Evidence-based recommendations for gastrointestinal cancers during the COVID-19 pandemic by the Brazilian Gastrointestinal Tumours Group

Abstract

As of 2020, the world is facing the great challenge of the COVID-19 (Coronavirus disease 2019) pandemic, caused by the SARS-CoV-2 virus. While the overall mortality is low, the virus is highly virulent and may infect millions of people worldwide. This will consequently burden health systems, particularly by those individuals considered to be at high risk of severe complications from COVID-19. Such risk factors include advanced age, cardiovascular and pulmonary diseases, diabetes and cancer. However, few data on the outcomes of cancer patients infected by SARS CoV-2 exist. Therefore, there is a lack of guidance on how to manage cancer patients during the pandemic. We sought to propose specific recommendations about the management of patients with gastrointestinal malignancies. Methods: The Brazilian Gastrointestinal Tumours Group board of directors and members sought up-to-date scientific literature on each tumour type and discussed all recommendations by virtual meetings to provide evidence-based-and sometimes, expert opinion-recommendation statements. Our objectives were to recommend evidence-based approaches to both treat and minimise the risk of COVID-19 for cancer patients, and simultaneously propose how to decrease the use of hospital resources at a time these resources need to be available to treat COVID-19 patients.

Coronavirus disease 2019 in patients with neuroendocrine neoplasms: Preliminary results of the INTENSIVE study

“…We searched PubMed on April 05, 2021, using the search terms (“novel coronavirus” OR “SARS-CoV2” OR “COVID-19”) AND (“neuroendocrine tumors” OR “neuroendocrine tumours” OR “neuroendocrine neoplasms” OR “neuroendocrine carcinomas” OR “carcinoids”) for articles in English that documented the COVID-19 in patients with NENs. Sixteen articles appeared, including three case reports, 12 recommendations or consensus statements and one only mini-series of four cases among a large thoracic cancers series 19 , 22 , 23 , 24 17 , 18 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 .…”

Professional Assessment of the Impact of COVID-19 on Handling NET Patients

“…There are several general recommendations from cancer societies and loco-regional reports [8][9][10], but hardly any published primary data or practical guidelines for diagnostics and therapies of NET in the era of COVID-19. The first NET-specific guideline was published 4 months after the pandemic had started and was not yet available at the time this survey was conducted [11].…”

COVID-19: Gastrointestinal manifestations, liver injury and recommendations

“…The COVID-19 pandemic negatively affected diagnosis and treatments of other patients with various diseases, including GI system cancer. Brazilian Gastrointestinal Tumors Group published evidence-based recommendations for GI cancers during the COVID-19 pandemic[ 116 ].…”

“…However, some recommendations performed an expert opinion. There are detailed recommendations and aimed to prioritize curative-intent cancer treatments during the pandemic, to support the treatment of aggressive tumors when effective therapies are available, to decrease the number of or delay oncological non-priority surgeries, to decrease hospital visits, to minimize anticancer therapy-related immunosuppression in a specific high-risk group[ 116 ]. Recommendations related to GI cancers are showed in Table 3 .…”