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“抗疫”与“防癌”两把利剑:“新冠”时期大医院如何应对?

"Swords and Shields" against COVID-19 for patients with cancer at "clean" and "pandemic" hospitals: are we ready for the second wave?

机构信息

Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, 06200, Ankara, Yenimahalle, Turkey.

Department of Medical Oncology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

出版信息

Support Care Cancer. 2021 Aug;29(8):4587-4593. doi: 10.1007/s00520-021-06001-6. Epub 2021 Jan 22.

Abstract

PURPOSE

COVID-19 will continue to disrupt the diagnosis-treatment process of cancer patients. Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital has been considered as a 'non-pandemic' center ('clean') in Ankara, the capital city of Turkey. The other state hospitals that also take care of cancer patients in Ankara were defined as 'pandemic' centers. This study aimed to evaluate hospital admission changes and the precautionary measures in clean and pandemic centers during the pandemic. The effect of these measures and changes on COVID-19 spreading among cancer patients was also evaluated.

METHODS

The patients admitted to the medical oncology follow-up, new diagnosis, or chemotherapy (CT) outpatient clinics during the first quarter of pandemic period (March 15-June 1, 2020) of each center were determined and compared with the admissions of the same frame of previous year (March 15-June 1, 2019). COVID-19 PCR test results in clean and pandemic centers were compared with each other. Telemedicine was preffered in the clean hospital to keep on follow-up of the cancer patients as 'noninfected'.

RESULTS

In the clean hospital, COVID-19-infected patients that needed to be hospitalized were referred to pandemic hospitals. COVID-19 test positivity rate was eight-fold higher for outpatient clinic admissions in pandemic hospitals (p < 0.001). The number of patients admitted new diagnosis outpatient clinics in both clean and pandemic hospitals decreased significantly during the pandemic compared with the previous year.

CONCLUSION

We consider that local strategic modifications and defining 'clean' hospital model during infectious pandemic may contribute to protect and treat cancer patients during pandemic.

摘要

目的

COVID-19 将继续扰乱癌症患者的诊断-治疗过程。安卡拉肿瘤医院的 Abdurrahman Yurtaslan 博士被认为是土耳其首都安卡拉的“非大流行”中心(“清洁”)。安卡拉的其他也照顾癌症患者的州立医院被定义为“大流行”中心。本研究旨在评估大流行期间清洁和大流行中心的住院变化和预防措施。还评估了这些措施和变化对癌症患者 COVID-19 传播的影响。

方法

确定每个中心大流行期间(2020 年 3 月 15 日至 6 月 1 日)第一季度接受医学肿瘤学随访、新诊断或化疗(CT)门诊治疗的患者,并将其与前一年同期(2019 年 3 月 15 日至 6 月 1 日)的入院人数进行比较。比较清洁和大流行中心的 COVID-19 PCR 检测结果。清洁医院优先采用远程医疗,以保持对癌症患者的“未感染”随访。

结果

在清洁医院,需要住院的 COVID-19 感染患者被转介到大流行医院。大流行医院门诊就诊的 COVID-19 检测阳性率高 8 倍(p < 0.001)。与前一年相比,清洁和大流行医院的新诊断门诊就诊患者人数在大流行期间显著减少。

结论

我们认为,在传染病大流行期间进行局部战略调整和定义“清洁”医院模式,可能有助于在大流行期间保护和治疗癌症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d744/7819771/f2322c2fd028/520_2021_6001_Fig1_HTML.jpg

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