2019 年冠状病毒病（COVID-19）大流行对中东、北非和西亚地区儿科肿瘤学护理的影响：来自儿科肿瘤学东部和地中海（POEM）小组的报告。
Impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric oncology care in the Middle East, North Africa, and West Asia region: A report from the Pediatric Oncology East and Mediterranean (POEM) group.
机构信息
Children's Cancer Institute, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Pediatrics, Pierre and Marie Curie Center, Algiers, Algeria.
出版信息
Cancer. 2020 Sep 15;126(18):4235-4245. doi: 10.1002/cncr.33075. Epub 2020 Jul 10.
BACKGROUND
Childhood cancer is a highly curable disease when timely diagnosis and appropriate therapy are provided. A negative impact of the coronavirus disease 2019 (COVID-19) pandemic on access to care for children with cancer is likely but has not been evaluated.
METHODS
A 34-item survey focusing on barriers to pediatric oncology management during the COVID-19 pandemic was distributed to heads of pediatric oncology units within the Pediatric Oncology East and Mediterranean (POEM) collaborative group, from the Middle East, North Africa, and West Asia. Responses were collected on April 11 through 22, 2020. Corresponding rates of proven COVID-19 cases and deaths were retrieved from the World Health Organization database.
RESULTS
In total, 34 centers from 19 countries participated. Almost all centers applied guidelines to optimize resource utilization and safety, including delaying off-treatment visits, rotating and reducing staff, and implementing social distancing, hand hygiene measures, and personal protective equipment use. Essential treatments, including chemotherapy, surgery, and radiation therapy, were delayed in 29% to 44% of centers, and 24% of centers restricted acceptance of new patients. Clinical care delivery was reported as negatively affected in 28% of centers. Greater than 70% of centers reported shortages in blood products, and 47% to 62% reported interruptions in surgery and radiation as well as medication shortages. However, bed availability was affected in <30% of centers, reflecting the low rates of COVID-19 hospitalizations in the corresponding countries at the time of the survey.
CONCLUSIONS
Mechanisms to approach childhood cancer treatment delivery during crises need to be re-evaluated, because treatment interruptions and delays are expected to affect patient outcomes in this otherwise largely curable disease.
背景
儿童癌症及时诊断和适当治疗可高度治愈。然而，由于新冠疫情的影响，儿童癌症患者获得治疗的机会可能会受到负面影响，但目前尚未对此进行评估。
方法
我们向中东、北非和西亚的儿科肿瘤学东部和地中海（POEM）协作组的儿科肿瘤学部门负责人分发了一份包含 34 个问题的调查问卷，重点关注新冠疫情期间儿科肿瘤管理的障碍。2020 年 4 月 11 日至 22 日收集了回复。从世界卫生组织数据库中检索了相应的已证实新冠病例和死亡病例的发生率。
结果
共有来自 19 个国家的 34 个中心参与了此次研究。几乎所有的中心都应用了指南来优化资源利用和安全性，包括延迟治疗后随访、轮班和减少工作人员，以及实施社交距离、手部卫生措施和使用个人防护设备。29%至 44%的中心延迟了化疗、手术和放疗等基本治疗，24%的中心限制了新患者的收治。28%的中心报告称临床护理服务受到了负面影响。超过 70%的中心报告称血液制品短缺，47%至 62%的中心报告手术和放疗中断以及药物短缺。然而，不到 30%的中心床位受到影响，这反映出在调查时相应国家的新冠住院率较低。
结论
在危机期间，需要重新评估儿童癌症治疗方案，因为治疗中断和延迟预计会影响这种本来可以高度治愈的疾病患者的预后。
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