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癌症患者与 2019 冠状病毒病:具体证据分析。

Cancer patients and coronavirus disease 2019: evidence in context.

机构信息

Division of Medical Oncology 2, IRCCS IFO-Regina Elena National Cancer Institute, 00144, Rome, Italy.

Scientific Direction, IRCCS IFO-Regina Elena National Cancer Institute, 00144, Rome, Italy.

出版信息

J Transl Med. 2020 Aug 15;18(1):315. doi: 10.1186/s12967-020-02483-w.

Abstract

In the rapidly evolving coronavirus disease 2019 (COVID-19) outbreak, inherent literature has been increasing at an impressive rate. Such a dynamic scenario imposes the necessity to define a new framework for cancer care. The first emerging evidence has transmitted contrasting messages with regards to cancer care management. Some authors have hypothesized an increased infection risk for cancer patients, with a more severe disease, requiring a reorganization of health care system that could disrupt an established high quality cancer care routine in many developed countries. Other authors have attempted to interpret data related to cancer patients by better defining their "active status". We herein present our point of view in the light of current evidence and based on the experience matured at our cancer institute in managing cancer patients during the COVID-19 pandemic. Our core idea is that "active cancer" may be considered a proxy of more recent exposure to diagnostic or therapeutic procedures, and the frequency of access to health care facilities can be predicted as a function of the severity of cancer symptoms. Hence, COVID-19 screening program and the adjustment of cancer care provision in a cancer institutions should be led by this risk model, while awaiting new evidence.

摘要

在迅速演变的 2019 年冠状病毒病(COVID-19)疫情中,相关文献的数量呈惊人的速度增长。这种动态情况需要为癌症治疗定义一个新的框架。第一个新兴证据在癌症治疗管理方面传递了相互矛盾的信息。一些作者假设癌症患者的感染风险增加,疾病更严重,需要对医疗保健系统进行重组,这可能会破坏许多发达国家既定的高质量癌症护理常规。其他作者试图通过更好地定义癌症患者的“活动状态”来解释与癌症患者相关的数据。我们根据当前的证据并基于我们癌症研究所在 COVID-19 大流行期间管理癌症患者的经验,提出了我们的观点。我们的核心思想是,“活动性癌症”可以被认为是最近接受诊断或治疗程序的代表,并且可以根据癌症症状的严重程度预测其对医疗设施的访问频率。因此,在等待新证据的同时,COVID-19 筛查计划和癌症机构中癌症治疗的调整应根据这一风险模型进行。

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本文引用的文献

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Int J Public Health. 2020 Jun;65(5):529-531. doi: 10.1007/s00038-020-01399-y. Epub 2020 May 28.
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JAMA Oncol. 2020 Oct 1;6(10):1527-1528. doi: 10.1001/jamaoncol.2020.1938.
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COVID-19 and smoking: A systematic review of the evidence.2019冠状病毒病与吸烟:证据的系统评价
Tob Induc Dis. 2020 Mar 20;18:20. doi: 10.18332/tid/119324. eCollection 2020.

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