Impact of the Novel Coronavirus 2019 (COVID‐19) Pandemic on Head and Neck Cancer Care

Thompson, Joshua A.; Lubek, Joshua E.; Joy, Reju; Dyalram, Donita; Ord, Robert A.; Taylor, Rodney J.; Wolf, Jeffrey S.; Mehra, Ranee; Cullen, Kevin J.; Molitoris, Jason K.; Witek, Matthew E.; Papadimitriou, John C.; Morales, Robert E.; Hatten, Kyle M.

doi:10.1177/01945998211004544

Cited by 12 publications

(26 citation statements)

References 21 publications

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“…Most of the studies that have compared patients treated in the pre-pandemic and pandemic periods have not found any significant demographic differences in sex or age, similar to our results [ 7 , 9 , 10 ]. However, we did find a significantly higher proportion of patients diagnosed with oral cancer in the pre-COVID period (45.3% vs. 32.1%, Table 2 ), but the reason for this difference is difficult to determine.…”

Section: Discussionsupporting

confidence: 91%

“…Nevertheless, cancer centres in many countries have remained open, with adequate local restrictions, while other hospitals were responsible for treating only patients with COVID-19 [ 6 ]. In fact, this approach allowed cancer centres in those countries to treat more patients during the pandemic than in the prior year [ 5 , 7 ]. We observed similar results, as evidenced by the 22% increase in the number of patients who presented to the MTB.…”

Section: Discussionmentioning

confidence: 99%

“…found no significant differences in the main head and neck cancer locations at their centre between the two periods; nor did they find any other studies reporting such differences [ 8 ]. In contrast, Thomson and colleagues found a substantial increase in the percentage of patients diagnosed with oral cancer (from 23% to 44.4%), but they did not explain the potential reasons for this difference [ 7 ]. Interestingly, we observed a significant increase in the number of nasopharyngeal cancer patients (from 1 to 11), perhaps because most of the symptoms and side effects of COVID-19 affect the nasal cavity and paranasal sinuses, which could have led to early detection of nasopharyngeal cancer during the diagnostic process for COVID-19.…”

Section: Discussionmentioning

confidence: 99%

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The impact of the COVID-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland

Szewczyk¹,

Pazdrowski²,

Golusiński³

et al. 2021

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Aim of the study: To assess the impact of the COVID-19 pandemic on the diagnosis and treatment of patients at a tertiary hospital in Poland. Material and methods: This was a retrospective review of head and neck cancer patients who presented to the multidisciplinary tumour board (MTB) during the 12-month period from March 2020 to February 2021 and compared to patients who presented to the MTB during the prior, pre-pandemic 12-month period from February 2019 to March 2020: Patient demographic and clinical variables were compared: sex, age at diagnosis, distance from hospital, date of first visit, radiological diagnosis, pathology specimen, MTB meeting, and initiation of primary and adjuvant treatment Results: The number of patients who presented to the MTB increased by 22% (278 to 340) from the pre-pandemic to the pandemic period. The mean time from MTB presentation to treatment initiation increased significantly from 17.1 to 21.7 days. The mean time from first visit to treatment start increased from 44.7 to 54.4 days. The proportion of patients with early-stage oropharyngeal cancer who underwent primary surgery rose from 47.3% to 86.6%. The percentage of patients who received palliative radiotherapy increased from 20.5% to 32.9%. The proportion of patients who received best supportive care rose from 1.8% to 6.2%. Conclusions: One of the most notable findings of this study was the increased time from first visit to treatment initiation, which could negatively impact patient outcomes. The differences in the treatment received in these two periods should be further evaluated to determine their influence on survival.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The impact of the COVID-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland

Szewczyk¹,

Pazdrowski²,

Golusiński³

et al. 2021

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“…Several previous studies that reported COVID-19-related reductions in HNC admissions and diagnoses ( 12 – 16 , 31 , 32 ) were hospital-based studies, conducted on a relatively limited population, focused on the first pandemic wave only, and did not account for temporal trends in HNC detection. The reported reductions in HNC referrals and diagnoses in the first pandemic months varied from 12% to up to 60% in different contexts and populations ( 13 , 15 , 16 , 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Head and Neck Cancer Diagnosis in the Piedmont Region, Italy: Interrupted Time-Series Analysis

