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During the COVID-19 lockdown the prolonged closure of sport facilities is causing Legionella growth in the system. Based on an in-house developed simulation tool, the L. pneumophila concentration is predicted dynamically throughout the system and restart guidelines are evaluated. © International Building Performance Simulation Association, 2022
ABSTRACT
BACKGROUND: Solid cancer is an independent prognostic factor for poor outcome with COVID-19. As guidelines for patient management in that setting depend on retrospective efforts, we here present the first analyses of a nationwide database of patients with cancer hospitalized with COVID-19 in Belgium, with a focus on changes in anticancer treatment plans at the time of SARS-CoV-2 infection. METHODS: Nineteen Belgian hospitals identified all patients with a history of solid cancer hospitalized with COVID-19 between March 2020 and February 2021. Demographic, cancer-specific and COVID-specific data were pseudonymously entered into a central Belgian Society of Medical Oncology (BSMO)-COVID database. The association between survival and primary cancer type was analyzed through multivariate multinomial logistic regression. Group comparisons for categorical variables were carried out through a Chi-square test. RESULTS: A total of 928 patients were registered in the database; most of them were aged ≥70 years (61.0%) and with poor performance scores [57.2% Eastern Cooperative Oncology Group (ECOG) ≥2]. Thirty-day COVID-related mortality was 19.8%. In multivariate analysis, a trend was seen for higher mortality in patients with lung cancer (27.6% versus 20.8%, P = 0.062) and lower mortality for patients with breast cancer (13.0% versus 23.3%, P = 0.052) compared with other tumour types. Non-curative treatment was associated with higher 30-day COVID-related mortality rates compared with curative or no active treatment (25.8% versus 14.3% versus 21.9%, respectively, P < 0.001). In 33% of patients under active treatment, the therapeutic plan was changed due to COVID-19 diagnosis, most frequently involving delays/interruptions in systemic treatments (18.6%). Thirty-day COVID-related mortality was not significantly different between patients with and without treatment modifications (21.4% versus 20.5%). CONCLUSION: Interruption in anticancer treatments at the time of SARS-CoV-2 infection was not associated with a reduction in COVID-related mortality in our cohort of patients with solid cancer, highlighting that treatment continuation should be strived for, especially in the curative setting.
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In attempting to manage and cope with the coronavirus disease 2019 (COVID-19) pandemic, varying health strategies were implemented by governments worldwide. The South African government passed legislation implementing a lockdown in the country which included a prohibition of the sale and transportation of alcohol and cigarettes. In this contribution, the impact of this legislation on the mental health of those in addiction and those in recovery was explored. Against the backdrop of the global political climate of COVID-19, factors influencing the concepts of health and healing were questioned. National online recovery groups were identified as interventions aimed at promoting a sense of community in the face of social isolation and social distancing. The integration of shared ideas between Christian theology and positive psychology relating to the concept of self-control was explored. Building forth on, ‘The interface of religion, spirituality and mental health in a South African context: Naming the unnamed conflict’ attitudes of collaboration between the two worlds of psychology and pastoral ministry included, amongst others, humility, integrity, honesty and teachableness. These attitudes were linked to underlying spiritual pillars of recovery evident in the Christian-based online recovery groups of Project Exodus. Intradisciplinary and/or interdisciplinary implications: These online recovery groups provided an example of an interdisciplinary approach to healing where psychology and Christian spirituality, as represented by mental health professionals, pastors and others in community, collaborated and encouraged the taking of personal responsibility, and supported the collective love, compassion and care towards those struggling with addiction, and those in recovery during the COVID-19 lockdown in South Africa. © 2021. The Authors. Licensee: AOSIS.
ABSTRACT
Background: There is a broad range of clinical presentations of a SARS-CoV-2 viral infection varying from asymptomatic, sensation of a mild cold or flu to severe bilateral pneumonia and death. Liang et al. already reported the most severe complications in cancer patients particularly when they had undergone chemotherapy or surgery over the last month. In absence of a vaccine or adequate treatment of COVID-19 current measures to minimize the infectious risk of SARS-CoV-2 in a cancer patient population are focused on social distancing and protective measures for the medical and nursing staff members, and in some settings also patients. As it is clear that a hospital is a high risk setting to contract COVID-19, one of the strategies we can use to treat cancer patients as safe as possible, is to reduce hospital visits to a strict minimum. Trial design: The COREO-trial is a non-randomized cohort study at the Oncology unit of the Antwerp University Hospital (COVID-19 reference center) and AZ Maria Middelares Gent, both in Belgium. This trial contains two groups. Group A consists of patients that undergo outpatient monitoring (blood sampling at home and monitoring side effects using a smartphone application). Group B consists of patients that are in the classical hospital setting (= control group). The primary objective is to assess whether patients having home monitored oncologic treatment (cohort A) have a lower risk to the develop (severe) clinical COVID-19 compared to patients having classic in hospital oncologic treatment (cohort B). The working hypothesis is that interactive outpatient monitoring and management within the COREO-trial allows high quality cancer care with reduction of COVID-19 related complications. Legal entity responsible for the study: Antwerp University Hospital. Funding: Antwerp University Hospital. Disclosure: All authors have declared no conflicts of interest.