COVID-19 pandemic: changes in cancer admissions

Güven, Deniz Can; Aktaş, Burak Yasin; Aksun, Melek Seren; Ucgul, Enes; Şahin, Taha Koray; Yıldırım, Hasan Çağrı; Guner, Gurkan; Kertmen, Neyran; Dizdar, Ömer; Kılıçkap, Saadettin; Aksoy, Sercan; Yalçın, Şuayib; Türker, Alev; Uckun, Fatih M.; Arık, Zafer

doi:10.1136/bmjspcare-2020-002468

Cited by 24 publications

(30 citation statements)

References 14 publications

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“…There was also a statistically significant decrease in hospitalization for elective procedures and palliative support. In contrast, an increase in chemotherapyrelated hospitalization was observed [42]. Previous studies have targeted different disease groups and evaluated treatment flaws associated with hospital overfilling during a pandemic in cancer clinics [43,44].…”

Section: Discussionmentioning

confidence: 99%

Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

2021

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Purpose Pandemics can be associated with anxiety and depression in cancer patients who are undergoing treatment. In the present study, we aimed to perform a comparative evaluation of the conditions of cancer patients before and during the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) to detect the impact of the pandemic on treatment delays that are associated with anxiety and depression in cancer patients. In addition, the effect of public transport use on treatment delays was examined. Methods BDI and BAI were administered to 595 breast, ovarian, colon and gastric cancer patients before and during the pandemic. The questionnaires were administered by the physician blindly, who was unaware of the delay of the patients. The number of days by which the patients delayed their treatment due to the fear of contamination were recorded retrospectively. Correlation analyses were performed between the obtained scores and treatment delays. Results The depression and anxiety levels in cancer patients were found to increase during the pandemic (p = 0.000), and this increase was positively correlated with the disruption of their treatment (p = 0.000, r = 0.81). Depression and anxiety levels and treatment delays were higher in elderly patients (p = 0.021). Depression and anxiety were more pronounced in female patients (p = 0.000). Moreover, treatment delays were more common in patients who had to use public transportation (p = 0.038). Conclusion SARS-CoV-2 pandemic may increase anxiety and depression in cancer patients. This can cause patients to experience treatment delays due to concerns about becoming infected. At this point, if necessary, assistance should be obtained from psychiatric and public health experts.

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Section: Discussionmentioning

confidence: 99%

Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

2021

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“…However, this catastrophe has victimized the cancer patients the most, adversely impacting diagnosis and treatment in about 55% of cases worldwide ( World Health Organisation, 2020 ). The number of patients visiting and accessing oncological services has considerably reduced and the collateral damage can have an adverse impact on cancer outcomes ( Guven et al, 2020 ; Sud et al, 2020 ). It is generally assumed that patients with cancer are at a higher risk of contracting COVID-19 due to their immunosuppressive state, and side effects associated with anticancer therapies like leukopenia and disruption of the barrier to infections ( ElGohary et al, 2020 ; Ganatra, Hammond & Nohria, 2020 ; Liang et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India

