Two months of Radiation Oncology in the heart of Italian “red zone” during COVID-19 pandemic: paving a safe path over thin ice.

Buglione, Michela; Spiazzi, L.; Guerini, Andrea Emanuele; Barbera, Fernando; Pasinetti, Nadia; Pegurri, Ludovica; Triggiani, Luca; Tomasini, Davide; Greco, Diana; Costantino, Gianluca; Bragaglio, Alessandra; Bonometti, Nadia; Liccioli, Mara; Mascaro, Lorella; Staff, Radiation Oncology Department; Alongi, Filippo; Magrini, Stefano Maria

doi:10.21203/rs.3.rs-34725/v2

Cited by 1 publication

(5 citation statements)

References 34 publications

(52 reference statements)

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“…The results from our experience during the first wave, 13 consistently with reports from other centers, 17,18 confirmed the feasibility of continuing radiation oncology activity through adequate selection of patients and targeted preventive measures. The endorsement of systematic NPS screening for SARS-CoV-2 likely contributed to a further reduction in COVID-19 incidence and to a remarkable reduction of severe presentations and mortality.…”

Section: Discussionsupporting

confidence: 85%

“…11,12 Conversely, through complete reorganization of the workflow and the adoption of dedicated measures, the activity of our Department faced only a slight reduction. 13 Mortality among patients with COVID-19 on active anticancer treatment at our institution was relatively high, as reported in a previous article. 14 The large majority of infections and deaths was reported during the first week, when the entity of COVID-19 was largely underestimated and thus preventive measures were suboptimal, especially outside of the hospital.…”

Section: Introductionsupporting

confidence: 74%

“…Although the majority of SARS-CoV-2 infections were detected at the first test (10/16 [62.5%]), almost half of the positive cases were identified at sequential procedures (3 patients [18.8%] at second NPS and 1 [6.3%] each at third, fifth, and up to the seventh test performed in a previously negative patient). Characteristics of COVID-19–positive patients enrolled in this analysis and (for comparison) in our previous experience during the first COVID-19 outbreak 13 are summarized in the Table. Of the 16 patients with a positive NPS, 13 (81.3%) were asymptomatic, 2 (12.5%) had mild disease (fever and diarrhea), and 1 (6.3%) severe disease that led to death 63 days after diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…All the healthcare staff underwent RT-PCR on a three-weekly basis. Our experience during the first 2 months of the first COVID-19 outbreak has been recently published 13 : on that occasion, NPS were performed only in presence of suspect symptoms or high-risk contacts. We report here the results of the intensive testing applied during the second wave of the outbreak and the differences observed versus the previous strategy.…”

Section: Methodsmentioning

confidence: 99%

“…14 The large majority of infections and deaths was reported during the first week, when the entity of COVID-19 was largely underestimated and thus preventive measures were suboptimal, especially outside of the hospital. 13 The systematic deployment of personal protective equipment (PPE) and the institution of targeted triage and clinical monitoring was effective in reducing COVID-19 incidence. Nevertheless, the shortage of supplies did not allow universal screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus hindering the detection of a large number of asymptomatic infections, the main source of the outbreak spread.…”

Section: Introductionmentioning

confidence: 99%

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Universal testing for COVID-19 in patients undergoing cancer treatment during the second outbreak in Brescia

Magrini

Guerini

Borghetti

et al. 2021

Tumori

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Background: The impact of coronavirus disease 2019 (COVID-19) has been overwhelming on patients with cancer, who may be at higher risk of developing severe disease. During the second COVID-19 outbreak in Italy, we planned universal microbiologic screening for patients scheduled for antineoplastic treatment. Methods: All patients with planned active treatment at Brescia University Radiation Oncology Department were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA with repeated nasopharyngeal swabs (NPS) from October 31, 2020. Treatment continuation, suspension, or delay was modulated for patients testing positive according to clinical presentation. Results: From October 31, 2020, to February 6, 2021, 636 patients were enrolled and 1243 NPS were performed, of which 28 (2.25%) were positive. The infection rate was 2.52%; 81.3% of the patients with a positive NPS were asymptomatic, 2 had mild disease, and 1 severe disease that led to death. All patients already on treatment with mild or asymptomatic COVID-19 carried on the therapy with no or minimal delay. Median delay for patients with infection detected before treatment start was 16.5 days. Conclusions: Detected incidence of COVID-19 was lower during the second outbreak in our patients (2.52% vs 3.23%), despite the extensive testing schedule, and substantiates the high rate of asymptomatic infections and the low mortality among patients with COVID-19 (6.3% vs 38.5% during the first outbreak). Universal SARS-CoV-2 screening for all patients with planned treatment might allow early identification of patients with COVID-19, resulting in timely management that could improve clinical outcomes and prevent spread of the infection.

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Section: Discussionsupporting

confidence: 85%