de Marinis Filippo, Attili Ilaria, Morganti Stefania, Stati Valeria, Spitaleri Gianluca, Gianoncelli Letizia, Del Signore Ester, Catania Chiara, Rampinelli Cristiano, Omodeo Salè Emanuela, Spaggiari Lorenzo, Mastrilli Fabrizio, Passaro Antonio
Division of Thoracic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Division of Early Drug Development for Innovative Therapies, IEO European Institute of Oncology IRCCS, Milan, Italy.
Front Oncol. 2020 Apr 22;10:665. doi: 10.3389/fonc.2020.00665. eCollection 2020.
A novel coronavirus causing severe acute respiratory syndrome (SARS), named SARS-CoV-2, was identified at the end of 2019. The spread of coronavirus disease 2019 (COVID-19) has progressively expanded from China, involving several countries throughout the world, leading to the classification of the disease as a pandemic by the World Health Organization (WHO). According to published reports, COVID-19 severity and mortality are higher in elderly patients and those with active comorbidities. In particular, lung cancer patients were reported to be at high risk of pulmonary complications related to SARS-CoV2 infection. Therefore, the management of cancer care during the COVID-19 pandemic is a crucial issue, to which national and international oncology organizations have replied with recommendations concerning patients receiving anticancer treatments, delaying follow-up visits and limiting caregiver admission to the hospitals. In this historical moment, medical oncologists are required to consider the possibility to delay active treatment administration based on a case-by-case risk/benefit evaluation. Potential risks associated with COVID-19 infection should be considered, considering tumor histology and natural course, disease setting, clinical conditions, and disease burden, together with the expected benefit, toxicities (e.g., myelosuppression or interstitial lung disease), and response obtained from the planned or ongoing treatment. In this study, we report the results of proactive measures including social media, telemedicine, and telephone triage for screening patients with lung cancer during the COVID-19 outbreak in the European Institute of Oncology (Milan, Italy). Proactive management and containment measures, applied in a structured and daily way, has significantly aided the identification of advance patients with suspected symptoms related to COVID-19, limiting their admission to our cancer center; we have thus been more able to protect other patients from possible contamination and at the same time guarantee to the suspected patients the immediate treatment and evaluation in referral hospitals for COVID-19.
2019年末，一种导致严重急性呼吸综合征（SARS）的新型冠状病毒被确定，名为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。2019冠状病毒病（COVID-19）的传播已从中国逐渐蔓延，波及全球多个国家，导致世界卫生组织（WHO）将该疾病列为大流行病。根据已发表的报告，老年患者和患有活动性合并症的患者中，COVID-19的严重程度和死亡率更高。特别是，据报道肺癌患者感染SARS-CoV-2相关肺部并发症的风险很高。因此，在COVID-19大流行期间癌症护理的管理是一个关键问题，国家和国际肿瘤学组织已针对接受抗癌治疗的患者、推迟随访以及限制护理人员入院等问题给出了建议。在这个历史时刻，医学肿瘤学家需要根据具体情况的风险/获益评估来考虑推迟积极治疗的可能性。应考虑与COVID-19感染相关的潜在风险，同时考虑肿瘤组织学和自然病程、疾病背景、临床状况和疾病负担，以及预期获益、毒性（如骨髓抑制或间质性肺病）和从计划或正在进行的治疗中获得的反应。在本研究中，我们报告了在意大利米兰欧洲肿瘤研究所COVID-19疫情期间，包括社交媒体、远程医疗和电话分诊在内的主动措施用于筛查肺癌患者的结果。以结构化和日常方式应用的主动管理和控制措施，显著有助于识别出与COVID-19相关疑似症状的进展期患者，限制他们进入我们的癌症中心；因此，我们更有能力保护其他患者免受可能的污染，同时保证疑似患者能在COVID-19转诊医院得到及时治疗和评估。
