dose pembrolizumab. The results also confirm the clinical activity of pembrolizumab at a lower dose than 2 mg/kg every 3 weeks, which could provide considerable cost savings to patients and the health system.
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Affiliation(s)
- Jia Li Low
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore
| | - Yiqing Huang
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore
| | - Kenneth Sooi
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore
| | - Yvonne Ang
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore
| | - Zhi Yao Chan
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore.,Department of Pharmacy, National University Hospital, National University Health System, Singapore, Singapore
| | - Katie Spencer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Anand Devaprasath Jeyasekharan
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore.,Cancer Science Institute, Singapore (CSI), Singapore, Singapore
| | - Raghav Sundar
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore
| | - Boon Cher Goh
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore.,Cancer Science Institute, Singapore (CSI), Singapore, Singapore
| | - Ross Soo
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore.,Cancer Science Institute, Singapore (CSI), Singapore, Singapore
| | - Wei Peng Yong
- Department of Haematology-Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore.,Cancer Science Institute, Singapore (CSI), Singapore, Singapore
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22
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Grossheim L, Ruff P, Ngoma T, Vanderpuye V, Mwango G, Ochieng P, Palmer D, Kouya F, Lasebikan N, Ntekim A, Ngoma M, Bih N, Malloum A, Elzawawy A, Kerr D, Ngwa W. Cancer and COVID-19 Experiences at African Cancer Centers: The Silver Lining. JCO Glob Oncol 2021; 7:410-415. [PMID: 33760639 PMCID: PMC8081519 DOI: 10.1200/go.20.00564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The COVID-19 pandemic significantly disrupted cancer care in Africa, further exposing major health disparities. This paper compares and contrasts the experiences of 15 clinicians in six different African cancer centers to highlight the positive aspects (silver linings) in an otherwise negative situation. METHODS Data are from personal experience of the clinicians working at the six cancer centers blended with what is available in the literature. RESULTS The impact of COVID-19 on cancer care appeared to vary not only across the continent but also over cancer centers. Different factors such as clinic location, services offered, available resources, and level of restrictions imposed because of COVID-19 were associated with these variations. Collectively, delays in treatment and limited access to cancer care were commonly reported in the different regions. CONCLUSION There is a lack of data on cancer patients with COVID-19 and online COVID-19 and cancer registries for Africa. Analysis of the available data, however, suggests a higher mortality rate for cancer patients with COVID-19 compared with those without cancer. Positive or silver linings coming out of the pandemic include the adoption of hypofractionated radiation therapy and teleoncology to enhance access to care while protecting patients and staff members. Increasing collaborations using online technology with oncology health professionals across the world are also being seen as a silver lining, with valuable sharing of experiences and expertise to improve care, enhance learning, and reduce disparities. Advanced information and communication technologies are seen as vital for such collaborations and could avail efforts in dealing with the ongoing pandemic and potential future crises.
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Affiliation(s)
| | - Paul Ruff
- University of the Witwatersrand, Johannesburg, South Africa
| | - Twalib Ngoma
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Verna Vanderpuye
- National Center for Radiotherapy, Korlebu Teaching Hospital, Accra, Ghana
| | | | | | | | | | | | | | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Noella Bih
- Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | | | | | - David Kerr
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Wilfred Ngwa
- Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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23
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Nnaji CA, Moodley J. Impact of the COVID-19 pandemic on cancer diagnosis, treatment and research in African health systems: a review of current evidence and contextual perspectives. Ecancermedicalscience 2021; 15:1170. [PMID: 33680084 PMCID: PMC7929764 DOI: 10.3332/ecancer.2021.1170] [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: 10/07/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has immensely disrupted health care services globally. The pandemic has been particularly disruptive for cancer services and more so in low-resource settings. In this narrative review, we highlight the reported impact of the COVID-19 pandemic on cancer prevention, screening, diagnosis, treatment and research across the African continent. We also explore ways in which identified structural and contextual constraints can be navigated for the re-escalation of oncological activities, while discussing how the pandemic has necessitated the reimagination of how oncology services can be delivered now and in the future. We conducted a literature search of MEDLINE (via PubMed) and Scopus for relevant articles and synthesised the findings thematically. In spite of the dearth of data, available evidence suggests a substantial impact of the pandemic on the various aspects of cancer management in African countries. Aggravating factors include pre-existing health system and cancer management gaps in many countries within the region, which are typically faced with inadequate availability of oncology resources, oncologists and other vital resources; in addition to the acute and lingering consequences of social distancing, movement restrictions and other public health measures implemented to contain the spread of the virus. As the pandemic evolves and movement restrictions are eased, there is a need for the timely and safe return to normal oncological care. This will require a risk-adjusted and multidisciplinary approach, with the aim of mitigating the further impact of the disruption on cancer patients, their families and healthcare providers.
