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Faur CI, Moldovan MA, Paraschivescu T, Megieșan S, Roman RC. Epidemiology and Management Paradigm of Head and Neck Infections, Including COVID-19 Pandemic Period: A 10-Year Retrospective Study in a Maxillofacial Center of Cluj-Napoca. J Clin Med 2024; 13:4046. [PMID: 39064086 PMCID: PMC11277223 DOI: 10.3390/jcm13144046] [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: 05/22/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Background. The management of odontogenic infections varies across the globe. To shed light on the subject, this study delves into the practices of the Oral and Maxillofacial Department at Cluj-Napoca County Hospital. Material and Methods. This comprehensive retrospective analysis of 10 years of clinical experience covered a range of factors, including demographics, clinical and investigations factors, medical and surgical treatment approaches, and follow-up. Additionally, the study examined the change in trends over the course of the COVID-19 pandemic. Results. While head and neck infection occurrence had a decreasing trend before the COVID-19 pandemic, during the pandemic era the number of patients almost doubled. The infections were prevalent in the submandibular space, teeth being the prevalent cause. Young adults are prone to suffer from odontogenic infections. High levels of C reactive protein, ASA II-IV risk, and hepatic dysfunction indicated a longer time of hospitalization. The majority of antibiograms were negative, and the positive ones indicated Streptococcus and Staphylococcus species as prevalent pathogens. Extra- or intraoral surgical drainage and wide-spectrum antibiotics proved to be the workhorse for odontogenic infections. Conclusion. This study advances our understanding of oral and maxillofacial surgery and offers actionable strategies for improving patient outcomes in similar healthcare institutions worldwide.
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Affiliation(s)
- Cosmin Ioan Faur
- Department of Oral Radiology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania;
| | - Mădălina Anca Moldovan
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Tino Paraschivescu
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Sergiu Megieșan
- Applied Mathematics, Imperial College London Alumni, London SW7 2AZ, UK;
| | - Rareș Călin Roman
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
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Galletti C, De Marco L, Ciodaro F, Freni F, Saraniti C, Galletti F, Galletti B. Impact of the Sars-COVID-19 Pandemic on the "Early Diagnosis" of Laryngeal Tumors: Data From Monocentric Tertiary Care Hospital of South Italy. J Voice 2024:S0892-1997(23)00404-6. [PMID: 38290926 DOI: 10.1016/j.jvoice.2023.12.013] [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: 10/21/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE The aim of this retrospective case-control study is to investigate how the Sars-COVID-19 pandemic has influenced the delay in the early diagnosis of laryngeal cancer in patients who visited the University Hospital "G. Martino" in the last 3 years of the pandemic. It is also proposed to compare the diagnosis, surgical staging, and therapeutic approach offered to patients affected by laryngeal cancer in the years affected by the COVID-19 pandemic compared to cases treated during the 3 years preceding the pandemic METHODOLOGY/PRINCIPAL: A single-center retrospective study was carried out to analyze the effects of the COVID-19 pandemic on the diagnosis and treatment of patients with squamous cell carcinoma of the larynx at our Otorhinolaryngology Division of the "Gaetano Martino" University hospital. The research period, 6 years, was divided into two sub-periods of equal months for which we divided the patients into two groups "Before COVID-19" and "During COVID-19", defined, respectively, from February 2017 to March 2020 and from April 2020 to May 2023. Patients aged 18 years and older with a diagnosis of squamous cell carcinoma, seen and surgically treated at the Otorhinolaryngology division of the "Gaetano Martino" University Hospital and patients referred from other hospitals were included in the study population. Patients affected by malignancies in other sites with secondary laryngeal involvement, patients not amenable to surgical therapy, treated only with radio-chemotherapy therapy, and patients not amenable to surgical therapy were excluded from the study. RESULTS A total of 141 patients were recruited, divided into 76 patients in the "Before COVID-19" arm and 65 patients in the "During COVID-19" arm, with a male prevalence of 119 patients (84.4%). The mean age of our study population stands at a median of 69 years (percentile 25th 60.00 and percentile 75th 77.00). Smoking and alcohol are two predominant variables in our study population with a prevalence of 89.4% and 79.4%, respectively. A higher number of TNM stage IV cases was detected, 29.2% in the group "During COVID-19" compared to 5.3 detected in the group "Before COVID-19" (P = 0.005). In the "During COVID-19" group, we find an overall percentage of 61.5% for stages II-III-IV versus 36.9% present in the "Before COVID-19" group of patients. An adjuvant radiotherapy treatment was actuated in 30.26% of patients in the "Before COVID-19" versus 41.54% in "During COVID-19". CONCLUSIONS The most important result of our research was the statistically significant difference in tumor staging at the time of diagnosis between the "Before COVID-19" and "During COVID-19" groups, with a higher mean value in the latter. The current data confirm the previously exposed hypothesis according to which the COVID-19 pandemic has led to a delay in early diagnosis, negatively influencing the staging at the time of the first ENT visit and the subsequent therapeutic approach to be offered to the patient.
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Affiliation(s)
- Cosimo Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
| | - Laura De Marco
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
| | - Francesco Ciodaro
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
| | - Carmelo Saraniti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy.
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125 Messina, ME, Italy.
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Faur CI, Dinu C, Toma V, Jurj A, Mărginean R, Onaciu A, Roman RC, Culic C, Chirilă M, Rotar H, Fălămaș A, Știufiuc GF, Hedeșiu M, Almășan O, Știufiuc RI. A New Detection Method of Oral and Oropharyngeal Squamous Cell Carcinoma Based on Multivariate Analysis of Surface Enhanced Raman Spectra of Salivary Exosomes. J Pers Med 2023; 13:jpm13050762. [PMID: 37240933 DOI: 10.3390/jpm13050762] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Raman spectroscopy recently proved a tremendous capacity to identify disease-specific markers in various (bio)samples being a non-invasive, rapid, and reliable method for cancer detection. In this study, we first aimed to record vibrational spectra of salivary exosomes isolated from oral and oropharyngeal squamous cell carcinoma patients and healthy controls using surface enhancement Raman spectroscopy (SERS). Then, we assessed this method's capacity to discriminate between malignant and non-malignant samples by means of principal component-linear discriminant analysis (PC-LDA) and we used area under the receiver operating characteristics with illustration as the area under the curve to measure the power of salivary exosomes SERS spectra analysis to identify cancer presence. The vibrational spectra were collected on a solid plasmonic substrate developed in our group, synthesized using tangential flow filtered and concentrated silver nanoparticles, capable of generating very reproducible spectra for a whole range of bioanalytes. SERS examination identified interesting variations in the vibrational bands assigned to thiocyanate, proteins, and nucleic acids between the saliva of cancer and control groups. Chemometric analysis indicated discrimination sensitivity between the two groups up to 79.3%. The sensitivity is influenced by the spectral interval used for the multivariate analysis, being lower (75.9%) when the full-range spectra were used.
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Affiliation(s)
- Cosmin Ioan Faur
- Department of Oral Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Valentin Toma
- MedFuture-Research Center for Advanced Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Anca Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Radu Mărginean
- MedFuture-Research Center for Advanced Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Anca Onaciu
- MedFuture-Research Center for Advanced Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Rareș Călin Roman
- Department of Oral and Craniomaxillofacial Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Carina Culic
- Department of Odontology, Endodontics, Oral Pathology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Magdalena Chirilă
- Department of Otorhinolaryngology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Horațiu Rotar
- Department of Oral and Craniomaxillofacial Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Alexandra Fălămaș
- Department of Molecular and Biomolecular Physics, National Institute for Research and Development of Isotopic and Molecular Technologies, 400293 Cluj-Napoca, Romania
| | | | - Mihaela Hedeșiu
- Department of Oral Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthodontics and Dental Materials, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Rares Ionuț Știufiuc
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
- Department of Pharmaceutical Physics & Biophysics, Faculty of Pharmacy, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Lim AE, Zahra B, Moen C, Montgomery J. The effect of local anaesthetic biopsy in head and neck cancer on cancer pathway waiting times. Ann R Coll Surg Engl 2023; 105:331-335. [PMID: 35617116 PMCID: PMC10066636 DOI: 10.1308/rcsann.2022.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The 31-day target in urgent suspicion of cancer (USOC) referrals fast-tracks patients through the cancer pathway. Local anaesthetic (LA) biopsy can be performed during an outpatient clinic and may improve pathway times. The aim of this study was to compare LA biopsy in head and neck USOC referrals with the traditional general anaesthetic (GA) pathway. METHODS This was a retrospective cohort study of USOC referrals to the NHS Greater Glasgow and Clyde head and neck multidisciplinary team between 1 June 2018 and 28 December 2020, and compared pathway times in LA and GA biopsies. RESULTS The mean number of days from clinic to biopsy was 4.4 in the LA group and 28.0 in the GA group. This was significantly faster in the LA biopsy group (p < 0.05). The overall pathway time in the LA and GA biopsy groups was 35.7 and 61.5 days, respectively, and was significantly faster in LA biopsy group (p < 0.05). CONCLUSIONS The LA cohort had significantly faster pathway times compared with GA biopsy. LA biopsy requires careful patient selection, but is an effective alternative to GA biopsy in the appropriate patient group.
