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Cancer patient management strategy in a Cancer Center of Zhejiang, China during the COVID-19 pandemic

机译:中国浙江省癌症中心癌症患者管理策略在中国浙江省Covid-19大流行期间

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Due to the increased risk of viral infection and the severe shortage of medical resources during the pandemic of COVID-19, most hospitals in the epidemic areas significantly reduced non-emergency admissions and services, if not closed. As a result, it has been difficult to treat cancer patients on time, which adversely affects their prognosis. To address this problem, cancer centers must develop a strategic plan to manage both inpatients and outpatients during the pandemic, provide them with the necessary treatment, and at the same time prevent the spread of the virus among patients, visitors and medical staff. Based upon the epidemic situation in Zhejiang Province, China, the number of running non-emergency medical wards in the Zhejiang Cancer Hospital was gradually increased in a controlled manner. All staff of the hospital received COVID-19 preventive training and was provided with three different levels of protection according to the risks of their services. Only patients without a known history of SARS-CoV-2 contact were eligible to schedule an appointment. Body temperature was measured on all patients upon their arrival at the hospital. Chest CT image, blood cell counting and travel/contact history were investigated in patients with fever. Respiratory tract samples, such as sputum and throat swabs, from all patients, including those clinically suspected of SARS-CoV-2 infection, were collected for nucleic acid detection of SARS-CoV-2 before treatment. A total of 3697 inpatients and 416 outpatients seeking cancer treatment were enrolled from February 1 to April 3, 2020, in compliance with the hospital’s infection-control interventions. The clinicopathological parameters of the patients were summarized herein. 4237 samples from 4101 patients produced negative RNA testing results. Four clinically suspected patients all presented negative RNA test results and were excluded from the SARS-CoV-2 infection through follow-up retesting and monitoring. Seven patients with only N-gene positive results were retested, followed by CT scan and SARS-CoV-2 contact history investigation. All of them were finally diagnosed as non-infected patients. There was one outpatient who was confirmed positive by virus RNA test and then followed up. She might be an asymptomatic laboratory-confirmed case. During the study period, there was no SARS-CoV-2 infection among staff, patients and escorts of patients in the Zhejiang Cancer Hospital. This study suggested our infection-control interventions, including viral nucleic acid test, could be used as a reliable method to screen cancer patients in the area with moderate COVID-19 prevalence. Cancer may not be a high-risk factor of SARS-CoV-2 infection.
机译:由于病毒感染的风险增加以及Covid-19流行病中的医疗资源严重短缺,疫情地区的大多数医院都会显着减少非应急招生和服务,如果没有关闭。结果,难以按时治疗癌症患者,这对其预后产生了不利影响。为了解决这个问题,癌症中心必须制定战略计划,在大流行期间管理住院患者和门诊病人,为他们提供必要的治疗,同时防止病毒,访客和医务人员之间的传播。根据中国浙江省的疫情,浙江癌症医院运行的非紧急医疗病房数量以受控的方式逐步增加。该医院的所有工作人员都收到了Covid-19预防培训,并根据其服务风险提供了三种不同的保护。只有没有已知历史的SARS-COV-2联系人的患者才有资格安排预约。在所有患者到达医院时测量体温。发烧患者中研究了胸部CT图像,血细胞计数和旅行/接触历史。呼吸道样品,例如痰和喉拭子,包括临床疑似SARS-COV-2感染的患者,用于治疗前SARS-COV-2的核酸检测。共有3697名住院患者和416名寻求癌症治疗的门诊患者于2020年至4月3日至4月3日,符合医院的感染控制干预措施。本文总结了患者的临床病理学参数。 4237来自4101名患者的样品产生负RNA检测结果。四个临床疑似患者全部呈现阴性RNA测试结果,通过随访重新调整和监测中从SARS-COV-2感染中排除。 7例只有N-基因阳性结果的患者被重新测试,其次是CT扫描和SARS-COV-2接触历史调查。所有这些都被诊断为未感染的患者。有一个门诊通过病毒RNA测试证实了阳性,然后随访。她可能是一个无症状的实验室确认的案例。在研究期间,浙江癌医院患者的员工,患者和护送中没有SARS-COV-2感染。本研究表明我们的感染控制干预(包括病毒核酸试验)可作为可靠的方法,以筛选该地区的癌症患者,中度Covid-19流行率。癌症可能不是SARS-COV-2感染的高危因素。

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