Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 111
Filter
1.
Epidemiol Infect ; 150: e40, 2022 02 21.
Article in English | MEDLINE | ID: covidwho-1747291

ABSTRACT

Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7-8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities , Cross Infection/epidemiology , Day Care, Medical , Infectious Disease Transmission, Professional-to-Patient , Neoplasms/therapy , Adolescent , Adult , Aged , COVID-19/immunology , COVID-19/transmission , Caregivers , Child , Child, Preschool , Cross Infection/immunology , Cross Infection/transmission , Disease Outbreaks , Female , Humans , Immunocompromised Host , Infant , Male , Middle Aged , Neoplasms/immunology , Republic of Korea/epidemiology , SARS-CoV-2 , Young Adult
2.
Eur Rev Med Pharmacol Sci ; 26(1): 284-290, 2022 01.
Article in English | MEDLINE | ID: covidwho-1630130

ABSTRACT

OBJECTIVE: The COVID-19 pandemic and the measures accompanying it have been accused of having a negative influence on the frequency and methods of treatment of various diseases including head and neck cancer (HNSCC). To go further into this assumption, the diagnoses made, and treatments performed at one of Germany's largest head and neck cancer centres were evaluated. PATIENTS AND METHODS: This study consisted of one single centre and involved a retrospective review of all patients with newly diagnosed or recurrent HNSCC. The diagnosis and treatment methods used in the pre-COVID-19 time period between March 1st, 2019, and March 1st, 2020, were analysed and compared with the COVID-19 time period from April 1st, 2020, until April 1st, 2021. The primary objective was defined as the number of malignant diagnoses and the secondary objectives as the disease stage and the time to therapy. RESULTS: A total of 612 patients (160♀; mean 63 yrs.) were included. 319 patients (52%) were treated in the pre-COVID-19 time. The two groups did not differ in terms of age (p=0.304), gender (p=0.941), presence of recurrent disease (p=0.866), tumour subsite (p=0.194) or the duration from presentation to the multidisciplinary tumour board until start of therapy (p=0.202). There were no significant differences in the T stage (p=0.777), N stage (p=0.067) or UICC stage (p=0.922). During the pre-COVID-19 period more patients presented with distant metastases (n= 23 vs. n=8; p=0.011). CONCLUSIONS: This study shows that there was no significant change in either the number and severity of HNSCC diagnoses or the time until start of therapy at this large head and neck cancer centre as a result of the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/epidemiology , Pandemics , Adolescent , Adult , Aged , Aged, 80 and over , Cancer Care Facilities , Delayed Diagnosis/trends , Female , Germany , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck , Young Adult
3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(3): 369-374, dez 20, 2021. fig, tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1633647

ABSTRACT

Introdução: o câncer é uma das principais causas de morte no mundo e o seu tratamento, associado com o processo da doença, acaba tornando esses pacientes mais vulneráveis. A pandemia de COVID-19 foi declarada no Brasil em março de 2020 e se estende até o presente momento, com centenas de milhares de infectados e de óbitos. No seu início, algumas medidas de prevenção foram adotadas, principalmente para populações de risco como os pacientes oncológicos, mediante o fechamento de centros de diagnósticos e de serviços eletivos, além da aderência ao distanciamento social. Objetivo: este estudo teve como objetivo determinar o impacto quantitativo gerado no atendimento de pacientes em um serviço de radioterapia, no perfil sociodemográfico dos pacientes oncológicos e no estadiamento tumoral desses pacientes. Metodologia: Tratou-se de estudo observacional descritivo, onde foram coletados dados dos prontuários dos pacientes, a partir do relatório mensal de atendimentos iniciais do serviço de radioterapia de uma Unidade de Alta Complexidade em Oncologia, em hospital público de Salvador, referentes às terapias iniciadas no período entre março e agosto dos anos de 2019 e 2020. Resultados: avaliaram-se 259 prontuários no ano de 2019 e 227 em 2020. A maioria dos pacientes foi do sexo feminino (78%) nos dois anos e residentes da cidade de Salvador. Segundo os resultados obtidos, percebeu-se uma diminuição de 12% no número de atendimentos realizados em 2020, com uma piora no estadiamento tumoral desses pacientes, chegando a um aumento de 115% nos casos de presença de metástase. As principais neoplasias encontradas foram câncer de mama, cabeça e pescoço, próstata e colo do útero. Conclusões: houve uma redução no número de atendimentos na referida unidade, não existindo grande mudança no perfil desses pacientes, que apresentam uma amostra predominantemente do sexo feminino, sendo sua maioria residente da cidade de Salvador-BA. Porém foi possível notar uma diminuição da população acima de 60 anos e também um agravamento do estadiamento tumoral.


