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COVID-19 pandemic: Impact on the management of patients with hepatocellular carcinoma at a tertiary care hospital.
Pomej, Katharina; Scheiner, Bernhard; Hartl, Lukas; Balcar, Lorenz; Meischl, Tobias; Mandorfer, Mattias; Reiberger, Thomas; Müller, Christian; Trauner, Michael; Pinter, Matthias.
  • Pomej K; Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
  • Scheiner B; Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria.
  • Hartl L; Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
  • Balcar L; Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria.
  • Meischl T; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria.
  • Mandorfer M; Rare Liver Disease (RALID) Centre of the ERN RARE-LIVER, Medical University of Vienna, Vienna, Austria.
  • Reiberger T; Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria.
  • Müller C; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria.
  • Trauner M; Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria.
  • Pinter M; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria.
PLoS One ; 16(8): e0256544, 2021.
Article in English | MEDLINE | ID: covidwho-1374151
ABSTRACT

BACKGROUND:

Patients with hepatocellular carcinoma (HCC) represent a vulnerable population potentially negatively affected by COVID-19-associated reallocation of healthcare resources. Here, we report the impact of COVID-19 on the management of HCC patients in a large tertiary care hospital.

METHODS:

We retrospectively analyzed clinical data of HCC patients who presented at the Vienna General Hospital, between 01/DEC/2019 and 30/JUN/2020. We compared patient care before (period 1) and after (period 2) implementation of COVID-19-associated healthcare restrictions on 16/MAR/2020.

RESULTS:

Of 126 patients, majority was male (n = 104, 83%) with a mean age of 66±11 years. Half of patients (n = 57, 45%) had impaired liver function (Child-Pugh stage B/C) and 91 (72%) had intermediate-advanced stage HCC (BCLC B-D). New treatment, was initiated in 68 (54%) patients. Number of new HCC diagnoses did not differ between the two periods (n = 14 vs. 14). While personal visits were reduced, an increase in teleconsultation was observed (period 2). Number of patients with visit delays (n = 31 (30%) vs. n = 10 (10%); p = 0.001) and imaging delays (n = 25 (25%) vs. n = 7 (7%); p = 0.001) was higher in period 2. Accordingly, a reduced number of patients was discussed in interdisciplinary tumor boards (lowest number in April (n = 24), compared to a median number of 57 patients during period 1). Median number of elective/non-elective admissions was not different between the periods. One patient contracted COVID-19 with lethal outcome.

CONCLUSIONS:

Changes in patient care included reduced personal contacts but increased telephone visits, and delays in diagnostic procedures. The effects on long-term outcome need to be determined.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Carcinoma, Hepatocellular / COVID-19 / Liver Neoplasms Type of study: Diagnostic study / Observational study / Qualitative research / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0256544

Full text: Available Collection: International databases Database: MEDLINE Main subject: Carcinoma, Hepatocellular / COVID-19 / Liver Neoplasms Type of study: Diagnostic study / Observational study / Qualitative research / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0256544