Impact of nationwide lockdown on cancer care during COVID-19 pandemic: A retrospective analysis from western India

Abstract

Background and aims COVID-19 has impacted healthcare system worldwide including cancer case. Aim of this study was to describe the experience of lockdown on cancer care concerning patient's visit and reception of treatment in western India. Methods This is a retrospective observational study conducted in patients with cancer attending a tertiary care center pre-lockdown and during lockdown (from January to May 2020). Data related to demographic parameters, type of tumor, type of treatment received and functional status of patients were retrieved from hospital medical records of patients. Results Of the 5258 patients included, 4363 visited hospital pre-lockdown (median age, 50 years) and 895 visited during the lockdown period (median age, 47 years). A total of 1168 and 106 patients visiting hospital before and during lockdown, respectively, had comorbidities. Breast cancer (25.6% and 29.7%), head and neck cancer (21.3% and 16.9%) were the most common type of solid tumors; leukemia (58.0% and 73.0%), lymphoma (18.8% and 13.5%) and multiple myeloma (18.6% and 12.2%) were the most common type of hematological malignancies observed in patients visiting pre-lockdown and during lockdown, respectively. Chemotherapy was most commonly received treatment (pre-lockdown, 71.8%; during lockdown, 45.9%). Other therapies reported includes supportive/palliative, targeted, hormonal, and immunotherapy. The majority of patients who visited the hospital pre-lockdown (68.4%) and during lockdown (62.8%) had 0 or 1 Eastern Cooperative Oncology Group (ECOG) score. Conclusion Overall observations highlight a substantial impact of an imposed nationwide lockdown during COVID-19 pandemic on cancer care of patients in terms of reduced patient visits and number of treatments received.

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

“…1 : General health services include different levels of care or type of service; 2 : aggregated data and/or no specification of the different periods of analysis; 3 : studies that did not analyze whether the changes were statistically significant (the rest of articles presented results statistically significant); AF: associated factors; ED: emergency department; ICU: intensive care unit; IRR: incidence rate ratio; OB-GYN: obstetrics-gynecology; OR: odds ratio; PC: primary care; RR: relative risk; SC: secondary care; SRH: sexual and reproductive health. With regard to the type of service, of the studies on realized access, 5 focused on health services in general [46][47][48][49][50]; 12 on emergencies [51][52][53][54][55][56][57][58][59][60][61][62] (of which 5 were related to pediatric emergencies [56][57][58]60,61]); 15 on secondary care (SC) (outpatient visits, hospital admissions, etc., for nephrology [63], oncology [64,65], pediatrics [66], psychiatry [67,68], rehabilitation [69], respiratory diseases [70], sexual and reproductive health (SRH) [71,[73][74][75], and traumatology [78,79]); two on primary care (PC) [80,81]; one on preventive services…”

“…In terms of geographical area, 19 studies were conducted in European countries [47,51,53,55,57,62,64,[67][68][69][70]75,79,83,84,88,90,92,95], 9 in North American countries [49,58,59,77,78,80,82,85,86], 9 in Sub-Saharan Africa [46,48,71,72,76,87,93,94,98], 3 in Latin America [60,91,96], 5 in the East Asia-Pacific region [50,56,61,66,81], 3 in South Asia [63,65,74], 2 in the North Africa-Middle East region [52], and, lastly, 3 studies covered various regions…”

“…With regard to the period of analysis, 38 of the selected studies were conducted over the first months of the pandemic (February to June 2020) [46][47][48][49][50][51][52][53][54][55][57][58][59][60]62,[65][66][67][68][69][70][72][73][74][75][76][77][78][79][80]82,84,86,88,90,92,93,98]; 4 during the second stage of the pandemic (June to September 2020) [85,89,91,96]; 1 at a later stage (September to November 2020) [94]; finally, 8 analyzed the whole period (February to December 2020) [56,61,63,64,71,…”

“…No studies were found that analyzed periods after December 2020. All studies that analyzed realized access presented their results in comparison with a previous period: 32 of the first-stage studies compared the changes to pre-pandemic periods of reference [46][47][48][49][50][51][52][53][54][55][57][58][59][60]62,[65][66][67][68][69][70][72][73][74][75][76][77][78][79][80]82,98], as did 6 of those that analyzed the whole period [56,61,63,64,71,83]. One study did not specify the exact period of 2020 analyzed [95].…”

Impact of COVID Pandemic on Cancer Care: Cross-sectional Scenario of an Indian State (Bihar)

“…The healthcare system of many countries was nearly collapsed and required extensive support and resources for the restoration. The cancer care globally is no exception to suffer worst hit by the pandemic [11][12][13] With our retrospective study of the census of cancer patients of our institute particularly during the first wave of COVID-19 pandemic, we analysed several aspects of cancer care including the demographic distribution and overall impact of pandemic on the cancer care in the state. With slightly increased female: male ratio in the post lockdown era, we may observe that, there is apparently no domestic and social discrimination towards the female cancer patients in the time of economic and logistic crisis.…”