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Affiliation(s)
- Chukwudi A Nnaji
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town; Anzio Road, Observatory, 7925 Cape Town, South Africa.,Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925 Cape Town, South Africa
| | - Jennifer Moodley
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town; Anzio Road, Observatory, 7925 Cape Town, South Africa.,Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925 Cape Town, South Africa.,SAMRC Gynaecology Cancer Research Centre, University of Cape Town, 7925 Cape Town, South Africa
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Wright H, Martin F, Clyne W, Clark CCT, McGillion M, Matouskova G, Turner A. A Digital Program (Hope) for People Living With Cancer During the COVID-19 Pandemic: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e24264. [PMID: 33237877 PMCID: PMC7721632 DOI: 10.2196/24264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 12/23/2022] Open
Abstract
Background During the COVID-19 lockdown period in the United Kingdom that began on March 23, 2020, more than a quarter of a million people with cancer reported worsening mental health. Help to Overcome Problems Effectively (Hope) is a self-management program for people with cancer, designed to provide support for distress, unmet needs, and poor psychological health. In light of social distancing during the COVID-19 pandemic, digital delivery of the Hope Programme has become ever more vital for people with cancer. Previous pre-post studies of the digital Hope Programme have found reduced anxiety and depression and improved well-being for people with cancer. However, evaluation of this evidence has been limited by the lack of a control group in these previous studies. Objective We now present a protocol for a feasibility randomized controlled trial of the digital Hope Programme for people with cancer during the COVID-19 pandemic. Primary outcomes will be recruitment, dropout, and adherence rates, and estimations of sample and effect size. To detect signals of efficacy, secondary outcomes will be participant mental health and well-being. Methods Participants will be recruited by Macmillan Cancer Support (MCS) through their social media networks. The study will employ a feasibility wait-list randomized controlled trial (RCT) design, with people with cancer being randomized to join the digital Hope Programme immediately (intervention group [IG]) or join a 6-week waiting list (wait-list control group [WLCG]) with a 1:1 allocation ratio. Participants will complete digital measures of depression, anxiety, mental well-being, and confidence in managing their own health. Online questionnaires will be administered preprogram and 6 weeks postprogram. Results All people who had requested access to the Hope Programme from MCS (N=61) will be invited to participate in the trial. Baseline data collection commenced in April 2020, and the Hope Programme began for the IG in May 2020 and for the WLCG in June 2020. Postprogram data collection was completed by the end of August 2020. Conclusions This feasibility study will provide data to inform the design of a future definitive trial. Wider-scale provision of the digital Hope Programme has potential to improve the lives of thousands of people with cancer and reduce the burden on health care providers during these unprecedented times. Trial Registration ISRCTN Registry ISRCTN79623250; http://www.isrctn.com/ISRCTN79623250 International Registered Report Identifier (IRRID) DERR1-10.2196/24264
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Affiliation(s)
- Hayley Wright
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Faith Martin
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Wendy Clyne
- National Institute for Health Research, Research Design Service South West, Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | | | - Gabriela Matouskova
- Hope For The Community, Community Interest Company, The Enterprise Hub, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
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25
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Jammu AS, Chasen MR, Lofters AK, Bhargava R. Systematic rapid living review of the impact of the COVID-19 pandemic on cancer survivors: update to August 27, 2020. Support Care Cancer 2020; 29:2841-2850. [PMID: 33242162 PMCID: PMC7690065 DOI: 10.1007/s00520-020-05908-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/20/2020] [Indexed: 12/26/2022]
Abstract
Background The COVID-19 pandemic has resulted in drastic changes in the global healthcare delivery landscape and has had practical repercussions for cancer survivors. This systematic rapid living review has been undertaken to synthesise the available knowledge regarding the impact of the COVID-19 pandemic in a timely manner. This initial rapid review will present the findings of literature published up to August 27, 2020. Design A systematic search of PubMed, Scopus and Google Scholar databases was conducted to identify all articles, available in English language, regarding the impact of the COVID-19 pandemic on cancer survivors published between December 2019 and August 27, 2020. The search strategy employed the following search strings: “covid-19 OR coronavirus OR sars-cov-2” with “cancer survivors OR cancer survivorship”. Results The database search yielded 1639 articles, of which 19 were included. Of the 19 selected articles, there were 12 expert opinion articles, two literature reviews, two prospective cohort studies, one retrospective cohort study, one descriptive study and one pooled meta-analysis that comment on the impact of the COVID-19 pandemic on the physical wellbeing (16 articles), psychosocial wellbeing (15 articles) and financial wellbeing of cancer survivors (3 articles). Conclusions Limited definitive evidence exists regarding the impact of the COVID-19 pandemic on cancer survivors. Currently available literature provides preliminary indications of wide-ranging impacts of the pandemic on cancer survivors with respect to the requirement to adapt to new means of healthcare delivery as well as their physical, psychosocial and economic wellbeing. The pandemic has left survivors dealing with the consequences of rigorous cancer treatment in the context of new challenges related to social isolation, financial hardship and uncertainty with respect to their ongoing care. Additional rigorously designed research initiatives are required to elucidate the impact of the pandemic on cancer survivors.
