Evaluation of medical practices in oncology in a context of COVID-19 pandemic in France: Point of view of physicians, PRATICOVID study

Background: The cancer population seems to be more susceptible to COVID-19 infection and have worse outcomes. Front of this pandemic, we had to adapt our patient care to protect our patients without compromising their prognosis related to their cancer. The national PRATICOVID study aims to describe the modification of the medical and surgical patient care for this population, according to the recommendations in this context of pandemic, within our hospitals which are strongly mobilized. Methods: We analyzed data from 9 different institutions, 3 Military Hospitals, 4 Academics Hospital, 2 Private Hospital, from oncologists, surgeons, radiotherapists. The primary endpoint was to assess the prevalence of adapted patient care during pandemic. The secondary endpoints were to describe the point of view of clinicians and patients during and after the pandemic. Results: We analyzed 435 medical care between 9th of March and 30th of April. The median age was 69 years (range, 24-99), 54% was male. 167 patients (38.4%) were newly diagnosed and only 4% were included in a clinical trial. Because of COVID-19 pandemic, 47.6% of the outpatients had modified patient care. The main primary tumor site was breast cancer (22.7%) at a metastatic stage. 24.6% have postponed surgery, or not receive perioperative chemotherapy, 18.4% received hypofractioned schedule and 57% had an adaptive systemic protocol (stopped, oral protocol, spacing between cures). 70% of physicians are used telemedicine. During this period, 67% of the physicians were relaxed to taking care of their patients. 57% of the patients have seen to be relaxed or low worried about the pandemic. However, 71% are worried after the lockdown, because of future patient care, stage at diagnosis, access to clinical trial, our abilities to receive in the same time all the patients. Conclusions: PRATICOVID study is the first to assess modification of patients cares during an epidemic in cancer outpatients. Faces with this unprecedented crisis, physicians were able to adapt their practice in order to protect their patients against the virus and while ensuring the course of patient care. But physicians are worried after de lockdown because of the care pathway’s issues. Clinical trial identification: CNIL;reference number: 2217722v0. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

[Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis]. / Recommandations du Comité Lithiase de l'Association Française d'Urologie pour la prise en charge des calculs urinaires durant la crise sanitaire liée à la pandémie à COVID-19.

For the first time, faced with a crisis with an exceptional magnitude due to the COVID-19 pandemic responsible for saturation of emergency services and intensive care units, the urolithiasis committee of the French Urology Association designed the recommendations for care and treatment of stone-forming patients and their treatment during crisis.