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Liao YT, Shen HC, Huang JR, Sun CY, Ko HJ, Chang CJ, Chen YM, Feng JY, Chen WC, Yang KY. Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure. BMC Pulm Med 2024; 24:34. [PMID: 38225613 PMCID: PMC10789018 DOI: 10.1186/s12890-024-02850-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has affected individuals worldwide, and patients with cancer are particularly vulnerable to COVID-19-related severe illness, respiratory failure, and mortality. The relationship between COVID-19 and cancer remains a critical concern, and a comprehensive investigation of the factors affecting survival among patients with cancer who develop COVID-19-related respiratory failure is warranted. We aim to compare the characteristics and outcomes of COVID-19-related acute respiratory failure in patients with and without underlying cancer, while analyzing factors affecting in-hospital survival among cancer patients. METHODS We conducted a retrospective observational study at Taipei Veterans General Hospital in Taiwan from May to September 2022, a period during which the omicron variant of the severe acute respiratory syndrome coronavirus 2 was circulating. Eligible patients had COVID-19 and acute respiratory failure. Clinical data, demographic information, disease severity markers, treatment details, and outcomes were collected and analyzed. RESULTS Of the 215 enrolled critically ill patients with COVID-19, 65 had cancer. The patients with cancer were younger and had lower absolute lymphocyte counts, higher ferritin and lactate dehydrogenase (LDH) concentrations, and increased vasopressor use compared with those without cancer. The patients with cancer also received more COVID-19 specific treatments but had higher in-hospital mortality rate (61.5% vs 36%, P = 0.002) and longer viral shedding (13 vs 10 days, P = 0.007) than those without cancer did. Smoking [odds ratio (OR): 5.804, 95% confidence interval (CI): 1.847-39.746], elevated LDH (OR: 1.004, 95% CI: 1.001-1.012), vasopressor use (OR: 5.437, 95% CI: 1.202-24.593), and new renal replacement therapy (OR: 3.523, 95% CI: 1.203-61.108) were independent predictors of in-hospital mortality among patients with cancer and respiratory failure. CONCLUSION Critically ill patients with cancer experiencing COVID-19-related acute respiratory failure present unique clinical features and worse clinical outcomes compared with those without cancer. Smoking, elevated LDH, vasopressor use, and new renal replacement therapy were risk factors for in-hospital mortality in these patients.
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Affiliation(s)
- Ying-Ting Liao
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Chin Shen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jhong-Ru Huang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chuan-Yen Sun
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Jui Ko
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Jung Chang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Kuang-Yao Yang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Mulet A, Núñez-Gil IJ, Carbonell JA, Soriano JB, Viana-Llamas MC, Raposeiras-Roubin S, Romero R, Alfonso-Rodríguez E, Uribarri A, Feltes G, Becerra-Muñoz VM, Santoro F, Pepe M, Castro-Mejía AF, Chipayo D, Corbi-Pascual M, López-Pais J, Vedia O, Manzone E, Molina-Romera G, Espejo-Paeres C, López-Masjuan Á, Velicki L, Fernández-Ortiz A, El-Battrawy I, Signes-Costa J. Clinical Profile and Determinants of Mortality in Patients with Interstitial Lung Disease Admitted for COVID-19. J Clin Med 2023; 12:jcm12113821. [PMID: 37298018 DOI: 10.3390/jcm12113821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/19/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Concern has risen about the effects of COVID-19 in interstitial lung disease (ILD) patients. The aim of our study was to determine clinical characteristics and prognostic factors of ILD patients admitted for COVID-19. METHODS Ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed. The subgroup of ILD patients was selected and compared with the rest of the cohort. RESULTS A total of 114 patients with ILDs were evaluated. Mean ± SD age was 72.4 ± 13.6 years, and 65.8% were men. ILD patients were older, had more comorbidities, received more home oxygen therapy and more frequently had respiratory failure upon admission than non-ILD patients (all p < 0.05). In laboratory findings, ILD patients more frequently had elevated LDH, C-reactive protein, and D-dimer levels (all p < 0.05). A multivariate analysis showed that chronic kidney disease and respiratory insufficiency on admission were predictors of ventilatory support, and that older age, kidney disease and elevated LDH were predictors of death. CONCLUSIONS Our data show that ILD patients admitted for COVID-19 are older, have more comorbidities, more frequently require ventilatory support and have higher mortality than those without ILDs. Older age, kidney disease and LDH were independent predictors of mortality in this population.