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Affiliation(s)
- AE Lim
- NHS Greater Glasgow and Clyde, UK
| | - B Zahra
- NHS Greater Glasgow and Clyde, UK
| | - C Moen
- NHS Greater Glasgow and Clyde, UK
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Prioritization of head and neck cancer patient care during the COVID-19 pandemic: a retrospective cohort study. J Otolaryngol Head Neck Surg 2023; 52:15. [PMID: 36782236 PMCID: PMC9925359 DOI: 10.1186/s40463-023-00625-w] [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: 09/07/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic placed considerable strain on the healthcare system, leading to the re-allocation of resources and implementation of new practice guidelines. The objective of this study is to assess the impact of COVID-19 guideline modifications on head and neck cancer (HNC) care at two tertiary care centers in Canada. METHODS A retrospective cohort study was conducted. HNC patients seen at two tertiary care centers before and after the onset of the COVID-19 pandemic (pre-pandemic: July 1st, 2019, to February 29th, 2020; pandemic: March 1st, 2020, to October 31st, 2020) were included. The pre-pandemic and pandemic cohorts were compared according to patient and tumor characteristics, duration of HNC workup, and treatment type and duration. Mean differences in cancer care wait times, including time to diagnosis, tumor board, and treatment as well as total treatment package time and postoperative hospital stay were compared between cohorts. Univariate and multivariate analyses were used to compare characteristics and outcomes between cohorts. RESULTS Pre-pandemic (n = 132) and pandemic (n = 133) patients did not differ significantly in sex, age, habits, or tumor characteristics. The percentage of patients who received surgery only, chemo/radiotherapy (CXRT) only, and surgery plus adjuvant CXRT did not differ significantly between cohorts. Pandemic patients experienced a significant time reduction compared to pre-pandemic patients with regards to the date first seen by a HNC service until start of treatment ([Formula: see text] = 48.7 and 76.6 days respectively; p = .0001), the date first seen by a HNC service until first presentation at tumor board ([Formula: see text] = 25.1 and 38 days respectively; p = .001), mean total package time for patients who received surgery only ([Formula: see text] = 3.7 and 9.0 days respectively; p = .017), and mean total package time for patients who received surgery plus adjuvant CXRT ([Formula: see text] = 80.2 and 112.7 days respectively; p = .035). CONCLUSION The time to treatment was significantly reduced during the COVID-19 pandemic as compared to pre-pandemic. This transparent model of patient-centered operative-room prioritization can serve as a model for improving resource allocation and efficiency of HNC care during emergency and non-emergency scenarios.
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Hewitt L, Ashford B. Career reflections of retired surgeons. ANZ J Surg 2023; 93:21-23. [PMID: 36420700 DOI: 10.1111/ans.18173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/31/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Lyndel Hewitt
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bruce Ashford
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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Wang G, Bai L, Zhao M, Wang S. Global landscape of COVID-19 and epilepsy research: A bibliometric analysis. Front Neurol 2022; 13:1034070. [PMID: 36353128 PMCID: PMC9637663 DOI: 10.3389/fneur.2022.1034070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/10/2022] [Indexed: 01/03/2023] Open
Abstract
Background A large number of papers regarding coronavirus disease 2019 (COVID-19) and epilepsy have been published since the declaration of the COVID-19 pandemic. However, there is no bibliometric analysis on these papers. In this study, we aimed to analyze the bibliometric characteristics of these papers, thus identifying the trends and future directions of COVID-19 and epilepsy research. Methods Scientific papers regarding COVID-19 and epilepsy were retrieved through searches of the Web of Science Core Collection database. Title, authors, contributing institute, country, source journal, times cited, and additional information were extracted from each selected paper. Microsoft Excel 2019 and GraphPad Prism 8 were used to analyze the extracted data and export the bar charts and tables whilst VOSviewer software was used to perform and visualize co-authorship analysis and co-occurrence analysis of keywords. Results A total of 317 papers regarding COVID-19 and epilepsy were included in the final analysis. Epilepsy & Behavior published the largest number of papers (n = 84). J. Helen Cross and Naoto Kuroda were the most prolific authors (n = 13 each). The United States (n = 88) and the University of London (n = 23) were the country and organization with the most contributions, respectively. The strongest authors' collaborations were between Giovanni Assenza and Jacopo Lanzone and between J. Helen Cross and Nathalie Jette. Selected author keywords were organized into seven clusters, and the keywords in clusters 1 and cluster 4 had the largest average appearing year of any clusters. Conclusion This is the first bibliometric analysis of papers regarding COVID-19 and epilepsy. Our results showed that the United States was the leading country whilst J. Helen Cross was the most influential scholar in COVID-19 and epilepsy research. psychological consequences of COVID-19, and the safety of COVID-19 vaccines for people with epilepsy, are possible areas for future research on COVID-19 and epilepsy.
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Affiliation(s)
- Guangxin Wang
- Shandong Innovation Center of Intelligent Diagnosis, Jinan Central Hospital, Shandong University, Jinan, China
- Department of Pediatics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lian Bai
- General Medical Department, Jinan Central Hospital, Shandong University, Jinan, China
| | - Mingxue Zhao
- Shandong Innovation Center of Intelligent Diagnosis, Jinan Central Hospital, Shandong University, Jinan, China
- Department of Pediatics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shumei Wang
- General Medical Department, Jinan Central Hospital, Shandong University, Jinan, China
- *Correspondence: Shumei Wang
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Faur CI, Roman RC, Jurj A, Raduly L, Almășan O, Rotaru H, Chirilă M, Moldovan MA, Hedeșiu M, Dinu C. Salivary Exosomal MicroRNA-486-5p and MicroRNA-10b-5p in Oral and Oropharyngeal Squamous Cell Carcinoma. Medicina (B Aires) 2022; 58:medicina58101478. [PMID: 36295638 PMCID: PMC9610161 DOI: 10.3390/medicina58101478] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: The research aimed at evaluating the capacity of salivary exosomal miR-10b-5p and miR-486-5p for oral and oropharyngeal cancer detection. Materials and Methods: The saliva samples were harvested from histopathological diagnosed oral and oropharyngeal squamous cell carcinoma patients and healthy volunteer subjects. The exosomes were isolated by differential ultracentrifugation and quantified by Nano Track Analysis. The microRNAs were extracted and quantified from salivary exosomes by quantitative Real-Time Polymerase Chain Reaction. Results: This research comprised fifty participants. When compared to healthy controls, salivary exosomal miR-486-5p was elevated and miR-10b-5p was reduced in oral and oropharyngeal squamous cell carcinoma. Moreover, miR-486-5p had a high expression level in stage II of cancer in comparison to the other cancer stages. The cancer samples presented an increased exosome dimension compared to the control samples. Conclusions: Salivary exosomal miR-10b-5p and miR-486-5p have an altered expression in oral and oropharyngeal cancer.
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Affiliation(s)
- Cosmin Ioan Faur
- Department of Maxillofacial Surgery and Radiology, Oral Radiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Rareș Călin Roman
- Department of Maxillofacial Surgery and Radiology, Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
- Correspondence:
| | - Ancuța Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, 400337 Cluj-Napoca, Romania
| | - Lajos Raduly
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 23 Gheorghe Marinescu Street, 400337 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Horațiu Rotaru
- Department of Maxillofacial Surgery and Radiology, Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Magdalena Chirilă
- 8th Department-Surgical Secialties, O.R.L., “Iuliu Hațieganu” University of Medicine and Pharmacy, 4-6 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Mădălina Anca Moldovan
- Department of Maxillofacial Surgery and Radiology, Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Radiology, Oral Radiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Radiology, Maxillofacial Surgery and Implantology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400429 Cluj-Napoca, Romania
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Abstract
Objective Delay in the diagnosis of head and neck cancer can result in significant excess morbidity and mortality. How the pandemic has affected patient presentation in Scotland is unknown. Method This retrospective cohort study compared all presentations of head and neck cancer between June and October of 2019 with the same period following the peak of the pandemic in 2020 in West Scotland, a region populated by 2.5 million people. Results A total of 528 patients met our inclusion criteria. Compared with 2019, patients in 2020 were more likely to present with a higher American Joint Committee on Cancer stage (odds ratio, 1.67 (95 per cent confidence interval = 1.20 to 2.31); p = 0.002), a longer preceding symptom duration (odds ratio, 2.03 (95 per cent confidence interval = 1.44 to 2.87; p < 0.001) and to have an emergency presentation (odds ratio, 2.53, (95 per cent confidence interval = 1.15 to 5.55; p = 0.017). Conclusion Patients are presenting later with more advanced head and neck cancer following the coronavirus disease 2019 pandemic.
