The impact of Coronavirus disease 2019 pandemic on the treatment of cancer patients: the first steps in this fight

Gabriela Rahnea-Nita, Dumitru-Cristinel Badiu, Cristian Gabriel Popescu, Valentin-Titus Grigorean, Dragos Serban, Catalin Gabriel Smarandache, Roxana-Andreea Rahnea-Nita, Anda-Natalia Ciuhu, Mihaela Mandu, Liliana-Florina Andronache, Alexandru-Rares Stoian

Abstract


Background: The new Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global threat due to its increased mortality, especially among the elderly and people with severe comorbidities, such as cancer.


Objectives: Through the specific measures that have been imposed to reduce the risk of infection and death, the working hypothesis is prepared: Coronavirus disease 2019 (COVID-19) pandemic has drastically decreased the hospital admissions of cancer patients, the frequency of hospitalizations and determined an increased mortality rate through the infection with SARS-CoV-2 virus in cancer patients.


Methods: For a period of 16 weeks, the hospitalizations of patients to the Chronic Oncology-Palliative Care Department of “St. Luke” Hospital for Chronic Diseases, Bucharest, were analyzed, being compared to the same period of the previous year and, also, there were patients with symptoms specific to COVID-19 infection, tested for SARS-CoV-2 by means of RT-PCR.


Results: The data analysis shows a 53.7% decrease among hospitalized patients – with 51.4 for day hospitalization and 50.2% for inpatient hospitalization, during the COVID-19 pandemic. 4 patients out of the 477 admitted to the Oncology Department in this period had a positive RT-PCR SARS-CoV-2 test during their hospitalization and 5 patients with symptoms common for both cancer and COVID-19 had a negative result through specific testing (Table I, Table II). Two other patients recorded on the unit were infected with SARS-CoV-2 virus and required admission and treatment in the COVID-19 Department. The willingness of the cancer patient to consult a physician for admission has greatly decreased in the first 16 weeks from the declaration of the COVID-19 pandemic.


Conclusion: Cancer patients, although at an increased risk of being infected, did not exhibit severe symptoms, and the evolution of the symptoms and the performance state after the discharge from the COVID-19 department was influenced by the age and the associated comorbidities.

Keywords


COVID-19; Cancer patients; Clinical Psycho-Oncology; Common symptoms; Hospital admissions; RT-PCR.

Full Text:

PDF

References


AlRyalat, S. A. S., Malkawi, L. W., & Momani, S. M. (2019). Comparing bibliometric analysis using PubMed, Scopus, and Web of Science databases. JoVE (Journal of Visualized Experiments), (152), e58494. https://doi.org/10.3791/58494

Amghel, R. M.., Minea, L. N., Ciuhu, A. N., Bacinschi, X., Isacu, I., & Tarlea, A. (2009). Concomitant radical non-platinum radiochemotherapy for elderly patients with invasive bladder cancer. Journal of Clinical Oncology, 27(15_suppl), e16135-e16135. https://doi.org/10.1200/jco.2009.27.15_suppl.e16135

Archer, S., Holch, P., Armes, J., Calman, L., Foster, C., Gelcich, S., ... & Absolom, K. (2020). "No turning back" Psycho‐oncology in the time of COVID‐19: Insights from a survey of UK professionals. PsychoOncology, 29(9), 1430-1435. https://doi.org/10.1002/pon.5486

Bacinschi, X. E., Zgura, A., Safta, I., & Anghel, R. (2020). Biomolecular Factors Represented by Bcl-2, p53, and Tumor-Infiltrating Lymphocytes Predict Response for Adjuvant Anthracycline Chemotherapy in Patients with Early Triple-Negative Breast Cancer. Cancer Management and Research, 12, 11965. https://doi.org/10.2147/CMAR.S274104

Bernacki, J., Błażejczyk, I., Indyka-Piasecka, A., Kopel, M., Kukla, E., & Trawiński, B. (2016, March). Responsive web design: testing usability of mobile web applications. In Asian Conference on Intelligent Information and Database Systems (pp. 257-269). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49381-6_25

Boldrini, T., Schiano Lomoriello, A., Del Corno, F., Lingiardi, V., & Salcuni, S. (2020). Psychotherapy during COVID-19: How the clinical practice of Italian psychotherapists changed during the pandemic. Frontiers in psychology, 11, 2716. https://doi.org/10.3389/fpsyg.2020.591170

