Radiotherapy workflow and protection procedures during the Coronavirus Disease 2019 (COVID-19) outbreak: Experience of the Hubei Cancer Hospital in Wuhan, China

Wei, Wei; Zheng, Dandan; Yu, Long-Chuan; Wu, Shen; Verma, Vivek; Liu, Yongsheng; Xu-bin, Wei; Bi, Jianping; Hu, Desheng; Hân, Gia

doi:10.1016/j.radonc.2020.03.029

Cited by 92 publications

(152 citation statements)

References 16 publications

(19 reference statements)

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“…This, combined with the considerable rate of transmission from asymptomatic subjects [33] and the incubation time [34], could justify the high incidence of infection in the initial two weeks. The strict application of a dedicated work ow and the constant adoption of adequate PPE [35][36] allowed us not only to contain and almost neutralize the diffusion of the infection, but also to carry on radiation therapy in patients positive for SARS-Cov-2 with mild or asymptomatic disease. The infection rate among patients undergoing treatment at our department outstandingly precipitated to 0.43% considering the period from March 25 to April 24 and no new contagion among our staff was observed in this time span.…”

Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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Abstract Background: Coronavirus Disease 2019 (COVID-19) pandemic had an overwhelming impact on healthcare worldwide. Outstandingly, the aftermath on neoplastic patients is still largely unknown, and only isolated cases of COVID-19 during radiotherapy have been published. We will report the two-months experience of our Department, set in Lombardy “red-zone”.Methods: data of 402 cancer patients undergoing active treatment from February 24 to April 24, 2020 were retrospectively reviewed; several indicators of the Department functioning were also analyzed.Results: dedicated measures allowed an overall limited reduction of the workload. Decrease of radiotherapy treatment number reached 17%, while the number of administration of systemic treatment and follow up evaluations kept constant. Conversely, new treatment planning faced substantial decline. Considering the patients, infection rate was 3.23% (13/402) and mortality 1.24% (5/402). Median age of COVID-19 patients was 69.7 years, the large majority were male and smokers (84.6%); lung cancer was the most common tumor type (61.5%), 84.6% of subjects were stage III-IV and 92.3% had comorbidities. Remarkably, 92.3% of the cases were detected before March 24. Globally, only 2.5% of ongoing treatments were suspended due to suspect or confirmed COVID-19 and 46.2% of positive patients carried on radiotherapy without interruption. Considering only the last month, infection rate among patients undergoing treatment precipitated to 0.43% (1/232) and no new contagions were reported within our staff. Conclusions: although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during SARS-Cov-2 pandemic by endorsing consistent preventive measures.

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Section: Covid-19 Impact On the Staffmentioning

confidence: 99%

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione

Spiazzi

Guerini

et al. 2020

Preprint

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“…29 At any given time, 33% to 50% of staff should be working at the clinic. 30 Staff must get training in donning and doffing of personal protective equipment and should be provided with appropriate PPE. 31,32 The staff should be encouraged to do frequent hand washing with soap and water for at least 20 seconds.…”

Section: Consensus Guidelines For the Staff Rotation And Training Imentioning

confidence: 99%

COVID ‐19 Pandemic: Consensus guidelines for preferred practices in an aesthetic clinic