Introduction: Cancer is one of the main causes of death in the world and its treatment, associated with the disease process, ends up making these patients more vulnerable. The COVID-19 pandemic was declared in Brazil in March 2020 and has continued to date, with hundreds of thousands of infected people and deaths. At its beginning, some prevention measures were adopted, mainly for populations at risk such as cancer patients, through the closing of diagnostic centers and elective services, in addition to adherence to social distance. Objective: this study aimed to determine the quantitative impact generated on the care of patients in a radiotherapy service, on the sociodemographic profile of cancer patients and on the tumor staging of these patients. Methods: this was a descriptive observational study, where data were collected from the patients' medical records, from the monthly report of initial care at the radiotherapy service of a High Complexity Oncology Unit, in a public hospital in Salvador, regarding the therapies started in the period between March and August in the years 2019 and 2020. Results: two hundred and fifty nine (259) medical records were evaluated in 2019 and 227 in 2020. Most patients were female (78%) in both years and residents in the city of Salvador. According to the results obtained, there was a 12% decrease in the number of consultations performed in 2020, with a worsening in the tumor staging of these patients, reaching an increase of 115% in cases of metastasis. The main neoplasms found were breast, head and neck, prostate and cervical cancer. Conclusions: there was a reduction in the number of consultations in that unit, with no major change in the profile of these patients, who have a predominantly female sample, most of them residing in the city of Salvador-BA. However, it was possible to notice a decrease in the population over 60 years of age and also an aggravation of tumor staging.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Radiotherapy , Cancer Care Facilities , COVID-19 , Neoplasms , Epidemiology, Descriptive , Observational Study
5.
JCO Glob Oncol ; 7: 1490-1499, 2021 09.
Article in English | MEDLINE | ID: covidwho-1477493

ABSTRACT

PURPOSE: The COVID-19 pandemic has affected health care systems worldwide, resulting in critical shortages of essential items and materials. The available guidelines are of little use for cancer hospitals in low-income and low-middle-income countries. They have been designed for community hospitals serving in a centralized health care network. This study aimed to draft and field test a framework to establish a list of essential supplies that should be stockpiled for subsequent waves of the COVID-19 virus by a tertiary care cancer hospital in a low-middle-income country. MATERIALS AND METHODS: A model was formulated using the consumption trends during the peak month of the first wave of COVID-19 infection to compile a list of essential materials and supplies. Furthermore, costing analyses were conducted to determine the financial benefits of stockpiling. RESULTS: A proposed list of items to stockpile, including personal protective equipment, radiology supplies, laboratory reagents, medication, and oxygen, was shared with the hospital administration. However, the hospital administration only accepted the proposals for stockpiling personal protective equipment and oxygen. CONCLUSION: This paper provides a framework and strategies that cancer hospitals and health care systems can modify and use as per individual, institutional requirements and specifications for stockpiling essential items during the COVID-19 or other similar pandemics.