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Affiliation(s)
- Anish Singh Jammu
- Global Health Program, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Martin Robert Chasen
- Division of Palliative Care, William Osler Health System, 2100 Bovaird Dr E, Brampton, ON, L6R 3J7, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
- The Global Institute of Psychosocial, Palliative and End-of-Life Care, University of Toronto, Toronto, Ontario, Canada.
| | - Aisha Kamilah Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Family Practice Health Centre, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Ravi Bhargava
- The Global Institute of Psychosocial, Palliative and End-of-Life Care, University of Toronto, Toronto, Ontario, Canada
- PHMI Program Queen's University, Kingston, ON, Canada
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26
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Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature. J Med Internet Res 2020; 22:e22280. [PMID: 33079693 PMCID: PMC7652596 DOI: 10.2196/22280] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/25/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is favoring digital transitions in many industries and in society as a whole. Health care organizations have responded to the first phase of the pandemic by rapidly adopting digital solutions and advanced technology tools. OBJECTIVE The aim of this review is to describe the digital solutions that have been reported in the early scientific literature to mitigate the impact of COVID-19 on individuals and health systems. METHODS We conducted a systematic review of early COVID-19-related literature (from January 1 to April 30, 2020) by searching MEDLINE and medRxiv with appropriate terms to find relevant literature on the use of digital technologies in response to the pandemic. We extracted study characteristics such as the paper title, journal, and publication date, and we categorized the retrieved papers by the type of technology and patient needs addressed. We built a scoring rubric by cross-classifying the patient needs with the type of technology. We also extracted information and classified each technology reported by the selected articles according to health care system target, grade of innovation, and scalability to other geographical areas. RESULTS The search identified 269 articles, of which 124 full-text articles were assessed and included in the review after screening. Most of the selected articles addressed the use of digital technologies for diagnosis, surveillance, and prevention. We report that most of these digital solutions and innovative technologies have been proposed for the diagnosis of COVID-19. In particular, within the reviewed articles, we identified numerous suggestions on the use of artificial intelligence (AI)-powered tools for the diagnosis and screening of COVID-19. Digital technologies are also useful for prevention and surveillance measures, such as contact-tracing apps and monitoring of internet searches and social media usage. Fewer scientific contributions address the use of digital technologies for lifestyle empowerment or patient engagement. CONCLUSIONS In the field of diagnosis, digital solutions that integrate with traditional methods, such as AI-based diagnostic algorithms based both on imaging and clinical data, appear to be promising. For surveillance, digital apps have already proven their effectiveness; however, problems related to privacy and usability remain. For other patient needs, several solutions have been proposed, such as telemedicine or telehealth tools. These tools have long been available, but this historical moment may actually be favoring their definitive large-scale adoption. It is worth taking advantage of the impetus provided by the crisis; it is also important to keep track of the digital solutions currently being proposed to implement best practices and models of care in future and to adopt at least some of the solutions proposed in the scientific literature, especially in national health systems, which have proved to be particularly resistant to the digital transition in recent years.