Calina, D., Docea, A. O., Petrakis, D., Egorov, A. M., Ishmukhametov, A. A., Gabibov, A. G., ... & Tsatsakis, A. (2020). Towards effective COVID‑19 vaccines: Updates, perspectives and challenges. International journal of molecular medicine, 46(1), 3-16. https://doi.org/10.3892/ijmm.2020.4596

Catrinoiu, D., Ceriello, A., Rizzo, M., Serafinceanu, C., Montano, N., Stoian, A. P., ... & Dumitrescu, I. B. (2020). Diabetes and reninangiotensin-aldosterone system: implications for COVID-19 patients with diabetes treatment management. Farmacia, 3, 377-383. https://doi.org/10.31925/farmacia.2020.3.1

Ciążyńska, M., Pabianek, M., Szczepaniak, K., Ułańska, M., Skibińska, M., Owczarek, W., ... & Lesiak, A. (2020). Quality of life of cancer patients during coronavirus disease (COVID-19) pandemic. Psycho-oncology, 29(9), 1377-1379. https://doi.org/10.1002/pon.5434

Ciuhu, A. N., Badica, R., Popescu, M., Radoi, M., Rahnea Nita, R. A., & Rahnea Nita, G. (2016). Defense mechanisms and coping style at very next diagnostic period in advanced and metastatic cancer. https://doi.org/10.1200/JCO.2016.34.15_suppl.e21610

Ciuhu, A. N., Pantea-Stoian, A. M., Nitipir, C., & Rahena Nita, G. (2017a). Assessment of cachexia in cancer patients with advanced disease. In Conference: 3rd International Conference on Interdisciplinary Management of Diabetes Mellitus and its Complications (INTERDIAB) Location: Bucharest, ROMANIA Date: MAR (pp. 02-04).

Ciuhu, A. N., Rahnea Nita, R. A., Popescu, M., Badiu, C. D., Pantea Stoian, A. M., Lupuliasa, D. U. M. I. T. R. U., ... & Rahnea-Nita, G. (2017b). Evidence of strong opioid therapy for palliation of breathlesness in cancer patients. Farmacia, 65(2), 173-178.

Conversano, C., & Di Giuseppe, M. (2021). Psychological factors as determinants of chronic conditions: clinical and psychodynamic advance. Frontiers in Psychology, 12, 86. https://doi.org/10.3389/fpsyg.2021.635708

Dascalu, A. M., Tudosie, M. S., Smarandache, G. C., & Serban, D. (2020). Impact of the COVID-19 pandemic upon the ophthalmological clinical practice. Rom. J. Leg. Med, 28, 96-100. https://doi.org/10.4323/rjlm.2020.96

Di Giuseppe, M., Ciacchini, R., Micheloni, T., Bertolucci, I., Marchi, L., & Conversano, C. (2018). Defense mechanisms in cancer patients: a systematic review. Journal of psychosomatic research, 115, 76-86. https://doi.org/10.1016/j.jpsychores.2018.10.016

Di Giuseppe, M., Miniati, M., Miccoli, M., Ciacchini, R., Orrù, G., Sterzo, R. L., ... & Conversano, C. (2020). Defensive responses to stressful life events associated with cancer diagnosis. Mediterranean Journal of Clinical Psychology, 8(1). https://doi.org/10.6092/2282-1619/mjcp-2384

Di Giuseppe, M., Nepa, G., Prout, T. A., Albertini, F., Marcelli, S., Orrù, G., & Conversano, C. (2021). Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms. International journal of environmental research and public health, 18(10), 5258. https://doi.org/10.3390/ijerph18105258

Dimitriu, M. C., Pantea-Stoian, A., Smaranda, A. C., Nica, A. A., Carap, A. C., Constantin, V. D., ... & Socea, B. (2020). Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Medical Hypotheses, 144, 109972.