Subject(s)
COVID-19 , Neoplasms , Cancer Care Facilities , Humans , Pandemics , Personal Protective Equipment , SARS-CoV-2
6.
Cancer Control ; 28: 10732748211045275, 2021.
Article in English | MEDLINE | ID: covidwho-1463162

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has overwhelmed the capacity of healthcare systems worldwide. Cancer patients, in particular, are vulnerable and oncology departments drastically needed to modify their care systems and established new priorities. We evaluated the impact of SARS-CoV-2 on the activity of a single cancer center. METHODS: We performed a retrospective analysis of (i) volumes of oncological activities (2020 vs 2019), (ii) patients' perception rate of the preventive measures, (iii) patients' SARS-CoV-2 infections, clinical signs thereof, and (iv) new diagnoses made during the SARS-CoV-2 pandemic. RESULTS: As compared with a similar time frame in 2019, the overall activity in total numbers of outpatient chemotherapy administrations and specialist visits was not statistically different (P = .961 and P = .252), while inpatient admissions decreased for both medical oncology and thoracic oncology (18% (P = .0018) and 44% (P < .0001), respectively). Cancer diagnosis plummeted (-34%), but no stage shift could be demonstrated.Acceptance and adoption of hygienic measures was high, as measured by a targeted questionnaire (>85%). However, only 46.2% of responding patients regarded telemedicine, although widely deployed, as an efficient surrogate to a consultation.Thirty-three patients developed SARS-CoV-2, 27 were hospitalized, and 11 died within this time frame. These infected patients were younger, current smokers, and suffered more comorbidities. CONCLUSIONS: This retrospective cohort analysis adds to the evidence that continuation of active cancer therapy and specialist visits is feasible and safe with the implementation of telemedicine. These data further confirm the impact of SARS-CoV-2 on cancer care management, cancer diagnosis, and impact of infection on cancer patients.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/statistics & numerical data , Neoplasms/epidemiology , Neoplasms/therapy , Age Factors , Comorbidity , Cyclopentanes , Humans , Infection Control/organization & administration , Neoplasms/diagnosis , Neoplasms/mortality , Organosilicon Compounds , Pandemics , Perception , Retrospective Studies , SARS-CoV-2
8.
Asian Pac J Cancer Prev ; 22(9): 2945-2950, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1441449

ABSTRACT

The COVID-pandemic has shown significant impact on cancer care from early detection, management plan to clinical outcomes of cancer patients. The Asian National Cancer Centres Alliance (ANCCA) has put together the 9 "Ps" as guidelines for cancer programs to better prepare for the next pandemic. The 9 "Ps" are Priority, Protocols and Processes, Patients, People, Personal Protective Equipments (PPEs), Pharmaceuticals, Places, Preparedness, and Politics. Priority: to maintain cancer care as a key priority in the health system response even during a global infectious disease pandemic. Protocol and processes: to develop a set of Standard Operating Procedures (SOPs) and have relevant expertise to man the Disease Outbreak Response (DORS) Taskforce before an outbreak. Patients: to prioritize patient safety in the event of an outbreak and the need to reschedule cancer management plan, supported by tele-consultation and use of artificial intelligence technology. People: to have business continuity planning to support surge capacity. PPEs and Pharmaceuticals: to develop plan for stockpiles management, build local manufacturing capacity and disseminate information on proper use and reduce wastage. Places: to design and build cancer care facilities to cater for the need of triaging, infection control, isolation and segregation. Preparedness: to invest early on manpower building and technology innovations through multisectoral and international collaborations. Politics: to ensure leadership which bring trust, cohesion and solidarity for successful response to pandemic and mitigate negative impact on the healthcare system.


Subject(s)
Cancer Care Facilities/organization & administration , Disaster Planning/methods , Infection Control/methods , Neoplasms/prevention & control , Pandemics/prevention & control , Regional Health Planning/organization & administration , Telemedicine/methods , Artificial Intelligence , Asia/epidemiology , Delivery of Health Care , Humans , Neoplasms/epidemiology
9.
Bull Cancer ; 108(9): 787-797, 2021 Sep.
Article in French | MEDLINE | ID: covidwho-1336273