Mehta

Vasudevan

Parkash

et al. 2021

PeerJ

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Background Cancer patients, especially those receiving cytotoxic therapy, are assumed to have a higher probability of death from COVID-19. We have conducted this study to identify the Case Fatality Rate (CFR) in cancer patients with COVID-19 and have explored the relationship of various clinical factors to mortality in our patient cohort. Methods All confirmed cancer cases presented to the hospital from June 8 to August 20, 2020, and developed symptoms/radiological features suspicious of COVID-19 were tested by Real-time polymerase chain reaction assay and/or cartridge-based nucleic acid amplification test from a combination of naso-oropharyngeal swab for SARS-CoV-2. Clinical data, treatment details, and outcomes were assessed from the medical records. Results Of the total 3,101 cancer patients admitted to the hospital, 1,088 patients were tested and 186 patients were positive for SARS-CoV-2. The CFR in the cohort was 27/186 (14.52%). Univariate analysis showed that the risk of death was significantly associated with the presence of any comorbidity (OR: 2.68; (95% CI [1.13–6.32]); P = 0.025), multiple comorbidities (OR: 3.01; (95% CI [1.02–9.07]); P = 0.047 for multiple vs. single), and the severity of COVID-19 presentation (OR: 27.48; (95% CI [5.34–141.49]); P < 0.001 for severe vs. not severe symptoms). Among all comorbidities, diabetes (OR: 3.31; (95% CI [1.35–8.09]); P = 0.009) and cardiovascular diseases (OR: 3.77; (95% CI [1.02–13.91]); P = 0.046) were significant risk factors for death. Anticancer treatments including chemotherapy, surgery, radiotherapy, targeted therapy, and immunotherapy administered within a month before the onset of COVID-19 symptoms had no significant effect on mortality. Conclusion To the best of our knowledge, this is the first study from India reporting the CFR, clinical associations, and risk factors for mortality in SARS-CoV-2 infected cancer patients. Our study shows that the frequency of COVID-19 in cancer patients is high. Recent anticancer therapies are not associated with mortality. Pre-existing comorbidities, especially diabetes, multiple comorbidities, and severe symptoms at presentation are significantly linked with COVID-19 related death in the cohort.

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“…This large-scale surveillance system was informative for high-risk patients as they could make the decision to shield themselves if residing in a high-risk area. 43 The benefits of tracking were also evident in a study conducted by Ning et al who reported that active tracking reduced adverse effects that can occur from treatment delay and workforce incapacitation 46 (2) Outreach and Communication One of the most prominent strategies to ensure the maintenance of care continuity was regular communication between 77 P Brody et al 38 P P Butler et al 19 P P P P P P Casella et al 11 P P P P P P Chiang et al 14 P P P P P P Cinelli et al 53 P P Civantos et al 9 P P Civantos et al 49 P P P Collins et al 17 P P P P Curigliano et al 55 P P P Czernin et al 36 P P P P P de Marinis et al 39 P P P P Dharmarajan et al 51 P Elkaddoum et al 59 P P P Elkin et al 31 P Flannigan et al 57 P P Fosker 26 P P Frey et al 66 P Giuliani et al 58 P Gupta et al 48 P P P Grenda et al 54 P P Guven et al 12 P P P P Harky et al 61 P P P Indini et al 33 P P P P P P Jiang et al 60 P P Lee et al 15 P P P P P Lee et al 27 P P Lee et al 47 P P P Lobascio et al 56 P P Lombe et al 68 P P P Mei et al 21 P P P P P P Mendoza et al 23 P P P Millar et al 65 P Mirnezami et al 73 P P Morrison et al 69 P P Moss et al 32 P Mulvey et al 62 P...…”

Section: Covid-19 Andmentioning

confidence: 99%

The Effects of COVID-19 on Cancer Care Provision: A Systematic Review

et al. 2021

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This systematic review aims to gather primary data from cancer institutions that have implemented changes to cancer service provision amid the COVID-19 outbreak to inform future intervention and health care facility response strategies. A comprehensive literature search was done on Global Health Medline and EMBASE using pertinent key words and MeSH terms relating to COVID-19 and Cancer service provision. A total of 72 articles were selected for inclusion in this systematic review. Following the narrative synthesis that was conducted of the literature, 6 core themes that encompassed common cancer service intervention adopted by institutions were identified: (1) Testing and Tracking, (2) Outreach and Communication, (3) Protection, (4) Social Distancing (5) Treatment Management, (6) Service Restructuring. Since cancer patients are a high-risk population amid the COVID-19 pandemic, these areas of targeted intervention can be used to inform necessary actions in institutions facing similar risks, based on previous learning from numerous cancer centers globally.

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COVID-19 pandemic: changes in cancer admissions

Cited by 24 publications

References 14 publications

Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India

The Effects of COVID-19 on Cancer Care Provision: A Systematic Review

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