Delay in head and neck cancer care during the COVID-19 pandemic and its impact on health outcomes
Braz. oral res. (Online)
; 34: e126, 2020. tab
Article
in English
| LILACS, BBO - Dentistry
| ID: biblio-1142611
Responsible library:
BR1.1
ABSTRACT
Abstract The coronavirus disease 2019 (COVID-19) outbreak has created unprecedent challenges for healthcare systems worldwide. Oncology services have been reorganized to decrease the risk of nosocomial acquisition of SARS-CoV-2, but changes in treatment pathways and follow-up cancer care can result in patients receiving suboptimal or delayed care. Herein, we describe a cross-sectional nested cohort study conducted to evaluate delays in care for patients with head and neck cancer (HNC) in post-treatment follow-up or palliative care during the COVID-19 pandemic in Northeast Brazil and its impact on health outcomes. Information was extracted from medical records and supplemented by telephone interviews. We compared the following health outcomes:
self-perception of anxiety or sadness, fear of COVID-19 infection, cancer-related complications during social isolation, self-medication, diagnosis of COVID-19, and death between patients with and without delayed cancer care. The Mann-Whitney U test was used to compare distributions of continuous variables and the Fisher exact test was used for categorical variables. Thirty-one HNC patients were included in the study, and no case of confirmed SARS-CoV-2 was found. Delayed cancer care due to restriction in health services was reported in 58.1% of cases, and there was no report of telemedicine use during the COVID-19 outbreak. Cancer-related complications during the COVID-19 pandemic were described for most patients (67.7%) and included pain or discomfort, swelling, and dyspnea. Eight (25.8%) patients reported use of prescribed morphine or codeine to manage pain and six (19.4%) patients reported self-medication with over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs). We found an association between delayed HNC care and the use of self-medication (p = 0.028). This study indicated that patients with delayed HNC care during the COVID-19 outbreak are more likely to use self-medication with NSAIDs for pain management. Better strategies to follow HNC patients in socioeconomically disadvantaged communities need to be discussed and implemented.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
COVID-19
/
Pneumonia
/
Other Respiratory Diseases
Database:
BBO - Dentistry
/
LILACS
Main subject:
Time-to-Treatment
/
COVID-19
/
Head and Neck Neoplasms
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Braz. oral res. (Online)
Journal subject:
Dentistry
Year:
2020
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Federal de Alagoas/BR
/
Universidade Federal de Sergipe/BR