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Affiliation(s)
- Alba Mulet
- Pulmonary Department, Hospital Clínico Universitario Valencia, INCLIVA, 46010 Valencia, Spain
| | - Iván J Núñez-Gil
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | | | - Joan B Soriano
- Faculty of Medicine, Universitat de les Illes Balears, 07120 Palma, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María C Viana-Llamas
- Intensive Medicine Department, Hospital Universitario Guadalajara, 19002 Guadalajara, Spain
| | - Sergio Raposeiras-Roubin
- National Center for Cardiovascular Research (CNIC), Department of Cardiology, Álvaro Cunqueiro University Hospital, 36312 Vigo, Spain
| | - Rodolfo Romero
- Emergency Department, Hospital Universitario Getafe, 28905 Madrid, Spain
| | | | - Aitor Uribarri
- Cardiology Department, Hospital Clínico Universitario Vall D'Hebrón, 08035 Barcelona, Spain
| | - Gisela Feltes
- Cardiology Department, Hospital Universitario Vithas Arturo Soria, 28043 Madrid, Spain
| | - Victor M Becerra-Muñoz
- Cardiology Department, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Francesco Santoro
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Martino Pepe
- Cardiology Department, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Alex F Castro-Mejía
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil 090615, Ecuador
| | - David Chipayo
- Department of Cardiology, Hospital Universitario de Cáceres, 10004 Cáceres, Spain
| | - Miguel Corbi-Pascual
- Department of Cardiology, Complejo Hospitalario Universitario de Albacete, 02008 Albacete, Spain
| | - Javier López-Pais
- Department of Cardiology, Complejo Hospitalario Universitario de Ourense, 32005 Ourense, Spain
| | - Oscar Vedia
- Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | - Germán Molina-Romera
- Department of Preventive Medicine, Hospital Santiago de Compostela, Instituto de Investigaciones Sanitarias de Santiago de Compostela, 15706 A Coruña, Spain
| | | | - Álvaro López-Masjuan
- Department of Cardiology, Hospital Universitario Juan Ramon Jimenez, 21005 Huelva, Spain
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Institute of Cardiovascular Diseases Vojvodina, 21204 Sremska Kamenica, Serbia
| | - Antonio Fernández-Ortiz
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibrahim El-Battrawy
- Department of Cardiology, University Medical Center Mannheim, 68167 Mannheim, Germany
| | - Jaime Signes-Costa
- Pulmonary Department, Hospital Clínico Universitario Valencia, INCLIVA, 46010 Valencia, Spain
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Heron PN, Henderson LM, Crosland S, Gilbody SM, Johnston GA, Moriarty AS, Newbronner E, Paterson A, Spanakis P, Wadman R, Walker L, Peckham E. Sleep health among people with severe mental ill health during the COVID-19 pandemic: Results from a linked UK population cohort study. Front Psychiatry 2022; 13:975593. [PMID: 36299533 PMCID: PMC9589097 DOI: 10.3389/fpsyt.2022.975593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Sleep problems are a transdiagnostic feature of nearly all psychiatric conditions, and a strong risk factor for initial and recurrent episodes. However, people with severe mental ill health (SMI) are often excluded from general population surveys, and as such the extent and associates of poor sleep in this population are less well understood. This study explores sleep health in an SMI sample during the COVID-19 pandemic, using multiple regression to identify risk factors, including daily routine, wellbeing and demographics. Methods An existing cohort of people with an SMI diagnosis were sampled. Participants were invited to complete a self-report survey about their health and the impacts of COVID-19 and associated public health measures. Sleep duration, efficiency, and quality were measured using items from the Pittsburgh Sleep Quality Index (PSQI). Results Two hundred forty-nine adults (aged 21-84 years) completed the survey. Mean sleep duration and efficiency were similar to general population estimates, at 7 h 19 min and 78%, respectively. However, 43% reported "bad" sleep quality that was associated with being younger in age as well as disturbed routine and declined wellbeing. Indeed, 37% reported a disturbed routine during the pandemic. Conclusions High estimates of perceived poor sleep quality in the SMI population align with previous findings. Supporting people with SMI to maintain routine regularity may work to protect sleep quality and wellbeing. Future research should more closely examine sleep health in people with SMI, using accessible and scalable measures of objective and subjective sleep, examining longitudinal trends.
