Cancer management challenge in a developing country in COVID-19 pandemic: reflection of a group of Moroccan oncologists

Abstract

Management of cancer patients during the COVID-19 pandemic is a worldwide challenge – in particular in developing countries where the risk of saturation of health facilities and intensive care beds must be minimized. The first case of COVID-19 was declared in Morocco on 2 March 2020, after which a panel of Moroccan experts, consisting of medical oncologists from universities and regional and private oncology centers, was promptly assembled to conduct a group reflection on cancer patient's management. The main objective is to protect the immunocompromised population from the risk of COVID-19, while maintaining an adequate management of cancer, which can quickly compromise their prognosis. Recommendations are provided according to each clinical situation: patients undergoing treatment, new cases, hospitalized patients, palliative care and surveillance.

Truscreen Detection of Cervical Tissues for High-Risk Human Papillomavirus-Infected Women During the COVID-19 Pandemic

“…SARS-CoV-2 infection rate appeared to be higher in cancer patients than in the general population (1 vs 0.29%). In particular, the risk of developing severe respiratory complications requiring intensive care was higher in cancer patients than in noncancer patients (39 vs 8%; p = 0.0003) [3]. Oncology departments and associations have made new recommendations and therapeutic options for these high-risk patients.…”

COVID-19 Recommendations for Patients with Cancer: The post-COVID-19 Era

“…The decision on the priorities for surgery should be undertaking in a multidisciplinary team (MDT) meeting in accordance with recommendations established by national and international societies [3,4,7,8]. The possibility of adapting the treatment sequence will depend on the disease stage and the acceptable time to defer surgery.…”

“…Teleconsultation has become a new opportunity for triage of patients into those who should be physically examined, and those who should benefit from additional workup before their admission physically to limit their exposure to the hospital environment and therefore to reduce their risk of contamination. The main limitation of teleconsultation during follow-up is the impossibility of examining patients, but as long as the epidemic situation is not controlled, teleconsultation remains preferable [3][4][5][7][8][9].…”

“…During the COVID-19 pandemic, national and international societies recommend continuing the management of cancer patients despite the spread of the virus in the world. They established guidelines to adapt patient care and to limit the risk of contamination by the virus while preserving their chances of recovery [2][3][4][5][6][7] (http://smc.ma/recommandation-cancer-etcovid-19-smc/). For example, Table 1 summarizes special recommendations implemented for patients diagnosed with breast cancer during the COVID-19 pandemic [4].…”

Prevalence and associated factors of COVID-19 among Moroccan physicians: A cross-sectional study

“…Thus, several studies have been carried out in Morocco assessing the management strategies in healthcare environments including primary care, intensive care units, hemodialysis units, blood transfusion, and cancer centers [26][27][28][29][30][31][32][33][34][35][36]. Studies also included ethical and legal issues related to hydroxychloroquine treatment prescription for COVID-19 and COVID-19 disease recognition as work-related accident [14,37].…”