Cancer disease progression and death during the COVID-19 pandemic: a multidisciplinary analysis for the Peruvian setting

Astigueta, Juan Carlos; Abad-Licham, Milagros; Chávez-Chirinos, Carlos; Beraun-Milla, Luis; Lachos-Dávila, Alberto; Diaz-Pérez, Elizabeth; Portugal-Valdivia, Karem; Castañeda, P.; Alférez, Isaías Pérez; Mezones‐Holguín, Edward

doi:10.3332/ecancer.2020.1098

Cited by 6 publications

(11 citation statements)

References 35 publications

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“… 25 Also, New Zealand and Brazil reported that there was a reduction in medical oncology appointments, number of patients undergoing intravenous systemic treatment, and number of hematopoietic stem cell transplants; however, there was an increase in oral-systemic and radiation therapies. 26 , 27 Compared to the previous year, these services decreased significantly from March to July 2020, 25 similar to another Peruvian study by Astigueta et al 14 Also, we observed in our cohort that approximately 50% of patients had some delay in cancer treatment.…”

Section: Discussionsupporting

confidence: 88%

“…These factors contributed to the inappropriate and delayed management of cancer patients, already described in initial reports. 14 …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have found that postponing cancer treatment and changes in the management of patients’ disease was the main cause of death. 14 , 22 Lin et al reported a delay in cancer treatment in 49% of patients and changes in treatment strategy in 30–40% of cases. 28 This study found that treatment discontinuation was higher than other series 29 but similar to that reported in Brazil, 27 probably due to the Peruvian healthcare system’s deficit compared to those in developed countries.…”

Section: Discussionmentioning

confidence: 99%

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Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study

Valdiviezo¹,

Alcarraz²,

Castro³

et al. 2022

CMAR

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Purpose The aim of this study is to evaluate the oncological care during the first state of national emergency due to the COVID-19 pandemic in several public cancer hospitals in Peru. Materials and Methods A multicentric cross-sectional descriptive study was conducted by interviewing adult cancer patients diagnosed and treated between January 2019 and February 2020 from 18 hospitals. This study was carried out in September 2020, the last month of the first state of national emergency. Demographic and clinical characteristics were evaluated, including COVID-19 status and cancer treatment features. Results A total of 1472 patients were included; the median age was 55 years (range 19–97). Most patients (85.8%, n = 1263) had solid neoplasia, 13.5% (n = 198) hematologic neoplasia, and 0.7% (n = 11) others. SARS-CoV-2 infection was confirmed in 8.6% (n = 126), 1.2% (n = 18) were probable, 1.6% (n = 24) suspected, and 88.6% (n = 1304) negative cases. Overall, 51.6% of patients (n = 759) had cancer treatment delays, 42.5% (n = 626) changed treatment delivery (endovenous to oral systemic therapy), and 12.6% (n = 185) of cases cancer therapy was discontinued. In total, 10.3% (n = 117) of patients whose disease was controlled or in remission, experienced progression of disease during the state of emergency. A total of 6.7% (n = 98) of patients died, of whom 73.5% (n = 72) died from disease progression; 18.4% (n = 18) from SARS-CoV-2 infection and 8.1% (n = 8) from undetermined causes. Patients with hematological malignancies [hazard ratio (HR): 5.11 (95% confidence interval (CI): 1.99–13.07)] and no response to therapy before the onset of the pandemic [5.01 (1.44–17.42)] had an increased risk of death among COVID-19 infected individuals, whereas advanced clinical stage [5.09 (2.37–10.95)] and discontinuation of treatment [3.66 (1.97–6.78)] were risk factors among non-COVID-19 patients. Conclusion Our study suggests that the COVID-19 pandemic has an adverse impact on the outcomes of Peruvian cancer patients. In our cohort, cancer mortality was higher than COVID-19 disease mortality.

