Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic

Abstract

Background: On February 23rd, the 1st case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed at the University Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was converted into a 22-inpatient bed coronavirus disease (COVID) Unit, and we reshaped our organisation to face the SARS-CoV-2 epidemic, while maintaining oncological activities. Methods: We tracked down (i) volumes of oncological activities (January 1st -March 31st, 2020 versus the same period of 2019), (ii) patients' and caregivers' perception and (iii) SARS-CoV-2 infection rate in oncology health professionals and SARS-CoV-2 infection erelated hospital admissions of "active"' oncological patients. Results: As compared with the same trimester in 2019, the overall reduction in total numbers of inpatient admissions, chemotherapy administrations and specialist visits in JanuaryeMarch 2020 was 8%, 6% and 3%, respectively; based on the weekly average of daily accesses, reduction in some of the oncological activities became statistically significant from week 11. The overall acceptance of adopted measures, as measured by targeted questionnaires administered to a sample of 241 outpatients, was high (>70%). Overall, 8 of 85 oncology health professionals tested positive for SARS-CoV-2 infection (all but one employed in the COVID Unit, no hospital admissions and no treatment required); among 471 patients admitted for SARS-CoV-2 infection, 7 had an "active"' oncological disease (2 died of infection-related complications). Conclusions: A slight, but statistically significant reduction in oncology activity was registered during the SARS-CoV-2 epidemic peak in Verona, Italy. Organisational and protective measures adopted appear to have contributed to keep infections in both oncological patients and health professionals to a minimum.

Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review

“…Therefore, we identified 62 studies that fully met our inclusion criteria. 2 , 39 - 59 , 60 - 80 , 81 - 99 The flowchart of the process of study identification and selection is presented in Figure 1 .…”

“…Among analytical cross-sectional studies, the quality was considered moderate for 13 41 , 46 , 49 , 52 , 53 , 58 , 61 , 68 , 71 , 78 , 89 , 97 , 99 and low for the remaining 14. 51 , 54 , 55 , 63 , 64 , 69 , 73 , 74 , 82 , 88 , 91 , 92 , 96 , 98 …”

Management of patients with cancer during the COVID-19 pandemic: The Italian perspective on the second wave

“…Since March 2020, Italy has been heavily hit by COVID-19 9 , 10 . The subsequent overburden of the national health system required oncologists to implement measures to safely carry on the everyday clinical activity 11 , 12 , 13 . At the beginning of COVID-19 pandemic in Italy, the Italian college of directors of the National Health System (NHS) of the Hospital Department of Medical Oncology (Collegio Italiano dei Primari Oncologi Medici Ospedalieri [CIPOMO]) promoted a nationwide survey regarding the reorganisation of Italian oncology departments 14 .…”

Epidemiology and clinical course of severe acute respiratory syndrome coronavirus 2 infection in cancer patients in the Veneto Oncology Network: The Rete Oncologica Veneta covID19 study

“…Notably, a decrease in cancer diagnosis and access to cancer facilities have been reported, and some screening services have been temporarily interrupted, raising the concern on a potential increase in cancer mortality overtime due to underdiagnoses or under treatment. 30 , 31 In our view, the high mortality rate reported in our and other studies largely overcome these concerns, and in the absence of an effective vaccine and treatment, preventing transmission of SARS-CoV-2 remains the goal. Cancer patients are a fragile population, and maximum effort should be made to ensure proper care in a safe environment.…”