Síntesis de evidencia para intervenciones en COVID-19: informes de actualización de la Comisión Nacional de Evaluación de Tecnologías de Salud de Argentina

Tortosa, Fernando; Donato, Manuel; Torales, Santiago; Malla, Carlos González; Uribe, Javier; Izcovich, Ariel

doi:10.26633/rpsp.2023.28

Cited by 1 publication

(2 citation statements)

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“…In Spain, the health crisis broke out during the first two weeks of March 2020 and officially lasted until July 5, 2023. There were six main waves until March 28, 2022 and, according to official data, it caused about 122000 deaths[ 1 ]. The first wave of the COVID-19 pandemic in Spain lasted from the beginning of the outbreak until June 21, 2020.…”

Section: Introductionmentioning

confidence: 99%

“…The discrepancy in these numbers could be due to the significant rise in observed deaths (compared with other years). It is suspected that many people died at home without any diagnostic test, and these data were considered by some institutions such as the INE; and (2) Until 10 May 2020, the last day these data were published separately, there were 40961 infections in healthcare professionals, of whom 4188 (10.5%) required hospital admission, 310 (1.1%) management in intensive care units (ICU) and 52 (0.1%) died[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes

Trébol,

Carabias-Orgaz,

Esteban-Velasco

et al. 2024

World J Methodol

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BACKGROUND The first wave of coronavirus disease 2019 (COVID-19) pandemic in Spain lasted from middle March to the end of June 2020. Spanish population was subjected to lockdown periods and scheduled surgeries were discontinued or reduced during variable periods. In our centre, we managed patients previously and newly diagnosed with cancer. We established a strategy based on limiting perioperative social contacts, preoperative screening (symptoms and reverse transcription-polymerase chain reaction) and creating separated in-hospital COVID-19-free pathways for non-infected patients. We also adopted some practice modifications (surgery in different facilities, changes in staff and guidelines, using continuously changing personal protective equipment…), that supposed new inconveniences. AIM To analyse cancer patients with a decision for surgery managed during the first wave, focalizing on outcomes and pandemic-related modifications. METHODS We prospectively included adults with a confirmed diagnosis of colorectal, oesophago-gastric, liver-pancreatic or breast cancer with a decision for surgery, regardless of whether they ultimately underwent surgery. We analysed short-term outcomes [30-d postoperative morbimortality and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection] and outcomes after 3 years (adjuvant therapies, oncological events, death, SARS-CoV-2 infection and vaccination). We also investigated modifications to usual practice. RESULTS From 96 included patients, seven didn’t receive treatment that period and four never (3 due to COVID-19). Operated patients: 28 colon and 21 rectal cancers; laparoscopy 53.6%/90.0%, mortality 3.57%/0%, major complications 7.04%/25.00%, anastomotic leaks 0%/5.00%, 3-years disease-free survival (DFS) 82.14%/52.4% and overall survival (OS) 78.57%/76.2%. Six liver metastases and six pancreatic cancers: no mortality, one major complication, three grade A/B liver failures, one bile leak; 3-year DFS 0%/33.3% and OS 50.0%/33.3% (liver metastases/pancreatic carcinoma). 5 gastric and 2 oesophageal tumours: mortality 0%/50%, major complications 0%/100%, anastomotic leaks 0%/100%, 3-year DFS and OS 66.67% (gastric carcinoma) and 0% (oesophagus). Twenty breast cancer without deaths/major complications; 3-year OS 100% and DFS 85%. Nobody contracted SARS-CoV-2 postoperatively. COVID-19 pandemic–related changes: 78.2% treated in alternative buildings, 43.8% waited more than 4 weeks, two additional colostomies and fewer laparoscopies. CONCLUSION Some patients lost curative-intent surgery due to COVID-19 pandemic. Despite practice modifications and 43.8% delays higher than 4 weeks, surgery was resumed with minimal changes without impacting outcomes. Clean pathways are essential to continue surgery safely.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%