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The coronavirus disease 2019 reported in Wuhan, China, in December 2019, has expanded in Japan, and has had a signi cant impact on patient consultation behavior and medical treatment. In particular, cancer patients are more susceptible to infections because of the immunosuppressive state caused by both surgery and anticancer treatments. Therefore, discontinuation, postponement, or change of the regimen of postoperative adjuvant chemotherapy is being considered. Thus, we investigated how the outbreak of COVID-19 actually affects the implementation of adjuvant chemotherapy in our hospital. We retrospectively investigated patients undergoing surgery for colorectal cancer, and compared the result for one year before and after January 2020, when COVID-19 initially occurred in Tokyo. As a result, there was a negative correlation between the ratio of surgeries for colorectal cancer to the number of hospitalized patients at the surgical department and the infection status of COVID-19 in Tokyo (r = -0.431), However, there was no signi cant difference in the number of patients classi ed as High risk Stage II or Stage III for postoperative diagnosis before and after the outbreak (P = 0.882). Although some patients were concerned about the risk of infection, there was no change in the rate of adjuvant chemotherapy (P = 0.321) and its regimen (P = 0.678) before and after the outbreak. Based on this survey, despite the absence of suf cient evidence for treatment under the COVID-19 epidemic, these ndings suggest that adjuvant chemotherapy could be performed as usual by ensuring risk management such as securing beds and manpower.

At Tokyoʼs Ebara Hospital, infectious disease physicians have led interventions among patients with positive blood cultures. However, pharmacists began to lead such interventions from April 2020 triggered by the coronavirus disease 2019 (COVID-19) pandemic and the reduction in the number of infectious disease physicians. Therefore, this study aims to compare the effects of physician-led and pharmacist-led interventions among patients with positive blood cultures. We divided the study period into a physician-led period (April 2019 to October 2019) and pharmacist-led period (April 2020 to October 2020). We retrospectively investigated the patientsʼ characteristics, number of blood cultures, blood culture positivity rates, sources of infections, and the types of bacteria detected. We set the primary endpoints as a 30-day mortality and in-hospital mortality, and the secondary endpoint as days of therapy (DOT) per 1,000 patients with broad-spectrum antimicrobial agents, anti-MRSA agents, and all intravenous antimicrobial agents. During the study period, 68 and 63 patients received interventions during the physician-led and pharmacist-led periods, respectively. During the pharmacist-led period, malignancies and blood culture positivity rates were found to be high in patients, and the number of DOT with anti-MRSA agents increased. However, no signi cant differences were observed in the 30-day mortality and in-hospital mortality. The study results demonstrated that pharmacist-led interventions may not be signi cantly different from physician-led interventions implemented among patients with positive blood cultures. However, as the study was conducted under the special situation of the COVID-19 pandemic, the effect of these conditions must be considered.