RESUMEN
BACKGROUND: Concerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, we review the experience of a comprehensive cancer center. METHODS: A prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days. RESULTS: Among 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography scan. In line with our case mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19-related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O2 saturation. CONCLUSIONS: COVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.
Asunto(s)
Antivirales/uso terapéutico , Tratamiento Farmacológico de COVID-19 , Neoplasias/terapia , Sistema de Registros/estadística & datos numéricos , SARS-CoV-2/efectos de los fármacos , Anciano , COVID-19/diagnóstico , COVID-19/epidemiología , Prueba de COVID-19/métodos , Comorbilidad , Femenino , Francia/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/epidemiología , Evaluación de Resultado en la Atención de Salud/métodos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Pandemias/prevención & control , Factores de Riesgo , SARS-CoV-2/genética , SARS-CoV-2/fisiología , Análisis de SupervivenciaAsunto(s)
Anestesia Local/métodos , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/métodos , Prótesis Vascular , Angiografía por Tomografía Computarizada , Procedimientos Endovasculares , Hipnosis , Anciano , Fluoroscopía , Humanos , Masculino , Diseño de PrótesisRESUMEN
BACKGROUND AND OBJECTIVES: The authors conducted a scanographic study in order to characterize the local anesthetic spread of injectate resulting from a single-injection technique of deep cervical plexus block. METHODS: Six consecutive American Society of Anesthesiologists II and III patients scheduled for elective carotid endarterectomy under regional anesthesia were enrolled. Deep cervical plexus block was placed via an anterolateral approach using a nerve stimulator to guide the injection on contact with the levator scapulae nerve. With specific contractions evoked at a stimulating current intensity Asunto(s)
Anestésicos Locales/farmacocinética
, Bloqueo Nervioso Autónomo/métodos
, Plexo Cervical
, Endarterectomía Carotidea
, Anciano
, Anestesia Local
, Bloqueo Nervioso Autónomo/instrumentación
, Medios de Contraste
, Estimulación Eléctrica/instrumentación
, Estimulación Eléctrica/métodos
, Humanos
, Inyecciones/métodos
, Yopamidol
, Persona de Mediana Edad
, Cuello/diagnóstico por imagen
, Estudios Prospectivos
, Tomografía Computarizada por Rayos X