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Ralli M, Colizza A, D’Aguanno V, Scarpa A, Russo G, Petrone P, Grassia R, Guarino P, Capasso P. Risk of SARS-CoV-2 contagion in otolaryngology specialists. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:S58-S67. [PMID: 35763275 PMCID: PMC9137374 DOI: 10.14639/0392-100x-suppl.1-42-2022-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 has rapidly spread in the past two years with a profound impact on otolaryngological activities, which has undergone radical transformation to guarantee diagnostic and therapeutic procedures mainly in oncology and urgent patients, while ensuring protection for healthcare personnel and patients. During the initial phases of the pandemic, scheduled visits and elective surgeries were postponed leading to a delay in the diagnosis and treatment of several diseases, including head and neck cancer, with a shift toward more advanced cancer stages and more aggressive treatments. Aerosol and droplets are the main routes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus leading to a high risk of contagion during otolaryngology visits and surgery. Therefore, the correct use of personal protective equipment (PPE) and attention to procedure-specific risks and measures to avoid contagion are of utmost importance for healthcare professionals, and especially for those dealing with otolaryngology diseases. This narrative review highlights that otolaryngological activity implies a high risk of contagion during outpatient visit, surgery, or urgent conditions. The correct use of PPE, evaluation of procedure-specific risks and reduction of non-urgent procedures are considered the main strategies to limit contagion.
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Affiliation(s)
- Massimo Ralli
- Department of Sense Organs. Sapienza University of Rome, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs. Sapienza University of Rome, Rome, Italy
| | | | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry. University of Salerno, Salerno, Italy
| | - Gennaro Russo
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
| | | | - Rosa Grassia
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
| | - Pierre Guarino
- Otolaryngology Unit, Santo Spirito Hospital, Pescara, Italy
| | - Pasquale Capasso
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
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Solis RN, Mehrzad M, Faiq S, Frusciante RP, Sekhon HK, Abouyared M, Bewley AF, Farwell DG, Birkeland AC. The Impact of COVID-19 on Head and Neck Cancer Treatment: Before and During the Pandemic. OTO Open 2022; 5:2473974X211068075. [PMID: 34993385 PMCID: PMC8725009 DOI: 10.1177/2473974x211068075] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives To describe the impact that the coronavirus disease 2019 (COVID-19) pandemic had on the presentation of patients with head and neck cancer in a single tertiary care center. Study Design Retrospective cohort study. Setting Academic institution. Methods We performed a retrospective review of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC) who presented as new patients between September 10, 2019, and September 11, 2020. Patients presenting during the 6 months leading up to the announcement of the pandemic (pre–COVID-19 period) on March 11, 2020, were compared to those presenting during the first 6 months of the pandemic (COVID-19 period). Demographics, time to diagnosis and treatment, and tumor characteristics were analyzed. Results There were a total of 137 patients analyzed with newly diagnosed malignancies. There were 22% fewer patients evaluated during the COVID-19 timeframe. The groups were similar in demographics, duration of symptoms, time to diagnosis, time to surgery, extent of surgery, and adjuvant therapy. There was a larger proportion of tumors classified as T3/T4 (61.7%) in the COVID-19 period vs the pre–COVID-19 period (40.3%) (P = .024), as well as a larger median tumor size during the COVID-19 period (P = .0002). There were no differences between nodal disease burden (P = .48) and distant metastases (P = .42). Conclusion Despite similar characteristics, time to diagnosis, and surgery, our findings suggest that there was an increase in primary tumor burden in patients with HNSCC during the early COVID-19 pandemic.
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Affiliation(s)
- Roberto N Solis
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Mehrnaz Mehrzad
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Samya Faiq
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Roberto P Frusciante
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Harveen K Sekhon
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Marianne Abouyared
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Arnaud F Bewley
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - D Gregory Farwell
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
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12
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Boutros M, Moujaess E, Kourie HR. Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea. Crit Rev Oncol Hematol 2021; 167:103273. [PMID: 33737160 PMCID: PMC7959683 DOI: 10.1016/j.critrevonc.2021.103273] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023] Open
Abstract
COVID-19 was declared a "Public Health Emergency of International Concern" in March 2020. Since then, drastic measures were implemented to reduce the virus spread. These measures prevented cancer patients from receiving prompt medical care. A delay in testing and treating cancer patients is thought to protect them from serious COVID-19 complications but exposes them at the same time to the risk of disease progression and cancer related mortality. Healthcare providers are therefore facing the dilemma of choosing between two unpleasant scenarios. To shed light upon the matter, we present in this review article, based on an extensive search of the literature, an overview of the delay in the management of cancer patients, possible contributors to this delay and its benefits and risks on cancer patients' health.
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Affiliation(s)
- Marc Boutros
- Faculty of Medicine, Saint Joseph University of Beirut, Lebanon
| | - Elissar Moujaess
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Beirut, Lebanon,Corresponding author
| | - Hampig Raphael Kourie
- Department of Hematology and Oncology, Hotel Dieu de France University Hospital, Beirut, Lebanon
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13
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Murri D, Botti C, Bassano E, Fornaciari M, Crocetta FM, Ghidini A. Reduction in healthcare services during the COVID-19 pandemic: Patient screening based on symptoms is an effective strategy for avoiding delayed laryngeal cancer diagnosis. Am J Otolaryngol 2021; 42:103162. [PMID: 34325180 PMCID: PMC8302476 DOI: 10.1016/j.amjoto.2021.103162] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022]
Abstract
Objective Restriction in healthcare services during the COVID-19 pandemic caused delays in the diagnosis and treatment of several diseases. To overcome the risk of missed diagnosis of head and neck cancers, before deleting the scheduled appointments, we have introduced a selection of the patients by examining the clinical presenting issue and previous medical history. The aim of this study is to show the effects of the abovementioned strategy on the diagnosis and management of laryngeal cancer. Methods Data were extracted from the Hospital software regarding the new diagnosis of laryngeal SCC in the periods from March 2020 to December 2020 during the pandemic (study group) and from March 2019 to December 2019 (control group) were collected. Data were compared regarding: TNM stage, time from first medical examination to histological diagnosis (Time-1), and time form histological diagnosis to beginning of treatments (Time-2). Results The final study group was composed by 19 laryngeal cancers, the control group by 25 cases. No significant differences were found in the tumour stage between the groups. In the study group, Time-1 was shorter (24 days versus 43 days, p = 0.012), while Time-2 in surgically-treated patients was longer (20 days versus 9 days, p = 0.012). Conclusion During the pandemic, there was a dramatic lack of medical and nurse staff needed for surgical procedures. As consequence, the time between the diagnosis of malignancy and surgical treatment increased. In our unit, an efficient patient selection strategy to reschedule medical appointments avoided a dangerous shift toward higher laryngeal cancer stages.
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14
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Meerwein CM, Stadler TM, Balermpas P, Soyka MB, Holzmann D. Diagnostic pathway and stage migration of sinonasal malignancies in the era of the COVID-19 pandemic. Laryngoscope Investig Otolaryngol 2021; 6:904-910. [PMID: 34667832 PMCID: PMC8513453 DOI: 10.1002/lio2.640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic bears the risk of delayed cancer diagnoses. METHODS Study on the diagnostic pathway of sinonasal malignancies during the COVID-19 pandemic. RESULTS Median time from first symptom to treatment initiation was not increased during the pandemic: 137 days (interquartile range [IQR] 104-193) vs 139 days (IQR 103-219) (P = .60). Median time from first appointment at our institution to treatment initiation was even reduced in 2020: 18 days (IQR 11-25) vs 11 days (IQR 7-17) (P = .02). A trend toward advanced tumor stages during the pandemic was seen: 11/30 patients (36.7%) ≥ stage 4 in 2018 to 2019 vs 12/19 patients (63.2%) ≥ stage 4 in 2020 (P = .064). CONCLUSION Both, time to diagnosis and time to treatment initiation were similar during the pandemic. However, a higher proportion of advanced tumors stages was observed. Despite the pandemic, we provided a swift diagnostic workflow, including a virtual tumor board decision and a prompt treatment initiation. Level of Evidence: 4.
