A moonshot approach toward the management of cancer patients in the COVID-19 time: what have we learned and what could the Italian network of cancer centers (Alliance Against Cancer, ACC) do after the pandemic wave?
新型冠状病毒肺炎时期癌症患者管理的兼职方法: 我们学到了什么，意大利癌症中心网络 (抗癌联盟，ACC) 在大流行浪潮后能做些什么？
- 作者列表："Silvestris N","Apolone G","Botti G","Ciliberto G","Costantini M","De Paoli P","Franceschi S","Opocher G","Paradiso A","Pronzato P","Sgambato A","De Maria R
:If we focus our attention on seven main features of COVID-19 infection (heterogeneity, fragility, lack of effective treatments and vaccines, "miraculous cures", psychological suffering, deprivation, and globalization), we may establish parallelism with the challenges faced in the steep road to the understanding and treatment of neoplastic diseases. How the similarities between these two conditions can help us cope with the emergency effort represented by the management of cancer patients in the COVID-19 era, today and in the future? In a manner similar to the Cancer Moonshot initiative in the United States, we can hypothesize a multinational moonshot project towards the management of cancer patients during COVID-19 pandemic. In particular, we believe that the main road to elaborate meaningful scientific evidence is represented by the collection of all the data on COVID-19 and cancer comorbidity that are and will become available in cancer centers, coupled with the design of large clinical studies. To address this goal, it is essential to identify the entity that can produce this scientific evidences and the potentially most successful research strategy to undertake. The largest Italian organization for cancer research, Alliance Against Cancer (Alleanza Contro il Cancro, ACC), is called to play a scientific leadership in addressing these challenges, which requires the coordination of oncology teams at regional, national, and international levels. To fulfill this commitment, ACC will create a liaison with health government agencies in order to develop "dynamic" indications able to fight such an unpredictable pandemic.
: 如果我们把注意力集中在新型冠状病毒肺炎感染的七个主要特征上 (异质性、脆弱性、缺乏有效的治疗和疫苗、 “神奇的治疗” 、心理痛苦、剥夺和全球化)，我们可以与在理解和治疗肿瘤疾病的陡峭道路上面临的挑战建立平行。这两种情况之间的相似性如何帮助我们应对新型冠状病毒肺炎时代、今天和未来癌症患者管理所代表的紧急努力？以类似于美国癌症登月计划的方式，我们可以假设一个跨国登月计划在新型冠状病毒肺炎大流行期间管理癌症患者。特别是，我们认为，阐述有意义的科学证据的主要途径是收集癌症中心现有和将要获得的新型冠状病毒肺炎和癌症共病的所有数据，加上大型临床研究的设计。为了实现这一目标，必须确定能够产生这一科学证据的实体以及可能最成功的研究策略。意大利最大的癌症研究组织，抗癌联盟 (Alleanza Contro il Cancro，ACC) 被称为在应对这些挑战方面发挥科学领导作用，这需要区域、国家和国际各级肿瘤团队的协调。为了履行这一承诺，行政协调会将与卫生政府机构建立联系，以便发展能够对抗这种不可预测的流行病的 “动态” 迹象。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.