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文献精选 > 近年高分"阿尔茨海默病"研究（IF≥30，近5年）

Cardio-oncology care in the era of the coronavirus disease 2019 (COVID-19) pandemic: An International Cardio-Oncology Society (ICOS) statement. ​

文献信息 ​

DOI10.3322/caac.21635
PMID32910493
期刊CA: a cancer journal for clinicians
影响因子232.4
JCR 分区Q1
发表年份2020
被引次数24
关键词最佳实践，癌症，心脏安全，心脏肿瘤学，2019冠状病毒病 (COVID-19)
文献类型Journal Article, Practice Guideline, Research Support, N.I.H., Extramural, Review
ISSN0007-9235
页码480-504
期号70(6)
作者Daniel Lenihan, Joseph Carver, Charles Porter, Jennifer E Liu, Susan Dent, Paaladinesh Thavendiranathan, Joshua D Mitchell, Anju Nohria, Michael G Fradley, Iskra Pusic, Keith Stockerl-Goldstein, Anne Blaes, Alexander R Lyon, Sarju Ganatra, Teresa López-Fernández, Rupal O'Quinn, Giorgio Minotti, Sebastian Szmit, Daniela Cardinale, Jose Alvarez-Cardona, Giuseppe Curigliano, Tomas G Neilan, Joerg Herrmann

一句话小结 ​

本研究探讨了SARS-CoV-2疫情对同时患有癌症和心血管疾病患者的影响，指出这一高风险群体在COVID-19大流行期间需要特别关注与管理。研究强调在医疗实践中应调整策略，利用心脏生物标志物和心血管影像学方法，以降低感染风险并改善患者预后。

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最佳实践 · 癌症 · 心脏安全 · 心脏肿瘤学 · 2019冠状病毒病 (COVID-19)

摘要 ​

严重急性呼吸综合症冠状病毒2型（SARS-CoV-2）因其高度传染性及对人类健康和社会的影响，引发了现代史上前所未有的大流行：2019冠状病毒病（COVID-19）。具有心血管（CV）风险因素和确诊心血管疾病（CVD）的患者是最初被识别为面临严重并发症（包括死亡）最高风险的群体。后续研究指出，癌症患者在疾病严重进展方面也处于高风险之中。因此，似乎最脆弱的患者群体是同时患有癌症和心血管疾病的患者，在COVID-19大流行期间，特别需要对这一患者群体进行仔细而统一的评估和管理。本文回顾了病毒暴发对心脏肿瘤学领域的独特影响，并概述了在应对这一日益增加的患者群体时所需的关键调整。这些调整包括在通常的实践路径修改的更广泛背景下，向更大程度地利用心脏生物标志物和更专注的心血管影像学方法转变。这一战略调整的目标是尽量减少SARS-CoV-2感染（或其他未来病毒暴发）的风险，同时不忽视心血管疾病及其对癌症治疗患者整体预后的重要影响。

英文摘要 ​

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has given rise to a pandemic of unprecedented proportions in the modern era because of its highly contagious nature and impact on human health and society: coronavirus disease 2019 (COVID-19). Patients with cardiovascular (CV) risk factors and established CV disease (CVD) are among those initially identified at the highest risk for serious complications, including death. Subsequent studies have pointed out that patients with cancer are also at high risk for a critical disease course. Therefore, the most vulnerable patients are seemingly those with both cancer and CVD, and a careful, unified approach in the evaluation and management of this patient population is especially needed in times of the COVID-19 pandemic. This review provides an overview of the unique implications of the viral outbreak for the field of cardio-oncology and outlines key modifications in the approach to this ever-increasing patient population. These modifications include a shift toward greater utilization of cardiac biomarkers and a more focused CV imaging approach in the broader context of modifications to typical practice pathways. The goal of this strategic adjustment is to minimize the risk of SARS-CoV-2 infection (or other future viral outbreaks) while not becoming negligent of CVD and its important impact on the overall outcomes of patients who are being treated for cancer.

