Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis.

Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study.

The novel COVID-19 outbreak has affected more than 200 countries and territories as of March 2020. Given that patients with cancer are generally more vulnerable to infections, systematic analysis of diverse cohorts of patients with cancer affected by COVID-19 is needed. We performed a multicenter study including 105 patients with cancer and 536 age-matched noncancer patients confirmed with COVID-19. Our results showed COVID-19 patients with cancer had higher risks in all severe outcomes. Patients with hematologic cancer, lung cancer, or with metastatic cancer (stage IV) had the highest frequency of severe events. Patients with nonmetastatic cancer experienced similar frequencies of severe conditions to those observed in patients without cancer. Patients who received surgery had higher risks of having severe events, whereas patients who underwent only radiotherapy did not demonstrate significant differences in severe events when compared with patients without cancer. These findings indicate that patients with cancer appear more vulnerable to SARS-CoV-2 outbreak. SIGNIFICANCE: Because this is the first large cohort study on this topic, our report will provide much-needed information that will benefit patients with cancer globally. As such, we believe it is extremely important that our study be disseminated widely to alert clinicians and patients.This article is highlighted in the In This Issue feature, p. 747.

https://cancerdiscovery.aacrjournals.org/content/candisc/10/6/783.full.pdf

Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak.

Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China.

The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Scientific advancements since the pandemic of severe acute respiratory syndrome (SARS) in 2002~2003 and Middle East respiratory syndrome (MERS) in 2012 have accelerated our understanding of the epidemiology and pathogenesis of SARS-CoV-2 and the development of therapeutics to treat viral infection. As no specific therapeutics and vaccines are available for disease control, the epidemic of COVID-19 is posing a great threat for global public health. To provide a comprehensive summary to public health authorities and potential readers worldwide, we detail the present understanding of COVID-19 and introduce the current state of development of measures in this review.

Virology, Epidemiology, Pathogenesis, and Control of COVID-19.

Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China.

Objective We aim to report a novel surgical technique that robotic-assisted thoracoscopic surgery combined with non-intubated spontaneous ventilation to perform tracheal/airway surgery. Summary background data Our team has demonstrated video-assisted transthoracic surgery (VATS) can be used for thoracic tracheal diseases with satisfactory outcomes. Our team has also demonstrated that tracheal/ airway resection and reconstruction under spontaneous ventilation can improve the anastomosis and operating time. Recently, robotic-assisted thoracoscopic surgery (RATS) emerged as an available alternative minimally invasive approach for lung cancer, with lower perioperative mortality and conversion rate to open. Methods Five patients fulfilling the criteria for non-intubated approach underwent RATS tracheal/airway surgery. Patient 1 has a tumor in the thoracic trachea; patient 2 had involving secondary carina; patient 3 had involving trachea carina, and patient 4 had involving left main bronchus. Patient 5 had involving mid-tracheal. Results All patients had an uneventful procedure. The total operative time ranged from 5 h 5 min to 9 h 55 min. The postoperative hospital stays ranged from 4 days to 14 days. Fiber-optic bronchoscopy performed one month after the procedure showed good anastomotic healing with no stricture. Conclusion This is the first report on RATS use in tracheal/airway surgery, in combination with non-intubation spontaneous ventilation. In selected patients, this novel combined approach is feasible and safe. A patient can potentially benefit from the combined advantages of both techniques. More cases and longer-term data are required to establish its role in tracheal/airway surgery.

Non-intubated Robotic-Assisted Thoracic Surgery for Tracheal/Airway Resection and Reconstruction: Technique Description and Preliminary Results.

BACKGROUND Early endotracheal extubation in operating room (E-OR) after lung transplantation is rarely reported worldwide. Herein, we aim to explore the feasibility and safety of E-OR after lung transplantation and demonstrate its potential benefits. METHODS This study is a single-center retrospective database analysis of 18 patients. All lung transplantation patients with E-OR attempted between June 2018 and September 2019 were included retrospectively. Perioperative variables, including ischemia time, total blood loss, blood lactic acid, the partial pressure of oxygen, partial pressure of oxygen/fraction of inspiration oxygen ratio, time of semi-open pulmonary artery occlusion clamp, extubation rate, and complications after E-OR, were analyzed. Data were compared using non-parametric tests and expressed as the median or number (percentage). RESULTS Clinical data of 18 patients with E-OR attempted were collected. Overall, 15/18 (83.33%) patients successfully underwent E-OR without reintubation. Reintubation occurred in 3/18 (16.67%) patients; one patient presented with decreased blood oxygen saturation and unconsciousness, while two patients developed hypoxemia and respiratory failure after E-OR. Extracorporeal membrane oxygenation (ECMO) was not used postoperatively. No grade 3 primary graft dysfunction was observed and all eighteen patients were alive 1 year after the transplant. No postoperative hemodialysis and tracheotomy occurred. The median length of stay in the intensive care unit (ICU) for E-OR patients was 120 hours, the median length of postoperative hospital stay was 19 days, and the median hospitalization cost was 35,577 USD. CONCLUSIONS Early endotracheal extubation in operating room was feasible and did not delay postoperative recovery in these 18 lung transplantation recipients.

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Early extubation in operating room after single-lung transplantation: a single institutional experience.

Background To increase locoregional and systemic tumor control, a portion of patients with stage III (N2, N3) non-small cell lung cancer (NSCLC) received pulmonary resection after immunochemotherapy in our center. Herein, we assessed the real-world downstage (T, N stage) effectiveness of immunochemotherapy as induction treatment and explored the proper cycle number for stage III (N2, N3) NSCLC. Methods Biopsy confirmed stage III (N2, N3) NSCLC patients who underwent immunochemotherapy between January 1st, 2018, to August 30th, 2019, were identified. Tumor radiologic regression, lymph node down-staging, and pathological response information were collected. Results In total, 16 patients with stage IIIA NSCLC, 30 with stage IIIB NSCLC, 9 with stage IIIC NSCLC (N2, N3 metastasis) were included. After immunochemotherapy, 25/55 (45.5%) patients achieved an objective response. Ultimately, 33/55 (60.0%) patients received lobectomy plus systemic lymphadenectomy, of whom 18/33 (54.5%) obtained major pathological response (MPR) of the primary lesion, and 24 (72.7%) had pathological-confirmed lymph node downstage (N2-3 to N0-1). Notably, four patients had MPR of the primary lesion but without lymph node downstage. At the time of data cutoff (December 30th, 2020), the median follow-up duration was 9.2 months (IQR 8.0-11.7), 24/33 (72.7%) of patients that had pulmonary resection were progression-free, with 30 of them alive. Binary logistics analysis showed that 3-4 induction cycles were favorably associated with MPR than 1-2 cycles (p = 0.017). Conclusions Immunochemotherapy as induction treatment showed encouraging MPR and lymph nodes down-staging rates in stage III (N2, N3) NSCLC in this study. Prolonged (3-4) cycles of immunochemotherapy were recommended for a better pathological response.

/pdf/immunochemotherapy-as-induction-treatment-in-stage-iii-n2-n3-1buwlzvmyp.pdf

Qing Ai

Papers

Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China.

Non-intubated Robotic-Assisted Thoracic Surgery for Tracheal/Airway Resection and Reconstruction: Technique Description and Preliminary Results.

Early extubation in operating room after single-lung transplantation: a single institutional experience.

Immunochemotherapy as induction treatment in Stage III (N2, N3) Non-small cell lung cancer