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Affiliation(s)
- Christian M. Meerwein
- Department of Otorhinolaryngology, Head & Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
- University of ZurichZurichSwitzerland
| | - Thomas M. Stadler
- Department of Otorhinolaryngology, Head & Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
- University of ZurichZurichSwitzerland
| | - Panagiotis Balermpas
- University of ZurichZurichSwitzerland
- Department of Radiation OncologyUniversity Hospital ZurichZurichSwitzerland
| | - Michael B. Soyka
- Department of Otorhinolaryngology, Head & Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
- University of ZurichZurichSwitzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head & Neck SurgeryUniversity Hospital ZurichZurichSwitzerland
- University of ZurichZurichSwitzerland
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15
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Panda S, Vig S, Singh CA, Konkimalla A, Thakar A, Sakthivel P, Sikka K, Kumar R, Bhatnagar S, Mohan A, Tiwari P, Meena VP, Garg RK, Bollu S, Thakur K. Head and Neck Surgery During COVID-19 Pandemic: Experience from a Tertiary Care in India. Indian J Surg Oncol 2021; 12:279-289. [PMID: 34539130 PMCID: PMC8435157 DOI: 10.1007/s13193-021-01424-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 07/27/2021] [Indexed: 11/25/2022] Open
Abstract
Head and neck pathologies requiring surgical intervention are considered a high-risk subsite in the context of COVID-19 pandemic by virtue of its close proximity to the mucosa of the upper aerodigestive tract. Retrospective review of all head and neck surgical procedures is undertaken during the pandemic from 23rd April 2020 to 30th September 2020. One hundred procedures were performed on 98 patients. COVID-19 status determined by SARS-Cov-2 RT-PCR at baseline was negative for 81, positive in 8 and unknown in 11. The RT-PCR negative subgroup included 40 diagnostic procedures and 41 ablative and or reconstructive procedures for head and neck neoplasms. None of the patients or health-care workers converted to COVID-19-positive status during the duration of the hospital stay. There were no cases with 30-day mortality. Clavien-Dindo grading for postoperative complications was as follows: 1–4, 2–12, 3a-2, 3b-1. Eleven patients with unknown COVID-19 status at baseline underwent emergency tracheostomy in a COVID-19 designated operating room for upper airway obstruction secondary to head and neck cancer. Of the 8 procedures conducted on known cases of COVID-19, 6 were tracheostomies performed for COVID-19 ARDS. The rest were maxillectomy for acute invasive mucormycosis and incision and drainage for parotid abscess. A matched-pair analysis was performed with similarly staged historical cohort operated during January to December 2016 to compare peri-operative complication rates (Clavien-Dindo Score). Incidence of complication with higher Clavien Dindo Score (>/=3a) was found to be lower in those patients operated during the pandemic (p=0.007). By meticulous preoperative COVID-19 screening and isolation, head and neck surgical procedures can be continued to avoid delay in diagnosis and treatment without jeopardising the risk of transmission of COVID-19 to the patients or health-care workers.
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Affiliation(s)
- Smriti Panda
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Saurabh Vig
- Department of Onco-Anesthesia, Pain and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chirom Amit Singh
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Abhilash Konkimalla
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Alok Thakar
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Pirabu Sakthivel
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Kapil Sikka
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anesthesia, Pain and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pavan Tiwari
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ved Prakash Meena
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit K. Garg
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sumanth Bollu
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
| | - Kuldeep Thakur
- Department of Otorhinolaryngology and,Head and Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi, India
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16
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Tan H, Preston J, Hunn S, Kwok M, Borschmann M. COVID-19 did not delay time from referral to definitive management for head and neck cancer patients in a regional Victorian centre. ANZ J Surg 2021; 91:1364-1368. [PMID: 34185361 PMCID: PMC8420257 DOI: 10.1111/ans.17057] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/16/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022]
Abstract
Background The COVID‐19 pandemic has had widespread impacts on health services, particularly regarding the provision of urgent elective surgical services. It has influenced the evaluation of surgical patients, patient willingness to consult with medical services, and the ability to provide timely care to these patients. The aim of this study is to assess the impact of the COVID‐19 pandemic on the time to definitive management for head and neck cancer in a regional setting. Methods A retrospective review was performed through the University Hospital Geelong Head and Neck Unit records and electronic medical records. Ethics approval for quality assurance was attained. The primary outcome was time from the first clinic appointment to commencement of definitive management. Statistical analysis was performed using Prism (version 8.0, GraphPad). Results A total of 127 patients were identified, 64 in the pre‐COVID and 63 in the post‐COVID period. In the post‐COVID period, more patients (14.3%) had their first clinic appointment with telehealth compared to the pre‐COVID period (1.6%). There was also no significant difference in time from referral to first clinic appointment or time from first clinic appointment to date of definitive treatment decision or multidisciplinary meeting. There was no significant difference in definitive treatment modality between groups. Conclusion Despite increased adoption of telemedicine and increased public health considerations, there was no increase in time to definitive treatment from the time of referral to a regional head and neck cancer service.
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Affiliation(s)
- Hannah Tan
- Department of Otolaryngology, Head and Neck Surgery, Barwon Health, Geelong, Victoria, Australia
| | - Joel Preston
- Department of Otolaryngology, Head and Neck Surgery, Barwon Health, Geelong, Victoria, Australia
| | - Samuel Hunn
- Department of Otolaryngology, Head and Neck Surgery, Barwon Health, Geelong, Victoria, Australia
| | - Matthew Kwok
- Department of Otolaryngology, Head and Neck Surgery, Barwon Health, Geelong, Victoria, Australia
| | - Michael Borschmann
- Department of Otolaryngology, Head and Neck Surgery, Barwon Health, Geelong, Victoria, Australia
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17
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Kiong KL, Diaz EM, Gross ND, Diaz EM, Hanna EY. The impact of COVID-19 on head and neck cancer diagnosis and disease extent. Head Neck 2021; 43:1890-1897. [PMID: 33650276 PMCID: PMC8013528 DOI: 10.1002/hed.26665] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Due to COVID-19, diagnostic delays and a surge of advanced head and neck cancer (HNC) is anticipated. We hereby evaluate patient and tumor characteristics before and during the early COVID-19 period. METHODS Retrospective review of patients with HNC presented at a multidisciplinary tumor conference from May 14, 2020 to June 18, 2020 was performed and compared to a similar 6-week period a year before. Demographics, time to diagnosis, and tumor characteristics were analyzed. RESULTS There was a 25% reduction in newly diagnosed malignancies. Groups were similar in baseline characteristics, duration of symptoms, and time to diagnosis. However, median primary tumor size was significantly larger (p = 0.042) and T stage more advanced for mucosal subsites (p = 0.025) in the COVID-19 group. CONCLUSION Our findings suggest increased tumor burden in patients with HNC presenting during the pandemic, despite a similar time to diagnosis. This may become more pronounced as the pandemic duration is extended.
