Outcome of Oncology Patients Infected With Coronavirus.

PURPOSE: This study investigated the features of oncology patients with confirmed Middle East respiratory syndrome (MERS) at the Ministry of National Guard Health Affairs-Riyadh during the outbreak of June 2015 to determine the clinical course and outcome of affected patients. METHODS: The patients' demographic information, cancer history, treatment pattern, information about MERS-coronavirus (CoV) infection, history of travel, clinical symptoms, test results, and outcome were collected and analyzed as part of a quality improvement project to improve the care and safety of our patients. Only patients with confirmed infection were included. RESULTS: A total of 19 patients were identified, with a median age of 66 years (range, 16-88 years), and 12 patients (63%) were males. The most common underlying disease was hematologic malignancies (47.4%), followed by colorectal cancer (21%) and lung cancer (15.8%). Hypertension and diabetes mellitus were the most common comorbidities (57.9% and 52.6%, respectively). Infection was diagnosed by nasopharyngeal swab in all patients. All patients contracted the infection during their hospitalization for other reasons. Sixteen patients (80%) were admitted to the intensive care unit; 13 patients (81%) had acute respiratory distress syndrome, 11 were intubated (68.75%), 9 had acute renal injury (56.25%), and 3 required dialysis (18.75%). Only 3 patients (15.8%) with early-stage cancers survived. Patients with hematologic malignancies and advanced solid tumors had a 100% case fatality rate. The majority of the causes of death were due to multi-organ failure and septic shock. CONCLUSION: MERS-CoV infection resulted in a high case fatality rate in patients with malignancy. Therefore, it is critical to implement effective primary preventive measures to avoid exposure of patients with cancer to the virus.

Managing Oncology Services During a Major Coronavirus Outbreak: Lessons From the Saudi Arabia Experience.

Outbreaks of infectious etiology, particularly those caused by a novel virus that has no known treatment or vaccine, may result in the interruption of medical care provided to patients with cancer and put them at risk for undertreatment in addition to the risk of being exposed to infection, a life-threatening event among patients with cancer. This article describes the approach used to manage patients with cancer during a large-scale Middle East respiratory syndrome-coronavirus hospital outbreak in Saudi Arabia to ensure continuity of care and minimize harm from treatment interruption or acquiring infection. The approach taken toward managing this high-risk situation (COVID-19) could be easily adopted by health care organizations and would be helpful to ensure readiness for the occurrence of future outbreaks of different infectious etiologies like those recent episodes of new coronavirus.

Use of complementary and alternative medicine by patients with cancer in Saudi Arabia.

BACKGROUND: The use of complementary and alternative medicine (CAM) is common among patients with cancer. However, the issue is not well-studied among the Saudi patient population. Our study aimed at determining the patterns of CAM use among patients with cancer in Saudi Arabia. METHODS: A cross-sectional study using interview-administered questionnaire was conducted in patients with cancer in the Oncology Department of King Abdulaziz Medical City for National Guards, Riyadh, Kingdom of Saudi Arabia. Patients were asked about CAM use including dietary supplement (DS) and non-DS remedies. Univariate and multivariate analyses were conducted to identify predicting factors for CAM use. RESULTS: A total of 453 adult patients were enrolled in the study, with a median age of 53.5 years (14.7-94.6), and the ratio of females to males was 271/182 (59.8%/40.2%). Of those, 410 patients (90.5%) used some type of CAM remedy. Non-DS remedies were used by 399 patients (88%) and were mainly of a religious nature including reciting the Quran (74.8%), prayer (16%), supplication (13%), and others (3.7%). However, 386 patients (85.2%) used DS including: Zamzam water (59.8%), honey (54.3%), black seed (35.1%), water with the Quran recited over it (29.8%), and other remedies. The majority of patients (90%) used CAM as a cancer treatment and the rest used it for various reasons, such as symptom control or supportive treatment. Only 18% of the patients discussed CAM use with their physicians, compared to 68% discussing it with religious clergypeople (Sheikhs).The univariate analysis revealed that only female gender is a predictor of CAM use, which remained significant in a multivariate analysis, in addition to current employment. CONCLUSIONS: The use of complementary therapies among Saudi patients with cancer is highly prevalent, with a predominance of interventions of religious background, indicating the strong influence of religion on peoples' lives, especially when people are faced with life-threatening illnesses.