Objective To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. ConclusionIt is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.
Objective To explore the vascular access infection (VAI) incidence of hemodialysis patients during the the maximum spread of the COVID-19 epidemic (epidemic period) compared with the corresponding period with no local cases of COVID-19 (control period). Methods A single-center, retrospective study was carried out. Adult patients who underwent hemodialysis at the Department of Blood Purification Center, the Affiliated Hospital of Xuzhou Medical University during the epidemic period between December 7, 2022 and February 23, 2023 and the control period between December 7, 2020 and February 23, 2021 were selected. The incidence of local access site infection (LASI) and access related bloodstream infection (ARBSI) in included patients were observed and compared. ResultsA total of 1 401 patients were included. Among them, there were 737 cases during the epidemic period and 664 cases during the control period. There was no statistically significant difference in the age, gender, and duration of catheterization among patients of different periods and pathway types (P>0.05). There was no statistically significant difference in the occurrence of LASI between the epidemic period and the control period (χ2=1.800, P=1.180). There was a statistically significant difference in the occurrence of ARBSI between the epidemic period and the control period [χ2=4.610, relative risk (RR)=2.575, 95% confidence interval (CI) (1.053, 6.298), P=0.032]. There was no statistically significant difference in the incidence of LASI and ARBSI at different stages in patients with arteriovenous fistula and unnel-cuffed catheters (TCC) (P＞0.05). There were statistically significant differences in the incidence of LASI [χ2=4.898, RR=3.832, 95%CI (1.058, 13.885), P=0.027] and ARBSI [χ2=7.150, RR=4.684, 95%CI (1.333, 16.460), P=0.005] among non cuffed catheters (NCC) patients at different stages. TCC patients might experience LASI (P<0.05) during the epidemic period and ARBSI (P<0.05) during the control period compared with the arteriovenous fistula patients; both central venous catheterization and NCC patients might experience LASI and ARBSI during the control period (P<0.05). Conclusion Targeting COVID-19 prevention may be associated with the reduction of vascular access infection in hemodialysis patients, in particular in NCC patients.
With the change of COVID-19, the prevention and control of COVID-19 infection epidemic entered a new stage in December 2022. How to quickly complete the emergency treatment of a large number of patients in a short period of time, and ensure that patients in emergency department can get rapid and effective medical treatment has always been an urgent problem that emergency department need to solve. The Department of Emergency Medicine of West China Hospital of Sichuan University has adopted patient-oriented management measures based on the core idea of the new public management theory, and has achieved remarkable results. Therefore, this article summarizes the workflow and nursing management strategies of the emergency department rescue area of West China Hospital of Sichuan University in dealing with the batch treatment of COVID-19 infected patients, including optimizing and correcting the environment layout of the ward, implementing the “secondary triage” mode in the rescue area, adding an inter-hospital referral platform for critical patients with COVID-19 emergency, building a conventional COVID-19 reserve material repository in the emergency department, setting up a field office for multi-department joint emergency admission service, optimizing emergency transport services for patients with COVID-19, scientific scheduling and reasonable human resource management, and providing humanistic care for employees, in order to provide reference for the management practice of the emergency department.
Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.
Most patients with coronavirus disease 2019 (COVID-19) have a good prognosis, but a certain proportion of the elderly and people with underlying diseases are still prone to develop into severe and critical COVID-19. Kidney is one of the common target organs of COVID-19. Acute kidney injury (AKI) is a common complication of severe COVID-19 patients, especially critical COVID-19 patients admitted to intensive care units. AKI associated with COVID-19 is also an independent risk factor for poor prognosis in patients. This article mainly focuses on the epidemiological data, possible pathogenesis, diagnostic criteria, and prevention and treatment based on the 5R principle of AKI associated with COVID-19. It summarizes the existing evidence to explore standardized management strategies for AKI associated with COVID-19.
