Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
St George's University of London, London, UK.
Arch Gynecol Obstet. 2022 Mar;305(3):555-565. doi: 10.1007/s00404-021-06295-1. Epub 2021 Nov 3.
Synthesis of available evidence on clinical practice in gynaecological oncology during the COVID-19 pandemic is highly warranted, as women with cancer are at increased risk due to their systemic immunosuppressed state and changes in their care are inevitable. Rapid review of available data is a quick way of providing useful information and insight into the way medical practice has been affected by the COVID pandemic.
We conducted a systematic rapid review, based on a literature search of MEDLINE/PubMed, Embase, and Cochrane CENTRAL. We considered all studies on gynaecological oncology care during the COVID-19 pandemic using relevant keywords and MeSH terms. Selection criteria were English language, studies with more than five cases and publication in peer-review journal.
Nine retrospective studies, one systematic review and five questionnaire surveys were included. Quality of the studies has been assessed. Development of higher quality evidence is warranted. Mortality of COVID-19 infection is higher in patients with gynaecological cancer than in non-cancer patients. Reported delays in diagnosis and management of cancer and changes in treatments, may affect the natural history of cancer and increase patients' anxiety and fear of disease progression while causing concerns to healthcare professionals affecting their clinical practice. The number of new diagnoses has declined. Prioritization is important, face-to-face interactions should be limited, and appropriate protective measures are essential. Cancer surgery, chemotherapy, and radiotherapy should continue as high priority practices.
The COVID-19 pandemic has affected clinical practice significantly. Adaptations in clinical practice may improve mortality and complication rates.
由于癌症患者处于全身免疫抑制状态，并且其治疗方式不可避免地发生了改变，因此非常有必要对 COVID-19 大流行期间妇科肿瘤学的临床实践进行综合现有证据的评估。快速审查现有数据是提供有关医疗实践受 COVID 大流行影响方式的有用信息和见解的快速方法。
我们进行了系统的快速审查，检索了 MEDLINE/PubMed、Embase 和 Cochrane CENTRAL 中的文献。我们使用相关的关键词和 MeSH 术语考虑了所有关于 COVID-19 大流行期间妇科肿瘤学护理的研究。选择标准为英语语言、超过 5 例患者的研究以及在同行评审期刊上发表的研究。
共纳入 9 项回顾性研究、1 项系统评价和 5 项问卷调查。评估了研究的质量。需要制定更高质量的证据。与非癌症患者相比，妇科癌症患者的 COVID-19 感染死亡率更高。报道的癌症诊断和治疗延迟以及治疗方式的改变可能会影响癌症的自然病程，并增加患者对疾病进展的焦虑和恐惧，同时也使医疗保健专业人员感到担忧，影响他们的临床实践。新诊断的数量有所下降。优先考虑是很重要的，应限制面对面的互动，并采取适当的保护措施。癌症手术、化疗和放疗应继续作为高度优先的治疗方法。
COVID-19 大流行对临床实践产生了重大影响。临床实践的调整可能会降低死亡率和并发症发生率。
