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应对 SARS-CoV-2 大流行期间癌症护理管理中的挑战:回顾性分析。

Meeting the Challenges in Cancer Care Management During the SARS-Cov-2 Pandemic: A Retrospective Analysis.

机构信息

Department of Oncology, 60202Antwerp University Hospital Antwerp, Antwerp, Belgium.

Clinical Trials Center (CTC), CRC Antwerp, 60202Antwerp University Hospital, Antwerp, Belgium.

出版信息

Cancer Control. 2021 Jan-Dec;28:10732748211045275. doi: 10.1177/10732748211045275.

Abstract

BACKGROUND

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has overwhelmed the capacity of healthcare systems worldwide. Cancer patients, in particular, are vulnerable and oncology departments drastically needed to modify their care systems and established new priorities. We evaluated the impact of SARS-CoV-2 on the activity of a single cancer center.

METHODS

We performed a retrospective analysis of (i) volumes of oncological activities (2020 vs 2019), (ii) patients' perception rate of the preventive measures, (iii) patients' SARS-CoV-2 infections, clinical signs thereof, and (iv) new diagnoses made during the SARS-CoV-2 pandemic.

RESULTS

As compared with a similar time frame in 2019, the overall activity in total numbers of outpatient chemotherapy administrations and specialist visits was not statistically different ( = .961 and = .252), while inpatient admissions decreased for both medical oncology and thoracic oncology (18% ( = .0018) and 44% ( < .0001), respectively). Cancer diagnosis plummeted (-34%), but no stage shift could be demonstrated.Acceptance and adoption of hygienic measures was high, as measured by a targeted questionnaire (>85%). However, only 46.2% of responding patients regarded telemedicine, although widely deployed, as an efficient surrogate to a consultation.Thirty-three patients developed SARS-CoV-2, 27 were hospitalized, and 11 died within this time frame. These infected patients were younger, current smokers, and suffered more comorbidities.

CONCLUSIONS

This retrospective cohort analysis adds to the evidence that continuation of active cancer therapy and specialist visits is feasible and safe with the implementation of telemedicine. These data further confirm the impact of SARS-CoV-2 on cancer care management, cancer diagnosis, and impact of infection on cancer patients.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行使全球医疗体系不堪重负。癌症患者尤其脆弱,肿瘤科室急需调整其护理系统并制定新的重点。我们评估了 SARS-CoV-2 对单一癌症中心活动的影响。

方法

我们对(i)肿瘤活动量(2020 年与 2019 年相比)、(ii)患者对预防措施的感知率、(iii)患者 SARS-CoV-2 感染、临床症状和(iv)SARS-CoV-2 大流行期间新诊断的情况进行回顾性分析。

结果

与 2019 年同期相比,门诊化疗和专科就诊总次数的总体活动没有统计学差异( =.961 和 =.252),而内科住院治疗无论是在肿瘤内科还是胸科肿瘤都有所减少(分别为 18%( =.0018)和 44%( <.0001))。癌症诊断骤降(-34%),但未发现分期转移。通过一项有针对性的问卷调查(>85%)表明,患者对卫生措施的接受和采用率很高。然而,尽管广泛应用,只有 46.2%的应答患者认为远程医疗是一种有效的咨询替代方法。在此期间,有 33 名患者感染 SARS-CoV-2,其中 27 名住院,11 名死亡。这些感染患者更年轻、当前吸烟且合并症更多。

结论

本回顾性队列分析进一步证明了在实施远程医疗的情况下,继续进行积极的癌症治疗和专科就诊是可行且安全的。这些数据进一步证实了 SARS-CoV-2 对癌症护理管理、癌症诊断以及感染对癌症患者的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/deee/8504214/9419d8a02150/10.1177_10732748211045275-fig1.jpg

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