Valenza Franco, Papagni Gabriele, Marchianò Alfonso, Daidone Maria Grazia, DeBraud Filippo, Colombo Mario Paolo, Frignani Andrea, Galmozzi Gustavo, Ladisa Vito, Pruneri Giancarlo, Salvioni Roberto, Spada Pierangelo, Torresani Michele, Rinaldi Oliviero, Manfredi Stefano, Votta Marco, Apolone Giovanni
Department of Anesthesia and Critical Care, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy.
Department of Oncology and Oncohematology, University of Milan, Milan, Italy.
Tumori. 2020 May 4:300891620923790. doi: 10.1177/0300891620923790.
The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degrees of respiratory failure, actions to preserve aliquots of the healthcare system to guarantee treatment to patients are mandatory.
In order to protect the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano from the spread of COVID-19, a number of to-hospital and within-hospital filters were applied. Among others, a triage process to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in patients with cancer was developed consisting of high-resolution low-dose computed tomography (CT) scan followed by reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 in nose-throat swabs whenever CT was suggestive of lung infection. To serve symptomatic patients who were already admitted to the hospital or in need of hospitalization while waiting for RT-PCR laboratory confirmation of infection, a COVID-19 surveillance zone was set up.
A total of 301 patients were screened between March 6 and April 3, 2020. Of these, 47 were hospitalized, 53 needed a differential diagnosis to continue with their cancer treatment, and 201 were about to undergo surgery. RT-PCR was positive in 13 of 40 hospitalized patients (32%), 14 of 52 day hospital patients (27%), and 6 of 201 surgical patients (3%).
Applying filters to protect our comprehensive cancer center from COVID-19 spread contributed to guaranteeing cancer care during the COVID-19 crisis in Milan. A surveillance area and surgical triage allowed us to protect the hospital from as many as 33 patients infected with SARS-CoV-2.
冠状病毒病（COVID-19）的迅速传播正在影响许多国家。医疗系统需要应对治疗大量不同程度呼吸衰竭患者的需求，同时必须采取行动保留医疗系统的部分资源以确保为患者提供治疗。
为保护米兰国立肿瘤研究所基金会（Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano）免受COVID-19传播的影响，采用了一系列院外和院内筛查措施。其中，制定了一个对癌症患者进行严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性检测的分诊流程，包括高分辨率低剂量计算机断层扫描（CT），然后在CT提示肺部感染时，对鼻咽拭子进行SARS-CoV-2逆转录聚合酶链反应（RT-PCR）检测。为了服务那些已经入院或需要住院治疗、同时等待RT-PCR实验室确认感染的有症状患者，设立了一个COVID-19监测区。
在2020年3月6日至4月3日期间，共筛查了301名患者。其中，47名患者住院，53名患者需要进行鉴别诊断以继续癌症治疗，201名患者即将接受手术。40名住院患者中有13名RT-PCR呈阳性（32%），52名日间医院患者中有14名（27%），201名手术患者中有6名（3%）。
应用筛查措施保护我们的综合癌症中心免受COVID-19传播，有助于在米兰的COVID-19危机期间保证癌症护理。一个监测区域和手术分诊使我们能够保护医院免受多达33名感染SARS-CoV-2患者的影响。
