Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea

Boutros, Marc; Moujaess, Elissar; Kourié, Hampig Raphaël

doi:10.1016/j.critrevonc.2021.103273

Cited by 23 publications

(18 citation statements)

References 104 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Resource limitations, such as available hospital space, staffing, and supplies, led some facilities to adopt crisis standards of care, the most extreme operating condition for hospitals, in which the focus of medical decision‐making shifted from achieving the best outcomes for individual patients to addressing the immediate care needs of larger groups of patients 3 . When hospitals deviated from conventional standards of care, many preventive and elective procedures were suspended, leading to the progression of serious conditions among some persons who would have benefitted from earlier diagnosis and intervention 4 . During March–May 2020, U.S. emergency department visits declined by 23% for heart attacks, 20% for strokes, and 10% for diabetic emergencies 5 .…”

Section: Figurementioning

confidence: 99%

“…3 When hospitals deviated from conventional standards of care, many preventive and elective procedures were suspended, leading to the progression of serious conditions among some persons who would have benefitted from earlier diagnosis and intervention. 4 During March-May 2020, U.S. emergency department visits declined by 23% for heart attacks, 20% for strokes, and 10% for diabetic emergencies. 5 CDC provided data on excess deaths from all causes; data on hospital strain came from U.S. Department of Health and Human Services (HHS) hospital utilization timeseries dataset.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of hospital strain on excess deaths during the COVID-19 pandemic—United States, july 2020–july 2021

French

Hulse

Sobotka

et al. 2022

American Journal of Transplantation

View full text Add to dashboard Cite

This article describes the excess deaths observed when hospitals are strained by COVID‐19 admissions, as defined by intensive care unit bed occupancy. Specifically, when intensive care unit bed occupancy reaches 75% of capacity, there are an estimated 12,000 additional excess deaths; when hospitals exceed 100% of their intensive care unit bed capacity, approximately 80,000 excess deaths are expected in the following 2 weeks nationally. This report suggests that all patient populations, including transplant candidates and recipients, will experience additional excess deaths when there is increased strain on hospitals due to COVID‐19 surges.

show abstract

Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of hospital strain on excess deaths during the COVID-19 pandemic—United States, july 2020–july 2021

French

Hulse

Sobotka

et al. 2022

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Cancer patients are a vulnerable population during the ongoing COVID-19 pandemic [15][16][17]. They are at a high risk of SARS-CoV-2 infection and are more likely than other COVID-19 patients to develop severe disease [2].…”

Section: Discussionmentioning

confidence: 99%

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

Lee¹,

Koh²,

Lee³

et al. 2021

Yeungnam Univ J Med

View full text Add to dashboard Cite

Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic. Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.

show abstract

“…In view of the risk of missing a diagnosis or of prolonging times to treatment for a substantial number of people, the measures in relation to screening were not renewed during subsequent lockdown periods, despite intensive care unit occupancy being on a par with or exceeding usual capacity. Indeed, a number of studies suggest a reduction in survival associated with increased waiting times to undergo screening 10 – 12 , diagnosis, or treatment 13 – 15 . This had led the health authorities to propose new strategies, prioritise cancer patients, and take action in the uncertainty.…”

Section: Introductionmentioning

confidence: 99%

Monitoring the impact of COVID-19 in France on cancer care: a differentiated impact

Benjamin

Simonnet

Rocchi

et al. 2022

Sci Rep

View full text Add to dashboard Cite

The COVID-19 pandemic has had a substantial and lasting impact on care provision, particularly in the field of cancer care. National steering has helped monitor the health situation and adapt the provision and organisation of care. Based on data from the French administrative healthcare database (SNDS) on the entire French population (67 million people), screening, diagnostic and therapeutic activity was monitored and compared 2019 on a monthly basis. A noteworthy decline in all activities (with the exception of chemotherapy) was observed during the first lockdown in France. Over the months that followed, this activity returned to normal but did not make up for the shortfall from the first lockdown. Finally, during the lockdown in late 2020, cancer care activity was conserved. In brief, in 2020, the number of mammograms decreased by 10% (− 492,500 procedures), digestive endoscopies by 19% (− 648,500), and cancer-related excision by 6% (− 23,000 surgical procedures). Hospital radiotherapy activity was down 3.8% (− 4400 patients) and that in private practice was down 1.4% (− 1600 patients). Chemotherapy activity increased by 2.2% (7200 patients), however. To summarize, COVID-19 had a very substantial impact during the first lockdown. Safeguarding cancer care activity helped limit this impact over the months that followed, but the situation remains uncertain. Further studies on the medium- and long-term impact on individuals (survival, recurrence, after-effects) will be conducted.

show abstract

Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea

Cited by 23 publications

References 104 publications

Impact of hospital strain on excess deaths during the COVID-19 pandemic—United States, july 2020–july 2021

Impact of hospital strain on excess deaths during the COVID-19 pandemic—United States, july 2020–july 2021

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

Monitoring the impact of COVID-19 in France on cancer care: a differentiated impact

Contact Info

Product

Resources

About