Docea, A. O., Tsatsakis, A., Albulescu, D., Cristea, O., Zlatian, O., Vinceti, M., ... & Calina, D. (2020). A new threat from an old enemy: Re‑emergence of coronavirus. International journal of molecular medicine, 45(6), 1631-1643. https://doi.org/10.3892/ijmm.2020.4555

Espinel, Z., & Shultz, J. M. (2020). Using guidance from disaster psychiatry to frame psychiatric support for cancer patients during the COVID‐19 lockdown. Psycho-oncology, 29(9), 1412-1415. https://doi.org/10.1002/pon.5464

Fontaine, J. F., Barbosa-Silva, A., Schaefer, M., Huska, M. R., Muro, E. M., & Andrade-Navarro, M. A. (2009). MedlineRanker: flexible ranking of biomedical literature. Nucleic acids research, 37(suppl_2), W141-W146. https://doi.org/10.1093/nar/gkp353

Fredrikson, M., Annas, P., Fischer, H., & Wik, G. (1996). Gender and age differences in the prevalence of specific fears and phobias. Behaviour research and therapy, 34(1), 33-39. https://doi.org/10.1016/0005-7967(95)00048-3

Frisone, F. (2019). Mask as an epiphenomenon of the complex in psychotherapy. Mediterranean Journal of Clinical Psychology, 7(1). https://doi.org/10.6092/2282-1619/2019.7.2235

Frisone, F., & Micali, R. (2020). The new-look of PubMed: A brief description of the changes in PubMed. Mediterranean Journal of Clinical Psychology, 8(2). https://doi.org/10.6092/2282-1619/mjcp-2534

Frisone, F., Alibrandi, A., & Settineri, S. (2020a). Problem gambling during Covid-19. Mediterranean Journal of Clinical Psychology, 8(3). https://doi.org/10.6092/2282-1619/mjcp-2457

Frisone, F., Settineri, S., Sicari, P. F., & Merlo, E. M. (2020b). Gambling in adolescence: a narrative review of the last 20 years. Journal of Addictive Diseases, 38(4), 438-457. https://doi.org/10.1080/10550887.2020.1782557

Frisone, F., Sicari, F., Settineri, S., & Merlo, E. M. (2021). CLINICAL PSYCHOLOGICAL ASSESSMENT OF STRESS: A NARRATIVE REVIEW OF THE LAST 5 YEARS. Clinical Neuropsychiatry, 18(2). https://doi.org/10.1080/10550887.2020.1782557

Gugliandolo, M. C., Costa, S., Cuzzocrea, F., Larcan, R., & Martino, G. (2020). Adolescents and body uneasiness: the contribution of supportive parenting and trait emotional intelligence. Journal of Child and Family Studies, 29(9), 2453-2462. https://doi.org/10.1007/s10826-020-01779-1

Gusenbauer, M., & Haddaway, N. R. (2020). Which academic search systems are suitable for systematic reviews or meta‐analyses? Evaluating retrieval qualities of Google Scholar, PubMed, and 26 other resources. Research synthesis methods, 11(2), 181-217. https://doi.org/10.1002/jrsm.1378

Hanna, T. P., Evans, G. A., & Booth, C. M. (2020). Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic. Nature reviews Clinical oncology, 17(5), 268-270. https://doi.org/10.1038/s41571-020-0362-6

Humer, E., Stippl, P., Pieh, C., Pryss, R., & Probst, T. (2020). Experiences of Psychotherapists with remote psychotherapy during the COVID-19 pandemic: Cross-sectional web-based survey study. Journal of Medical Internet Research, 22(11), e20246. https://doi.org/10.2196/20246

Lee, L. Y., Cazier, J. B., Angelis, V., Arnold, R., Bisht, V., Campton, N. A., ... & Hughes, D. J. (2020a). Coronavirus Monitoring Project Team; Kerr R; Middleton G. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet, 395, 1919-1926. https://doi.org/10.1016/S0140-6736(20)31173-9

Lee, L. Y., Cazier, J. B., Starkey, T., Turnbull, C. D., Team, U. C. C. M. P., Kerr, R., & Middleton, G. (2020b). COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. The Lancet, 395(10241), 1919-1926. https://doi.org/10.1016/S0140-6736(20)31173-9

Lenzo, V., Quattropani, M. C., Sardella, A., Martino, G., & Bonanno, G. A. (2021). Depression, anxiety, and stress among healthcare workers during the COVID-19 outbreak and relationships with expressive flexibility and context sensitivity. Frontiers in Psychology, 12, 348. https://doi.org/10.3389/fpsyg.2021.623033

Makarov, V. V. (2020). Psychotherapeutic Perspective of the Pandemic Caused by the New Coronavirus Infection COVID-19. In Anthology of World Psychotherapy Special Issue (pp. 164-169).

