The impact of the COVID-19 pandemic on tertiary care cancer center: Analyzing administrative data.

INTRODUCTION: Patients with cancer need to receive their proper treatment and often cannot wait for their treatment, despite delays due to the COVID-19 pandemic. As a result, many cancer centers have had challenges maintaining their oncological activities. OBJECTIVES: To compare the average hospital management data and indicators in two different periods, with and without the peak of COVID-19 cases, from an important tertiary cancer center in the northeast region of Brazil. METHODS: A retrospective and observational study was performed comparing average hospital administrative data and indicators, between January to March v April to June, 2020 exclusively at the Hospital de Câncer de Pernambuco, Brazil. RESULTS: There were on average a 13% reduction in the chemotherapy administered (P = .131), 17% fewer radiotherapy treatments carried out (P = .043) and 41% as many oncologic surgeries undertaken (P = .002). There was a reduction in the number of sessions of out-patient chemotherapy of 8•6% (P = .271) and chemotherapy inpatients of 33% (P = .038). Admission of new cases of patients with cancer was reduced by 44% (P = .007) during the period analyzed. Ambulatory appointments also decreased by 55% (P = .004) and emergency room appointments fell by 7•9% (P = .495). The number of hospitalizations was reduced by 36% (P = .005) and the occupancy rate decreased by 23•6% (P = .003), while the length of individual hospital stays (in days) increased 10•5% (P = .116). CONCLUSION: We report a reduction in the number of radiotherapy treatments and surgeries performed cancer carried out, ambulatory and emergency appointments, hospitalization and admission of new cases of cancer during peak of COVID-19 in an important public tertiary cancer center in the northeast region of Brazil.

SARS-CoV-2 Delta variant of concern in Brazil - multiple introductions, communitary transmission, and early signs of local evolution (preprint)

The dissemination of the Delta VOC in Brazil is still unclear, despite the frequent reports of isolated cases from different Brazilian states. In this report we characterize the dissemination of the Delta VOC in Brazil and where the introductions of this lineage fall within the global Delta phylogeny. We also examined the mutational profile of the largest clade within the Brazilian Delta VOCs, with a focus on samples which were obtained in the State of Sao Paulo, and especially in the city of Sao Paulo, the largest metropolis of South America, and a national and international transportation hub.