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Affiliation(s)
- Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Erik Boetto
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gherardo Carullo
- Department of Italian and Supranational Public Law, University of Milan, Milan, Italy
| | | | | | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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27
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Manasanch EE, Mulanovich V, Manzano JG, Gaeta MS, Becnel M, Kaufman GP, Lee HC, Amini B, Thomas SK, Iyer SP, Weber DM, Berkova Z, Flowers CR, Orlowski RZ, Patel KK. SARS-CoV-2 in multiple myeloma: initial observation and management. Leuk Lymphoma 2020; 61:2763-2766. [PMID: 33167721 PMCID: PMC8092112 DOI: 10.1080/10428194.2020.1780588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/27/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Elisabet E Manasanch
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Victor Mulanovich
- Department of Internal Medicine/Infectious Disease, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joanna-Grace Manzano
- Department of Internal Medicine/Infectious Disease, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maria Susan Gaeta
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Melody Becnel
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gregory P Kaufman
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hans C Lee
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Behrang Amini
- Radiodiagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sheeba K Thomas
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan P Iyer
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Donna M Weber
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zuzana Berkova
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher R Flowers
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Z Orlowski
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Krina K Patel
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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28
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Jahani M, Dokaneheifard S, Mansouri K. Hypoxia: A key feature of COVID-19 launching activation of HIF-1 and cytokine storm. JOURNAL OF INFLAMMATION-LONDON 2020; 17:33. [PMID: 33139969 PMCID: PMC7594974 DOI: 10.1186/s12950-020-00263-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
COVID-19, disease caused by the new coronavirus, SARS-CoV-2, appeared in the end of 2019 and was rapidly spread in most countries. This respiratory virus has different symptoms from moderate to severe, and results in lung pneumonia following acute respiratory distress syndrome (ARDS) and patient’s death in severe cases. ARDS is a severe form of acute lung injury that is caused by high inflammatory response of the innate immunity cells. Hypoxia is the common feature in the inflammatory sites with having various impacts on this condition by induction of some factors such as hypoxia inducible factor-1α (HIF-1α). HIF-1α regulates some important cellular processes including cell proliferation, metabolism and angiogenesis. Furthermore, this factor is activated during the immune responses and plays important roles in the inflammation site by inducing pro-inflammatory cytokines production through immune cells. So, in this study the possible effect of the HIF-1α on the COVID-19 pathogenesis with emphasizes on its role on innate immunity response has been discussed.
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Affiliation(s)
- Mozhgan Jahani
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sadat Dokaneheifard
- Department of Human Genetics, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida 33136 USA
| | - Kamran Mansouri
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Molecular Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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29
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Kooshkaki O, Derakhshani A, Conradie AM, Hemmat N, Barreto SG, Baghbanzadeh A, Singh PK, Safarpour H, Asadzadeh Z, Najafi S, Brunetti O, Racanelli V, Silvestris N, Baradaran B. Coronavirus Disease 2019: A Brief Review of the Clinical Manifestations and Pathogenesis to the Novel Management Approaches and Treatments. Front Oncol 2020; 10:572329. [PMID: 33194671 PMCID: PMC7658542 DOI: 10.3389/fonc.2020.572329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022] Open
Abstract
The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) in China, which spread to the rest of the world, led the World Health Organization to classify it as a global pandemic. COVID-19 belongs to the Bettacoronavirus genus of the Coronaviridae family, and it mainly spreads through the respiratory tract. Studies have now confirmed a human-to-human transmission as the primary pathway of spread. COVID-19 patients with a history of diseases such as respiratory system diseases, immune deficiency, diabetes, cardiovascular disease, and cancer are prone to adverse events (admission to the intensive care unit requiring invasive ventilation or even death). The current focus has been on the development of novel therapeutics, including antivirals, monoclonal antibodies, and vaccines. However, although there is undoubtedly an urgent need to identify effective treatment options against infection with COVID-19, it is equally important to clarify management protocols for the other significant diseases from which these patients may suffer, including cancer. This review summarizes the current evidence regarding the epidemiology, pathogenesis, and management of patients with COVID-19. It also aims to provide the reader with insights into COVID-19 in pregnant patients and those with cancer, outlining necessary precautions relevant to cancer patients. Finally, we provide the available evidence on the latest potent antiviral drugs and vaccines of COVID-19 and the ongoing drug trials.