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Affiliation(s)
- Kimberley L. Kiong
- Department of Head and Neck SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA,Department of Otorhinolaryngology – Head and Neck SurgerySingapore General HospitalSingaporeSingapore
| | - Edward M. Diaz
- Department of Head and Neck SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - Neil D. Gross
- Department of Head and Neck SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - Eduardo M. Diaz
- Department of Head and Neck SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - Ehab Y. Hanna
- Department of Head and Neck SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
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18
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Papautsky EL, Rice DR, Ghoneima H, McKowen ALW, Anderson N, Wootton AR, Veldhuis C. Characterizing Health Care Delays and Interruptions in the United States During the COVID-19 Pandemic: Internet-Based, Cross-sectional Survey Study. J Med Internet Res 2021; 23:e25446. [PMID: 33886489 PMCID: PMC8136407 DOI: 10.2196/25446] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/16/2021] [Accepted: 04/20/2021] [Indexed: 12/14/2022] Open
Abstract
Background The COVID-19 pandemic has broader geographic spread and potentially longer lasting effects than those of previous disasters. Necessary preventive precautions for the transmission of COVID-19 has resulted in delays for in-person health care services, especially at the outset of the pandemic. Objective Among a US sample, we examined the rates of delays (defined as cancellations and postponements) in health care at the outset of the pandemic and characterized the reasons for such delays. Methods As part of an internet-based survey that was distributed on social media in April 2020, we asked a US–based convenience sample of 2570 participants about delays in their health care resulting from the COVID-19 pandemic. Participant demographics and self-reported worries about general health and the COVID-19 pandemic were explored as potent determinants of health care delays. In addition to all delays, we focused on the following three main types of delays, which were the primary outcomes in this study: dental, preventive, and diagnostic care delays. For each outcome, we used bivariate statistical tests (t tests and chi-square tests) and multiple logistic regression models to determine which factors were associated with health care delays. Results The top reported barrier to receiving health care was the fear of SARS-CoV-2 infection (126/374, 33.6%). Almost half (1227/2570, 47.7%) of the participants reported experiencing health care delays. Among those who experienced health care delays and further clarified the type of delay they experienced (921/1227, 75.1%), the top three reported types of care that were affected by delays included dental (351/921, 38.1%), preventive (269/921, 29.2%), and diagnostic (151/921, 16.4%) care. The logistic regression models showed that age (P<.001), gender identity (P<.001), education (P=.007), and self-reported worry about general health (P<.001) were significantly associated with experiencing health care delays. Self-reported worry about general health was negatively related to experiencing delays in dental care. However, this predictor was positively associated with delays in diagnostic testing based on the logistic regression model. Additionally, age was positively associated with delays in diagnostic testing. No factors remained significant in the multiple logistic regression for delays in preventive care, and although there was trend between race and delays (people of color experienced fewer delays than White participants), it was not significant (P=.06). Conclusions The lessons learned from the initial surge of COVID-19 cases can inform systemic mitigation strategies for potential future disruptions. This study addresses the demand side of health care delays by exploring the determinants of such delays. More research on health care delays during the pandemic is needed, including research on their short- and long-term impacts on patient-level outcomes such as mortality, morbidity, mental health, people’s quality of life, and the experience of pain.
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Affiliation(s)
- Elizabeth Lerner Papautsky
- Department of Biomedical & Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Dylan R Rice
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Hana Ghoneima
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Anna Laura W McKowen
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Nicholas Anderson
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Angie R Wootton
- School of Social Welfare, University of California Berkeley, Berkeley, CA, United States
| | - Cindy Veldhuis
- Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
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19
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Meister KD, Pandian V, Hillel AT, Walsh BK, Brodsky MB, Balakrishnan K, Best SR, Chinn SB, Cramer JD, Graboyes EM, McGrath BA, Rassekh CH, Bedwell JR, Brenner MJ. Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review. Otolaryngol Head Neck Surg 2021; 164:984-1000. [PMID: 32960148 PMCID: PMC8198753 DOI: 10.1177/0194599820961990] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy. DATA SOURCES PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents. REVIEW METHODS Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations. CONCLUSIONS Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel. IMPLICATIONS FOR PRACTICE Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.
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Affiliation(s)
- Kara D. Meister
- Clinical Assistant Professor, Aerodigestive and Airway Reconstruction Center, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, Palo Alto, California, United States
- Clinical Assistant Professor, Center for Pediatric Voice and Swallowing Disorders, Department of Otolaryngology – Head & Neck Surgery, Division of Pediatric Otolaryngology, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, Palo Alto, California, United States
| | - Vinciya Pandian
- Associate Professor, Department of Nursing Faculty, Johns Hopkins University, Baltimore, Maryland, United States
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland, United States
| | - Alexander T. Hillel
- Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, United States
| | - Brian K. Walsh
- Professor, Department of Health Sciences, Liberty University, Lynchburg, United States
| | - Martin B. Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland, United States
- Associate Professor, Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, United States
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Karthik Balakrishnan
- Clinical Assistant Professor, Aerodigestive and Airway Reconstruction Center, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, Palo Alto, California, United States
- Clinical Assistant Professor, Center for Pediatric Voice and Swallowing Disorders, Department of Otolaryngology – Head & Neck Surgery, Division of Pediatric Otolaryngology, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, Palo Alto, California, United States
| | - Simon R. Best
- Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, United States
| | - Steven B. Chinn
- Assistant Professor, Department of Otolaryngology – Head and Neck Surgery, University of Michigan, Michigan, United States
| | - John D. Cramer
- Assistant Professor, Department of Otolaryngology – Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Evan M. Graboyes
- Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States
- Hollings Cancer Center, Charleston, South Carolina, United States
| | - Brendan A. McGrath
- Anesthesiology Consultant, University of Manchester, NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, United Kingdom
| | - Christopher H. Rassekh
- Professor, Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Joshua R. Bedwell
- Associate Professor, Baylor College of Medicine, Houston, Texas, United States
- Associate Professor, Division of Pediatric Otolaryngology-Head and Neck Surgery, Texas Children’s Hospital, Houston, Texas, United States
| | - Michael J. Brenner
- Associate Professor, Department of Otolaryngology – Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States, and President-elect, Global Tracheostomy Collaborative, Raleigh, North Carolina, United States
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20
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Thompson JA, Lubek JE, Amin N, Joy R, Dyalram D, Ord RA, Taylor RJ, Wolf JS, Mehra R, Cullen KJ, Molitoris JK, Witek M, Papadimitriou JC, Morales RE, Hatten KM. Impact of the Novel Coronavirus 2019 (COVID-19) Pandemic on Head and Neck Cancer Care. Otolaryngol Head Neck Surg 2021; 166:93-100. [PMID: 33784206 PMCID: PMC8010374 DOI: 10.1177/01945998211004544] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective The study aimed to assess the impact of the coronavirus disease 2019
(COVID-19) pandemic on head and neck oncologic care at a tertiary care
facility. Study Design This was a cross-sectional study conducted between March 18, 2020, and May
20, 2020. The primary planned outcome was the rate of treatment
modifications during the study period. Secondary outcome measures were tumor
conference volume, operative volume, and outpatient patient procedure and
clinic volumes. Setting This single-center study was conducted at a tertiary care academic hospital
in a large metropolitan area. Methods The study included a consecutive sample of adult subjects who were presented
at a head and neck interdepartmental tumor conference during the study
period. Patients were compared to historical controls based on review of
operative data, outpatient procedures, and clinic volumes. Results In total, 117 patients were presented during the review period in 2020,
compared to 69 in 2019. There was an 8.4% treatment modification rate among
cases presented at the tumor conference. There was a 61.3% (347 from 898)
reduction in outpatient clinic visits and a 63.4% (84 from 230) reduction in
procedural volume compared to the prior year. Similarly, the operative
volume decreased by 27.0% (224 from 307) compared to the previous year. Conclusion Restrictions related to the COVID-19 pandemic resulted in limited treatment
modifications. Transition to virtual tumor board format observed an increase
in case presentations. While there were reductions in operative volume,
there was a larger proportion of surgical cases for malignancy, reflecting
the prioritization of oncologic care during the pandemic.
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Affiliation(s)
- Joshua Adam Thompson
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Joshua E Lubek
- Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Neha Amin
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Reju Joy
- Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Donita Dyalram
- Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Robert A Ord
- Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Rodney J Taylor
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey S Wolf
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ranee Mehra
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Kevin J Cullen
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Jason K Molitoris
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Matthew Witek
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - John C Papadimitriou
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Robert E Morales
- Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kyle M Hatten
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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21
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Ito A, Kobayashi K, Shiotsuka M, Sato T, Omura G, Matsumoto Y, Ikeda A, Sakai A, Eguchi K, Takano T, Matsumoto F, Kobayashi O, Iwata S, Yoshimoto S. Uniform infection screening allowed safe head and neck surgery during the coronavirus disease 2019 pandemic in Japan. Jpn J Clin Oncol 2021; 51:400-407. [PMID: 33048119 PMCID: PMC7665677 DOI: 10.1093/jjco/hyaa195] [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: 09/12/2020] [Accepted: 09/27/2020] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study was to determine whether a uniform infection screening protocol could be used to safely perform head and neck cancer surgery during the coronavirus disease 2019 pandemic and clarify how surgical treatment changed compared with the pre-pandemic period. Materials and methods During the unprecedented coronavirus disease 2019 pandemic in Tokyo, we continued providing head and neck cancer care, guided by our own uniform screening protocol. In this study, medical records of 208 patients with head and neck malignancy, who underwent surgical treatment at our hospital during the first and second wave of pandemic for each 2-month period (first wave: 30 March 2020–30 May 2020, second wave: 14 July 2020–14 September 2020) and the 2-month pre-pandemic period (30 October 2019–30 December 2020), were analysed. Results A total of 133 patients were admitted for surgical treatment and all, except six patients with emergency tracheostomy, were screened according to the protocol. As a result, all 127 patients received surgical treatment as planned, and all 1247 medical staff members involved in the surgeries were uninfected by severe acute respiratory syndrome coronavirus 2. During the first wave of pandemic, 20% reduction of head and neck surgery was requited; however, restrictions of surgery were not necessary during the second wave. Surgical procedure, length of hospitalization, postoperative complications and number of medical staff were unchanged compared with pre-pandemic period. Conclusion Our data indicate that continuation of head and neck anticancer surgical treatment in an epidemic area during the coronavirus disease 2019 pandemic were safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out.
