ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic may have affected cancer management. We aimed to evaluate changes in every oncology care pathway essential step, from screening to treatment, during the pandemic. Monthly oncological activity differences between 2019 and 2020 (screening tests, histopathological analyzes, multidisciplinary tumor board meetings (MTBMs), diagnostic announcement procedures (DAPs), and treatments were calculated in two French areas experiencing different pandemic intensity (Reims and Colmar). COVID-19 has had a dramatic impact in terms of screening (-86% to -100%), diagnosis (-39%), and surgical treatment (-30%). This global decrease in all essential oncology care pathway steps contrasted with the relative stability of chemotherapy (-9%) and radiotherapy use (-16%). Outbreak occurred earlier and with more intensity in Colmar but had a comparable impact in both areas regarding MTMBs and DAPs. The current ONCOCARE-COV study is still in progress and with a longer follow-up to analyze postlockdown situation.
Subject(s)
COVID-19/prevention & control , Infection Control/standards , Medical Oncology/trends , Neoplasms/therapy , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Testing/standards , Critical Pathways/standards , Critical Pathways/statistics & numerical data , Critical Pathways/trends , France/epidemiology , Humans , Mass Screening/standards , Mass Screening/statistics & numerical data , Mass Screening/trends , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Neoplasms/diagnosis , Neoplasms/immunology , Patient Care Team/organization & administration , Patient Care Team/standards , Patient Care Team/statistics & numerical data , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Telemedicine/standardsSubject(s)
Coronavirus Infections , Critical Pathways/statistics & numerical data , Dementia , Pandemics , Pneumonia, Viral , Aged , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Dementia/diagnosis , Dementia/epidemiology , Dementia/physiopathology , Female , Humans , Male , Mortality , Multiple Chronic Conditions/epidemiology , New York/epidemiology , Outcome and Process Assessment, Health Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Prognosis , Risk Assessment , Risk Factors , SARS-CoV-2ABSTRACT
The public health emergency caused by the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant reallocation of health resources with a consequent reorganization of the clinical activities also in several urological centers. A panel of Italian urologists has agreed on a set of recommendations on pathways of pre-, intra- and post-operative care for urological patients undergoing urgent procedures or non-deferrable oncological interventions during the COVID-19 pandemic. Simplification of the diagnostic and staging pathway has to be prioritized in order to reduce hospital visits and consequently the risk of contagion. In absence of strict uniform regulations that impose the implementation of nasopharyngeal swabs, we recommend that an accurate triage for COVID-19 symptoms be performed both by telephone at home before hospitalization and at the time of hospitalization. We recommend that during hospital stay patients should be provided with as many instructions as possible to facilitate their return to, and stay at, home. Patients should be discharged under stable good conditions in order to minimize the risk of readmission. It is advisable to reduce or reschedule post-discharge controls and implement an adequate system of communication for telemonitoring discharged patients.