COVID-19 management in a cancer center: the ICU storm
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ORIGINAL ARTICLE
COVID-19 management in a cancer center: the ICU storm Alice Boilève 1 & Annabelle Stoclin 2,3 & Fabrice Barlesi 1 & Florent Varin 4 & Stéphanie Suria 4 & André Rieutord 5 & François Blot 2,3 & Florence Netzer 5 & Florian Scotté 3 Received: 4 May 2020 / Accepted: 27 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract A novel coronavirus, SARS-CoV-2, was first reported as a respiratory illness in December 2019 in Wuhan, China. Since then, the World Health Organization (WHO) Emergency Committee declared a global health. COVID-19 has now spread worldwide and is responsible of more than 472,216 persons, out of 9,100,090 officially diagnosed worldwide since 23 of June. In the context of cancer patients, COVID-19 has a severe impact, regarding pulmonary infection but also cancer treatments in this fragile and immunocompromised population, and ICU admission for cancer patients in the context of COVID-19 requires ethical and clinical consideration. In our cancer center, intensivists, oncologists, pharmacists, and hospital administrators had to prepare for a substantial increase in critical care bed capacity (from 10 ICU beds, 6 medical intensive care beds, and 12 surgical intensive care beds, bed capacity was increased to 28 medical intensive care beds with ventilating capacity) and to adapt infrastructure (i.e., ICU beds), supplies (i.e., drugs, ventilators, protective materials), and staff (i.e., nurses and medical staff). Overall, thirty-three COVID-19 patients were admitted in our ICU, 17 cancer-free and 16 with cancer, and 23 required mechanical ventilation, resulting in 4 deaths (of them two patients with cancer). We report here management of a dedicated intensive care unit of a cancer center during the COVID-19 infection pandemic, considering resource allocation and redistribution of healthcare workers. Keywords COVID-19 . Coronavirus . Cancer . Pandemic . Management . Intensive care unit
Introduction A worldwide public health emergency of international concern has emerged since December 2019, named coronavirus disease 2019 (COVID-19) and caused by a novel coronavirus SARS-CoV-2. First detected in China as a respiratory illness, this disease spread all around the world and achieved pandemic spread [1]. It is now responsible for the death of 472,216
* Alice Boilève [email protected] 1
Medical Oncology Department, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France
2
Intensive Care Unit, Gustave Roussy Cancer Campus, Villejuif, France
3
Interdisciplinary Cancer Course Department (DIOPP), Gustave Roussy Cancer Campus, Villejuif, France
4
Department of Anesthesia, Gustave Roussy Cancer Campus, Villejuif, France
5
Pharmacy Department, Gustave Roussy Cancer Campus, Villejuif, France
persons, out of 9,100,090 officially diagnosed worldwide since 23 of June [2]. This new respiratory illness is characterized by a rapid human-to-human transmission, with a broad range of symptoms and severity, from asymptomatic cases to acute respiratory dist
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