Martino, G., Caputo, A., Vicario, C. M., Feldt-Rasmussen, U., Watt, T., Quattropani, M. C., ... & Vita, R. (2021). Alexithymia, Emotional Distress, and Perceived Quality of Life in Patients With Hashimoto's Thyroiditis. Frontiers in Psychology, 12, 1295. https://doi.org/10.3389/fpsyg.2021.667237

Mazilu, L., Stanculeanu, D. L., Gheorghe, A. D., Suceveanu, A. P., Parepa, I. R., Stoian, A. P., ... & Suceveanu, A. I. (2019a). Chemotherapy and other factors affecting quality of life in non-small cell lung cancer (NSCLC) patients. Rev. Chim, 70, 33-35. https://doi.org/10.37358/RC.19.1.6845

Mazilu, L., STĂNCULEANU, D. L., Gheorghe, A. D., Voinea, F., Suceveanu, A. P., PIȚURU, S., ... & SUCEVEANU, A. I. (2019b). Incidence of chemotherapy-induced peripheral neuropathy in cancer patients in clinical practice. Age, 57(13.21), 60-8. https://doi.org/10.31925/farmacia.2019.3.14

Mazilu, L., Suceveanu, A. I., Tomescu, D., Ciufu, N., Baz, R., Suceveanu, A. P., ... & Voinea, F. (2013). Optimizing the indication for breast-conservative surgery (BCS) in patients with locally-advanced breast cancer. Chirurgia, 108(4), 478-481.

Merlo, E. M. (2019). Opinion Article: The role of psychological features in chronic diseases, advancements and perspectives. Mediterranean Journal of Clinical Psychology, 7(3).

https://doi.org/10.6092/2282-1619/2019.7.2341

Merlo, E. M., Sicari, F., Frisone, F., Costa, G., Alibrandi, A., Avena, G., & Settineri, S. (2021a). Uncertainty, alexithymia, suppression and vulnerability during the COVID-19 pandemic in Italy. Health Psychology Report, 9(2), 169-179. https://doi.org/10.5114/hpr.2021.104078

Merlo, E. M., Stoian, A. P., Motofei, I. G., & Settineri, S. (2020). Clinical psychological figures in healthcare professionals: Resilience and maladjustment as the “cost of care”. Frontiers in Psychology, 11, 3166. https://doi.org/10.3389/fpsyg.2020.607783

Merlo, E. M., Stoian, A. P., Motofei, I. G., & Settineri, S. (2021b). The Role of Suppression and the Maintenance of Euthymia in Clinical Settings. Frontiers in Psychology, 12, 1534. https://doi.org/10.3389/fpsyg.2021.677811

Myles, L. A. M., & Merlo, E. M. (2021). Alexithymia and physical outcomes in psychosomatic subjects: a cross-sectional study. Journal of Mind and Medical Sciences, 8(1), 86-93. https://doi.org/10.22543/7674.81.P8693

Millar, C., Campbell, S., Fisher, P., Hutton, J., Morgan, A., & Cherry, M. G. (2020). Cancer and COVID-19: Patients' and psychologists' reflections regarding psycho-oncology service changes. Psychooncology, 29(9), 1402-1403. https://doi.org/10.1002/pon.5461

Öhman, A., & Mineka, S. (2001). Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. Psychological review, 108(3), 483. https://doi.org/10.1037/0033-295X.108.3.483

Orrù, G., Bertelloni, D., Diolaiuti, F., Mucci, F., Di Giuseppe, M., Biella, M., ... & Conversano, C. (2021, May). Long-COVID Syndrome? A study on the persistence of neurological, psychological and physiological symptoms. In Healthcare (Vol. 9, No. 5, p. 575). Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/healthcare9050575

Papachristou, S., Penlioglou, T., Stoian, A. P., & Papanas, N. (2020). COVID-19 and sodium-glucose cotransporter 2 inhibitors: no fear to attempt?. Experimental and Clinical Endocrinology & Diabetes. https://doi.org/10.1055/a-1235-5617