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主要研究问题 ​

  1. 在COVID-19疫情期间，心脏肿瘤学的管理策略有哪些具体的调整和变化？
  2. 针对同时患有癌症和心血管疾病的患者，如何优化他们的治疗方案以降低COVID-19的风险？
  3. 在心脏肿瘤学中，心脏生物标志物的使用对患者管理有什么潜在的好处和挑战？
  4. 疫情期间，心血管影像学在癌症患者中的应用如何影响临床决策？
  5. 未来在面对类似COVID-19的疫情时，心脏肿瘤学领域应如何改进患者护理和管理流程？

核心洞察 ​

研究背景和目的 ​

新冠病毒（SARS-CoV-2）引发的2019冠状病毒病（COVID-19）疫情对全球健康造成了前所未有的影响，特别是对心血管疾病（CVD）和癌症患者。研究表明，具有心血管风险因素和已确诊心血管疾病的患者在感染COVID-19后面临更高的并发症风险。该文献旨在为心脏肿瘤学领域提供在COVID-19大流行期间对癌症患者的心脏安全管理的指导建议。

主要方法/材料/实验设计 ​

本研究采用文献综述的方法，综合了多项关于COVID-19对心血管系统影响的研究结果，分析了癌症患者在COVID-19大流行期间的心脏安全问题，并提出了相应的管理策略。以下是研究的技术路线示意图：

Mermaid diagram

关键结果和发现 ​

  1. 心血管影响：COVID-19感染可导致心肌损伤、心律失常及血流动力学支持需求。约27.8%的COVID-19患者出现心肌损伤，20%有心律失常。
  2. 癌症患者的风险：癌症患者在感染COVID-19后表现出更高的重症和死亡风险，尤其是那些同时存在心血管疾病的患者。
  3. 管理策略：提出了一系列管理策略，包括：
    • 优先使用心脏生物标志物监测心脏安全。
    • 在适当情况下，推迟非急需的影像学检查。
    • 强调多学科团队合作，以优化患者的整体治疗方案。

主要结论/意义/创新性 ​

本研究强调了在COVID-19大流行期间，癌症患者的心脏安全管理的重要性。提出的基于生物标志物的监测和多学科合作策略为临床实践提供了新的视角和方法，帮助在资源有限的情况下优化患者的治疗结果。

研究局限性和未来方向 ​

  1. 局限性：本研究主要基于现有文献，缺乏大规模前瞻性研究的数据支持，建议未来进行更系统的临床试验。
  2. 未来方向：应进一步探索心脏生物标志物在癌症患者中的应用，以评估其在COVID-19大流行期间的有效性。同时，需建立更全面的跨学科合作模式，以应对复杂的患者需求。

参考文献 ​

  1. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. - Jing Yu;Wen Ouyang;Melvin L K Chua;Conghua Xie - JAMA oncology (2020)
  2. Exploratory analysis of cardiac biomarkers in women with normal cardiac function receiving trastuzumab for breast cancer. - Shom Goel;R John Simes;Jane M Beith - Asia-Pacific journal of clinical oncology (2011)
  3. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. - Dominic Wichmann - Annals of internal medicine (2020)
  4. COVID-19: consider cytokine storm syndromes and immunosuppression. - Puja Mehta;Daniel F McAuley;Michael Brown;Emilie Sanchez;Rachel S Tattersall;Jessica J Manson; - Lancet (London, England) (2020)
  5. A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group. - Humaid O Al-Shamsi;Waleed Alhazzani;Ahmad Alhuraiji;Eric A Coomes;Roy F Chemaly;Meshari Almuhanna;Robert A Wolff;Nuhad K Ibrahim;Melvin L K Chua;Sebastien J Hotte;Brandon M Meyers;Tarek Elfiki;Giuseppe Curigliano;Cathy Eng;Axel Grothey;Conghua Xie - The oncologist (2020)
  6. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. - Zunyou Wu;Jennifer M McGoogan - JAMA (2020)
  7. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). - Riccardo M Inciardi;Laura Lupi;Gregorio Zaccone;Leonardo Italia;Michela Raffo;Daniela Tomasoni;Dario S Cani;Manuel Cerini;Davide Farina;Emanuele Gavazzi;Roberto Maroldi;Marianna Adamo;Enrico Ammirati;Gianfranco Sinagra;Carlo M Lombardi;Marco Metra - JAMA cardiology (2020)
  8. Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association. - Dhanunjaya R Lakkireddy;Mina K Chung;Rakesh Gopinathannair;Kristen K Patton;Ty J Gluckman;Mohit Turagam;Jim Cheung;Parin Patel;Juan Sotomonte;Rachel Lampert;Janet K Han;Bharath Rajagopalan;Lee Eckhardt;Jose Joglar;Kristin Sandau;Brian Olshansky;Elaine Wan;Peter A Noseworthy;Miguel Leal;Elizabeth Kaufman;Alejandra Gutierrez;Joseph E Marine;Paul J Wang;Andrea M Russo - Circulation (2020)
  9. Myocarditis in Patients Treated With Immune Checkpoint Inhibitors. - Syed S Mahmood;Michael G Fradley;Justine V Cohen;Anju Nohria;Kerry L Reynolds;Lucie M Heinzerling;Ryan J Sullivan;Rongras Damrongwatanasuk;Carol L Chen;Dipti Gupta;Michael C Kirchberger;Magid Awadalla;Malek Z O Hassan;Javid J Moslehi;Sachin P Shah;Sarju Ganatra;Paaladinesh Thavendiranathan;Donald P Lawrence;John D Groarke;Tomas G Neilan - Journal of the American College of Cardiology (2018)
  10. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. - L Zhang;F Zhu;L Xie;C Wang;J Wang;R Chen;P Jia;H Q Guan;L Peng;Y Chen;P Peng;P Zhang;Q Chu;Q Shen;Y Wang;S Y Xu;J P Zhao;M Zhou - Annals of oncology : official journal of the European Society for Medical Oncology (2020)