ABSTRACT

The Curie Institute exclusively cares for cancer patients, who were considered particularly "vulnerable" from the start of the SARS-CoV 2 pandemic. This pandemic, which took the medical world by surprise, suddenly required the Institute's hospital to undergo rapid and multimodal restructuring, while having an impact on everyone to varying degrees. We will examine here how this hospital has coped, with the concern for a new benefit-risk balance, in times of greater medical uncertainty and scarcity of certain resources, for these "vulnerable" patients but also for their relatives and staff. We will highlight by theme the positive aspects and difficulties encountered, and then what could be useful for other hospitals as the pandemic is ongoing.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/organization & administration , Pandemics , SARS-CoV-2 , Delivery of Health Care/organization & administration , Ethics, Medical , Family , Guidelines as Topic , Health Resources/supply & distribution , Humans , Personnel Administration, Hospital , Pilot Projects , Psychotherapy/organization & administration , Remote Consultation , Research/organization & administration , Risk Assessment/methods , Teleworking , Videoconferencing/organization & administration
10.
Appl Clin Inform ; 12(3): 629-636, 2021 05.
Article in English | MEDLINE | ID: covidwho-1309479

ABSTRACT

OBJECTIVES: Accurate metrics of provider activity within the electronic health record (EHR) are critical to understand workflow efficiency and target optimization initiatives. We utilized newly described, log-based core metrics at a tertiary cancer center during rapid escalation of telemedicine secondary to initial coronavirus disease-2019 (COVID-19) peak onset of social distancing restrictions at our medical center (COVID-19 peak). These metrics evaluate the impact on total EHR time, work outside of work, time on documentation, time on prescriptions, inbox time, teamwork for orders, and undivided attention patients receive during an encounter. Our study aims were to evaluate feasibility of implementing these metrics as an efficient tool to optimize provider workflow and to track impact on workflow to various provider groups, including physicians, advanced practice providers (APPs), and different medical divisions, during times of significant policy change in the treatment landscape. METHODS: Data compilation and analysis was retrospectively performed in Tableau utilizing user and schedule data obtained from Cerner Millennium PowerChart and our internal scheduling software. We analyzed three distinct time periods: the 3 months prior to the initial COVID-19 peak, the 3 months during peak, and 3 months immediately post-peak. RESULTS: Application of early COVID-19 restrictions led to a significant increase of telemedicine encounters from baseline <1% up to 29.2% of all patient encounters. During initial peak period, there was a significant increase in total EHR time, work outside of work, time on documentation, and inbox time for providers. Overall APPs spent significantly more time in the EHR compared with physicians. All of the metrics returned to near baseline after the initial COVID-19 peak in our area. CONCLUSION: Our analysis showed that implementation of these core metrics is both feasible and can provide an accurate representation of provider EHR workflow adjustments during periods of change, while providing a basis for cross-vendor and cross-institutional analysis.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/statistics & numerical data , Electronic Health Records , Neoplasms/therapy , SARS-CoV-2 , Telemedicine/methods , Telemedicine/statistics & numerical data , Algorithms , Data Collection , Documentation , Health Policy , Humans , Pattern Recognition, Automated , Retrospective Studies , Software , User-Computer Interface , Workflow
11.
Blood ; 138(9): 811-814, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1288619
12.
J Cancer Res Ther ; 17(2): 551-555, 2021.
Article in English | MEDLINE | ID: covidwho-1268377

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. PURPOSE: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. CONCLUSION: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.


Subject(s)
COVID-19/diagnosis , Clinical Laboratory Services/organization & administration , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Tertiary Care Centers/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Clinical Laboratory Services/standards , Decontamination/methods , Decontamination/standards , Developing Countries , Disinfection/methods , Disinfection/organization & administration , Disinfection/standards , Hospitals, Rural/organization & administration , Hospitals, Rural/standards , Humans , India/epidemiology , Infection Control/standards , Medical Laboratory Personnel/organization & administration , Medical Laboratory Personnel/standards , Pandemics/prevention & control , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Specimen Handling/standards , Tertiary Care Centers/standards , Workforce/organization & administration , Workforce/standards
13.
Clin Lung Cancer ; 23(2): 91-94, 2022 03.
Article in English | MEDLINE | ID: covidwho-1267629

