Department of Urology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany.
Infection. 2022 Oct;50(5):1131-1137. doi: 10.1007/s15010-022-01775-1. Epub 2022 Feb 24.
As COVID-19 pandemic persists with variants, and despite effective vaccination campaigns, breakthrough infections surge. We implemented strategies to protect vulnerable patients of the uro-oncologic outpatient clinic. We adopted proactive non-symptomatic risk reduction measures, which include non-symptomatic testing requirements for both patients and health care professionals (HCP), intensified patient tracing and contact reduction by implementation of digital health options. Here, we present our best practice example to safely guide oncology professionals and patients with metastasized genitourinary cancers through the current and future pandemics.
Solely for this purpose, we created a registry of collected data (current telephone numbers, e-mail addresses, vaccination status). We collected a nasopharyngeal swab from every patient upon presentation for treatment. We implemented bi-weekly RNA-PCR assay tests for HCP with patient contact, and limited personal contact at our facility through digital patient consultations.
We started implementing our COVID prevention model at the beginning of the second wave in September 2020 and included 128 patients with urologic malignancies requiring systemic treatment. After COVID vaccination became available in December 2020, all of our HCP were fully vaccinated within 6 weeks and 97% of our patients (125/128) within 9 months. We performed 1410 nasopharyngeal swabs during in-house visits, thereby detecting two COVID-19 infections among our patients, who both survived and successfully continued treatment. To further reduce personal contact, half of our consultations were fully operated digitally, with 76% (97/128) of our patients participating in our digital health offers.
The willingness of patients and HCPs to participate in the study allowed us to implement strict standards to prepare for the ongoing and future pandemics in outpatient cancer units. Next to general preventive measures such as frequent hand disinfection, wearing facial masks, and keeping distance, an important measure to protect vulnerable uro-oncology patients is the capability to perform virus genome sequencing to trace transmission chains.
随着 COVID-19 大流行的持续和变异,尽管疫苗接种活动有效,但突破性感染仍在激增。我们实施了策略来保护泌尿肿瘤门诊的弱势患者。我们采取了积极的无症状风险降低措施,包括对患者和医护人员(HCP)进行无症状检测要求,通过实施数字健康选择来加强患者追踪和减少接触。在这里,我们提出了我们的最佳实践范例,以安全地指导肿瘤学专业人员和转移性泌尿生殖系统癌症患者应对当前和未来的大流行。
仅为此目的,我们创建了一个收集数据的注册表(当前电话号码、电子邮件地址、疫苗接种状况)。我们对每位来就诊的患者进行鼻咽拭子采集。我们对有患者接触的 HCP 进行每两周一次的 RNA-PCR 检测,并通过数字患者咨询在我们的设施中限制个人接触。
我们在 2020 年 9 月第二波疫情开始时开始实施我们的 COVID 预防模型,纳入了 128 名需要全身治疗的泌尿系统恶性肿瘤患者。2020 年 12 月 COVID 疫苗可用后,我们所有的 HCP 在 6 周内完全接种疫苗,97%的患者(125/128)在 9 个月内接种疫苗。我们在门诊就诊期间进行了 1410 次鼻咽拭子检测,从而在我们的患者中发现了两例 COVID-19 感染,他们都幸存下来并成功继续治疗。为了进一步减少个人接触,我们的一半咨询完全数字化运作,128 名患者中有 76%(97/128)参与了我们的数字健康服务。
患者和 HCP 参与研究的意愿使我们能够实施严格的标准,为门诊癌症病房的持续和未来的大流行做好准备。除了频繁手部消毒、戴口罩和保持距离等一般预防措施外,保护弱势泌尿肿瘤患者的重要措施是能够进行病毒基因组测序以追踪传播链。