The Impact of COVID-19 Pandemic on Cancer Care in a Tertiary Care Facility

Abstract

Background Coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on health care worldwide. Cancer patients represent a subgroup that is vulnerable and is under high risk. It is, therefore, necessary to analyze factors that predict outcomes in these patients so that they can be triaged accordingly to mitigate the effects of COVID-19 on cancer management. To date, the impact of COVID-19 on cancer patients remain largely unknown.

Methods Data of 291 cancer patients undergoing active treatment from March 23 to August 15, 2020 were retrospectively reviewed; the incidence, demographic and clinical characteristics, treatment, and outcomes of cancer patients infected by COVID-19 were included in the analysis.

Discussion During the index period (March 23–August 15, 2020), 4,494 confirmed cases of COVID-19 were admitted at our institute. In the department of medical oncology out of 578 patients presented to outpatient department, 291 patients were admitted for active treatment. Considering the cancer patients, infection rate was 7.9% (23/291) and mortality 13% (3/23). Median age was 40 years and the majority of patients were male (60%). The most common cancer type was acute lymphoblastic leukemia presented at various stages of treatment. Twenty patients (86.9%) were discharged after full clinical recovery and negative real-time polymerase chain reaction on a nasopharyngeal swab. Anticancer treatment was modified according to the type of cancer under intensive surveillance.

Conclusion Although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during pandemic by endorsing consistent preventive measures, but however should be modified based on the type and prognosis of cancer.

Keywords

anticancer treatment - cancer care - coronavirus - COVID-19 - impact - retrospective study

• References

• 1 Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA 2020; 323 (18) 1775-1776
• 2 Buglione M, Cavagnini R, Di Rosario F. et al. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement. Crit Rev Oncol Hematol 2016; 97: 131-142
• 3 Curigliano G. How to guarantee the best of care to patients with cancer during the COVID-19 epidemic: the Italian experience. Oncologist 2020; 25 (06) 463-467
• 4 Pathak R, Chitkara G, Kulkarni P, Bhattacharyya GS, Gupta S, Bajpai J. Tale of constant adaptation, revision, and change of cancer therapy during the ongoing COVID crisis: adapting to cope and win. Indian J Med Paediatr Oncol 2020; 41: 103-109
• 5 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323 (13) 1239-1242
• 6 Liang W, Guan W, Chen R. et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020; 21 (03) 335-337
• 7 Tata Memorial Centre COVID-19 Working Group, Tata Memorial Centre COVID-19 Working Group comprises the following. The COVID-19 pandemic and the Tata Memorial Centre response. Indian J Cancer 2020; 57 (02) 123-128
• 8 Bansal S, Jagtap V, Bora G. A practical guide to mitigate the response of corona virus pandemic in radiotherapy treatment. Asian Pac J Cancer Care 2020; 5 (01) 153-156
• 9 Ramaswamy A, Nayak L, Roy Moulik N. et al. COVID-19 in cancer patients on active systemic therapy - outcomes from LMIC scenario with an emphasis on need for active treatment. Cancer Med 2020; 9 (23) 8747-8753
• 10 Mehta A, Vasudevan S, Parkash A, Sharma A, Vashist T, Krishna V. COVID-19 mortality in cancer patients: a report from a tertiary cancer centre in India. PeerJ 2021; 9: e10599
• 11 Zhang L, Zhu F, Xie L. et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol 2020; 31 (07) 894-901
• 12 Sharin F, Singh AG, Qayyumi B, Chaturvedi P. A critical review of outcomes of cancer during the COVID-19 pandemic. Indian J Med Paediatr Oncol 2020; 41: 461-467
• 13 Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol 2020; 6 (07) 1108-1110
• 14 Wang D, Hu B, Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323 (11) 1061-1069