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Section: Discussionsupporting

confidence: 88%

“…These factors contributed to the inappropriate and delayed management of cancer patients, already described in initial reports. 14 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study

Valdiviezo¹,

Alcarraz²,

Castro³

et al. 2022

CMAR

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“…While regrettably by November 2020, SARS-CoV-2 infection has directly caused 1,231,017 deaths worldwide [16], we also have a duty of care to ensure that there is not a significant number of preventable deaths in patients who otherwise had survivable disease who have poor outcomes (such as disease progression and complications due to procedures performed in order to delay the surgery for instance ERCP or prolonged chemotheraphy [17][18][19]. due to cancelled or delayed operations or screening tests [20,21].…”

Section: Discussionmentioning

confidence: 99%

Should Local Rather than National Policy Determine our Approach to Surgery During SARS- CoV-2?

Boira¹,

Richards²

2021

J Gast Hepa Rep

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Purpose: A major disruption of routine hospital services has occurred globally after SARS-CoV-2 pandemic. Current publications are based on large databases collected from hospitals with different characteristics which may not apply to all centres since the impact of SARS-CoV-2 varies depending on the incidence in each area. We studied the incidence of perioperative SARS-CoV-2 infection in surgical patients. Methods: We performed an observational, retrospective cohort study in patients undergoing surgery between March 16th to May 15th 2020. Results: Four patients (5.4%) tested positive with SARS-CoV-2, all positive results were obtained postoperatively. SARS-CoV-2 status was known at the time of surgery in 23 (60%) patients in emergency surgery and 20 patients (57%) in elective surgery. Mortality rate was 13% in emergency surgery with no cases due to SARS-CoV-2 related complications. Nine patients (25.7%) had changes in their management in elective surgery, no deaths were reported and one patient developed SARS-CoV-2 bilateral pneumonia. Discussion: Our results show that SARS-CoV-2 infection among surgical patients was low in our centre. Changes in policies on surgical activity during the SARS-CoV-2 pandemic should be taken at a regional or hospital level to reflect the local burden of SARS-CoV-2 and availability of resources.

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“…Algumas iniciativas são de extrema importância voltada a promover o cuidado de pacientes com câncer, incluindo a prevenção ao manejo terapêutico especializado (Astigueta-Pérez et al, 2020).…”

Section: Clinical Impact Of Covid-19unclassified

Covid-19 em pacientes com câncer: um enfoque clinico-epidemiológico

Filho

Sousa

Cruz³

et al. 2021

RSD

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O presente estudo tem como objetivo levantar um enfoque Clinico-epidemiológico sobre a Covid-19 em Pacientes com câncer. O presente estudo utilizou como abordagem metodológica de pesquisa a revisão integrativa. Elegeu-se como questão norteadora: “Quais os principais sinais clínicos em pacientes oncológicos com Covid-19?” e “Qual a epidemiologia do câncer juntamente com a covid-19?”. Para a realização desse estudo, foram consultadas as bases de dados: MEDLINE, Scholar Google, LILACS, SCIELO e Repositórios. Utilizou-se os Descritores em Ciências da Saúde (DeCS) de forma associada: COVID-19, Câncer, Epidemiologia, Clinica e Coronavírus. Inicialmente, 165 artigos foram encontrados. Destes, 82 foram selecionados para a leitura completa. Os casos discordantes foram deliberados por consenso, resultando na seleção final de 12 artigos para a leitura na íntegra e elaboração deste estudo, onde possuíam informações clínicas e epidemiológicas de pacientes com câncer que foram infectados pelo novo coronavírus. As pessoas com idade avançada e aquelas com doenças crônicas, como diabetes, doenças cardiovasculares e respiratórias, e com imunidade baixa, possuem um risco maior de terem complicações graves se forem contaminadas pelo coronavírus. Da mesma forma, pessoas com câncer que estejam em tratamentos de quimioterapia, radioterapia, que tenham feito cirurgia há menos de um mês ou que façam uso de medicamentos imunossupressores fazem parte do grupo de risco, tendo em vista que pacientes oncológicos são efetivamente mais vulneráveis a desenvolver a COVID-19 em sua forma mais severa.

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Cancer disease progression and death during the COVID-19 pandemic: a multidisciplinary analysis for the Peruvian setting

Cited by 6 publications

References 35 publications

Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study

Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study

Should Local Rather than National Policy Determine our Approach to Surgery During SARS- CoV-2?

Covid-19 em pacientes com câncer: um enfoque clinico-epidemiológico

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