LitCovid-sentences  

PMC:7253235 / 38033-45398 JSONTXT 12 Projects

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Id Subject Object Predicate Lexical cue
T240 0-55 Sentence denotes Care of the Cardio-Oncology Patient in the COVID-19 Era
T241 56-311 Sentence denotes The COVID-19 pandemic has added a significant layer and complexity of how patient care is being delivered due to concerns of bidirectional transmission, with no protective algorithm widely in place to dictate ongoing management of cancer patients [108••].
T242 312-443 Sentence denotes Initiating cancer treatments, such as targeted immunotherapies and chemotherapy, require special consideration in the COVID-19 era.
T243 444-604 Sentence denotes As previously described, compromised immune systems render patients with cancer at higher risk for acquiring COVID-19 infection and the sequelae that may ensue.
T244 605-788 Sentence denotes Cancer treatment centers and cardio-oncologists must now consider not only the patient but also the integral healthcare workers who are regularly interfacing with high-risk exposures.
T245 789-994 Sentence denotes Devising strategies to ensure robust testing services and clearance mechanisms to protect patient and healthcare personnel is one of many methods now employed to continue ongoing treatments [48, 109, 110].
T246 995-1191 Sentence denotes Though there are no clear evidence-based modifications in systems of care to reduce transmission risk while balancing high-standard cardio-oncology care, various strategies are proposed (Table 2).
T247 1192-1437 Sentence denotes Life-prolonging surgeries and procedures can slowly be pursued and continued, although the risks of delaying any such advanced treatments—including bone marrow transplantation and chimeric antigen receptor treatment—need to be weighed carefully.
T248 1438-1610 Sentence denotes COVID-19 screening and testing prior to these surgeries/procedures, while not infallible, should be considered if available due to rising concern for asymptomatic carriers.
T249 1611-1762 Sentence denotes Following completing anti-cancer treatments, patients may additionally benefit from receiving immune system restorative treatments, such as filgastrim.
T250 1763-1862 Sentence denotes Table 2 Proposed special considerations of the cardio-oncology patient during the COVID-19 pandemic
T251 1863-1972 Sentence denotes Cardio-oncology aspect of care Theoretical areas of concern Proposed Strategies to Mitigate COVID-19 Exposure
T252 1973-2222 Sentence denotes Initiating/ongoing cancer treatments (i.e., chemotherapy, targeted therapies, immunotherapy, BMT, CAR-T), and timing of oncologic-related surgery • Compromised immune systems induced by cancer treatments may make patient more susceptible to COVID-19
T253 2223-2343 Sentence denotes • Cancer treatments may require healthcare facility/inpatient stay exposing patient to asymptomatic carriers (i.e., HCW)
T254 2344-2435 Sentence denotes • Delaying of potential critical, life-prolonging surgery as it may be deemed as “elective”
T255 2436-2646 Sentence denotes • Ensuring COVID-19 testing adequacy by healthcare providers • Implementation of universal PPE and social distancing during cancer treatments in outpatient/inpatient settings, and with family members/caretakers
T256 2647-2782 Sentence denotes • Weighing risk-benefit of postponing/delaying timing of cancer treatments/surgery to minimize exposure to inpatient healthcare setting
T257 2783-2843 Sentence denotes • Preoperative/procedural screening and testing for COVID-19
T258 2844-2942 Sentence denotes • Telemedicine for routine follow-up cardio-oncology/oncology visits unless clinically symptomatic
T259 2943-3057 Sentence denotes • Research efforts investigating earlier utilization of immune system restorative measures post anti-tumor therapy
T260 3058-3176 Sentence denotes • Consideration of delaying myeloablative therapies and immunotherapies for patients in clinical remission if possible
T261 3177-3263 Sentence denotes • Consideration of minimizing surveillance/staging imaging during and after treatments
T262 3264-3526 Sentence denotes Cardiotoxicity experienced during cancer treatments (i.e., cardiomyopathy, arrhythmias, and ischemic events) • Further delay of cancer treatments and cardio-oncology evaluation because of COVID-19 may increase cardiac and cancer-related comorbidity and mortality
