COVID-19 risk contagion: Organization and procedures in a South Italy geriatric oncology ward

Abstract

The novel coronavirus disease Sars-Cov-2 (COVID-19) has rapidly spread through the world, since the first cases were registered in the Hubei province of China in December 2019. Its disparate clinical conditions can lead to a severe bilateral interstitial pneumonia, and thus demand intensive care beds, overwhelming the healthcare system in every Nation. The World Health Organization declared the pandemic on March 11, 2020, when the disease spread globally, with Italy being the first nation severely affected in the Western world. Over the first trimester of 2020, the number of new cases affected drastically increased to 3.507.424, with 247.497 deaths [1]. In the first half of March the Italian Government, declared the state of emergency and imposed a national lockdown in order to help the health system to deal with the COVID-19 unprecedented diffusion. Several papers presented the great challenge that oncologists are facing during the COVID-19 pandemic advising about an over 3-fold risk of contagion in the oncologic patients [2]. El-Shakankery et al. reported the experience of the seven comprehensive cancer centers of Cancer Core Europe, a cooperation legal entity that act to maximize coherence and critical mass in oncology [2]. The authors postulated that the vulnerability due to cancer treatments, the unknown effects of delays of tumor resection surgeries or chemotherapy, and the risk related to the current limited availability of intensive care units' beds could severely expose these patients to complications. The authors further highlighted the importance of patients distancing, of delaying non-urgent outpatient visits, and of rationalizing of the oncological surgeries based on urgency of cancer cure. Furthermore, they stressed the importance of deescalating cancer regimens or to integrate them with immunostimulant factors, in order to make hospital operations "pandemic proof [2]". During this unprecedented pandemic outbreak, we would put a spotlight on the group of patients that probably are the frailest and often neglected-older patients with cancer. This topic is still lacking in literature despite the great social and healthcare interest. Older patients with cancer, in fact, presented an exponential contagion risk related to the immunodeficiency state belonging from the cytotoxic chemotherapy and the weakness deriving from to the multiple and

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