ABSTRACT

As the COVID-19 pandemic ravages the whole world, frontline doctors are tirelessly fighting to contain and manage the disastrous effects of the virus. However, thoracic surgeons will also become frontline doctors, because everyone around them is likely to be infected after the closed-loop management of the hospital. Stress, difficulty, fears, physical and psychological burnout and lowered morale are some side effects. We feature the perspectives of thoracic surgeons at the epicenter of the COVID-19 fight in Fudan University Shanghai Cancer Center, which highlight the emotions, measures, motivation and belief of thoracic surgeons while they work on frontlines.


Subject(s)
Attitude of Health Personnel , COVID-19/therapy , Cancer Care Facilities , Occupational Stress , Physician's Role , Thoracic Surgery , China , Humans , SARS-CoV-2
14.
JCO Oncol Pract ; 17(3): e369-e376, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1262524

ABSTRACT

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has raised a variety of ethical dilemmas for health care providers. Limited data are available on how a patient's concomitant cancer diagnosis affected ethical concerns raised during the early stages of the pandemic. METHODS: We performed a retrospective review of all COVID-related ethics consultations registered in a prospectively collected ethics database at a tertiary cancer center between March 14, 2020, and April 28, 2020. Primary and secondary ethical issues, as well as important contextual factors, were identified. RESULTS: Twenty-six clinical ethics consultations were performed on 24 patients with cancer (58.3% male; median age, 65.5 years). The most common primary ethical issues were code status (n = 11), obligation to provide nonbeneficial treatment (n = 3), patient autonomy (n = 3), resource allocation (n = 3), and delivery of care wherein the risk to staff might outweigh the potential benefit to the patient (n = 3). An additional nine consultations raised concerns about staff safety in the context of likely nonbeneficial treatment as a secondary issue. Unique contextual issues identified included concerns about public safety for patients requesting discharge against medical advice (n = 3) and difficulties around decision making, especially with regard to code status because of an inability to reach surrogates (n = 3). CONCLUSION: During the early pandemic, the care of patients with cancer and COVID-19 spurred a number of ethics consultations, which were largely focused on code status. Most cases also raised concerns about staff safety in the context of limited benefit to patients, a highly unusual scenario at our institution that may have been triggered by critical supply shortages.


Subject(s)
COVID-19 , Cancer Care Facilities , Ethics Consultation/trends , Neoplasms , Resuscitation Orders/ethics , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Renal Cell , Cardiopulmonary Resuscitation/ethics , Child , Decision Making , Ethics Committees, Clinical , Female , Health Care Rationing/ethics , Hematologic Neoplasms , Humans , Intensive Care Units , Intubation, Intratracheal/ethics , Kidney Neoplasms , Lung Neoplasms , Male , Medical Futility , Mental Competency , Middle Aged , Multiple Myeloma , New York City , Occupational Health/ethics , Patients' Rooms , Personal Autonomy , Proxy , SARS-CoV-2 , Sarcoma , Young Adult
15.
Eur J Clin Invest ; 51(8): e13623, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1258930