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Affiliation(s)
- Akiko Ito
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Mika Shiotsuka
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Tetsufumi Sato
- Department of Anesthesia and Intensive care, National Cancer Center Hospital, Tokyo, Japan
| | - Go Omura
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | | | - Atsuo Ikeda
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Azusa Sakai
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Kohtaro Eguchi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Tomonari Takano
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Fumihiko Matsumoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Osamu Kobayashi
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Satoshi Iwata
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
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22
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Abd-Alrazaq A, Schneider J, Mifsud B, Alam T, Househ M, Hamdi M, Shah Z. A Comprehensive Overview of the COVID-19 Literature: Machine Learning-Based Bibliometric Analysis. J Med Internet Res 2021; 23:e23703. [PMID: 33600346 PMCID: PMC7942394 DOI: 10.2196/23703] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/14/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Shortly after the emergence of COVID-19, researchers rapidly mobilized to study numerous aspects of the disease such as its evolution, clinical manifestations, effects, treatments, and vaccinations. This led to a rapid increase in the number of COVID-19-related publications. Identifying trends and areas of interest using traditional review methods (eg, scoping and systematic reviews) for such a large domain area is challenging. OBJECTIVE We aimed to conduct an extensive bibliometric analysis to provide a comprehensive overview of the COVID-19 literature. METHODS We used the COVID-19 Open Research Dataset (CORD-19) that consists of a large number of research articles related to all coronaviruses. We used a machine learning-based method to analyze the most relevant COVID-19-related articles and extracted the most prominent topics. Specifically, we used a clustering algorithm to group published articles based on the similarity of their abstracts to identify research hotspots and current research directions. We have made our software accessible to the community via GitHub. RESULTS Of the 196,630 publications retrieved from the database, we included 28,904 in our analysis. The mean number of weekly publications was 990 (SD 789.3). The country that published the highest number of COVID-19-related articles was China (2950/17,270, 17.08%). The highest number of articles were published in bioRxiv. Lei Liu affiliated with the Southern University of Science and Technology in China published the highest number of articles (n=46). Based on titles and abstracts alone, we were able to identify 1515 surveys, 733 systematic reviews, 512 cohort studies, 480 meta-analyses, and 362 randomized control trials. We identified 19 different topics covered among the publications reviewed. The most dominant topic was public health response, followed by clinical care practices during the COVID-19 pandemic, clinical characteristics and risk factors, and epidemic models for its spread. CONCLUSIONS We provide an overview of the COVID-19 literature and have identified current hotspots and research directions. Our findings can be useful for the research community to help prioritize research needs and recognize leading COVID-19 researchers, institutes, countries, and publishers. Our study shows that an AI-based bibliometric analysis has the potential to rapidly explore a large corpus of academic publications during a public health crisis. We believe that this work can be used to analyze other eHealth-related literature to help clinicians, administrators, and policy makers to obtain a holistic view of the literature and be able to categorize different topics of the existing research for further analyses. It can be further scaled (for instance, in time) to clinical summary documentation. Publishers should avoid noise in the data by developing a way to trace the evolution of individual publications and unique authors.
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Affiliation(s)
- Alaa Abd-Alrazaq
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Jens Schneider
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Borbala Mifsud
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Tanvir Alam
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Mounir Hamdi
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Zubair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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23
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Delayed presentation of head and neck cancer patients during COVID-19 pandemic. Eur Arch Otorhinolaryngol 2021; 278:5081-5085. [PMID: 33674926 PMCID: PMC7935695 DOI: 10.1007/s00405-021-06728-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/26/2021] [Indexed: 02/01/2023]
Abstract
Purpose Impact of COVID-19 pandemic on healthcare is huge. We intended to demonstrate how COVID-19 pandemic affected primary head and neck oncology patient’s referral and admission to a tertiary center by comparing the retrospective patient data in March–September 2020 and the same period in 2019. Methods In this cross-sectional study, from March 15th, 2020 to September 15th, 2020, medical records of 61 patients (Group 1) diagnosed and scheduled for surgery for head and neck cancer in our tertiary care center were revised and compared with 64 head and neck cancer patients treated in the same institution in the same time period of the previous year (Group2). Surgical site, TNM stages, need for reconstruction with flap, time from first symptom occurrence to first admission to our institution, and time to surgery were noted. Results In Group 1, out of 56 patients, 26 were diagnosed with T1-2 tumor, while 30 had T3-4 tumor. In Group 2, 43 of 60 patients had T1-2 tumor, while only 17 of them were diagnosed with T3-4 tumor. The rate of T3-4 tumors had significantly increased in 2020 when compared to 2019 (p = 0.049). In oral cavity cancer patients, N stage was significantly increased in Group 1 when compared to Group 2 (p = 0.024). Need for reconstruction with regional or free flaps were significantly increased in oral cavity cancer patients (p = 0,022). The mean time from the beginning of the first symptom to the admission was 19.01 ± 4.6 weeks (ranging between 11 and 32 weeks) in Group 1, while it was 16.6 ± 5.9 weeks in Group 2 (ranging between 6 and18 weeks); with significant increase (p = 0,02). The time to surgery from first admission was 3.4 ± 2.5 and 2.9 ± 1.2 weeks in Group 1 and 2, respectively, with no statistically significant difference (p = 0.06). Conclusion The COVID-19 pandemic has caused delay in the diagnosis and treatment of many diseases as such in head and neck cancers. Admission with advanced stage disease and the need for more complex reconstructive procedures were increased. During the pandemic, the management of other diseases that cause mortality and morbidity should not be neglected and priorities should be determined.
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24
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Vingiani V, Abadia AF, Posa A, Corvino A, Pasqualetto L, Presidente A, Losco M, Gray HN, Schoepf UJ. How the Workload and Outcome of Imaging Examinations Changed During the COVID-19 Pandemic Lockdown. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020166. [PMID: 33525213 PMCID: PMC7927480 DOI: 10.23750/abm.v91i4.10604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/26/2020] [Indexed: 12/28/2022]
Abstract
Background: On March 9th, 2020, the Italian government decided to go into lockdown due to the COVID-19 pandemic, which led to changes in the workflow of radiological examinations. Aims: Aim of the study is to illustrate how the workload and outcome of radiological exams changed in a community hospital during the pandemic. Methods and Material: The exams performed in the radiology department from March 9th to March 29th, 2020 were retrospectively reviewed and compared to the exams conducted during the same time-period in 2019. Only exams coming from the emergency department (ED) were included. Two radiologists defined the cases as positive or negative findings, based on independent blind readings of the imaging studies. Categorical measurements are presented as frequency and percentages, and p-values are calculated using the Chi-squared test. Results and Conclusions: There was a significant reduction in the amount of exams performed in 2020: there were 143 (93|65% male, 60.7±21.5 years) patients who underwent radiological examinations from the ED vs. 485 (255|53% male, 51.2±24.8 years) in 2019. Furthermore, the total number of ED exams dropped from 699 (2019) to 215 (2020). However, the percentage of patients with a positive result was significantly higher in 2020 (69|48%) compared to 2019 (151|31%) (p<.001). The reduction of emergency radiological examinations might be a result of the movement restrictions enforced during the lockdown, and possible fear of the hospital as a contagious place. This translated to a relative increase of positive cases as only patients with very serious conditions were accessing the ED. (www.actabiomedica.it)
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Affiliation(s)
- Vincenzo Vingiani
- U.O.C. Radiologia, P.O. Sorrento, Ospedali riuniti "Area penisola Sorrentina".
| | - Andres F Abadia
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina.
| | - Alessandro Posa
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy.
| | - Antonio Corvino
- 1Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133 Naples, Italy 2Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples Italy.
| | - Luigi Pasqualetto
- U.O.C. Radiologia, P.O. Sorrento, Ospedali riuniti "Area penisola Sorrentina" .
| | - Alfonso Presidente
- U.O.C. Radiologia, P.O. Sorrento, Ospedali riuniti "Area penisola Sorrentina" .
| | - Matteo Losco
- U.O.C. Radiologia, P.O. Sorrento, Ospedali riuniti "Area penisola Sorrentina" .
| | - Hunter N Gray
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina .
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina .