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Affiliation(s)
- Omid Kooshkaki
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
- Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran
| | - Afshin Derakhshani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II” of Bari, Bari, Italy
| | | | - Nima Hemmat
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Savio George Barreto
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Amir Baghbanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pankaj Kumar Singh
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, United States
| | - Hossein Safarpour
- Cellularand Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Asadzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Souzan Najafi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Oronzo Brunetti
- Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II” of Bari, Bari, Italy
| | - Vito Racanelli
- Department of Biomedical Sciences and Human Oncology, University of Bari “AldoMoro”, Bari, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II” of Bari, Bari, Italy
- Department of Biomedical Sciences and Human Oncology, University of Bari “AldoMoro”, Bari, Italy
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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30
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Adesunkanmi AO, Ubom AE, Olasehinde O, Fasubaa OB, Ijarotimi OA, Adesunkanmi ARK, Okon NE. Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation. Pan Afr Med J 2020; 37:15. [PMID: 33343794 PMCID: PMC7733343 DOI: 10.11604/pamj.supp.2020.37.15.25935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/19/2020] [Indexed: 12/23/2022] Open
Abstract
The public health impact of the COVID-19 pandemic cannot be overstated. Its impact on the cost of surgical and obstetric care is significant. More so, in a country like Nigeria, where even before the pandemic, out-of-pocket spending (OOPS) has been the major payment method for healthcare. The increased cost of surgical and obstetric care occasioned by the pandemic has principally been due to the additional burden of ensuring the use of adequate/appropriate personal protective equipment (PPE) during patient care as a disease containment measure. These PPE are not readily available in public hospitals across Nigeria. Patients are therefore compelled to bear the financial burden of procuring scarce PPE for use by health care personnel, further increasing the already high cost of healthcare. In this study, we sought to appraise the impact of the COVID-19 pandemic on the cost of surgical and obstetric care in Nigeria, drawing from the experience from one of the major Nigerian teaching hospitals- the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State. The cost of surgical and obstetric care was reviewed and compared pre- and during the COVID-19 pandemic, deriving relevant examples from some commonly performed surgical operations in our centre (OAUTHC). We reviewed patients' hospital bills and receipts of consumables procured for surgery. Our findings revealed that the cost of surgical and obstetric care during the COVID-19 pandemic had significantly increased. We identified gaps and made relevant recommendations on measures to reduce the additional costs of surgical and obstetric care during and beyond pandemic.
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Affiliation(s)
| | - Akaninyene Eseme Ubom
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Olalekan Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olusola Benjamin Fasubaa
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Omotade Adebimpe Ijarotimi
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Abdul Rashid Kayode Adesunkanmi
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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31
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Suleiman AA, Suleiman A, Abdullahi UA, Suleiman SA. Estimation of the case fatality rate of COVID-19 epidemiological data in Nigeria using statistical regression analysis. BIOSAFETY AND HEALTH 2020; 3:4-7. [PMID: 32935084 PMCID: PMC7482605 DOI: 10.1016/j.bsheal.2020.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 11/27/2022] Open
Abstract
Following the emergence of COVID-19 outbreak, numbers of studies have been conducted to curtail the global spread of the virus by identifying epidemiological changes of the disease through developing statistical models, estimation of the basic reproduction number, displaying the daily reports of confirmed and deaths cases, which are closely related to the present study. Reliable and comprehensive estimation method of the epidemiological data is required to understand the actual situation of fatalities caused by the epidemic. Case fatality rate (CFR) is one of the cardinal epidemiological parameters that adequately explains epidemiology of the outbreak of a disease. In the present study, we employed two statistical regression models such as the linear and polynomial models in order to estimate the CFR, based on the early phase of COVID-19 outbreak in Nigeria (44 days since first reported COVID-19 death). The estimate of the CFR was determined based on cumulative number of confirmed cases and deaths reported from 23 March to 30 April, 2020. The results from the linear model estimated that the CFR was 3.11% (95% CI: 2.59% - 3.80%) with R 2 value of 90% and p-value of < 0.0001. The findings from the polynomial model suggest that the CFR associated with the Nigerian outbreak is 3.0% and may range from 2.23% to 3.42% with R 2 value of 93% and p-value of <0.0001. Therefore, the polynomial regression model with the higher R 2 value fits the dataset well and provides better estimate of CFR for the reported COVID-19 cases in Nigeria.