Popović

Fiano

Moirano

et al. 2022

Front. Public Health

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BackgroundThe COVID-19 pandemic has likely affected the most vulnerable groups of patients and those requiring time-critical access to healthcare services, such as patients with cancer. The aim of this study was to use time trend data to assess the impact of COVID-19 on timely diagnosis and treatment of head and neck cancer (HNC) in the Italian Piedmont region.MethodsThis study was based on two different data sources. First, regional hospital discharge register data were used to identify incident HNC in patients ≥18 years old during the period from January 1, 2015, to December 31, 2020. Interrupted time-series analysis was used to model the long-time trends in monthly incident HNC before COVID-19 while accounting for holiday-related seasonal fluctuations in the HNC admissions. Second, in a population of incident HNC patients eligible for recruitment in an ongoing clinical cohort study (HEADSpAcE) that started before the COVID-19 pandemic, we compared the distribution of early-stage and late-stage diagnoses between the pre-COVID-19 and the COVID-19 period.ResultsThere were 4,811 incident HNC admissions in the 5-year period before the COVID-19 outbreak and 832 admissions in 2020, of which 689 occurred after the COVID-19 outbreak in Italy. An initial reduction of 28% in admissions during the first wave of the COVID-19 pandemic (RR 0.72, 95% CI 0.62–0.84) was largely addressed by the end of 2020 (RR 0.96, 95% CI 0.89–1.03) when considering the whole population, although there were some heterogeneities. The gap between observed and expected admissions was particularly evident and had not completely recovered by the end of the year in older (≥75 years) patients (RR: 0.88, 0.76–1.01), patients with a Romano-Charlson comorbidity index below 2 (RR 0.91, 95% CI: 0.84–1.00), and primary surgically treated patients (RR 0.88, 95% CI 0.80–0.97). In the subgroup of patients eligible for the ongoing active recruitment, we observed no evidence of a shift toward a more advanced stage at diagnosis in the periods following the first pandemic wave.ConclusionsThe COVID-19 pandemic has affected differentially the management of certain groups of incident HNC patients, with more pronounced impact on older patients, those treated primarily surgically, and those with less comorbidities. The missed and delayed diagnoses may translate into worser oncological outcomes in these patients.

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“…Worse cancer survival is observed in patients with immunosuppression 152 . Pandemic‐related delays in oncologic procedures should be avoided 153,154 …”

Section: Head and Neck Oncologymentioning

confidence: 99%

Corticosteroid Use in Otolaryngology: Current Considerations During the COVID‐19 Era

Chang

McCoul

Briggs

et al. 2021

Otolaryngol.--head neck surg.

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Objective To offer pragmatic, evidence-informed advice on administering corticosteroids in otolaryngology during the coronavirus disease 2019 (COVID-19) pandemic, considering therapeutic efficacy, potential adverse effects, susceptibility to COVID-19, and potential effects on efficacy of vaccination against SARS-CoV-2, which causes COVID-19. Data Sources PubMed, Cochrane Library, EMBASE, CINAHL, and guideline databases. Review Methods Guideline search strategies, supplemented by database searches on sudden sensorineural hearing loss (SSNHL), idiopathic facial nerve paralysis (Bell’s palsy), sinonasal polyposis, laryngotracheal disorders, head and neck oncology, and pediatric otolaryngology, prioritizing systematic reviews, randomized controlled trials, and COVID-19–specific findings. Conclusions Systemic corticosteroids (SCSs) reduce long-term morbidity in individuals with SSNHL and Bell’s palsy, reduce acute laryngotracheal edema, and have benefit in perioperative management for some procedures. Topical or locally injected corticosteroids are preferable for most other otolaryngologic indications. SCSs have not shown long-term benefit for sinonasal disorders. SCSs are not a contraindication to vaccination with COVID-19 vaccines approved by the US Food and Drug Administration. The Centers for Disease Control and Prevention noted that these vaccines are safe for immunocompromised patients. Implications for Practice SCS use for SSNHL, Bell’s palsy, laryngotracheal edema, and perioperative care should follow prepandemic standards. Local or topical corticosteroids are preferable for most other otolaryngologic indications. Whether SCSs attenuate response to vaccination against COVID-19 or increase susceptibility to SARS-CoV-2 infection is unknown. Immunosuppression may lower vaccine efficacy, so immunocompromised patients should adhere to recommended infection control practices. COVID-19 vaccination with Pfizer-BioNTech, Moderna, or Johnson & Johnson vaccines is safe for immunocompromised patients.

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Impact of the Novel Coronavirus 2019 (COVID‐19) Pandemic on Head and Neck Cancer Care

Cited by 12 publications

References 21 publications

The impact of the COVID-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland

The impact of the COVID-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland

The Impact of the COVID-19 Pandemic on Head and Neck Cancer Diagnosis in the Piedmont Region, Italy: Interrupted Time-Series Analysis

Corticosteroid Use in Otolaryngology: Current Considerations During the COVID‐19 Era

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