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Affiliation(s)
- Paul N. Heron
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
| | | | - Suzanne Crosland
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
| | - Simon M. Gilbody
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | | | - Andrew S. Moriarty
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Elizabeth Newbronner
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
| | - Alastair Paterson
- Faculty of Medical and Human Sciences, Manchester University, Manchester, United Kingdom
| | - Panagiotis Spanakis
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
- Department of Psychology, University of Crete, Rethymmon, Greece
- School of Psychology, Mediterranean College, Athens, Greece
| | - Ruth Wadman
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
| | - Lauren Walker
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
| | - Emily Peckham
- Mental Health and Addictions Research Group, Department of Health Science, University of York, York, United Kingdom
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Karlsson Sundbaum J, Konradsen JR, Vanfleteren LEGW, Axelsson Fisk S, Pedroletti C, Sjöö Y, Syk J, Sterner T, Lindberg A, Tunsäter A, Nyberg F, Ekberg-Jansson A, Stridsman C. Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register. Ther Adv Respir Dis 2022; 16:17534666221091183. [PMID: 35430944 PMCID: PMC9019327 DOI: 10.1177/17534666221091183] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Severe asthma increases the risk of severe COVID-19 outcomes such as hospitalization and death. However, more studies are needed to understand the association between asthma and severe COVID-19. Methods: A cohort of 150,430 adult asthma patients were identified in the Swedish National Airway Register (SNAR) from 2013 to December 2020. Data on body mass index, smoking habits, lung function, and asthma control test (ACT) were obtained from SNAR, and uncontrolled asthma was defined as ACT ⩽19. Patients with severe COVID-19 were identified following hospitalization or in death certificates based on ICD-10 codes U07.1 and U07.2. The Swedish Prescribed Drug register was used to identify comorbidities and data from Statistics Sweden for educational level. Multivariate logistic regression analyses were used to estimate associations with severe COVID-19. Results: Severe COVID-19 was identified in 1067 patients (0.7%). Older age (OR = 1.04, 95% CI = 1.03–1.04), male sex (1.42, 1.25–1.61), overweight (1.56, 1.27–1.91), obesity (2.12, 1.73–2.60), high-dose inhaled corticosteroids in combination with long-acting β-agonists (1.40, 1.22–1.60), dispensed oral corticosteroids ⩾2 (1.48, 1.25–1.75), uncontrolled asthma (1.64, 1.35–2.00), cardiovascular disease (1.20, 1.03–1.40), depression (1.47, 1.28–1.68), and diabetes (1.52, 1.29–1.78) were associated with severe COVID-19, while current smoking was inversely associated (0.63, 0.47–0.85). When comparing patients who died from COVID-19 with those discharged alive from hospital until 31 December 2020, older age, male sex, and current smoking were associated with COVID-19 death. Conclusion: Patients with uncontrolled asthma and high disease burden, including increased asthma medication intensity, should be identified as risk patients for severe COVID-19. Furthermore, current smoking is strongly associated with COVID-19 death in asthma.