Objective To investigate the status of frailty in patients with coronavirus disease 2019 (COVID-19), and to analyze the influence of COVID-19 disease on the prevalence of frailty. Methods This study was conducted using a cross-sectional survey method. COVID-19 patients admitted to a centralized isolation point in Guangzhou were selected for an questionnaire survey by “questionnaire star”, between November and December 2022. The questionnaire included the general information questionnaire, Tilburg Frailty Indicator (TFI), the COVID-19 symptom scale and Mental Resilience Scale (RS-11). Multi-model logistic regression analysis was used to explore the influence of COVID-19 on the occurrence of debilitation. Results A total of 667 questionnaires were distributed, of which 594 were valid, with an effective rate of 89.1%. There were 150 patients (25.3%) were frail, 444 patients (74.7%) were non-frail, and 51 patients (8.6%) were newly frail after infected COVID-19. The median TFI score before COVID-19 was 3 (2, 4) points, 16.7% (99/594) were in a weak state. The median TFI score after COVID-19 was 3 (2, 5) points, 25.3% (150/594) were in a weak state. There were statistically significant differences in TFI scores (Z=−6.596, P＜0.001) and the incidence of debilitation (χ2=351.648, P＜0.001) before and after COVID-19. The results of multivariate logistic regression analysis showed that after controlling disease factors, demographic factors and psychosocial factors, the score of the COVID-19 symptom score was always the influencing factor of COVID-19 patients. The overall change trend of COVID-19 symptom score was statistically significant (P<0.001). Conclusions The COVID-19 symptom score is an important risk factor or predictor of frailty in patients with COVID-19. As the level of COVID-19 symptom score increases, the risk of frailty in COVID-19 patients increases.
Since the first case of corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019, the virus has spread rapidly around the world and has become a global public health problem. In the process of this virus epidemic, compared with the general population, cancer patients are considered to be highly susceptible people, especially the lung cancer patients. Some studies have shown that angiotensin converting enzyme 2 (ACE2) may be the pathway for SARS-CoV-2 to infect the host. At the same time, ACE2 is often abnormally expressed in non-small cell lung cancer. Therefore, understanding the respective mechanisms of ACE2 in COVID-19 and non-small cell lung cancer has extremely important reference value for the study of vaccines and therapeutic drugs, and also provides meaningful guidance for the protection of patients with lung cancer during the epidemic. This article reviews the possible invasive mechanism of ACE2 in SARS-CoV-2 and its abnormal expression in non-small cell lung cancer.
With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
Objective To investigate the impact of COVID-19 infection on the early clinical outcomes of patients undergoing valve replacement. MethodsPerioperative data of patients who underwent single valve replacement at the Second Affiliated Hospital of Chinese People's Liberation Army Medical University from January to February 2023 were consecutively collected. Based on COVID-19 infection status, patients were divided into a COVID-19 group and a non-COVID-19 group. The perioperative data were compared between the two groups. ResultsA total of 136 patients were included, comprising 53 males and 83 females, with a mean age of (53.4±10.2) years. There were 32 patients receiving aortic valve replacements, 102 mitral valve replacements, and 2 tricuspid valve replacements. The COVID-19 group comprised 70 patients, and the non-COVID-19 group included 66 patients. No statistical difference was observed in the incidence of postoperative complications between the two groups [9.09% (6/66) vs. 11.43% (8/70), P=0.654]. However, the COVID-19 group had longer postoperative mechanical ventilation duration [1 201.00 (1 003.75, 1 347.75) min vs. 913.50 (465.50, 1 251.00) min, P=0.001] and ICU stay [3 (2, 3) days vs. 2 (2, 3) days, P<0.001] compared to the non-COVID-19 group. Additionally, troponin I [4.76 (2.55, 7.93) ng/mL vs. 2.66 (1.19, 5.65) ng/mL, P=0.001] and brain natriuretic peptide [608.50 (249.75, 1 150.00) pg/mL vs. 192.00 (100.93, 314.75) pg/mL, P<0.001] levels were significantly higher in the COVID-19 group. ConclusionFor patients with single valve disease undergoing elective surgery, short-term outcomes after recovery from COVID-19 infection are favorable, with no significant increase in in-hospital mortality or postoperative complication rates.
Lung cancer is a complex disease with its own challenges, and is considered to be one of the most common causes of cancer death worldwide. The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exacerbated these challenges. The aim of this review is to explore the impact of the COVID-19 pandemic on the screening, diagnosis and treatment of lung cancer. We hope to provide some experience and help for the whole process management of lung cancer patients.