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Affiliation(s)
- Ahmad Abubakar Suleiman
- Department of Statistics, Faculty of Computing and Mathematical Sciences, Kano University of Science and Technology, Wudil 713281, Nigeria
| | - Aminu Suleiman
- Department of Statistics, Faculty of Computing and Mathematical Sciences, Kano University of Science and Technology, Wudil 713281, Nigeria
| | - Usman Aliyu Abdullahi
- Department of Statistics, Faculty of Computing and Mathematical Sciences, Kano University of Science and Technology, Wudil 713281, Nigeria
| | - Suleiman Abubakar Suleiman
- Department of Hydrology, Kano State Ministry of Water Resources, Gidan Murtala 700221, Kano State, Nigeria
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32
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McMahon M, Nadigel J, Thompson E, Glazier RH. Informing Canada's Health System Response to COVID-19: Priorities for Health Services and Policy Research. Healthc Policy 2020; 16:112-124. [PMID: 32813643 PMCID: PMC7435075 DOI: 10.12927/hcpol.2020.26249] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
To inform Canada's research response to COVID-19, the Canadian Institutes of Health Research's Institute of Health Services and Policy Research (IHSPR) conducted a rapid-cycle priority identification process. Seven COVID-19 priorities for health services and policy research were identified: system adaptation and organization of care; resource allocation decision-making and ethics; rapid synthesis and comparative policy analysis of the COVID-19 response and outcomes; healthcare workforce; virtual care; long-term consequences of the pandemic; and public and patient engagement. Three additional cross-cutting themes were identified: supporting the health of Indigenous Peoples and vulnerable populations, data and digital infrastructure, and learning health systems and knowledge platforms. IHSPR hopes these research priorities will contribute to the broader ecosystem for collective research investment and action.
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Affiliation(s)
- Meghan McMahon
- Associate Director, CIHR Institute of Health Services and Policy Research, Toronto, ON
| | - Jessica Nadigel
- Associate Director, CIHR Institute of Health Services and Policy Research, Montreal, QC
| | - Erin Thompson
- Project Officer, CIHR Institute of Health Services and Policy Research, Toronto, ON
| | - Richard H Glazier
- Scientific Director, CIHR Institute of Health Services and Policy Research, Senior Scientist, ICES (Institute for Clinical Evaluative Sciences), Research Scientist, MAP Centre for Urban Health Solutions, St. Michael's Hospital, Professor, Family and Community Medicine, University of Toronto, Toronto, ON
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33
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Di Lorenzo G, Di Trolio R, Kozlakidis Z, Busto G, Ingenito C, Buonerba L, Ferrara C, Libroia A, Ragone G, Ioio CD, Savastano B, Polverino M, De Falco F, Iaccarino S, Leo E. COVID 19 therapies and anti-cancer drugs: A systematic review of recent literature. Crit Rev Oncol Hematol 2020; 152:102991. [PMID: 32544802 PMCID: PMC7239789 DOI: 10.1016/j.critrevonc.2020.102991] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND It is reasonable to think that cancer patients undergoing chemotherapy, targeted therapy or immunotherapy could have a more aggressive course if positive for Coronavirus disease CoV-2 (COVID- 19). METHODS We conducted a literature review on https://www.ncbi.nlm.nih.gov/pubmed/, https://scholar.google.com, www.arxiv.org, www.biorxiv.org, of all articles published using the keywords COVID-19 therapy or treatment and cancer until May 2, 2020. A total of 205 articles were identified and 53 were included in this review. RESULTS We describe the ongoing COVID-19 therapies that should be known by oncologists and highlight the potential interactions with antineoplastic drugs, commonly used in clinical practice. The main drug interactions were found with tocilizumab, ruxolitinib and colchicine. CONCLUSIONS The literature provides an inconclusive picture on potential preferred treatments for COVID-19 and their interactions with antineoplastic agents. Future clinical trials are needed to better understand the interactions between different drugs in the context of COVID-19 pandemic.
