Care of immunocompromised patients with head and neck cancer during the <scp>COVID</scp>‐19 pandemic: Two challenging and informative clinical cases

Civantos, Alyssa M.; Carey, Ryan M.; Lichtenstein, Gary R.; Lukens, John N.; Cohen, Roger B.; Rassekh, Christopher H.

doi:10.1002/hed.26165

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…10 Many elective surgeries, on the other hand, are cancerrelated, and, therefore, the evaluation of their urgency in the pandemic scenario becomes very challenging. 11 Our review proposes to organize the current knowledge on the specific characteristics for otorhinolaryngology. Our objective is to bring together the main recommendations regarding surgery indication, use of protective equipment during procedures, endoscopy precautions, and telemedicine application.…”

Section: Introductionmentioning

confidence: 99%

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Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Hojaij

Chinelatto

Boog

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Head and neck specialists and otorhinolaryngologists are greatly exposed to coronavirus disease 2019 (COVID-19) transmission in their everyday praxis. Many articles are being published regarding medical staff protection and patient management during the pandemic. Objective To provide an easy access to and a trustful review of the main aspects that have changed in the head and neck surgery and otorhinolaryngology practice due to the COVID-19 pandemic. Data Synthesis The search terms used were: (head and neck or otorhinolaryngology or ORL or thyroid) AND (severe acute respiratory syndrome coronavirus 2 [SARS-COV-2] or COVID-19 or CORONAVIRUS). The results were limited to the year of 2020. Articles were read in English, Portuguese, French, German, and Spanish or translated from Chinese. All included articles were read by at least two authors. Thirty-five articles were included. Most articles suggest postponing elective surgeries, with exception to cancer surgeries, which should be evaluated separately. Twenty-five articles recommended some kind of screening prior to surgery, using polymerase chain reaction (PCR) tests and epidemiological data. Extra precautions, such as use of personal protective equipment (PPE), are suggested for both tracheostomies and endoscopies. Fifteen articles give recommendation on how to use telemedicine. Conclusion The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine.

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Section: Introductionmentioning

confidence: 99%

“… 10 Many elective surgeries, on the other hand, are cancer-related, and, therefore, the evaluation of their urgency in the pandemic scenario becomes very challenging. 11 …”

Section: Introductionmentioning

confidence: 99%

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Hojaij

Chinelatto

Boog

et al. 2020

Int Arch Otorhinolaryngol

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“…Since there are risks associated with an inpatient stay and possible lack of access to medical resources during a surge, in addition to risk of viral exposure, it is very hard to quantify this "moving target" relative to 30 to 35 visits to radiation oncology. Some have pointed out that for immunocompromised patients in particular, multiple trips to the hospital also represent a significant risk, 33 but the answer is just not known.…”

Section: A Departmental Surgical Review Committee Should Bementioning

confidence: 99%

Ethical surgical triage of patients with head and neck cancer during the COVID‐19 pandemic

et al. 2020

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Background: Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended.Methods: An Otolaryngologic Triage Committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for nonsurgical options. Patients were tested twice for coronavirus before performing urgent contaminated operations. N95 masks and protective equipment were conserved when possible.Patients with low-grade cancers were advised to delay surgery, and other difficult decisions were made.Results: Hundreds of surgeries were canceled. Sixty-five cases screened over 3 weeks are tabulated. Physicians and patients expressed discomfort regarding perceived deviations from standards, but risk of COVID-19 exposure tempered these discussions. Conclusions: We describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.

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“…Head and neck cancer patients are vulnerable to COVID-19 because in addition to the cancer diagnosis they may also share other risk factors (smoking, nutritional depletion, swallowing and/ or breathing dysfunction) [21,22]. In addition, many head and neck primaries are rapidly progressive causing significant clinical deterioration and often requiring hospital admission for nutritional support and refeeding syndrome.…”

Section: Oncology Site Specific Publications and Consensus Guidelinesmentioning

confidence: 99%

https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#

2020

Cancer Stud Ther J

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systemic management and may therefore not necessarily be immunecompromised, as well as the implication for daily attendance to a RT facility and the associated infection risk and how to best mitigate it. Other questions involve the ability to and safety of delaying or altering RT treatment schedules to minimize risk of infection. Important additional considerations abound in particular settings such a RT emergencies and treatment of the COVID-19 positive patient as well as the administration of radioactive isotopes such as radioactive iodine in thyroid patients who then need to self-isolate at home or as inpatients for several days. Since the COVID-19 pandemic has raised unprecedented challenges and questions, with ongoing lack of robust data, periodic review of the available evidence is important to help guide providers and patients in order to enable evidence-based care hence prompting this scoping review. Materials and Methods To carry out the scoping review, publications that specifically addressed the impact and management of cancer patients undergoing radiation therapy in the context of the COVID 19 pandemic were identified in PubMed using the following mesh terms: (("risk"[MeSH Terms] OR "risk"[All Fields]) OR "risk of "[All Fields]) AND ((((((("covid 19"[All Fields] OR "covid 2019"[All Fields]) OR "severe acute respiratory syndrome coronavirus 2"[Supplementary Concept]) OR "severe acute respiratory syndrome coronavirus 2"[All Fields]) OR "2019 ncov"[All Fields]) OR "sars cov 2"[All Fields]) OR "2019ncov"[All Fields]

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Care of immunocompromised patients with head and neck cancer during the COVID‐19 pandemic: Two challenging and informative clinical cases

Cited by 13 publications

References 29 publications

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Ethical surgical triage of patients with head and neck cancer during the COVID‐19 pandemic

https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#

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