ABSTRACT
PURPOSE: The HOLA COVID-19 study sought to evaluate the impact of COVID-19 on oncology practices across Latin America (LATAM), challenges faced by physicians, and how practices and physicians adapted while delivering care to patients with cancer. METHODS: This international cross-sectional study of oncology physicians in LATAM included a 43-item anonymous online survey to evaluate changes and adaptations to clinical practice. Multivariable logistic regression analyses were used to evaluate the association of caring for patients with COVID-19 and changes to clinical practice. RESULTS: A total of 704 oncology physicians from 19 countries completed the survey. Among respondents, the most common specialty was general oncology (34%) and 56% of physicians had cared for patients with COVID-19. The majority of physicians (70%) noted a decrease in the number of new patients evaluated during the COVID-19 pandemic when compared with prepandemic, and 73% reported adopting the use of telemedicine in their practice. More than half (58%) of physicians reported making changes to the treatments that they offered to patients with cancer. In adjusted models, physicians who had cared for patients with COVID-19 had higher odds of changing the type of chemotherapy or treatments that they offered (adjusted odds ratio 1.81; 95% CI, 1.30 to 2.53) and of delaying chemotherapy start (adjusted odds ratio 2.05; 95% CI, 1.49 to 2.81). Physicians identified significant delays in access to radiation and surgical services, diagnostic tests, and supportive care. CONCLUSION: The COVID-19 pandemic has significantly disrupted global cancer care. Although changes to health care delivery are a necessary response to this global crisis, our study highlights the significant disruption and changes to the treatment plans of patients with cancer in LATAM resulting from the COVID-19 health care crisis.
Subject(s)
COVID-19 , Neoplasms , Cross-Sectional Studies , Delivery of Health Care , Humans , Latin America/epidemiology , Neoplasms/therapy , Pandemics , Patient Care , SARS-CoV-2ABSTRACT
Countries in Latin America and the Caribbean have become hotspots of the novel coronavirus (COVID-19) pandemic, exacerbating socioeconomic inequalities and overwhelming fragmented health systems. Studies from the United States and Europe have highlighted the disproportionate effects of COVID-19 on patients with cancer and the disruption it has caused on cancer care delivery. The HOLA COVID-19 Study aims to understand how cancer care in Latin American countries has been affected by the COVID-19 pandemic.
Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Delivery of Health Care/statistics & numerical data , Delivery of Health Care/trends , Neoplasms/therapy , Pneumonia, Viral/complications , Practice Guidelines as Topic/standards , COVID-19 , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , International Cooperation , Latin America/epidemiology , Neoplasms/epidemiology , Neoplasms/virology , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2ABSTRACT
Patients with cancer represent a vulnerable population and are at greater risk of developing serious complications as a result of a COVID-19 infection. In response, oncology societies around the world have proposed changes to their standards of care. These changes have helped guide health care providers in prioritizing clinical management of patients with cancer: identifying situations in which urgent intervention is needed and those that can be triaged until the risk of infection has lessened.