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Spread of SARS-CoV-2 in the Icelandic Population.

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Authors
Gudbjartsson, Daniel F
Helgason, Agnar
Jonsson, Hakon
Magnusson, Olafur T
Melsted, Pall
Norddahl, Gudmundur L
Saemundsdottir, Jona
Sigurdsson, Asgeir
Sulem, Patrick
Agustsdottir, Arna B
Eiriksdottir, Berglind
Fridriksdottir, Run
Gardarsdottir, Elisabet E
Georgsson, Gudmundur
Gretarsdottir, Olafia S
Gudmundsson, Kjartan R
Gunnarsdottir, Thora R
Gylfason, Arnaldur
Holm, Hilma
Jensson, Brynjar O
Jonasdottir, Aslaug
Jonsson, Frosti
Josefsdottir, Kamilla S
Kristjansson, Thordur
Magnusdottir, Droplaug N
le Roux, Louise
Sigmundsdottir, Gudrun
Sveinbjornsson, Gardar
Sveinsdottir, Kristin E
Sveinsdottir, Maney
Thorarensen, Emil A
Thorbjornsson, Bjarni
Löve, Arthur
Masson, Gisli
Jonsdottir, Ingileif
Möller, Alma D
Gudnason, Thorolfur
Kristinsson, Karl G
Thorsteinsdottir, Unnur
Stefansson, Kari
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Issue Date
2020-04-14

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Citation
Gudbjartsson DF, Helgason A, Jonsson H, et al. Spread of SARS-CoV-2 in the Icelandic Population. N Engl J Med. 2020;382(24):2302-2315. doi:10.1056/NEJMoa2006100
Abstract
Context: Radical cystectomy and pelvic lymph node dissection (RC and PLND) are an essential part of the treatment paradigm in high risk bladder cancer. However, these patients have high rates of morbidity and mortality related both to the treatment and to the disease.Objective: To provide overview of current literature about clinical markers that can be used to predict and improve BC-patient outcomes at the time of RC and PLND and to study if they are properly validated.Evidence acquisition: A systematic literature search was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria between January 1990 and October 2018 to identify English written original and review articles relevant to this topic. Prospective and retrospective studies were included.Evidence synthesis: There are several risk factors identified from non-randomised trials that can be improved before surgery to reduce perioperative mortality and morbidity. These include poor nutritional status, anaemia, renal function and smoking. Preoperative nomograms have also been developed to help decision-making and to inform patients about the risks of surgery. They can be used to estimate risk of postoperative mortality after RC and PLND with accuracy varying from 70 to 86%. These nomograms are largely based on retrospective data. Likewise, nomograms developed to calculate estimates about patient's overall and cancer specific survival have the same limitations.Conclusion: Clinical markers to predict morbidity, mortality and survival in patients with bladder cancer treated with RC and PLND may help to improve patient outcomes and treatment decision-making, but available data come from small retrospective trials and have not been properly validated. Prospective, multi-centre studies are needed to implement and disseminate predictive clinical markers and nomograms such that they can be utilised in treatment decision-making in daily practice.
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Additional Links
https://www.nejm.org/doi/10.1056/NEJMoa2006100?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175425/
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Copyright © 2020 Massachusetts Medical Society.
ae974a485f413a2113503eed53cd6c53
10.1056/NEJMoa2006100
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