COVID-19 PANDEMIC IMPACT ON RADIOTHERAPY IN PATIENTS WITH HEAD AND NECK CANCER

Introduction: The COVID-19 pandemic has a significant impact on the primary, secondary and tertiary levels of the health system. In a low-middle income countries such as Bosnia and Herzegovina, ensuring optimal oncology care was challenging even before the COVID-19 pandemic. Since the beginning of the COVID-19 pandemic, there was a warning of the possible impact of worsening mortality and/ or morbidity due to delayed diagnosis and suboptimal treatment.1 The COVID 19 pandemic has impact on reducing the number of patients treated with radiotherapy.2 The aim of our study was to analyze the impact of the COVID-19 pandemic on radiotherapy in a patient with head and neck cancer who were treated with radiotherapy in a tertiary health care facility. Methods: We analyzed data from the institutional databases for radiotherapy of the Oncology Department at University Clinical Hospital Mostar, Bosnia and Herzegovina. We performed data extraction for patients with head and neck cancer who were treated with primary or adjuvant radiotherapy with or without chemotherapy from January 2018 to December 2021. Results: A total of 114 patients were treated with radiotherapy for head and neck cancer in the pre- COVID-19 period (2018-2019) and COVID-19 period (2020-2021). There were more patients treated with radiotherapy in the preCOVID19 period, 64 (56%) compared to the COVID19 period, 50 (44%). In the COVID 19 period, the number of patients treated with radiotherapy was reduced by 22% compared to the preCOVID19 period. Conclusion: A decline innumber of patients treated with radiotherapy in the COVID 19 period was detected. Health system optimization and education of the general population about the negative indirect impact of COVID 19 on the health system, diagnosis and treatment of cancer is needed.

INPATIENT ONCOLOGY CARE - IMPACT OF COVID-19 PANDEMIC, SINGLE-CENTER EXPERIENCE

Introduction: Last two pandemic years significantly changed our lives in many ways and also oncology care. Medical centers adapted to the situation and reorganized the service, including service on oncology departments. Inpatient Oncology Department, University Clinical Hospital Mostar, had a reduced number of hospital beds for oncology patients, patients had to own a negative RT-PCR COVID-19 test before admission, visits to patients were prohibited and patients were restricted from moving outside the department. We were interested in how these measures impacted our inpatient care in terms of the number of visits. Methods: We retrospectively analysed data from the Hospital Information System (BIS) for the University Clinical Hospital Mostar, Inpatient Oncology Department. We looked for the number of inpatient visits at our department within the 'pre-pandemic period', between 9 March 2018 to 31 January 2020, compared with the 'pandemic period', between 9 March 2020 to 31 January 2022. Furthermore, we made additional analyses by subunits: radiotherapy subunit and chemotherapy subunit. We calculated the percentage difference between the 'pre-pandemic period' and the 'pandemic period'. Results: Within the 'pre-pandemic period', the total number of inpatient visits was 1818, of which 1601 were at the chemotherapy subunit, and 217 were at the radiotherapy subunit. In the 'pandemic period' we had the total number of inpatient visits 1591, 1443 at the chemotherapy subunit, and 148 at the radiotherapy subunit. In the 'pandemic period' we had 87.5% of the total number of inpatient visits from the 'pre-pandemic period', 90.1% of the chemotherapy inpatient visits, and 68.2% of the radiotherapy visits. This was a 12.5% decrease in the total number of inpatient visits in the 'pandemic period' as compared with the 'pre-pandemic period'. The decrease in the number of chemotherapy visits was 9.9% and 31.8% for radiotherapy visits in the 'pandemic period' compared with the 'pre-pandemic period'. Conclusion: Measures that were taken to control the COVID-19 pandemic had a noticeable impact on inpatient oncology care in terms of patient visits, especially in terms of radiotherapy admissions. The extent to which these measures affect patient outcomes will be shown in the future and should be the subject of research.

HOW OFTEN ONCOLOGISTS RECORD THE PATIENTS' COVID-19 INFECTION IN THEIR FINDINGS

Introduction: COVID-19 pandemic significantly affects cancer care and the work of oncologists. Also, in cancer patients experiencing COVID-19 infection, oncological care, and therapeutic sequence may be disrupted by the infection itself. In our Inpatient Oncology Department at University Clinical Hospital Mostar, during the pandemic, all patients that are hospitalized in the regular procedure should possess a negative RT-PCR COVID-19 test. Until this pandemic, the epidemiological history for most infectious diseases was not part of the standard information collected for cancer patients by their oncologists. There is also a known fact of under-reporting by physicians.Talking about toxicities, under-reporting of severe toxicities ranged from 13 to 50% even in prospectively randomized trials. During the pandemic, our Hospital Information System (BIS) was adjusted, so if the patient has been RT-PCR COVID-19 tested in our institution, oncologists can see the last test results through the BIS and the Electronic Medical History (EPB), also for all previous test results too. But we were interested in how much oncologists changed their practice, and whether they record information about patients' COVID-19 infection in their findings. Methods: We retrospectively reviewed data from the Hospital Information System (BIS) of the Oncology Department at University Clinical Hospital Mostar. We extracted data on patients who tested positive for COVID-19 in our hospital before visiting the Inpatient Oncology Department, for patients hospitalized in the period from 1st December 2021 to 20 February 2022. Determining the date of the positive RT-PCR COVID-19 test, we reviewed oncological findings after infection in Electronic Medical History (EPB) to detect whether the prevalence of the COVID-19 infection was recorded in the oncological findings of these patients. Results: Within the period from 1st December 2021 until 20 February 2022, we detected 41 patients with previous RT-PCR COVID-19 positive test results, tested at University Clinical Hospital Mostar. We found records of the COVID-19 infection in oncological findings for 25 of detected 41 patients (60.9%). All other patients, 16 of them (39%), did not have records of previous COVID-19 infection or positive results in oncological findings. Conclusion: Even thoughCOVID-19 infection can affect the morbidity and mortality of cancer patients and the therapeutic sequence, and although oncologists in their findings do report this infection, it is still under-reported in high percent.