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Affiliation(s)
- Giuseppe Di Lorenzo
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy; Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100 Campobasso, Italy.
| | - Rossella Di Trolio
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, 150 cours Albert Thomas, 69372 Lyon, France
| | - Giuseppina Busto
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Concetta Ingenito
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Luciana Buonerba
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Claudia Ferrara
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Annamaria Libroia
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Gianluca Ragone
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | | | - Beatrice Savastano
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Mario Polverino
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | | | - Simona Iaccarino
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
| | - Emilio Leo
- Oncology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84016 Pagani, Italy
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34
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Okunade KS, Okunowo AA, Ohazurike EO, Anorlu RI. Good clinical practice advice for the management of patients with gynaecological cancer during the COVID-19 pandemic in Nigeria and other resource-constrained countries. Ecancermedicalscience 2020; 14:1075. [PMID: 32863869 PMCID: PMC7434503 DOI: 10.3332/ecancer.2020.1075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
The impact of the COVID-19 pandemic on healthcare services in settings with under-resourced health systems such as that of Nigeria is likely to be substantial in the coming months. The gynaecological oncology services still need to be prioritised as an essential core health service. There are increasing concerns from both physicians and patients regarding how to manage patients diagnosed with cancer during this pandemic as evidence suggests a substantial increase in the risk of COVID-19-related deaths amongst patients with cancer. However, we recognise that despite this great challenge, we must continue to provide the highest quality of care to the patients, whereas, at the same time, ensure adequate safety not only for the patients and their families but also for the entire oncology team. We advocate that due to the widespread travel restrictions and inability to refer patients for the highest level of care at this period, centres without radiotherapy facilities as seen in most resource-limited settings should always consider lower level care options such as the use of chemotherapy pending when there is a better access to these facilities. We, therefore, developed this good clinical practice advice to staff of the gynaecological oncology unit in the centre and other resource-constrained settings for the management of patients with gynaecological cancer during the COVID-19 pandemic.
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Affiliation(s)
- Kehinde S Okunade
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, PMB 12003, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria
- https://orcid.org/0000-0002-0957-7389
| | - Adeyemi A Okunowo
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, PMB 12003, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria
| | - Ephraim O Ohazurike
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria
| | - Rose I Anorlu
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, PMB 12003, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria
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35
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Rowaiye AB, Onuh OA, Oli AN, Okpalefe OA, Oni S, Nwankwo EJ. The pandemic COVID-19: a tale of viremia, cellular oxidation and immune dysfunction. Pan Afr Med J 2020; 36:188. [PMID: 32952832 PMCID: PMC7467617 DOI: 10.11604/pamj.2020.36.188.23476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023] Open
Abstract
COVID-19, caused by SARS-CoV-2 is a tester of the immune system. While it spares the healthy, it brings severe morbidity and in a few cases, mortality to its victims. This article aims at critically reviewing the key virulence factors of COVID-19 which are the viremia, cellular oxidation and immune dysfunction. The averse economic effect of certain disease control measures such as national lock-downs and social distancing, though beneficial, makes them unsustainable. Worse still is the fact that wild animals and domestic pets are carriers of SARS-CoV-2 suggesting that the disease would take longer than expected to be eradicated globally. A better understanding of the pathological dynamics of COVID-19 would help the general populace to prepare for possible infection by the invisible enemy. While the world prospects for vaccines and therapeutic agents against the SARS-CoV-2, clinicians should also seek to modulate the immune system for optimum performance. Immunoprophylactic and immunomodulatory strategies are recommended for the different strata of stakeholders combating the pandemic with the hope that morbidities and mortalities associated with COVID-19 would be drastically reduced.
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Affiliation(s)
- Adekunle Babajide Rowaiye
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria.,Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharm Scs, Nnamdi Azikiwe University, Awka, Nigeria
| | - Olukemi Adejoke Onuh
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
| | - Angus Nnamdi Oli
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharm Scs, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Solomon Oni
- Bioresources Development Centre, Isanlu, National Biotechnology Development Agency, Abuja, Nigeria
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36
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Tsamakis K, Triantafyllis AS, Tsiptsios D, Spartalis E, Mueller C, Tsamakis C, Chaidou S, Spandidos DA, Fotis L, Economou M, Rizos E. COVID-19 related stress exacerbates common physical and mental pathologies and affects treatment (Review). Exp Ther Med 2020; 20:159-162. [PMID: 32509006 PMCID: PMC7271730 DOI: 10.3892/etm.2020.8671] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