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25
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De Felice F, D'Angelo E, Ingargiola R, Iacovelli NA, Alterio D, Franco P, Bonomo P, Merlotti A, Bacigalupo A, Maddalo M, Di Rito A, Fanetti G, D'Onofrio I, Dionisi F, Miccichè F, Trignani M, Musio D, Paiar F, Romanello DA, Donato V, Orlandi E. A snapshot on radiotherapy for head and neck cancer patients during the COVID-19 pandemic: a survey of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) head and neck working group. Radiol Med 2020; 126:343-347. [PMID: 33025304 PMCID: PMC7538045 DOI: 10.1007/s11547-020-01296-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2023]
Abstract
Objectives The objective of the paper was to assess real-life experience in the management of head and neck cancer (HNC) patients during the COVID-19 pandemic in radiotherapy departments and to evaluate the variability in terms of adherence to American Society of Radiation Oncology (ASTRO) and European Society for Radiotherapy and Oncology (ESTRO) recommendations. Materials and methods In May 2020, an anonymous 30-question online survey, comparing acute phase of outbreak and pre-COVID-19 period, was conducted. Two sections exploited changes in general management of HNC patients and different HNC primary tumors, addressing specific statements from ASTRO ESTRO consensus statement as well. Results Eighty-eight questionnaires were included in the demographic/clinical workflow analysis, and 64 were analyzed for treatment management. Forty-eight percent of radiotherapy departments became part of oncologic hubs. First consultations reduced, and patients were addressed to other centers in 33.8 and 18.3% of cases, respectively. Telematic consultations were used in 50% of follow-up visits and 73.9% of multidisciplinary tumor board discussions. There were no practical changes in the management of patients affected by different primitive HNCs. Hypofractionation was not favored over conventional schedules. Conclusions Compared to pre-COVID era, the clinical workflow was highly re-organized, whereas there were no consistent changes in RT indications and schedules. Electronic supplementary material The online version of this article (10.1007/s11547-020-01296-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Elisa D'Angelo
- Radiation Oncology, University Hospital, AOU of Modena, Modena, Italy
| | - Rossana Ingargiola
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pierfrancesco Franco
- Radiation Oncology, Department of Oncology, University of Turin School of Medicine, Turin, Italy
| | - Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Anna Merlotti
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | | | - Marta Maddalo
- Department of Radiation Oncology, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alessia Di Rito
- Radiation Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Giuseppe Fanetti
- Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ida D'Onofrio
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Francesco Dionisi
- Proton Therapy Unit, Department of Oncology, Azienda Provinciale per i Servizi Sanitari, APSS, 38123, Trento, Italy
| | - Francesco Miccichè
- Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Marianna Trignani
- Department of Radiation Oncology, "SS. Annunziata" Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabiola Paiar
- Radiation Oncology Unit S, Chiara University Hospital of Pisa, Pisa, Italy
| | - Domenico Attilio Romanello
- School of Medicine, University of Milan-Bicocca, Milan, Italy.,National Center of Oncological Hadrontherapy (Fondazione CNAO), Strada Campeggi, 53, 27100, Pavia, Italy
| | - Vittorio Donato
- Radiation Oncology Division, Oncology and Specialty Medicine Department, San Camillo-Forlanini Hospital, Rome, Italy
| | - Ester Orlandi
- National Center of Oncological Hadrontherapy (Fondazione CNAO), Strada Campeggi, 53, 27100, Pavia, Italy.
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26
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American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Foundation Guide to Enhance Otologic and Neurotologic Care During the COVID-19 Pandemic. Otol Neurotol 2020; 41:1163-1174. [PMID: 32925832 DOI: 10.1097/mao.0000000000002868] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
: This combined American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Surgery Foundation document aims to provide guidance during the coronavirus disease of 2019 (COVID-19) on 1) "priority" of care for otologic and neurotologic patients in the office and operating room, and 2) optimal utilization of personal protective equipment. Given the paucity of evidence to inform otologic and neurotologic best practices during COVID-19, the recommendations herein are based on relevant peer-reviewed articles, the Centers for Disease Control and Prevention COVID-19 guidelines, United States and international hospital policies, and expert opinion. The suggestions presented here are not meant to be definitive, and best practices will undoubtedly change with increasing knowledge and high-quality data related to COVID-19. Interpretation of this guidance document is dependent on local factors including prevalence of COVID-19 in the surgeons' local community. This is not intended to set a standard of care, and should not supersede the clinician's best judgement when managing specific clinical concerns and/or regional conditions.Access to otologic and neurotologic care during and after the COVID-19 pandemic is dependent upon adequate protection of physicians, audiologists, and ancillary support staff. Otolaryngologists and associated staff are at high risk for COVID-19 disease transmission based on close contact with mucosal surfaces of the upper aerodigestive tract during diagnostic evaluation and therapeutic procedures. While many otologic and neurotologic conditions are not imminently life threatening, they have a major impact on communication, daily functioning, and quality of life. In addition, progression of disease and delay in treatment can result in cranial nerve deficits, intracranial and life-threatening complications, and/or irreversible consequences. In this regard, many otologic and neurotologic conditions should rightfully be considered "urgent," and almost all require timely attention to permit optimal outcomes. It is reasonable to proceed with otologic and neurotologic clinic visits and operative cases based on input from expert opinion of otologic care providers, clinic/hospital administration, infection prevention and control specialists, and local and state public health leaders. Significant regional variations in COVID-19 prevalence exist; therefore, physicians working with local municipalities are best suited to make determinations on the appropriateness and timing of otologic and neurotologic care.
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27
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Ghulam-Smith M, Choi Y, Edwards H, Levi JR. Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic. Otolaryngol Head Neck Surg 2020; 164:519-521. [PMID: 32928033 DOI: 10.1177/0194599820954838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Melissa Ghulam-Smith
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Yeyoon Choi
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Heather Edwards
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Jessica R Levi
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, MA, USA
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28
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Zaniboni A, Ghidini M, Grossi F, Indini A, Trevisan F, Iaculli A, Dottorini L, Moleri G, Russo A, Vavassori I, Brevi A, Rausa E, Boni L, Dondossola D, Valeri N, Ghidini A, Tomasello G, Petrelli F. A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic. Cancers (Basel) 2020; 12:E2452. [PMID: 32872421 PMCID: PMC7565383 DOI: 10.3390/cancers12092452] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception up to 1st June 2020, using the terms "(cancer or tumor) AND (COVID 19)". Articles were selected for relevance and split into five categories: (1) personal recommendations of single or multiple authors, (2) recommendations of single authoritative centers, (3) recommendations of panels of experts or of multiple regional comprehensive centers, (4) recommendations of multicenter cooperative groups, (5) official guidelines or recommendations of health authorities. Of the 97 included studies, 10 were personal recommendations of single or multiple independent authors, 16 were practice recommendations of single authoritative cancer centers, 35 were recommendations provided by panel of experts or of multiple regional comprehensive centers, 19 were cooperative group position papers, and finally, 17 were official guidelines statements. The COVID-19 pandemic is a global emergency, and has rapidly modified our clinical practice. Delaying unnecessary treatment, minimizing toxicity, and identifying care priorities for surgery, radiotherapy, and systemic therapies must be viewed as basic priorities in the COVID-19 era.
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Affiliation(s)
| | - Michele Ghidini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Francesco Grossi
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Alice Indini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | | | - Alessandro Iaculli
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Lorenzo Dottorini
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Giovanna Moleri
- Centro Servizi, Direzione Socio-Sanitaria, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandro Russo
- Surgical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Ivano Vavassori
- Urology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandra Brevi
- Otorhinolaryngology-Head and Neck Surgery Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Emanuele Rausa
- General Surgery 1 Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy;
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Daniele Dondossola
- General and Liver Transplant Surgery Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, Università degli Studi of Milan, 20122 Milan, Italy
| | - Nicola Valeri
- Division of Molecular Pathology and Centre for Evolution and Cancer, The Institute of Cancer Research, London SW7 3RP, UK;
- Department of Medicine, The Royal Marsden Hospital, London SW3 6JJ, UK
| | | | - Gianluca Tomasello
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Fausto Petrelli
- Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy
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29
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Abd-alrazaq A, Schneider J, Mifsud B, Alam T, Househ M, Hamdi M, Shah Z. A Comprehensive Overview of the COVID-19 Literature: Machine Learning–Based Bibliometric Analysis (Preprint).. [DOI: 10.2196/preprints.23703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Shortly after the emergence of COVID-19, researchers rapidly mobilized to study numerous aspects of the disease such as its evolution, clinical manifestations, effects, treatments, and vaccinations. This led to a rapid increase in the number of COVID-19–related publications. Identifying trends and areas of interest using traditional review methods (eg, scoping and systematic reviews) for such a large domain area is challenging.