Plakun, E. M. (2020). Psychotherapy in the Post-COVID-19 era. Journal of Psychiatric Practice®, 26(4), 309-312. https://doi.org/10.1097/PRA.0000000000000476

Prout, T. A., Zilcha-Mano, S., Aafjes-van Doorn, K., Békés, V., Christman-Cohen, I., Whistler, K., ... & Di Giuseppe, M. (2020). Identifying predictors of psychological distress during COVID-19: a machine learning approach. Frontiers in Psychology, 11, 3063. https://doi.org/10.3389/fpsyg.2020.586202

Rahnea-Nita, R. A., Paunica, S., Motofei, C., & Rahnea-Nita, G. (2019). Assessment of anxiety and depression in patients with advanced gynaecological cancer. Mediterranean Journal of Clinical Psychology, 7(2). https://doi.org/10.6092/2282-1619/2019.7.2214

Rahnea-Niță, R. A., Rahnea-Niță, G., & Stoian, A. R.. (2020). Managementul pacienților oncologici în pandemia COVID-19. Paliatia: Journal of Palliative Care, 11-14.

Rodica Maricela, A., Minea, L. N., Bacinschi, X., Isacu, I., & Tarlea, A. (2009). Concomitant radical non-platinum radiochemotherapy for elderly patients with invasive bladder cancer. Journal of Clinical Oncology, 27(15_suppl), e16135-e16135. https://doi.org/10.1200/jco.2009.27.15_suppl.e16135

Schrag, D., Hershman, D. L., & Basch, E. (2020). Oncology practice during the COVID-19 pandemic. Jama, 323(20), 2005-2006. https://doi.org/10.1001/jama.2020.6236

Serban, D., Smarandache, C. G., Tudor, C., Duta, L. N., Dascalu, A. M., & Aliuș, C. (2020). Laparoscopic Surgery in COVID-19 Era—Safety and Ethical Issues. Diagnostics, 10(9), 673. https://doi.org/10.3390/diagnostics10090673

Settineri, S., Frisone, F., Alibrandi, A., & Merlo, E. M. (2019a). Vulnerability and physical well-being of caregivers: what relationship?. Journal of Mind and Medical Sciences, 6(1), 95-102. https://doi.org/10.22543/7674.61.P95102

Settineri, S., Frisone, F., Merlo, E. M., Geraci, D., & Martino, G. (2019b). Compliance, adherence, concordance, empowerment, and self-management: five words to manifest a relational maladjustment in diabetes. Journal of multidisciplinary healthcare, 12, 299. https://doi.org/10.2147/JMDH.S193752

Settineri, S., Merlo, E. M., Alibrandi, A., Sicari, F., Dritto, I. P., Strangis, F., & Frisone, F. (2019c). Personality and phobias in adolescence: age and gender in psychopathological expressions. Journal of Mind and Medical Sciences, 6(2), 304-310. https://doi.org/10.22543/7674.62.P304310

Sicari, F., Frisone, F., Alibrandi, A., & Settineri, S. (2021). Validation of the Italian version of the Internet Behaviors Scale. Mediterranean Journal of Clinical Psychology, 9(1). https://doi.org/10.6092/2282-1619/mjcp-2990

Singh, A. K., Gupta, R., Ghosh, A., & Misra, A. (2020). Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 303-310. https://doi.org/10.1016/j.dsx.2020.04.004

Schellekens, M. P., & van der Lee, M. L. (2020). Loneliness and belonging: Exploring experiences with the COVID-19 pandemic in psycho-oncology. Psychooncology, 29(9), 1399-1401. https://doi.org/10.1002/pon.5459

Stoian, A. P., Banerjee, Y., Rizvi, A. A., & Rizzo, M. (2020a). Diabetes and the COVID-19 pandemic: how insights from recent experience might guide future management. Metabolic syndrome and related disorders, 18(4), 173-175. https://doi.org/10.1089/met.2020.0037

Stoian, A. P., Catrinoiu, D., Rizzo, M., & Ceriello, A. (2021). Hydroxychloroquine, COVID‐19 and diabetes. Why it is a different story. Diabetes/Metabolism Research and Reviews, 37(2), e3379. https://doi.org/10.1002/dmrr.3379

