ABSTRACT
Purpose or Objective: In 2020 a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 spread all over the world, causing COVID-19 (COronaVIrus Disease-2019) pandemic. COVID-19 pandemic had an indirect impact to all the hospital services, as well as oncological activities. This impact, especially in the early months of 2020, represented an issue for Radiotherapy Departments, often finding medical staff unprepared to face COVID-19 pandemic. Aim of this study was to assess the indirect impact of COVID-19 to all the activities in our Radiation Oncology Department. Materials and Methods: From a large database, we retrospectively evaluated clinical activities trend from January 2020 to December 2020, comparing to 2019. Data related to clinical visits (first evaluations, follow-up), planning CT and PET/CT, treatment plannings, total number (n) of treated patients and of radiotherapy sessions on our 4 LINACs were examined. Results: In 2020, first clinical visits were 1890 vs 2022 in 2019 (-6.53%), planning CT and PET/CT in 2020 were 1680, similar to 2019 (n=1675) and in 2020 treatment plannings were 1608 (vs 1585 in 2019, +1.45%). Follow-up visits rapidly decreased in March and April 2020, as shown in Figure 1 (n=1324 in 2020 vs 1757 in 2019, -24.6%). During COVID-19 first (March, April 2020) and second (October, November 2020) peaks, follow-up visits were performed as tele-visits form in n=628. Total number of treatment sessions during 2020 was 21880 (24341 in 2019, -10.1% in 2020);hypofractioned regimens were preferred to reduce patients’ residence time for treatment in our Department (171 in 2020 vs 141 in 2019 for single-fraction palliative radiotherapy, with percent variations + 21.3%). Data of 2020 were reported in Figure 2. Eight patients, all asymptomatics, resulted occasionally positive to COVID-19;1 patient affected by glioblastoma and 7 by metastases (2 brain, 3 bone, 1 lung and 1 vagina). These latter were hospitalized waiting to palliative radiation treatment. During all the course of 2020, 21 patients refused to undergo radiotherapy;7 of these delayed first clinical evaluation. (Figure Presented) Conclusion: This analysis helped us to better understand the impact of COVID-19 in our Department and the consequences in radiotherapy activities, especially in the pandemic acute phase. Compared to 2019, radiotherapy activity dropped mainly in the first months of 2020. This reduction regarded mostly patients’ clinical visits, because of people fear of COVID-19 spread. Despite this decrease, radiation treatments never stopped even in the first peak of COVID-19 spread in Italy (March-April 2020). During all the 2020, the use of hypofractioned regimens rapidly increased for all the pathologies.
ABSTRACT
BACKGROUND: On January 30, 2020, WHO declared COVID-19 a pandemic. In this article we describe our experience at Richmond University Medical Center with Chembio serological IgM, IgG testing. METHODS: In this prospective cohort study of patients and hospital employees, we utilized Chembio COVID-19 IgM/IgG serological testing in addition to Cepheid RT-PCR analysis. RESULTS: We evaluated the performance of Chembio serological test for IgM and IgG as an employee screening tool in a community hospital setting. The total number of currently asymptomatic employees screened was 1,866 from the Richmond University Medical Center. The non-exposed group included 1,253 (67.1%) employees with no significant clinical history and non-reactive IgM and IgG antibodies. The convalescent group included 255 (13.7%) of the employees with elevation of IgG only, 18 (1%) employees with past history of positive PCR and COVID-19 who currently have non-reactive IgM and IgG antibodies or demonstrate elevated IgG only, followed by 3 employees (< 1%) with no past clinical history who demonstrated reactive IgM and IgG antibodies and negative follow up by PCR. The reported 14.9% exposure/convalescent rate is lower than the reported 20% by the Department of Health and Governor Andrew Cuomo and may represent a better utilization of personal protective equipment, better hand washing techniques, and better disinfection procedures combined with strict social distancing. CONCLUSIONS: Chembio's performance is satisfactory; however, hospitals must design their own policies addressing: who needs to be screened and who will interpret the results as well as constructing management algorithms for employees with no previous history and current double positive antibodies.