OBJECTIVE
We aimed to conduct an extensive bibliometric analysis to provide a comprehensive overview of the COVID-19 literature.
METHODS
We used the COVID-19 Open Research Dataset (CORD-19) that consists of a large number of research articles related to all coronaviruses. We used a machine learning–based method to analyze the most relevant COVID-19–related articles and extracted the most prominent topics. Specifically, we used a clustering algorithm to group published articles based on the similarity of their abstracts to identify research hotspots and current research directions. We have made our software accessible to the community via GitHub.
RESULTS
Of the 196,630 publications retrieved from the database, we included 28,904 in our analysis. The mean number of weekly publications was 990 (SD 789.3). The country that published the highest number of COVID-19–related articles was China (2950/17,270, 17.08%). The highest number of articles were published in bioRxiv. Lei Liu affiliated with the Southern University of Science and Technology in China published the highest number of articles (n=46). Based on titles and abstracts alone, we were able to identify 1515 surveys, 733 systematic reviews, 512 cohort studies, 480 meta-analyses, and 362 randomized control trials. We identified 19 different topics covered among the publications reviewed. The most dominant topic was public health response, followed by clinical care practices during the COVID-19 pandemic, clinical characteristics and risk factors, and epidemic models for its spread.
CONCLUSIONS
We provide an overview of the COVID-19 literature and have identified current hotspots and research directions. Our findings can be useful for the research community to help prioritize research needs and recognize leading COVID-19 researchers, institutes, countries, and publishers. Our study shows that an AI-based bibliometric analysis has the potential to rapidly explore a large corpus of academic publications during a public health crisis. We believe that this work can be used to analyze other eHealth-related literature to help clinicians, administrators, and policy makers to obtain a holistic view of the literature and be able to categorize different topics of the existing research for further analyses. It can be further scaled (for instance, in time) to clinical summary documentation. Publishers should avoid noise in the data by developing a way to trace the evolution of individual publications and unique authors.
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González-Montero J, Valenzuela G, Ahumada M, Barajas O, Villanueva L. Management of cancer patients during COVID-19 pandemic at developing countries. World J Clin Cases 2020; 8:3390-3404. [PMID: 32913846 PMCID: PMC7457113 DOI: 10.12998/wjcc.v8.i16.3390] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/09/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
Cancer patient care requires a multi-disciplinary approach and multiple medical and ethical considerations. Clinical care during a pandemic health crisis requires prioritising the use of resources for patients with a greater chance of survival, especially in developing countries. The coronavirus disease 2019 crisis has generated new challenges given that cancer patients are normally not prioritised for admission in critical care units. Nevertheless, the development of new cancer drugs and novel adjuvant/neoadjuvant protocols has dramatically improved the prognosis of cancer patients, resulting in a more complex decision-making when prioritising intensive care in pandemic times. In this context, it is essential to establish an effective and transparent communication between the oncology team, critical care, and emergency units to make the best decisions, considering the principles of justice and charity. Concurrently, cancer treatment protocols must be adapted to prioritise according to oncologic response and prognosis. Communication technologies are powerful tools to optimise cancer care during pandemics, and we must adapt quickly to this new scenario of clinical care and teaching. In this new challenging pandemic scenario, multi-disciplinary work and effective communication between clinics, technology, science, and ethics is the key to optimising clinical care of cancer patients.
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Affiliation(s)
- Jaime González-Montero
- Basic and Clinical Oncology Department, Faculty of Medicine, University of Chile, Santiago 70058, Chile
| | - Guillermo Valenzuela
- Basic and Clinical Oncology Department, Faculty of Medicine, University of Chile, Santiago 70058, Chile
| | - Mónica Ahumada
- Basic and Clinical Oncology Department, Faculty of Medicine, University of Chile, Santiago 70058, Chile
- Basic and Clinical Oncology Department, Hospital Clinico Universidad de Chile and Clínica Dávila, Chile
| | - Olga Barajas
- Basic and Clinical Oncology Department, Faculty of Medicine, University of Chile, Santiago 70058, Chile
- Basic and Clinical Oncology Department, Hospital Clinico Universidad de Chile and Fundación Arturo López-Pérez, Chile
| | - Luis Villanueva
- Oncology Department, Hospital Clínico Universidad de Chile and Fundación Arturo López-Perez, Chile
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Alves FA, Saunders D, Sandhu S, Xu Y, de Mendonça NF, Treister NS. Implication of COVID-19 in oral oncology practices in Brazil, Canada, and the United States. Oral Dis 2020; 27 Suppl 3:793-795. [PMID: 32557965 PMCID: PMC7323326 DOI: 10.1111/odi.13493] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/07/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Fabio A Alves
- Stomatology Department, A.C. Camargo Cancer Center, Sao Paulo, Brazil.,Stomatology Department - School of dentistry, Sao Paulo University, Sao Paulo, Brazil
| | - Deborah Saunders
- Department of Dental Oncology, North East Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Shaiba Sandhu
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
| | - Yuanming Xu
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Nathaniel S Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
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Brody RM, Albergotti WG, Shimunov D, Nicolli E, Patel UA, Harris BN, Bur AM. Changes in head and neck oncologic practice during the COVID-19 pandemic. Head Neck 2020; 42:1448-1453. [PMID: 32357380 PMCID: PMC7267666 DOI: 10.1002/hed.26233] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has raised controversies regarding safe and effective care of patients with head and neck cancer. It is unknown how much the pandemic has changed surgeon practice. METHODS A questionnaire was distributed to head and neck surgeons assessing opinions related to treatment and concerns for the safety of patients, self, family, and staff. RESULTS A total of 88 head and neck surgeons responded during the study period. Surgeons continued to recommend primary surgical treatment for oral cavity cancers. Respondents were more likely to consider nonsurgical therapy for patients with early glottic cancers and HPV-mediated oropharynx cancer. Surgeons were least likely to be concerned for their own health and safety and had the greatest concern for their resident trainees. CONCLUSIONS This study highlights differences in the willingness of head and neck surgeons to delay surgery or alter plans during times when hospital resources are scarce and risk is high.
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Affiliation(s)
- Robert M Brody
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - William Greer Albergotti
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - David Shimunov
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Nicolli
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, Florida, USA
| | - Urjeet A Patel
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
| | - Brianna N Harris
- Department of Otolaryngology-Head and Neck Surgery, Scripps Memorial, San Diego, California, USA
| | - Andrés M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas, Kansas City, Kansas, USA
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A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries. Eur J Cancer 2020; 135:130-146. [PMID: 32580130 PMCID: PMC7834380 DOI: 10.1016/j.ejca.2020.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low- and middle-income countries (LMICs). In this review, we aimed to summarize these international guidelines in accordance with cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumour criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints.
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Syamal M. Literature-guided recommendations for otolaryngologists during the COVID-19 pandemic: A contemporary review. Laryngoscope Investig Otolaryngol 2020; 5:432-437. [PMID: 32596484 PMCID: PMC7314467 DOI: 10.1002/lio2.389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of this study was to review the current literature and guidelines on management of the novel coronavirus 2019 (COVID-19 or 2019nCoV) with respect to the field of Otolaryngology. DESIGN Contemporary literature review. METHODS Systematic literature review of global medical literature databases and communications were queried to find all available literature recommendations, research, and guidelines applicable to otolaryngologists in the COVID-19 pandemic. RESULTS Guidance on personal protective equipment, office visits, and surgical scheduling, as well as recommendations for safe airway management and tracheotomy performance during the COVID-19 pandemic were compiled and interpreted. CONCLUSIONS Little guidance exists for otolaryngologists who are among the highest risk groups during the rapidly evolving COVID-19 pandemic. This synthesis and compilation of global resources serve as a building block for further guidance during the epidemic. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Mausumi Syamal
- Lehigh Valley Health Network, Division of Otolaryngology‐Head & Neck Surgery (MS), University of South Florida, Morsani College of MedicineTampaFloridaUSA
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Shuman AG, Campbell BH. Ethical framework for head and neck cancer care impacted by COVID-19. Head Neck 2020; 42:1214-1217. [PMID: 32329948 PMCID: PMC7264503 DOI: 10.1002/hed.26193] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic has upended head and neck cancer care delivery in ways unforeseen and unprecedented. The impact of these changes parallels other fields in oncology, but is disproportionate due to protective measures and limitations on potentially aerosolizing procedures and related interventions specific to the upper aerodigestive tract. The moral and professional dimensions of providing ethically appropriate and consistent care for our patients in the COVID-19 crisis are considered herein for head and neck oncology providers.
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Affiliation(s)
- Andrew G Shuman
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Bruce H Campbell
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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