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      Health-Related Quality of Life and Experiences of Sarcoma Patients during the COVID-19 Pandemic

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          Abstract

          Sarcomas are rare cancers with a spectrum of clinical needs and outcomes. We investigated care experiences and health-related quality of life (HRQoL) in sarcoma patients during the COVID-19 pandemic. Patients with appointments during the first two months of the UK lockdown were invited to complete a survey. Questions included views on care modifications, COVID-19 worry and psychosocial impact, and EORTC-QLQ-C30 items. 350 patients completed the survey; median age 58 (16–92) years. Care modifications included telemedicine (74%) and postponement of appointments (34%), scans (34%) or treatment (10%). Most felt the quality of care was not affected (72%), however, social life (87%) and emotional wellbeing (41%) were affected. Worry about COVID-19 infection was moderately high (mean 5.8/10) and significantly related to higher cancer-related worry; associated with lower emotional functioning irrespective of treatment intent. Curative patients (44%) with low resilient coping scores had significantly higher COVID-19 worry. Patients who did not know their treatment intent (22%) had significantly higher COVID-19 worry and insomnia. In summary, care experiences were generally positive; however, cancer-related worry, low resilient coping and uncertainty about treatment intent were associated with COVID-19 worry. These patients may benefit from additional psychological support during the pandemic and beyond.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

            Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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              Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

              In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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                Author and article information

                Journal
                Cancers (Basel)
                Cancers (Basel)
                cancers
                Cancers
                MDPI
                2072-6694
                14 August 2020
                August 2020
                : 12
                : 8
                : 2288
                Affiliations
                [1 ]The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; eugenie.younger@ 123456rmh.nhs.uk (E.Y.); alannah.smrke@ 123456rmh.nhs.uk (A.S.); emma.lidington@ 123456rmh.nhs.uk (E.L.); sheima.farag@ 123456rmh.nhs.uk (S.F.); yolanda.augustin@ 123456rmh.nhs.uk (Y.A.); eve.merry@ 123456nhs.net (E.M.); charlotte.benson@ 123456rmh.nhs.uk (C.B.); aisha.miah@ 123456rmh.nhs.uk (A.M.); shane.zaidi@ 123456rmh.nhs.uk (S.Z.); spyridon.gennatas@ 123456rmh.nhs.uk (S.G.)
                [2 ]University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; katrina.ingley@ 123456nhs.net (K.I.); neha.chopra@ 123456nhs.net (N.C.); alessandra.maleddu@ 123456nhs.net (A.M.); anne.mctiernan@ 123456nhs.net (A.M.); sandra.strauss@ 123456nhs.net (S.J.S.); palma.dileo@ 123456nhs.net (P.D.)
                [3 ]Sarcoma Patients EuroNet e.V./Association, D-61200 Wolfersheim, Germany; roger.wilson@ 123456sarcoma-patients.eu
                [4 ]Institute of Cancer Research, London SM2 5NG, UK; olga.husson@ 123456icr.ac.uk
                Author notes
                [* ]Correspondence: robin.jones4@ 123456nhs.net ; Tel.: +44-207-352-8171
                [†]

                These authors contributed equally.

                Author information
                https://orcid.org/0000-0002-2088-3328
                https://orcid.org/0000-0002-9811-8159
                https://orcid.org/0000-0001-6176-8054
                https://orcid.org/0000-0002-1806-2686
                https://orcid.org/0000-0001-9063-7862
                https://orcid.org/0000-0002-5635-7696
                https://orcid.org/0000-0002-1387-8686
                https://orcid.org/0000-0003-4173-3844
                Article
                cancers-12-02288
                10.3390/cancers12082288
                7547383
                32823999
                cb1e2b71-e7dc-46c5-b3a7-2fcd707623ab
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 14 June 2020
                : 10 August 2020
                Categories
                Article

                sarcomas,hrqol,covid-19,patient experience
                sarcomas, hrqol, covid-19, patient experience

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