ABSTRACT
Introduction: The SARS-CoV-2 spread has led to a revolution in the healthcare. Veneto Institute of Oncology has adopted contagion containment measures to guarantee a greater level of protection to cancer patients. The anti- COVID vaccination for cancer patients has been a priority for the national health system and the institute has implemented a vaccination campaign to ensure coverage for patients. A survey was developed to assess the impact of the COVID-19 pandemic on patients' perceptions about the measures taken to limit the risk of SARS-CoV-2 infections and their concern about their cancer care. A questionnaire on the degree of satisfaction with vaccination was administered after anti-COVID vaccination. Methods: The Survey was distributed to all patients who entered in hospital during analysis period and it was divided into 3 items: characteristics of patients, concerns about the pandemic on their cancer path, perception of the measures adopted by the institute to limit the spread of the infection. The vaccination questionnaire was distributed to a cohort of vaccinated patients and explored the degree of satisfaction with the vaccination campaign. Results: From May18th until June15th, 3238 questionnaires were completed. Most of the responders said they were concerned about SARS-CoV-2 pandemic while keeping the concern for oncological disease as a priority. All measures (triage for hospital access, restrictions for caregivers, use of personal protective equipment, sanitization of environments) have been appreciated by patients. Telemedicine was positively evaluated by the responders while, the absence of the caregiver during visit, does not seem to have determined discomfort in about two thirds of patients. From April26th until May14th 2021, 356 vaccination questionnaires were completed. 60% of responders were female;90% were on active cancer treatment and 33% of the patients reported adverse events related to the anti-COVID vaccination. Patients expressed a high degree of satisfaction with the vaccination campaign (99% were satisfied/very satisfied) Conclusions: This survey reported the point of view of cancer patients regarding the impact of the COVID-19 pandemic on the oncological activities of which they are protagonists and patients' perceptions of the anti-COVID vaccination campaign. We believe that the perspective of patients can be crucial to help the reorganization of the health system, especially in this period of medical emergency.
ABSTRACT
Background: Since the beginning of the COVID19 outbreak, the Veneto Oncology Network ROV licensed dedicated guidelines for cancer patients care during the pandemic, and developed a regional registry (ROVID) aimed at describing epidemiology and clinical course of SARS-CoV-2 infection in cancer patients. Preliminary data on 170 patients mainly diagnosed during the first pandemic wave have been published (Guarneri V, Eur J Cancer 2021). Here we report the data of additional 270 patients, comparing clinical data and outcomes between first (W1) and second (W2) pandemic waves. Methods: All patients with cancer diagnosis and documented SARS-CoV-2 infection are eligible. Data on diagnosis, comorbidities, anticancer treatments, details on SARS-CoV-infection including source of contagion, clinical presentation, hospitalization, treatments and fate of the infection are recorded. Results: 440 patients have been enrolled, 196 diagnosed during W1 (until September 2020) and 244 during W2. The most common cancer type was breast cancer (n = 116). Significant differences in clinical characteristics between W1 and W2 were the followings: ECOG PS 0 (34% vs 58%), presence of cardiac comorbidities (30% vs 13%), presence of any co-morbidities (81% vs 62%), smoking habits (23% vs 13%). Patients diagnosed in W1 were less likely on active anticancer therapy (54% vs 73%) at the time of SARS-CoV-2 infection. Distribution per stage, presence of lung metastases, disease setting (curative vs palliative), active treatment discontinuation due to infection were similar between W1 and W2. Patients diagnosed in W1 were more likely symptomatic for SARS-CoV-2 infection (80% vs 67%), and reported more frequently an inhospital contact as potential source of infection (44% vs 9%). Significantly more patients diagnosed in W1 were hospitalized (76% vs 25%). All-cause mortality rates were 30.6% for patients diagnosed in W1 vs 12% for patients diagnosed in W2 (p < 0.001). However, deaths due to SARS-CoV-2 infection were more frequent in patients diagnosed in W2 (86% vs 54%, odds ratio 3.22;95% CI 1.97-5.279). Conclusions: Differences in clinical characteristics between W1 and W2 reflect different pattern of virus circulation. The dramatic reduction of in-hospital contact as a source of infection reflects the efforts put in place to protect this vulnerable population from in-hospital exposure. The lower all-cause mortality rate observed in W2 is in line with the observed less frail population. However, the higher relative risk of death due to SARS-CoV-2 infection observed in W2 reinforces the need to adopt protective measures including vaccination in cancer patients, irrespectively of age, stage, and comorbidities.
ABSTRACT
Background: Cancer patients are more susceptible to infections and potentially at higher risk to develop COVID-19. Tumor type and antitumor treatment may also affect both the susceptibility to and the severity of SARS COV-2. Methods: To analyze the distribution of patients who developed COVID-19 during active antineoplastic therapy and the related clinical course by tumor type, stage and class of oncologic treatment (chemo, immune, biologic, other) a multicenter, retro-prospective, observational study was proposed to the Hospital Medical Oncologic Units of the National Health Service in Italy (168 centers of the Collegio Italiano dei Primari Oncologi Medici Ospedalieri -CIPOMO). Data were collected on demographics, tumor characteristics, treatment setting, type of ongoing anti-cancer therapy and COVID-19 clinical course (phenotype, hospitalization, therapy, duration and outcome). Eligibility required a positive COVID-19 molecular test before May 4th, 2020 and at least 1 course of antitumor therapy delivered after January 15th. Results: At the present analysis data are available for 116 of 168 centers (7 declined, 28 pending, 17 data awaited). 64 of 116 centers (55%) had COVID-19 positive cases (cases /center: median 3, range 1-40). At these 64 centers, 283 positive cases (males 158, 55.9% - females 125, 44.1%;median age 67 years, range 28-89) were observed among a total population of 40894 patients receiving active treatment between January 15 and May 4 2020. 65 of 283 (23%) had cardiovascular comorbidities and 7 (2%) pre-existent pulmonary disease. 239/283 patients (84.4%) were receiving treatment for metastatic disease and 44 (15.6%) in the adjuvant setting. Breast, lung, colon and prostate cancer were the main tumor types accounting for 61 % of cases. Conclusions: The occurrence of COVID-19 among cancer patients receiving active antitumor treatment appears to reflect tumor epidemiology. Full analysis of the distribution of COVID-19 occurrence and clinical course by tumor type, stage and oncologic treatment will be presented. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.