ABSTRACT

BACKGROUND: We investigated the influence of population-wide COVID-19 lockdown measures implemented on 16, March 2020 on routine and emergency care of cancer outpatients at a tertiary care cancer centre in Vienna, Austria. METHODS: We compared the number/visits of cancer outpatients receiving oncological therapies at the oncologic day clinic (DC) and admissions at the emergency department (ED) of our institution in time periods before (pre-lockdown period: 1 January - 15 March 2020) and after (post-lockdown period: 16 March- 31 May 2020) lockdown implementation with the respective reference periods of 2018 and 2019. Additionally, we analysed Emergency Severity Index (ESI) score of unplanned cancer patient presentations to the ED in the same post-lockdown time periods. Patient outcome was described as 3-month mortality rate (3-MM). RESULTS: In total, 16 703 visits at the DC and 2664 patient visits for the respective time periods were recorded at the ED. No decrease in patient visits was observed at the DC after lockdown implementation (P = .351), whereas a substantial decrease in patient visits at the ED was seen (P < .001). This translates into a 26%-31% reduction of cancer-related patient visits per half month after the lockdown at the ED (P < .001 vs. 2018 + 2019). There was no difference in the distribution of ESI scores at ED presentation (P = .805), admission rates or 3-MM in association with lockdown implementation (P = .086). CONCLUSION: We demonstrate the feasibility of maintaining antineoplastic therapy administration during the COVID-19 pandemic. However, our data underline the need for adapted management strategies for emergency presentations of cancer patients.


Subject(s)
Ambulatory Care/trends , COVID-19/prevention & control , Cancer Care Facilities , Emergency Service, Hospital/trends , Mortality/trends , Neoplasms/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Austria , Communicable Disease Control , Female , Humans , Male , Middle Aged , Public Policy , SARS-CoV-2 , Young Adult
16.
Cancer Control ; 28: 10732748211017166, 2021.
Article in English | MEDLINE | ID: covidwho-1247532

ABSTRACT

BACKGROUND: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care. METHODS: As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease. CONCLUSIONS: The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.


Subject(s)
COVID-19/prevention & control , Cancer Care Facilities , Disease Transmission, Infectious/prevention & control , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Disease Transmission, Infectious/statistics & numerical data , Humans , Incidence , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Medical Oncology , SARS-CoV-2/isolation & purification
17.
BMC Cancer ; 21(1): 578, 2021 May 20.
Article in English | MEDLINE | ID: covidwho-1238711

ABSTRACT

BACKGROUND: The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is an important matter in daily practice. METHODS: ONCOSARS-1 was a single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were prospectively included. All patients (n = 363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the first peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to retrospectively determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients. RESULTS: Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P < 0.001). This association remained significant (odds ratio (OR) 4.1, P = 0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P < 0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients. CONCLUSION: Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Neoplasms/therapy , Aged , Ambulatory Care/statistics & numerical data , Belgium/epidemiology , COVID-19/complications , Cancer Care Facilities , Cohort Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Neoplasms/epidemiology , Risk Factors , SARS-CoV-2
18.
Cancer Rep (Hoboken) ; 5(2): e1426, 2022 02.
Article in English | MEDLINE | ID: covidwho-1237412

ABSTRACT

BACKGROUND: Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis. AIM: This study described the factors contributing to treatment delays during the pandemic and their impact on disease progression. MATERIALS AND RESULTS: This retrospective cohort study was done in St. Luke's Medical Center, a private tertiary healthcare institution based in Metro Manila, Philippines, composed of two facilities in Quezon City and Global City. Patients with solid malignancy with ongoing systemic cancer treatment prior to the peak of the pandemic were identified. Clinical characteristics and treatment data were compared between those with delayed and continued treatments. Multivariate analysis was done to determine factors for treatment delays and association of delays with disease progression and Covid-19 infection. Of the 111 patients, 33% experienced treatment delays and 67% continued treatment during the pandemic. There was a higher percentage of patients on palliative intent who underwent treatment delay, and 64% of delays were due to logistic difficulties. Treatment delays were significantly associated with disease progression (p < .0001). There was no evidence of association between delay or continuation of treatment and risk of Covid-19 infection. CONCLUSIONS: There was no difference in Covid-19 infection between those who delayed and continued treatment during the pandemic; however, treatment delays were associated with a higher incidence of disease progression. Our findings suggest that the risks of cancer progression due to treatment delays exceed the risks of Covid-19 infection in cancer patients implying that beneficial treatment should not be delayed as much as possible. Logistic hindrances were also identified as the most common cause of treatment delay among Filipino patients, suggesting that efforts should be focused into assistance programs that will mitigate these barriers to ensure continuity of cancer care services during the pandemic.


