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2019冠状病毒病大流行对肿瘤患者护理的影响:拉丁美洲大流行中心一家癌症中心的经验

Impact of COVID-19 pandemic on care of oncological patients: experience of a cancer center in a Latin American pandemic epicenter.

作者信息

Araujo Sérgio Eduardo Alonso, Leal Alessandro, Centrone Ana Fernanda Yamazaki, Teich Vanessa Damazio, Malheiro Daniel Tavares, Cypriano Adriana Serra, Cendoroglo Neto Miguel, Klajner Sidney

机构信息

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2020 Dec 21;19:eAO6282. doi: 10.31744/einstein_journal/2021AO6282. eCollection 2020.

Abstract

OBJECTIVE

Since the rising of coronavirus disease 2019 (COVID-19) pandemic, there is uncertainty regarding the impact of transmission to cancer patients. Evidence on increased severity for patients undergoing antineoplastic treatment is posed against deferring oncologic treatment. We aimed to evaluate the impact of COVID-19 pandemic on patient volumes in a cancer center in an epicenter of the pandemic.

METHODS

Outpatient and inpatient volumes were extracted from electronic health record database. Two intervals were compared: pre-COVID-19 (March to May 2019) and COVID-19 pandemic (March to May 2020) periods.

RESULTS

The total number of medical appointments declined by 45% in the COVID-19 period, including a 56.2% decrease in new visits. There was a 27.5% reduction in the number of patients undergoing intravenous systemic treatment and a 57.4% decline in initiation of new treatments. Conversely, there was an increase by 309% in new patients undergoing oral chemotherapy regimens and a 5.9% rise in new patients submitted to radiation therapy in the COVID-19 period. There was a 51.2% decline in length of stay and a 60% reduction in the volume of surgical cases during COVID-19. In the stem cell transplant unit, we observed a reduction by 36.5% in length of stay and a 62.5% drop in stem cell transplants.

CONCLUSION

A significant decrease in the number of patients undergoing cancer treatment was observed after COVID-19 pandemic. Although this may be partially overcome by alternative therapeutic options, avoiding timely health care due to fear of getting COVID-19 infection might impact on clinical outcomes. Our findings may help support immediate actions to mitigate this hypothesis.

摘要

目的

自2019年冠状病毒病(COVID-19)大流行以来,癌症患者的传播影响尚不确定。抗肿瘤治疗患者病情加重的证据与推迟肿瘤治疗的观点形成了对比。我们旨在评估COVID-19大流行对大流行中心的一家癌症中心患者数量的影响。

方法

从电子健康记录数据库中提取门诊和住院患者数量。比较了两个时间段:COVID-19之前(2019年3月至5月)和COVID-19大流行期间(2020年3月至5月)。

结果

在COVID-19期间,医疗预约总数下降了45%,其中新就诊人数下降了56.2%。接受静脉全身治疗的患者数量减少了27.5%,新治疗开始人数下降了57.4%。相反,在COVID-19期间,接受口服化疗方案的新患者增加了309%,接受放射治疗的新患者增加了5.9%。COVID-19期间住院时间缩短了51.2%,手术病例数量减少了60%。在干细胞移植单元,我们观察到住院时间缩短了36.5%,干细胞移植减少了62.5%。

结论

COVID-19大流行后,接受癌症治疗的患者数量显著减少。尽管这可能会被替代治疗方案部分克服,但由于担心感染COVID-19而避免及时就医可能会影响临床结果。我们的研究结果可能有助于支持立即采取行动来减轻这一假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a17/7793126/ee300a29e3ad/2317-6385-eins-19-eAO6282-gf01.jpg

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