COVID-19 pandemic has caused a global public health emergency resulting in unprecedented individual and societal fear and anxiety. The stress surrounding this biothreat appears to have clinical implications in all aspects of medicine, both in mental and physical health spheres. The impact of COVID-19 related anxiety in Cardiology, Paediatrics, Oncology, Dermatology, Neurology and Mental Health and how it affects treatments is discussed. Moreover, the need for introducing novel communication and therapeutic approaches is highlighted in the new landscape of the COVID-19 era.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
| | | | - Dimitrios Tsiptsios
- Department of Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR47TP, UK
| | - Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Charalampos Tsamakis
- Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | - Sofia Chaidou
- 1st Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Lampros Fotis
- Department of Paediatrics, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
| | - Marina Economou
- Byron-Kessariani Community Mental Health Centre, First Department of Psychiatry, University of Athens, ‘EGINITION’ Hospital, 11528 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, University of Athens, ‘ATTIKON’ University Hospital, 12462 Athens, Greece
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37
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Kaur G, Lungarella G, Rahman I. SARS-CoV-2 COVID-19 susceptibility and lung inflammatory storm by smoking and vaping. JOURNAL OF INFLAMMATION-LONDON 2020; 17:21. [PMID: 32528233 PMCID: PMC7284674 DOI: 10.1186/s12950-020-00250-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/21/2020] [Indexed: 12/18/2022]
Abstract
The current pandemic of COVID-19 has caused severe morbidity and mortality across the globe. People with a smoking history have severe disease outcomes by COVID-19 infection. Epidemiological studies show that old age and pre-existing disease conditions (hypertension and diabetes) result in severe disease outcome and mortality amongst COVID-19 patients. Evidences suggest that the S1 domain of the SARS-CoV-2 (causative agent of COVID-19) membrane spike has a high affinity towards the angiotensin-converting enzyme 2 (ACE2) receptor found on the host’s lung epithelium. Likewise, TMPRSS2 protease has been shown to be crucial for viral activation thus facilitating the viral engulfment. The viral entry has been shown to cause ‘cytokine storm’ involving excessive production of pro-inflammatory cytokines/chemokines including IL-6, TNF-α, IFN-γ, IL-2, IL-7, IP-10, MCP-3 or GM-CSF, which is augmented by smoking. Future research could target these inflammatory-immunological responses to develop effective therapy for COVID-19. This mini-review provides a consolidated account on the role of inflammation and immune responses, proteases, and epithelial permeability by smoking and vaping during SARS-CoV2 infection with future directions of research, and provides a list of the potential targets for therapies particularly controlling cytokine storms in the lung.
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Affiliation(s)
- Gagandeep Kaur
- Department of Environmental Medicine, University of Rochester Medical Center, Box 850, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - Giuseppe Lungarella
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Box 850, 601 Elmwood Avenue, Rochester, NY 14642 USA
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38
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Tsamakis K, Gavriatopoulou M, Schizas D, Stravodimou A, Mougkou A, Tsiptsios D, Sioulas V, Spartalis E, Sioulas AD, Tsamakis C, Charalampakis N, Mueller C, Arya D, Zarogoulidis P, Spandidos DA, Dimopoulos MA, Papageorgiou C, Rizos E. Oncology during the COVID-19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients. Oncol Lett 2020; 20:441-447. [PMID: 32565968 PMCID: PMC7285823 DOI: 10.3892/ol.2020.11599] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022] Open
Abstract
COVID-19 has caused unprecedented societal turmoil, triggering a rapid, still ongoing, transformation of healthcare provision on a global level. In this new landscape, it is highly important to acknowledge the challenges this pandemic poses on the care of the particularly vulnerable cancer patients and the subsequent psychosocial impact on them. We have outlined our clinical experience in managing patients with gastrointestinal, hematological, gynaecological, dermatological, neurological, thyroid, lung and paediatric cancers in the COVID-19 era and have reviewed the emerging literature around barriers to care of oncology patients and how this crisis affects them. Moreover, evolving treatment strategies and novel ways of addressing the needs of oncology patients in the new context of the pandemic are discussed.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
| | - Maria Gavriatopoulou
- Department of Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Athina Stravodimou
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - Aikaterini Mougkou
- Paediatric Infectious Diseases Dept, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Dimitrios Tsiptsios
- Department of Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR47TP, UK
| | - Vasileios Sioulas
- Department of Gynaecologic Oncology MITERA Hospital, 15123 Athens, Greece
| | - Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | | | - Charalampos Tsamakis
- Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | | | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Donna Arya
- Thornford Park, Elysium Healthcare, Berkshire RG19 8ET, UK
| | - Paul Zarogoulidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, 54621 Thessaloniki, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Meletios A Dimopoulos
- Hematology and Medical Oncology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, 11527 Athens, Greece
| | - Charalabos Papageorgiou
- First Department of Psychiatry, University of Athens, 'EGINITION' Hospital, 11528 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece
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