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Mitigating the impact of COVID-19 on oncology: Clinical and operational lessons from a prospective radiation oncology cohort tested for COVID-19.
Ning, Matthew S; McAleer, Mary Frances; Jeter, Melenda D; Minsky, Bruce D; Ghafar, Robert A; Robinson, Ivy J; Nitsch, Paige L; Zaebst, Denise J; Todd, Sarah E; Nguyen, Jennifer; Lin, Steven H; Liao, Zhongxing; Lee, Percy; Gunn, G Brandon; Klopp, Ann H; Dabaja, Bouthaina S; Nguyen, Quynh-Nhu; Chronowski, Gregory M; Bloom, Elizabeth S; Koong, Albert C; Das, Prajnan.
Afiliación
  • Ning MS; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: msning@mdanderson.org.
  • McAleer MF; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Jeter MD; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Minsky BD; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Ghafar RA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Robinson IJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Nitsch PL; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Zaebst DJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Todd SE; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Nguyen J; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Lin SH; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Liao Z; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Lee P; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Gunn GB; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Klopp AH; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Dabaja BS; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Nguyen QN; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Chronowski GM; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Bloom ES; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Koong AC; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Das P; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Radiother Oncol ; 148: 252-257, 2020 07.
Article en En | MEDLINE | ID: mdl-32474129
BACKGROUND AND PURPOSE: The COVID-19 pandemic warrants operational initiatives to minimize transmission, particularly among cancer patients who are thought to be at high-risk. Within our department, a multidisciplinary tracer team prospectively monitored all patients under investigation, tracking their test status, treatment delays, clinical outcomes, employee exposures, and quarantines. MATERIALS AND METHODS: Prospective cohort tested for SARS-COV-2 infection over 35 consecutive days of the early pandemic (03/19/2020-04/22/2020). RESULTS: A total of 121 Radiation Oncology patients underwent RT-PCR testing during this timeframe. Of the 7 (6%) confirmed-positive cases, 6 patients were admitted (4 warranting intensive care), and 2 died from acute respiratory distress syndrome. Radiotherapy was deferred or interrupted for 40 patients awaiting testing. As the median turnaround time for RT-PCR testing decreased from 1.5 (IQR: 1-4) to ≤1-day (P < 0.001), the median treatment delay also decreased from 3.5 (IQR: 1.75-5) to 1 business day (IQR: 1-2) [P < 0.001]. Each patient was an exposure risk to a median of 5 employees (IQR: 3-6.5) through prolonged close contact. During this timeframe, 39 care-team members were quarantined for a median of 3 days (IQR: 2-11), with a peak of 17 employees simultaneously quarantined. Following implementation of a "dual PPE policy," newly quarantined employees decreased from 2.9 to 0.5 per day. CONCLUSION: The severe adverse events noted among these confirmed-positive cases support the notion that cancer patients are vulnerable to COVID-19. Active tracking, rapid diagnosis, and aggressive source control can mitigate the adverse effects on treatment delays, workforce incapacitation, and ideally outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Betacoronavirus / Neoplasias Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2020 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Betacoronavirus / Neoplasias Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2020 Tipo del documento: Article Pais de publicación: Irlanda