Context:We describe the treatment of cancer patients carried out in a Government of India-designated, dedicated coronavirus disease (COVID) hospital (DCH) in a COVID hotspot in India. Aims: The aim was to study the change and delay in the management of cancer patients during the pandemic and its complications. Settings and Design: This was an observational cohort study conducted at a tertiary care center, which was also a DCH. Subjects and Methods: Cancer patients receiving cancer surgery, chemotherapy, and radiotherapy in our DCH, during the lockdown, were studied. Results: A total of 864 patients received treatment for cancer in our hospital during the period of March 20, 2020 -May 31, 2020. There were no COVID-related complications. The treatment of 109/864 patients (12.61%) was delayed due to the pandemic and lockdown situation and the treatment plan was changed for 84/864 (9.72%) patients. There were 21 deaths in these 864 patients (2.43%), but only two deaths were COVID related. Symptomatic patients were tested for COVID, and 3/864 patients (0.34%) were detected to be COVID positive. Conclusions: We successfully delivered cancer treatment to patients in our DCH. The percentage of adverse effects, symptomatic COVID infection, and related mortality has been very low in our study. Cancer care can be continued with due diligence even during this pandemic.
Introduction We document our data on the course of the coronavirus disease 2019 (COVID-19) infection in cancer patients in an attempt to help optimize their management in India and globally.
Material and Methods Between February 2020 and January 2021, participating oncologists from Pune (members of the Oncology Group of Pune) documented effect of COVID-19 infection in their cancer patients. Binomial logistic regression analysis as well as correlation analysis was done using Pearson Chi-square test to determine significance of clinical factors.
Results A total of 29 oncologists from 20 hospitals contributed their data involving 147 cancer patients who developed COVID-19 infections. COVID-19 infection resulted in higher deaths (likelihood ratio of 4.4) amongst patients with hematological malignancies (12/44 = 27.2%) as compared with those with solid tumors (13/90 = 14.4%, p = 0.030). Patients with uncontrolled or progressive cancer (11/34 = 32.4%) when they got infected with COVID-19 had higher mortality as compared with patients whose cancer was under control (14/113 = 12.4%; p = 0.020). Complication of thromboembolic episodes (seen in eight patients; 5.4% cases) was associated with higher risk (25.6 times) of death (five-eighths; 62.5%) as compared with those who did not develop it (20/139;14.4%; p <0.001).
Discussion Patients with cancer should be advised to take strict precautions to reduce the risk of being infected with COVID-19. They should also be given priority for COVID-19 vaccination. If infected with COVID-19, patients with hematological malignancy and uncontrolled cancer are at higher risk of morbidity and mortality. When they are being treated (OPD or inpatient basis), additional precautions are necessary to ensure their exposure to potential COVID-19 virus is minimized. If they get infected with COVID-19, they should be given aggressive treatment to prevent complications, especially thromboembolic episodes. If they develop any thromboembolic complication, their risk of dying are significantly higher, and management should be modified accordingly.
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