ABSTRACT
Background: The emergence of 2019 novel coronavirus disease (COVID-19) has caused a global public health emergency. Italy was the first European country where the disease widespread and Lombardy is the principal cluster. In the most affected areas, a rapid and thorough reorganization of hospital clinical procedures has taken place: all non-essential clinical activity has been suspended, while the ordinary activity continues for whom diagnostic procedures and treatments cannot be delayed. It is the case of cancer patients undergoing treatments with curative intent;in this situation of deep distress for the health care system, the inability to satisfy cancer patients' needs is an additional concern. In the light of the above, during the current COVID-19 pandemic it is likely to see a dramatic worsening of cancer patients' nutritional status, due to possible delayed clinical assistance and difficulties in procuring nutritionally adequate quality food as lock-down's repercussion. The consequences are reasonably foreseeable and will have a severe negative impact after the emergency. Hence, it is essential to carry on, as far as possible, the activity of clinical nutrition in oncology, which can be safely provided only by a thorough setting and approach to patients rearrangement. Methods: For this purpose, the Clinical Nutrition and Dietetics Unit and the Medical Oncology Unit of our hospital have reorganized the clinical routine activity in strict collaboration, to better face up to the challenge, while preserving cancer patients' needs. Results: Several general actions have been taken to protect both patients and healthcare professionals;remote capabilities have been implemented to minimize interactions, efforts are being done to secure medical resources and supplies. This allowed the regular provision of nutritional counseling and nutritional support in both inpatients and outpatients, in line with the recommended hygienic measures to protect both patients and healthcare professionals. Nutritional follow- up has been planned by regular telephone counseling and laboratory exams have been checked by email. Conclusions: Implementing appropriate nutritional care in oncology during this unprecedented emergency is a hard challenge. However, any effort should be done to guarantee, along with active treatment, adequate nutritional support to cancer patients, in order to prevent the deleterious consequences of malnutrition on clinical outcomes and quality of life.