Management of patients with cancer during the COVID-19 pandemic: The Italian perspective on the second wave

Abstract

The novel Coronavirus Disease 2019 (COVID-19) pandemic has been an overwhelming challenge for worldwide health systems. Since the beginning of year 2020, COVID-19 has represented a potential harm for cancer patients and has often hindered oncology care. The Collegio Italiano dei Primari Oncologi Medici (CIPOMO) is an Italian association of head physicians in oncology departments, which promotes working and research activities in oncology on a national basis. During the second wave of COVID-19 pandemic, the CIPOMO promoted a national survey aiming to evaluate the impact of COVID-19 on oncologists’ clinical activity and what changes have been made compared with the Italian situation during the first wave of the pandemic. Overall, 138 heads of medical oncology departments participated in this survey: 75 (54%) from the North, 24 (17%) from the Center, and 39 (28%) from the South of Italy and islands. This survey provides an overview of Italian oncologists facing the second wave of COVID-19 pandemic. The lesson learned during the first wave of COVID-19 pandemic has led to a better organization of clinical activities, and regular testing among healthcare practitioners, with better chances to grant patients’ protection. However, the lack of standardized informatic platforms results in serious challenges in replacing frontal visits, often making a concrete reduction of patients’ hospital accesses unfeasible. Oncologists need to keep preserving the continuum of care of patients. Standardization of safety measures, together with the implementation of informatic platforms, can significantly improve oncology pathways during this second wave of COVID-19 pandemic.

Impact of COVID-19 on Head and Neck Cancer Advancement Measured by the Increasing Numbers of Acute Dyspnea Cases. What Can be Improved for the Future?

“…Our results point out that telemedicine was a popular means of providing healthcare during the pandemic, which has also been observed across different healthcare systems [17,22,25]. Patients developing acute, dynamic dyspnea mostly had one telemedical consultation, which led to an immediate referral to the hospital.…”

“…The coronavirus pandemic, and the subsequent need for disease transmission mitigation efforts, signi cantly altered the delivery of cancer care [1,2]. In developed countries, the use of inpatient care and subsequent hospitalization de cit in oncology was estimated to be 7%-35% [19][20][21][22]. All oncological subspecialties in the US experienced signi cant decreases in new patient visits and surgery capacity during COVID-19 [23], with a 25% reduction in newly diagnosed head and neck malignancies [24].…”

“…Comparing the pre-pandemic use of telemedicine to the pandemic period, all the individuals in the COVID-19 cohort in this study, who underwent a telemedical consultation, developed symptoms over a longer period and constituted a minority of all cases in that cohort. Possibly, the lack of standardized IT platforms results in serious challenges in replacing frontal visits, often making a concrete reduction in patients' hospital access unfeasible [22]. Although telemedicine may improve healthcare access, patient preferences, technology-related barriers, and limitations regarding cancer surveillance must be addressed moving forward [25].…”

Impact of the COVID-19 Pandemic on Clinical Pathways for Non-SARS-CoV-2 Related Diseases in the Lazio Region, Italy

“…The COVID-19 pandemic has also led to a better organization of clinical activities and regular testing among healthcare workers, with better chances to grant patients’ protection, underlining the need to develop new protocols for the CPs already available [ 29 , 30 ]. It is notable that a low level of performance were found for the item “Impact on the treatment of patients also SARS-CoV-2 infected in the CPs”, that with a mean score 0.79 ± 0.22, was considered Not Acceptable.…”

Impact of COVID-19 on head and neck cancer advancement measured by the increasing numbers of acute dyspnea cases. What can be improved for the future?

“…The coronavirus pandemic, and the subsequent need for disease transmission mitigation efforts, signi cantly altered the delivery of cancer care [1,2]. In developed countries, the use of inpatient care and subsequent hospitalization de cit in oncology was estimated to be 7%-35% [19][20][21][22]. All oncological subspecialties in the US experienced signi cant decreases in new patient visits and surgery capacity during COVID-19 [23], with a 25% reduction in newly diagnosed head and neck malignancies [24].…”