引用本文的文献 ​

  1. Editorial commentary: Cardiovascular imaging in COVID-19: Focus on safety, value, and clinical relevance. - Sourbha S Dani;Shiv Bagga;Sarju Ganatra - Trends in cardiovascular medicine (2021)
  2. Cardiotoxicity of Contemporary Anticancer Immunotherapy. - Natalie Dal'bo;Rushin Patel;Rohan Parikh;Sachin P Shah;Avirup Guha;Sourbha S Dani;Sarju Ganatra - Current treatment options in cardiovascular medicine (2020)
  3. Current status of treatment of cancer-associated venous thromboembolism. - Wei Xiong - Thrombosis journal (2021)
  4. Reaching Across the Aisle: Cardio-Oncology Advocacy and Program Building. - Diego Sadler;Anita Arnold;Joerg Herrmann;Andres Daniele;Carolina Maria Pinto Domingues Carvalho Silva;Arjun K Ghosh;Sebastian Szmit;Roohi Ismail Khan;Luis Raez;Anne Blaes;Sherry-Ann Brown - Current oncology reports (2021)
  5. Cardiotoxicity of Immune Checkpoint Inhibitors. - Rushin P Patel;Rohan Parikh;Krishna S Gunturu;Rana Zouveenoor Tariq;Sourbha S Dani;Sarju Ganatra;Anju Nohria - Current oncology reports (2021)
  6. Cardio-oncology Training in the COVID-19 Era. - Stephanie Feldman;Jennifer Liu;Richard Steingart;Dipti Gupta - Current treatment options in oncology (2021)
  7. Impact of Cancer and Cardiovascular Disease on In-Hospital Outcomes of COVID-19 Patients: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry. - David Tehrani;Xiaoyan Wang;Asim M Rafique;Salim S Hayek;Joerg Herrmann;Tomas G Neilan;Pooja Desai;Alicia Morgans;Juan Lopez-Mattei;Rushi V Parikh;Eric H Yang - Research square (2021)
  8. Clinical characteristics, risk factors, and cardiac manifestations of cancer patients with COVID-19. - Yan Huang;Zhenhong Hu;Dong Hu;Zhou Quan;Xiaoyang Zhou;Guohua Fan;Xiu Chen;Xiaoxiong Liu;Zhonghe Zhang;Ganxiao Chen;Yanwen Wu;Fangqi Zhang;Congzheng Mao;Hao Xia;Jinjun Liang;Bo Yang;Hong Jiang;Congxin Huang;Hector Barajas-Martínez;Dan Hu - Journal of applied physiology (Bethesda, Md. : 1985) (2021)
  9. The Role and Impact of Social Media in Cardio-oncology During the COVID-19 Pandemic. - Jennifer M Kwan;Mariana L Henry;Briana Christophers;Kamala Tamirisa;Ritu Thamman;Diego Sadler;Niti R Aggarwal;Richard Cheng;Purvi Parwani;Susan Dent;Roohi Ismail-Khan;Michael G Fradley;Sherry-Ann Brown - Current oncology reports (2021)
  10. Consumer Wearables and the Integration of New Objective Measures in Oncology: Patient and Provider Perspectives. - Lakshan N Fonseka;Benjamin Kp Woo - JMIR mHealth and uHealth (2021)

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