T263 3527-3689 Sentence denotes • Cardiac imaging and testing may cause further exposure to asymptomatic carriers • Inpatient admission and evaluation as clinically indicated for severe symptoms
T264 3690-3839 Sentence denotes • Telemedicine for patients who are asymptomatic or minimally symptomatic, or CVD risk factor modification (i.e., visits for HTN and/or dyslipidemia)
T265 3840-3985 Sentence denotes • Preemptive aggressive treatment for suspected symptoms related to CAD, arrhythmias, or CHF and deferring of imaging unless clinically necessary
T266 3986-4067 Sentence denotes • Mail ambulatory rhythm monitors to home to evaluate suspected/known arrhythmias
T267 4068-4295 Sentence denotes Cardiotoxicity surveillance in cancer patients during and after treatment • Some cancer treatments (i.e., anti-HER2, BRAF-MEK treatments, clinical trials) require frequent surveillance of cardiac function (i.e., every 3 months)
T268 4296-4531 Sentence denotes • Patients with known cardiotoxicity, or with known treatments that can cause long-term cardiotoxicity (i.e., anthracyclines, radiation) may not get timely surveillance imaging • Minimize cardiac imaging to patients who are symptomatic
T269 4532-4693 Sentence denotes • Multidisciplinary discussion with hematologist/oncologist about reducing frequency of cardiotoxicity screening, especially if prior serial testing unremarkable
T270 4694-4767 Sentence denotes • Limited imaging protocols to evaluate LVEF to minimize acquisition time
T271 4768-4872 Sentence denotes • Defer primary prevention assessment (i.e., dyslipidemia management) unless critical to care of patient
T272 4873-5020 Sentence denotes • Telemedicine visits for patients who do not require face-to-face assessment for medical issues (i.e., blood pressure/lipid management/stable CHF)
T273 5021-5151 Sentence denotes • Defer asymptomatic long-term cancer survivor surveillance (i.e., assessment of ventricular and valvular function) if no symptoms
T274 5152-5411 Sentence denotes BMT bone marrow transplantation, CAR-T chimeric antigen receptor therapy, HCW healthcare workers, PPE personal protective equipment, CVD cardiovascular disease, CAD coronary artery disease, CHF congestive heart failure, LVEF left ventricular ejection fraction
T275 5412-5611 Sentence denotes Additionally, the transition to telemedicine to conduct interval cardiovascular and oncologic appointments can potentially protect patients from unnecessarily harmful nosocomial exposures [111, 112].
T276 5612-5904 Sentence denotes Certain chronic conditions (i.e., hypertension, stable/compensated congestive heart failure) may not necessarily require a face-to-face visit, whereas highly symptomatic patients should still be seen in the cardio-oncology clinic, preferably on the same day as their cancer outpatient visits.
T277 5905-6054 Sentence denotes Deferring primary prevention assessments, for example, cholesterol monitoring, unless otherwise indicated can augment protective mechanisms in place.
T278 6055-6156 Sentence denotes Cardiovascular-related blood draws, if necessary, should be coincided with cancer-related treatments.
T279 6157-6368 Sentence denotes In addition, the specter of cardiotoxicity related to certain cancer treatments also requires a reexamination of risk and benefit with respect to frequent cardiac monitoring due to previously mentioned concerns.
T280 6369-6529 Sentence denotes Peri-chemotherapeutic events and development of cardiomyopathy, ischemia, and life-threatening arrhythmias are further worsened by simultaneous COVID infection.
T281 6530-6759 Sentence denotes Reducing reliance on frequent cardiac imaging in otherwise asymptomatic patients and providing in-mail ambulatory rhythm monitors for patients symptomatic with possible arrhythmias will further assist in mitigating exposure risk.
T282 6760-7025 Sentence denotes Limited cardiac-imaging protocols (i.e., focused just on ventricular function and/or pericardial disease) if necessary for symptomatic patients or those necessitating cardiotoxicity surveillance can also be devised to reduce exposure time in the healthcare setting.
T283 7026-7365 Sentence denotes In addition, for patients at low risk of cardiotoxicity and/or with prior serial-documented normal cardiac function, it can be considered to defer serial cardiac imaging in certain treatments (i.e., anti-HER2 without anthracyclines, BRAF-MEK treatments), in multidisciplinary discussions with oncology if the patient is asymptomatic [113].