Counting the social, psychological, and economic costs of COVID-19 for cancer patients

Abstract

Purpose Cancer patients were particularly vulnerable to the adverse impacts of the COVID-19 pandemic given their reliance on the healthcare system, and their weakened immune systems. This systematic review examines the social, psychological, and economic impacts of COVID-19 on cancer patients. Methods The systematic search, conducted in March 2021, captures the experience of COVID-19 Wave I, when the most severe restrictions were in place globally, from a patient perspective. Results The search yielded 56 studies reporting on the economic, social, and psychological impacts of COVID-19. The economic burden associated with cancer for patients during the pandemic included direct and indirect costs with both objective (i.e. financial burden) and subjective elements (financial distress). The pandemic exasperated existing psychological strain and associated adverse outcomes including worry and fear (of COVID-19 and cancer prognosis); distress, anxiety, and depression; social isolation and loneliness. National and institutional public health guidelines to reduce COVID-19 transmission resulted in suspended cancer screening programmes, delayed diagnoses, postponed or deferred treatments, and altered treatment. These altered patients’ decision making and health-seeking behaviours. Conclusion COVID-19 compounded the economic, social, and psychological impacts of cancer on patients owing to health system adjustments and reduction in economic activity. Identification of the impact of COVID-19 on cancer patients from a psychological, social, and economic perspective following the pandemic can inform the design of timely and appropriate interventions and supports, to deal with the backlog in cancer care and enhance recovery.

Hospitalized COVID‐19 patients with diabetes have an increased risk for pneumonia, intensive care unit requirement, intubation, and death: A cross‐sectional cohort study in Mexico in 2020

“…48 The body's ability to mount an immune response against viral infections can be hindered by these comorbidities, which can disrupt the normal function of the immune system. [49][50][51] The increased risk of pneumonia, ICU stay, intubation, and death among diabetic patients in the Mexican cohort may be explained by the weakened immune system and association with other comorbidities. [52][53][54] The association between diabetes and worse outcomes in URIs has been attributed to a number of epidemiological explanations, one of which is COVID-19.…”

“…Inflammation and damage to blood vessels and tissues, including those in the respiratory system, can result from high blood sugar levels, making it more difficult for the body to fight off infections 48 . The body's ability to mount an immune response against viral infections can be hindered by these comorbidities, which can disrupt the normal function of the immune system 49‐51 . The increased risk of pneumonia, ICU stay, intubation, and death among diabetic patients in the Mexican cohort may be explained by the weakened immune system and association with other comorbidities 52‐54 …”

Malestar psicológico y preocupaciones psicosociales durante la tercera ola de la pandemia en pacientes oncológicos y familiares: Un análisis exploratorio

“…Las recomendaciones sanitarias como limitar las interacciones sociales o el distanciamiento social podrían haber contribuido a que los pacientes oncológicos y sus personas cuidadoras experimentaran soledad no deseada (8) o ausencia de soporte ante el temor a un posible contagio. Además, un estudio (15) reportó que la mayoría de los pacientes oncológicos no aceptaban visitas en sus domicilios. La sensación de soledad no deseada podría verse amplificada por ver las calles y comercios vacíos, lo cual era una de las fuentes de preocupación de la población oncológica.…”

“…Por otro lado, se ha reportado que los pacientes diagnosticados de cáncer han experimentado niveles superiores de ansiedad y depresión respecto a la población general debido a los retrasos que han tenido las citas médicas durante la pandemia (12)(13)(14) . Una encuesta aplicada en 16 países europeos constató que el 71% de los pacientes oncológicos estaban bastante intranquilos por el miedo al avance o progresión de la enfermedad, debido a la cancelación o demora que estaban sufriendo con respecto a las citas y revisiones médicas (15)(16)(17) .…”

Cancer and COVID-19: A Double Burden on the Healthcare System

“…Due to taking over a large part of the medical care system during the COVID-19 epidemic, cancer patients were severely affected by this pandemic. The most common mental concern in cancer patients during the pandemic period were the worry and/ or fear around getting COVID-19 (27). Several studies reported increased anxiety in cancer patients during the pandemic (27,28).…”