Subject(s)
Antineoplastic Agents/therapeutic use , COVID-19/epidemiology , Neoplasms/drug therapy , Time-to-Treatment/statistics & numerical data , Adult , Aged , COVID-19/immunology , COVID-19/prevention & control , COVID-19/transmission , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Disease Progression , Female , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/immunology , Pandemics/prevention & control , Philippines/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
19.
BJU Int ; 128(6): 752-758, 2021 12.
Article in English | MEDLINE | ID: covidwho-1219502

ABSTRACT

OBJECTIVE: To analyse the impact of the COVID-19 pandemic on a centralized specialist kidney cancer care pathway. MATERIALS AND METHODS: We conducted a retrospective analysis of patient and pathway characteristics including prioritization strategies at the Specialist Centre for Kidney Cancer located at the Royal Free London NHS Foundation Trust (RFH) before and during the surge of COVID-19. RESULTS: On 18 March 2020 all elective surgery was halted at RFH to redeploy resources and staff for the COVID-19 surge. Prioritizing of patients according to European Association of Urology guidance was introduced. Clinics and the specialist multidisciplinary team (SMDT) meetings were maintained with physical distancing, kidney surgery was moved to a COVID-protected site, and infection prevention measurements were enforced. During the 7 weeks of lockdown (23 March to 10 May 2020), 234 cases were discussed at the SMDT meetings, 53% compared to the 446 cases discussed in the 7 weeks pre-lockdown. The reduction in referrals was more pronounced for small and asymptomatic renal masses. Of 62 low-priority cancer patients, 27 (43.5%) were deferred. Only one (4%) COVID-19 infection occurred postoperatively, and the patient made a full recovery. No increase in clinical or pathological upstaging could be detected in patients who underwent deferred surgery compared to pre-COVID practice. CONCLUSION: The first surge of the COVID-19 pandemic severely impacted diagnosis, referral and treatment of kidney cancer at a tertiary referral centre. With a policy of prioritization and COVID-protected pathways, capacity for time-sensitive oncological interventions was maintained and no immediate clinical harm was observed.


Subject(s)
COVID-19/prevention & control , Carcinoma, Renal Cell/therapy , Kidney Neoplasms/therapy , Patient Care Team/statistics & numerical data , Referral and Consultation/statistics & numerical data , COVID-19/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/statistics & numerical data , Carcinoma, Renal Cell/pathology , Disease Progression , Hospitals, High-Volume/statistics & numerical data , Humans , Kidney Neoplasms/pathology , Neoplasm Staging , Nephrectomy/statistics & numerical data , Patient Selection , Retrospective Studies , Tertiary Care Centers/organization & administration , Tertiary Care Centers/statistics & numerical data , Time-to-Treatment , Watchful Waiting/statistics & numerical data
20.
Gynecol Oncol ; 162(1): 12-17, 2021 07.
Article in English | MEDLINE | ID: covidwho-1213578

ABSTRACT

OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.


Subject(s)
Elective Surgical Procedures/statistics & numerical data , Genital Neoplasms, Female/surgery , Hospitals, Private/statistics & numerical data , Hospitals, Public/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Canada/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/standards , Female , Genital Neoplasms, Female/diagnosis , Gynecologic Surgical Procedures/statistics & numerical data , Gynecology/economics , Gynecology/organization & administration , Gynecology/standards , Gynecology/statistics & numerical data , Hospitals, Private/economics , Hospitals, Private/organization & administration , Hospitals, Private/standards , Hospitals, Public/economics , Hospitals, Public/organization & administration , Hospitals, Public/standards , Humans , Medical Oncology/economics , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Middle Aged , Pandemics/prevention & control , Retrospective Studies , Tertiary Care Centers/economics , Tertiary Care Centers/organization & administration , Tertiary Care Centers/standards , Tertiary Care Centers/statistics & numerical data , Time Factors , Triage/statistics & numerical data , United States/epidemiology , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL