Clinical Haematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India.
Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India.
Natl Med J India. 2021 Jan-Feb;34(1):10-14. doi: 10.4103/0970-258X.315901.
. Coronavirus disease 2019 (Covid-19) was first described in December 2019 and has evolved into an ongoing global pandemic. Cancer patients on chemotherapy are immunocompromised and are at the highest risk of Covid-19-related complications. We describe our experience with the management of haematology-oncology and stem cell transplant (SCT) patients receiving curative chemotherapy in a hospital with a high influx of Covid-19 patients.
. We did a prospective observational study at a 99-bedded cancer centre of a tertiary care teaching hospital from April 2020 to September 2020. Preventive measures taken were categorized as follows: (i) staff: screening, mandatory use of personal protective equipment (PPE), risk stratification of potential exposure and testing and isolation as needed; (ii) patients: mandatory viral polymerase chain reaction testing, segregation of positive and untested patients and testing of family members; and (iii) environment: mandatory regular cleaning, visitor restriction, telemedicine services and reassignment of priority to clinic visits. Treatment of the underlying conditions was continued with added precautions.
. A total of 54 patients were included in the analysis, including 48 with haematological malignancies and 6 for stem cell therapy. Preventive measures were universally applied, and chemotherapy with a curative intent was initiated as per protocol. Three patients were detected to have Covid-19 infection before admission and one after the institution of chemotherapy. Nine patients died after the first cycle of chemotherapy, 2 due to severe Covid-19-related illness and 7 due to complications of chemotherapy or disease progression.
. In the wake of the Covid-19 pandemic, treatment for haematological malignancies must continue while balancing the risk of Covid-19 infections. Our report emphasizes the effectiveness of measures such as hand hygiene, social isolation, patient segregation, use of masks and PPE and universal pre-treatment testing for Covid-19 in reducing the risk of infection in a high-risk clinical setting.
2019 年 12 月首次描述了 2019 年冠状病毒病（Covid-19），它已演变成一场持续的全球大流行。接受化疗的癌症患者免疫功能低下，患与 Covid-19 相关并发症的风险最高。我们描述了在一家收治大量 Covid-19 患者的医院中，对接受根治性化疗的血液科肿瘤学和干细胞移植（SCT）患者进行管理的经验。
我们在一家三级护理教学医院的 99 张病床的癌症中心进行了一项前瞻性观察研究，从 2020 年 4 月至 2020 年 9 月。采取的预防措施分为以下几类：（i）工作人员：筛查、强制使用个人防护设备（PPE）、潜在暴露风险分层以及根据需要进行检测和隔离；（ii）患者：强制进行病毒聚合酶链反应检测、阳性和未检测患者的隔离以及家庭成员的检测；（iii）环境：强制性定期清洁、限制访客、远程医疗服务以及重新安排门诊就诊的优先级。在采取额外预防措施的同时，继续治疗基础疾病。
共纳入 54 例患者进行分析，其中 48 例为血液系统恶性肿瘤患者，6 例为干细胞治疗患者。普遍应用了预防措施，并按照方案开始进行有治愈意图的化疗。在入院前发现 3 例患者感染了 Covid-19，1 例在开始化疗后发现。9 例患者在第一周期化疗后死亡，其中 2 例死于严重的与 Covid-19 相关的疾病，7 例死于化疗或疾病进展的并发症。
在 2019 年冠状病毒病大流行期间，必须继续治疗血液系统恶性肿瘤，同时平衡感染 2019 年冠状病毒病的风险。我们的报告强调了在高风险临床环境中，通过手部卫生、社会隔离、患者隔离、使用口罩和个人防护设备以及普遍的 Covid-19 治疗前检测等措施，可以降低感染风险。
