1.Organ function support in patients with coronavirus disease 2019: Tongji experience.
Yong LI ; Fan HE ; Ning ZHOU ; Jia WEI ; Zeyang DING ; Luyun WANG ; Peng CHEN ; Shuiming GUO ; Binhao ZHANG ; Xiaoning WAN ; Wei ZHU
Frontiers of Medicine 2020;14(2):232-248
Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.
Antiviral Agents
;
therapeutic use
;
Betacoronavirus
;
Coronavirus Infections
;
drug therapy
;
therapy
;
Humans
;
Oxygen Inhalation Therapy
;
Pandemics
;
Pneumonia, Viral
;
therapy
;
Respiration
2.Clinical characteristics and risk factors for mortality in cancer patients with COVID-19.
Junnan LIANG ; Guannan JIN ; Tongtong LIU ; Jingyuan WEN ; Ganxun LI ; Lin CHEN ; Wei WANG ; Yuwei WANG ; Wei LIAO ; Jia SONG ; Zeyang DING ; Xiao-Ping CHEN ; Bixiang ZHANG
Frontiers of Medicine 2021;15(2):264-274
Patients with cancer are at increased risk of severe infections. From a cohort including 3060 patients with confirmed COVID-19, 109 (3.4%) cancer patients were included in this study. Among them, 23 (21.1%) patients died in the hospital. Cancer patients, especially those with hematological malignancies (41.6%), urinary carcinoma (35.7%), malignancies of the digestive system (33.3%), gynecological malignancies (20%), and lung cancer (14.3%), had a much higher mortality than patients without cancer. A total of 19 (17.4%) cancer patients were infected in the hospital. The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients. Multivariate Cox regression analysis indicated that a Nutritional Risk Screening (NRS2002) score ⩾ 3 (adjusted hazard ratio (HR) 11.00; 95% confidence interval (CI) 4.60-26.32; P < 0.001), high-risk type (adjusted HR 18.81; 95% CI 4.21-83.93; P < 0.001), tumor stage IV (adjusted HR 4.26; 95% CI 2.34-7.75; P < 0.001), and recent adjuvant therapy (< 1 month) (adjusted HR 3.16; 95% CI 1.75-5.70; P < 0.01) were independent risk factors for in-hospital death after adjusting for age, comorbidities, D-dimer, and lymphocyte count. In conclusion, cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer. Cancer patients with high-risk tumor, NRS2002 score ⩾ 3, advanced tumor stage, and recent adjuvant therapy (< 1 month) may have high risk of mortality.
COVID-19
;
Hospital Mortality
;
Humans
;
Neoplasms
;
Prognosis
;
Retrospective Studies
;
Risk Factors
;
SARS-CoV-2