Utjecaj COVID-19 pandemije na bolesnike s novootkrivenim kolorektalnim karcinomom u Općoj bolnici Zadar

Kolorektalni karcinom je jedna od najučestalijih zloćudnih bolesti u Republici Hrvatskoj.1 Ako se otkrije u ranom, odnosno lokaliziranom stadiju bolesti, petogodišnje preživljenje iznosi oko 90%.5 Iznimno je važno dijagnosticirati bolest u što ranijem stadiju radi boljeg ishoda liječenja. Stoga je odlukom Vlade Republike Hrvatske 2007. godine usvojen Nacionalni program ranog otkrivanja raka debelog crijeva.1 Pojava pandemije koronavirusne bolesti dovela je do izazova u funkcioniranju zdravstvenog sustava diljem svjeta, pa tako i programa ranog otkrivanja raka debelog crijeva.3 Za vrijeme Covid-19 pandemije zabilježen je smanjen broj obavljenih kolonoskopija i odaziv na program ranog otkrivanja raka debelog crijeva. Cilj ovog istraživanja je retrospektivno otvrditi utjecaj COVID-19 pandemije na bolesnike s novootkrivenim kolorektalnim karcinomom u razdoblju od 01.04.2020. do 30.09.2021. (za vrijeme COVID-19 pandemije) u odnosu na razdoblje od 01.04.2018. do 30.09.2019. (vrijeme prije COVID-19 pandemije) u Općoj bolnici Zadar. Glavni cilj istraživanja bio je odrediti vrstu operacije primarnog tumora (elektivne i hitne operacije) prije i za vrijeme COVID-19 pandemije. U našem istraživanju uspjeli smo dokazati hipotezu da će u COVID-19 pandemiji biti povećan udio hitnih operacijskih zahvata u odnosu na elektivne, što se može povezati sa smanjenim brojem preventivnih pregleda u sekundarnim zdravstvenim ustanovama, odnosno smanjenim odazivom na program za rano otkrivanje raka debelog crijeva

Secondary polycythemia in acutely ill COVID-19 patients is associated with higher mortality but not markedly higher thrombotic risk

Secondary polycythemia is commonly observed among patients with chronic pulmonary diseases. However, its significance in the context of Coronavirus disease 2019 (COVID-19) is unknown. We retrospectively evaluated a total of 5872 hospitalized COVID-19 patients with mostly severe and critical symptoms, and without prior or subsequently diagnosed myeloproliferative neoplasm. Patients were stratified based on admission hemoglobin into four subgroups: anemia (hemoglobin 165 g/L for females and >185 g/L for males). Among 5872 patients, a total of 158 (2.7%) had mild and 25 (0.4%) severe polycythemia. Polycythemia was significantly associated with higher respiratory and functional impairment, reduced plasma volume, higher serum osmolarity and comorbidity burden specific to the degree of polycythemia. Patients presenting with mild (odds ratio (OR) = 1.63, p = .003) and severe polycythemia (OR = 4.98, p < .001) had increased risk of death in comparison to patients with normal hemoglobin, whereas no significant associations with venous thromboembolism, arterial thrombosis nor major bleeding were observed. Anemia was associated with higher risk of death (OR = 1.42, p < .001), venous thromboembolism (OR = 1.34, p < .006) and major bleeding (OR = 2.27, p < .001) in comparison to normal hemoglobin. Associations of polycythemia and anemia with mortality diminished, and anemia with venous thromboembolism and major bleeding persisted, after multivariate adjustments for age, sex, comorbidities, COVID-19 severity and functional status. Secondary polycythemia in hospitalized COVID-19 patients without prior of subsequently diagnosed myeloproliferative neoplasm is rare and is associated with high mortality, increasing with degree of polycythemia, but not markedly higher thrombotic ris