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Affiliation(s)
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sten Axelsson Fisk
- Department of Clinical Sciences Lund, Obstetrics and Gynaecology, Lund University and Ystad Hospital, Lund, Sweden
| | | | - Yvonne Sjöö
- The Swedish National Airway Register, Gothenburg, Sweden
| | - Jörgen Syk
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Therese Sterner
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Umeå University, Devision of Medicine/ The OLIN- unit, Umeå University, Umeå, Sweden
| | - Alf Tunsäter
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Ekberg-Jansson
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Umeå University, Devision of Medicine/ The OLIN- unit, Umeå University, Umeå, Sweden
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5
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Pepe M, Napoli G, Brindicci G, Carulli E, Nestola PL, Santoro CR, Biondi-Zoccai G, Giordano A, D'Ascenzo F, Cirillo P, Saracino A, Favale S. Prognostic value of 12-leads admission electrocardiogram in low-risk patients hospitalized for Covid-19. Minerva Med 2021; 113:667-674. [PMID: 34761885 DOI: 10.23736/s0026-4806.21.07894-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cardiac involvement significantly contributes to coronavirus disease 2019 (COVID-19)mortality.12-lead electrocardiogram (ECG) represents a fast, cheap, and easy to perform exam with the adjunctive advantage of the remote reporting possibility. In this study, we sought to investigate if electrocardiographic parameters are able to identify patients, deemed at low-risk at admission,who will face in-hospital unfavourable course. METHODS From March 1, 2020 through March 30, 2021, 384 consecutive patients with confirmed low-risk COVID-19 were hospitalized at the AziendaOspedalieroUniversitariaPoliclinico di Bari (Italy). Criteria for low-risk were: admission to the division of Pneumology or Infectious Diseases, no need for immediate (within 24 hours from admission) transfer to Intensive Care Unit or for respiratory support with invasive mechanical ventilation (IMV) or for circulation support (either mechanical or pharmacological). Admission ECGs were reviewed and interpreted by two expert cardiologists. The primary outcomes were in-hospital death and the composite outcome of in-hospitaldeath and IMV. RESULTS In low-risk COVID-19 patients, atrial fibrillation (AF), poor R wave progression (PRWP), tachycardia, and right bundle branch block (RBBB) resulted as statistically significant and independent predictors of in-hospital all-cause mortality; AF, PRWP, Tachycardia, RBBB, and corrected QT interval showed to be statistically significant and independent risk factors for the occurrence of the composite endpoint of death and IMV. CONCLUSIONS Our study demonstrated for the first time that RBBB and PRWP, assessed upon admission with ECG, are associated with unfavourable clinical course in a baseline low-risk population hospitalized for COVID-19.
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Affiliation(s)
- Martino Pepe
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy -
| | - Gianluigi Napoli
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Gaetano Brindicci
- Clinic of Infectious Diseases, Policlinic Hospital of Bari, Bari, Italy
| | - Eugenio Carulli
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Palma L Nestola
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Carmen R Santoro
- Clinic of Infectious Diseases, Policlinic Hospital of Bari, Bari, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Napoli, Italy
| | - Arturo Giordano
- Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Sciences, University of Turin, Città della salute e della scienza Hospital, Turin, Italy
| | - Plinio Cirillo
- Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Annalisa Saracino
- Clinic of Infectious Diseases, Policlinic Hospital of Bari, Bari, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Stefano Favale
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
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How COVID-19 Pandemics Changed the Treatment Protocols for Patients with Gynecological Tumors. ARS MEDICA TOMITANA 2021. [DOI: 10.2478/arsm-2021-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
It was found that oncological patients are4 to 8 times more likely of developing severe forms of COVID-19 infection than other patients, so mortality is higher in patients with gyneco-logical cancer. Due to this pandemic, reported delays in diagnosis and treatment of genital cancer and changes in disease management, may influence the natural history of neoplasm. This fact adds more stress and fear for patients with neoplasms. Adequate protective measures are essen-tial for SARS CoV2 infection avoidance and lead to changes in healthcare professionals clinical practice. Prioritization is important, but direct personal interactions should be limited. However, gynecological tumors surgery, chemotherapy, and radiotherapy should continue as high priority practices, without essential modification. The conclusion is that COVID-19 pandemic has affect-ed many guides for management of diseases, especially oncological. Adaptations in clinical prac-tice may avoid viral infection and reduce mortality and severe complications.
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