Stoian, A. P., Papanas, N., Prazny, M., Rizvi, A. A., & Rizzo, M. (2020b). Incretin-based therapies role in COVID-19 era: evolving insights. Journal of cardiovascular pharmacology and therapeutics, 25(6), 494-496. https://doi.org/10.1177/1074248420937868

Stoian, A. P., Pricop-Jeckstadt, M., Pana, A., Ileanu, B. V., Schitea, R., Geanta, M., ... & Jinga, V. (2020c). Death by SARS-CoV 2: a Romanian COVID-19 multi-centre comorbidity study. Scientific reports, 10(1), 1-11. https://doi.org/10.1038/s41598-020-78575-w

Strickland, D., Hodges, L., North, M., & Weghorst, S. (1997). Overcoming phobias by virtual exposure. Communications of the ACM, 40(8), 34-39. https://doi.org/10.1145/257874.257881

Swartz, H. A. (2020). The role of psychotherapy during the COVID-19 pandemic. https://doi.org/10.1176/appi.psychotherapy.20200015

Tsamakis, K., Gavriatopoulou, M., Schizas, D., Stravodimou, A., Mougkou, A., Tsiptsios, D., ... & Rizos, E. (2020). Oncology during the COVID‑19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients. Oncology Letters, 20(1), 441-447. https://doi.org/10.3892/ol.2020.11599

van der Lee, M. L., & Schellekens, M. P. (2020). Bridging the distance: Continuing psycho-oncological care via video-consults during the COVID-19 pandemic. Psycho-oncology, 29(9), 1421-1423. https://doi.org/10.1002/pon.5468

Vicario, C. M., Martino, G., Marcuzzo, A., & Craparo, G. (2021). No evidence of perceptual pseudoneglect in Alexithymia. Brain Sciences, 11(3), 376. https://doi.org/10.3390/brainsci11030376

Vicario, C. M., Nitsche, M. A., Salehinejad, M. A., Avanzino, L., & Martino, G. (2020). Time processing, interoception, and insula activation: a mini-review on clinical disorders. Frontiers in Psychology, 11, 1893. https://doi.org/10.3389/fpsyg.2020.01893

Vita, R., Caputo, A., Quattropani, M. C., Watt, T., Feldt-Rasmussen, U., Puleio, P., ... & Martino, G. (2020). Quality of life in patients with hyperthyroidism: where do we stand?. Mediterranean Journal of Clinical Psychology, 8(2). https://doi.org/10.6092/2282-1619/mjcp-2521

Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., ... & Peng, Z. (2020). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama, 323(11), 1061-1069. https://doi.org/10.1001/jama.2020.1585

Zhang, H., Wang, L., Chen, Y., Wu, Q., Chen, G., Shen, X., ... & Xie, C. (2020a). Outcomes of novel coronavirus disease 2019 (COVID‐19) infection in 107 patients with cancer from Wuhan, China. Cancer, 126(17), 4023-4031. https://doi.org/10.1002/cncr.33042

Zhang, L., Zhu, F., Xie, L., Wang, C., Wang, J., Chen, R., ... & Zhou, M. (2020b). Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Annals of oncology, 31(7), 894-901. https://doi.org/10.1016/j.annonc.2020.03.296

Zhao, Q., Meng, M., Kumar, R., Wu, Y., Huang, J., Lian, N., ... & Lin, S. (2020). The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐analysis. Journal of medical virology, 92(10), 1915-1921. https://doi.org/10.1002/jmv.25889

Zugravu, C. A., Baciu, A., Patrascu, D., Tarcea, M., & Pantea Stoian, A. (2012, November). Depression and diabetes: are there any consequences on self-care?. In European journal of public health (Vol. 22, pp. 272-272). GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND: OXFORD UNIV PRESS.

Zucchetti, G., Bertolotti, M., & Fagioli, F. (2020). How paediatric psycho-oncology is changing during the COVID-19 epidemic in Italy: New approaches. Psycho-oncology, 29(9), 1384-1386. https://doi.org/10.1002/pon.5444




DOI: https://doi.org/10.13129/2282-1619/mjcp-3011

Refbacks

  • There are currently no refbacks.