Kapoor

Chatrath²,

Boxley

et al. 2020

Dermatologic Therapy

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Background: Strict infection control measures in response to the current COVID-19 pandemic are expected to remain for an extended period. In aesthetic clinics, most procedures are provided on one to one basis by the physician or therapist. In such a scenario, guidelines detailing the infection control measures for aesthetic clinics are of particular importance.Methods: An online meeting of an international group of experts in the field of aesthetic medicine, with experience in administration of an aesthetic clinic, was convened. The meeting aimed to provide a set of consensus guidelines to protect clinic staff and patients from SARS-CoV-2 infection. Results:Consensus guidelines for 'preferred practices' were provided for scheduling of patients, patient evaluation and triaging, and for safety precautions about the different procedures. Procedures were categorized into low-risk, moderate risk, and high-risk based on the likelihood of transmission of SARS-CoV-2 virus from the patient to the treating physician or therapist. Conclusions:While not intended to be complete or exhaustive, these guidelines provide sound infection control measures for aesthetic practices. Since guidelines regarding safety measures and use This article is protected by copyright. All rights reserved.of PPEs may vary from country to country, the local guidelines should also be followed to prevent Abstract:Background: Strict infection control measures in response to the current COVID-19 pandemic are expected to remain for an extended period. In aesthetic clinics, most procedures are provided on one to one basis by the physician or therapist. In such a scenario, guidelines detailing the infection control measures for aesthetic clinics are of particular importance.Methods: An online meeting of an international group of experts in the field of aesthetic medicine, with experience in administration of an aesthetic clinic, was convened. The meeting aimed to provide a set of consensus guidelines to protect clinic staff and patients from SARS-CoV-2 infection. Results:Consensus guidelines for 'preferred practices' were provided for scheduling of patients, patient evaluation and triaging, and for safety precautions about the different procedures. Procedures This article is protected by copyright. All rights reserved.were categorized into low-risk, moderate risk, and high-risk based on the likelihood of transmission of SARS-CoV-2 virus from the patient to the treating physician or therapist. Conclusions:While not intended to be complete or exhaustive, these guidelines provide sound infection control measures for aesthetic practices. Since guidelines regarding safety measures and use of PPEs may vary from country to country, the local guidelines should also be followed to prevent COVID-19 infection in aesthetic clinics.

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“…These strategies have been described in depth in reports from China, Italy and the United States of America. [52][53][54][55] Meanwhile, a patient who tests positive for COVID-19 and is asymptomatic, may still be considered physiologically unfit to tolerate any further lung cancer therapies as many patients develop worsening symptoms in the second week of infection. 56 Early studies have shown that COVID-19 can lead to acute respiratory distress syndrome with pathological changes such as destruction of the alveoli and cellular fibromyxoid exudates.…”

Section: Covid-19 Infected Patientsmentioning

confidence: 99%

Alternative Multidisciplinary Management Options for Locally Advanced Non-Small Cell Lung Cancer During the COVID-19 Global Pandemic

Kumar¹,

Chmura²,

Robinson³

et al. 2020

Preprint

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Importance: The COVID-19 pandemic is currently accelerating. Patients with locally advanced non-small cell lung cancer (LA-NSCLC) may require treatment in locations where resources are limited and the prevalence of infection is high. Patients with LA-NSCLC frequently present with comorbidities that increase the risk for severe morbidity and mortality from COVID-19. These risks may be further increased by treatments for LA-NSCLC. Observation: We present expert thoracic oncology multidisciplinary (radiation oncology, medical oncology, surgical oncology) consensus of alternative strategies for the treatment of LA-NSCLC during a pandemic. The overarching goals of these approaches are to reduce the number of visits to a healthcare facility, reduce the risk of SARS-CoV-2 exposure, and attenuate the immunocompromising effects of lung cancer therapies. Patients with resectable disease can be treated with definitive non-operative management if surgical resources are limited or the risks of perioperative care are high. Non-operative options include chemotherapy, chemoimmunotherapy, and radiation therapy with sequential schedules. The order of treatments may be based on patient factors and clinical resources. Whenever radiation therapy is delivered without concurrent chemotherapy, hypofractionated schedules are appropriate. For patients who are confirmed to have COVID-19, usually cancer therapies may be withheld until symptoms have resolved with negative viral test results. Conclusions and Relevance: The risk of severe treatment-related morbidity and mortality is significantly elevated for patients undergoing treatment for LA-NSCLC during the COVID-19 pandemic. Adapting alternative treatment strategies as quickly as possible may save lives and should be implemented through communication with the multidisciplinary cancer team.

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Radiotherapy workflow and protection procedures during the Coronavirus Disease 2019 (COVID-19) outbreak: Experience of the Hubei Cancer Hospital in Wuhan, China

Cited by 92 publications

References 16 publications

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

COVID ‐19 Pandemic: Consensus guidelines for preferred practices in an aesthetic clinic

Alternative Multidisciplinary Management Options for Locally Advanced Non-Small Cell Lung Cancer During the COVID-19 Global Pandemic

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