Clinical management of lung cancer patients during the outbreak of COVID-19 epidemic
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Clinical management of lung cancer patients during the outbreak of COVID-19 epidemic Li Wang, Man Jiang, Jialin Qu, Na Zhou and Xiaochun Zhang*
Abstract The rapid growth of 2019 novel coronavirus (COVID-19) outbreak in Wuhan, China, at the early December 2019. COVID-19 spread all over the word just a few months. The outbreak of COVID-19 infection poses major threat to international health and economy. World Health Organization (WHO) announced that the new coronavirus was an international public health emergency on January 30, 2020. However, with the spread of COVID-19, the routine medical care of lung cancer patients was affected. Because lung cancer patients have low immunity after antitumor treatment, they should become the main targets for epidemic prevention. Lung cancer patients are increasingly concerned about the prevention of COVID-19. It is necessary to provide individualized medical treatment and management for lung cancer patients based on patients’ conditions and regional epidemic patterns. Keywords: COVID-19, Lung cancer, Patient management
Introduction Coronaviruses (CoVs) are enveloped non-segmented positive sense RNA viruses, belongs to the subfamily Coronavirinae, the order Nidovirales, and this subfamily including alpha-, beta-, gamma-, and delta-coronavirus [1]. Coronaviruses mainly cause infections in birds and mammals and, in recent decades, also have shown an ability to infecting humans [2]. The outbreak of betacoronavirus including severe acute respiratory syndrome coronavirus (SARS) in 2002 [3] and Middle East respiratory syndrome coronavirus (MERS) in 2012 [4] has confirmed that the lethality of coronaviruses when they infect humans. The mortality rates of SARS and MERS are 10 and 37%, respectively [5, 6]. At the end of 2019, a novel influenza coronavirus (COVID-19) that similar to SARS and MERS appeared in Wuhan, Hubei, China and has been confirmed that has the ability of human-to-human transmission [7–9]. * Correspondence: [email protected] Precision Medicine Center of Oncology, The Affiliated Hospital of Qingdao University, Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
The genome of COVID-19 is a single-stranded positive sense RNA [10]. The gene sequence analysis showed that COVID-19 has a typical coronavirus genome structure and belongs to the beta- coronavirus cluster [10]. With the rapid increase of the number of cases and increasing evidence of human-to-human transmission, the virus is more contagious than SARS and MERS [11–16]. Moreover, COVID-19 show very different virological characteristics compare with SARS. For the SARS, the level of RNA usually reaches a peak after 7–10 days of symptoms. However, the level of RNA reaches a peak within 5 days of the symptoms of COVID-19, which can be 1000 times higher than the SARS [17]. In additional, three major COVID-19 variants have been found, which are divided into A, B and C types. Among them, the A virus is the closest to the coronavirus found in bats and pangolins. It is the original virus t
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