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Otolaryngol Head Neck Surg ; 162(6): 816-817, 2020 06.
Article in English | MEDLINE | ID: covidwho-913950


The impact of the coronavirus disease 2019 (COVID-19) pandemic on the management of head and neck cancer must be addressed. Immediate measures to reduce transmission rates and protect patients and providers take priority and necessitate some delays in care, particularly for patients with mild symptoms or less aggressive cancers. However, strict guidelines have yet to be developed, and many unintentional delays in care are to be expected based on the magnitude of the looming public health crisis. The medical complexity of head and neck cancer management may lead to prolonged delays that worsen treatment outcomes. Therefore, those caring for patients with head and neck cancer must take action to reduce these negative impacts as the country rallies to overcome the challenges posed by this pandemic.

Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Head and Neck Neoplasms/therapy , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/prevention & control , COVID-19 , Disease Management , Disease Outbreaks/statistics & numerical data , Female , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/immunology , Humans , Immunocompromised Host , Male , Outcome Assessment, Health Care , Pandemics/statistics & numerical data , Risk Assessment , United States , Vulnerable Populations/statistics & numerical data
Nat Immunol ; 21(6): 597-599, 2020 06.
Article in English | MEDLINE | ID: covidwho-828055
Head Neck ; 42(7): 1507-1515, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-614117


INTRODUCTION: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has altered the health care environment for the management of head and neck cancers. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management in order to achieve a medically and ethically appropriate balance of risks and benefits. METHODS: Creation of consensus document. RESULTS: The process yielded a consensus statement among a wide range of practitioners involved in the management of patients with head and neck cancer in a multihospital tertiary care health system. CONCLUSIONS: These guidelines support an ethical approach for the management of head and neck cancers during the COVID-19 epidemic consistent with both the local standard of care as well as the head and neck oncological literature.

Betacoronavirus , Coronavirus Infections/prevention & control , Head and Neck Neoplasms/therapy , Infection Control/standards , Medical Oncology/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Ambulatory Care/standards , COVID-19 , Combined Modality Therapy , Continuity of Patient Care/standards , Coronavirus Infections/diagnosis , Head and Neck Neoplasms/diagnosis , Humans , Multi-Institutional Systems , Otorhinolaryngologic Surgical Procedures/standards , Palliative Care/standards , Patient Safety , Pennsylvania , Personal Protective Equipment , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Terminal Care/standards , Tertiary Care Centers
Head Neck ; 42(6): 1131-1136, 2020 06.
Article in English | MEDLINE | ID: covidwho-66373


BACKGROUND AND METHODS: There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances. RESULTS: After careful consideration of the options, we took different approaches in the care of these two patients. CONCLUSIONS: Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.

Conservative Treatment/methods , Coronavirus Infections/epidemiology , Head and Neck Neoplasms/therapy , Immunocompromised Host , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Time-to-Treatment/organization & administration , Adult , COVID-19 , Clinical Decision-Making , Communicable Disease Control/methods , Disease Management , Female , Follow-Up Studies , Head and Neck Neoplasms/pathology , Humans , Interdisciplinary Communication , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/surgery , Male , Middle Aged , Mouth Neoplasms/pathology , Mouth Neoplasms/surgery , Patient Safety , Risk Assessment , Sampling Studies , Time Factors , United States , Vocal Cords/pathology , Vocal Cords/surgery