Impact of the COVID-19 pandemic on patients suffering from musculoskeletal tumours

Abstract

Background The aim of the current study was to evaluate the impact of the coronavirus disease (COVID-19) pandemic on musculoskeletal tumor service by conducting an online survey of physicians. Methods The survey was conducted among the members of the ISOLS (International Society of Limb Salvage) and the EMSOS (European Musculo-Skeletal Oncology Society). The survey consisted of 20 questions (single, multiple-response, ranked): origin and surgical experience of the participant (four questions), potential disruption of healthcare (12 questions), and influence of the COVID-19 pandemic on the particular physician (four questions). A matrix with four different response options was created for the particular surgical procedures). Results One hundred forty-nine physicians from five continents completed the survey. Of the respondents, 20.1% and 20.7% stated that surgery for life-threatening sarcomas were stopped or delayed, respectively. Even when the malignancy was expected to involve infiltration of a neurovascular bundle or fracture of a bone, still 13.8% and 14.7% of the respondents, respectively, stated that surgery was not performed. In cases of pending fractures of bone tumors, 37.5 to 46.2% of operations were canceled. Conclusion The SARS-CoV-2 pandemic caused a significant reduction in healthcare (surgery, radiotherapy, chemotherapy) for malignancies of the musculoskeletal system. Delaying or stopping these treatments is life-threatening or can cause severe morbidity, pain, and loss of function. Although the coronavirus disease causes severe medical complications, serious collateral damage including death due to delayed or untreated sarcomas should be avoided.

Health-Related Quality of Life and Experiences of Sarcoma Patients during the COVID-19 Pandemic

“…Treatment interruptions (postponement or cessation) were uncommon for patients in our study, however, these decisions were understandably perceived with uncertainty among some patients undergoing palliative treatment. An international survey of 149 physicians across five continents also reported reductions in all treatments including surgery, radiotherapy and chemotherapy for patients with musculoskeletal tumours [24]. Notably, palliative chemotherapy and radiotherapy were stopped or delayed in 20% and 17% of cases, respectively [24].…”

“…An international survey of 149 physicians across five continents also reported reductions in all treatments including surgery, radiotherapy and chemotherapy for patients with musculoskeletal tumours [24]. Notably, palliative chemotherapy and radiotherapy were stopped or delayed in 20% and 17% of cases, respectively [24]. While the authors concluded that significant harm (pain, morbidity, loss of function) could be caused by delays to care for musculoskeletal tumours such as sarcomas, the true impact in terms of reduction in COVID-19 risk compared to cancer outcome is unknown [24].…”

“…Notably, palliative chemotherapy and radiotherapy were stopped or delayed in 20% and 17% of cases, respectively [24]. While the authors concluded that significant harm (pain, morbidity, loss of function) could be caused by delays to care for musculoskeletal tumours such as sarcomas, the true impact in terms of reduction in COVID-19 risk compared to cancer outcome is unknown [24]. Importantly, in our study, the vast majority of patients themselves reported the decision to delay care within the pandemic was a good decision.…”

Changes in Healthcare Utilization, Spending, and Perceived Health during COVID–19: A Longitudinal Study from Singapore

“…We used a difference-in-differences (DID) method by comparing monthly changes to estimate the associations of the COVID-19 outbreak with individuals' healthcare use and spending, and perceived health status between the 2019 to 2020 season and the 2018 to 2019 season ("two seasons" hereafter). Specifically, we estimated equation 1 [28,29] and perceived health status [30][31][32] in the midst of the pandemic. To extend the literature, we provide comprehensive evidence on the changes in healthcare utilization, healthcare spending, and perceived health status during the COVID-19 pandemic using the individuallevel panel data.…”

Reaching a new ‘normal’ after COVID pandemic and orthopaedic implications

“…This perspective is supplemented by other Italian contributions from Grassi et al, detailing 'The Covid-19 outbreak' [3] as well as 'The chronic of a silent war' by Benazzo and coll [4]. Orthopaedic oncologist Martin Thaler from Austria relays vital information in his paper on the 'Impact of the COVID-19 Pandemic on Patients Suffering from Musculoskeletal Tumours [5].…”