Practical recommendations for the management of patients with gastroenteropancreatic and thoracic (carcinoid) neuroendocrine neoplasms in the COVID-19 era

Rodríguez-Freixinós, Víctor; Capdevila, Jaume; Pavel, Marianne; Thawer, Alia; Baudin, Éric; O’Toole, Dermot; Herrmann, Ken; Welin, Staffan; Grozinsky‐Glasberg, Simona; Herder, Wouter W. de; Valle, Juan W.; Herman, Jackie; Kolarova, Teodora; Bouvier, Catherine; Falconi, Massimo; Ferone, Diego; Singh, Simron

doi:10.1016/j.ejca.2020.11.037

Cited by 13 publications

(21 citation statements)

References 38 publications

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“…However, currently there is no available data regarding the risk of infection, disease status and complications of NEN patients during the COVID-19 pandemic, although several consensus papers have been published reporting some general recommendations 17 , 18 , 19 , 20 , 21 .…”

Section: Introductionmentioning

confidence: 99%

“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

Fazio

Halfdanarson

Salvia

et al. 2021

European Journal of Cancer

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Background Specific data regarding COVID-19 in patients with neuroendocrine neoplasms (NEN) are lacking. This aim of this study is to describe the characteristics of NEN patients who tested SARS-CoV-2 positive. Material and methods This is a worldwide study collecting cases of NEN patients with a positive nasopharyngeal swab RT-PCR for SARS-CoV-2 between June 1, 2020, and March 31, 2021. Centers treating NEN patients were directly contacted by the principal investigator. Patients with NEN of any primary site, grade, and stage were included, excluding small-cell lung carcinoma and mixed adeno-neuroendocrine carcinoma. Results Among 81 centers directly contacted 88.8% responded and 48.6% of them declined due to lack of cases or interest. On March 31 st , 2021, eight recruiting centers enrolled 89 patients. Median age was 64 years at the COVID-19 diagnosis. Most patients had metastatic, non-functioning, low/intermediate grade gastro-entero-pancreatic (GEP) NEN, on treatment with somatostatin analogs (SSA) and radioligand therapy (RLT). Most of them had comorbidities. Only 8% of patients had high grade NEN and 12% were receiving chemotherapy. Most patients had symptoms or signs of COVID-19, mainly fever and cough. Only 3 patients underwent sub-intensive treatment, whereas the majority received medical therapies, mostly antibiotics. In two third of cases, no changes occurred for the anti-NEN therapy. More than 80% of patients completely recovered without sequelae whereas 7.8% patients died due to COVID-19. Conclusions Patients included in this study reflect the typical NEN population regardless of SARS-CoV-2. In the majority of cases they overcome COVID-19 without need of intensive care, short-term sequelae and discontinuation of systemic oncological therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Fazio

Halfdanarson

Salvia

et al. 2021

European Journal of Cancer

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“…Regarding cancer care, experts have suggested potential modifications while preserving standards of care for patients with neuroendocrine neoplasia (NEN) during the COVID-19 era. 15 An example of such modification includes the utilization of telemedicine to facilitate continued multidisciplinary care and social distancing. 15 Another example is the consideration of deescalation of care, when appropriate, to minimize the risk of exposure and reduce the impact on the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Carcinoid Heart Disease and Subsequent Modified Healthcare Delivery in the COVID-19 Era

Willauer

Hajjar

Estes

et al. 2022

CASE

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“…A proactive functional control was recommended to avoid hospitalisation of patients with functional syndromes focusing on virtual or home assistance of the patients with adjustment of somatostatin analogues doses if necessary. Regarding PRRT specifically, the recommendation was made to consider COVID-19 testing of all patients before starting treatment and again after starting treatment when an infection is suspected ( 40 ).…”

Section: Impact On Diagnostic and Therapeutic Activitymentioning

confidence: 99%

“…Clinicians should nevertheless consider the possible consequences of postponing PRRT against the possible risk of a patient acquiring SARS-CoV-2 infection during radionuclide therapy(41). Delaying PRRT or modifying the timing or scheme of the treatment should be individually weighed against the possible risk of infection but may be considered in selected patients, for example, those presenting with grade III-IV neutropenia or lymphopenia or those with slow or no progression before treatment, low tumour burden and non-functional disease ( 40 ). Particular attention should be paid to the prevalence of COVID-19 in the geographical area in which patients reside, as well as the comorbidities of the patients who will undergo radionuclide therapy, focusing mainly on the possibility of pulmonary and renal complications ( 42 ).…”

Section: Impact On Diagnostic and Therapeutic Activitymentioning

confidence: 99%

The Impact of COVID-19 on Nuclear Medicine in Europe

Kirienko

Telo

Hustinx

et al. 2022

Seminars in Nuclear Medicine

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The COVID-19 pandemic has profoundly changed hospital activities, including nuclear medicine (NM) practice. This review aimed to determine and describe the impact of COVID-19 on NM in Europe and critically discuss actions and strategies applied to face the pandemic. A literature search for relevant articles was performed on PubMed, covering COVID-19 studies published up until January 21, 2021. The findings were summarized according to general and specific activities within the NM departments. The pandemic strongly challenged NM departments: a reduction in the workforce has been experienced in almost every centre in Europe due to personnel diagnosed with COVID-19 and other reasons related to the coronavirus. NM departments introduced procedures to limit COVID-19 transmission, including environmental and personal hygiene, social distancing, rescheduling of non–high-priority procedures, the correct use of personal protective equipment, and prompt identification of suspect COVID-19 cases. A proportion of the departments experienced a delay in radiopharmaceuticals supply or technical assistance during the pandemic. Furthermore, the pandemic resulted in a significant reduction of diagnostic and therapeutic NM procedures, as well as a reduced level of care for patients affected by diseases other than COVID-19, such as cancer or acute cardiovascular disease. Telemedicine services have been set up to maintain medical assistance for patients. COVID-19 pandemic has reshaped human work resources, patient's diagnostic and therapeutic management, operative models, radiopharmaceutical supplies, teaching, training and research of NM departments. Limits of availability of resources emerged. Nonetheless, we have to provide continuity in care, especially for fragile patients, maintaining infection control measures. Challenges that have been faced should reshape our vision and get us prepared for the future.

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Practical recommendations for the management of patients with gastroenteropancreatic and thoracic (carcinoid) neuroendocrine neoplasms in the COVID-19 era

Cited by 13 publications

References 38 publications

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

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

Delayed Presentation of Carcinoid Heart Disease and Subsequent Modified Healthcare Delivery in the COVID-19 Era

The Impact of COVID-19 on Nuclear Medicine in Europe

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