Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge

Abstract

Purpose To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). Methods We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. Results The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. Conclusions Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.

Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic

“…Studies from various countries have suggested that thyroid cancer care has been significantly impacted by the COVID-19 pandemic, including reports of reductions in: fine needle aspiration biopsies of thyroid nodules [2,3], outpatient visits [3], thyroid surgery volumes [2], and radioactive iodine ablation [3]. Furthermore, virtual care has been increasingly adopted in thyroid cancer outpatient care [4]. Virtual care may be defined as "any interaction occurring remotely between patients and/or members of their circle of care, through any form of communication or information technology with the aim of facilitating or maximizing the quality and effectiveness of patient care" [5].…”

COVID‑19‑related thyroid conditions (Review)

“…Consequently, physicians must rethink the strategies of approach (51). Most of these patients do not seem at a higher risk of COVID-19 infection but we still need convincing data (52). Risk-benefit analysis in each case will indicate the adequate approach considering the reality of the pandemic period (53).…”

The Impact of COVID-19 on Nuclear Medicine in Europe

“…By contrast, in a study focusing on telemedicine to assist outpatients, Klain et al reported that the 2 referring physicians, 3 residents and 1 nurse who were usually involved in in-ward consultations at the centre they studied, were not reduced in number during the pandemic. Indeed, the teleconsultations implemented during the pandemic involved a significant workload, requiring approximately 30–40 min per teleconsultation, while the meantime for an in-ward consultation was 15–25 min ( 8 ).…”

“…If the attending physician, after a teleconsultation, indicated that a more detailed assessment was necessary, patients were offered an in-ward consultation, at which all measures necessary to prevent the spread of COVID-19 were employed. The authors noticed that using these measures, the number of patients with DTC evaluated during the early months of the pandemic was only 15% less than that evaluated by in-ward examinations in the corresponding months of 2019 ( 8 )…”