31/7/20

Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic

Zuliani S, Zampiva I, Tregnago D, Casali M, Cavaliere A, Fumagalli A,  Merler S, Riva ST, Rossi A, Zacchi F, Zaninotto E, Auriemma A, Pavarana  M, Soldà C, Benini L, Borghesani M, Caldart A, Casalino S, Gaule M,  Kadrija D, Mongillo M, Pesoni C, Biondani P, Cingarlini S, Fiorio E,  Melisi D, Parolin V, Tondulli L, Belluomini L, Zecchetto C, Avesani B,  Biasi A, Bovo C, Dazzani E, Dodi A, Gelmini S, Leta LC, Lo Cascio G,  Lombardo F, Lucin E, Martinelli IA, Messineo L, Moscarda V, Pafumi S,  Reni A, Sartori G, Scaglione IM, Shoval Y, Sposito M, Tacconelli E,  Trestini I, Zambonin V, Zanelli S, Pilotto S, Milella M..

Eur J Cancer. 2020 Aug;135:159-169. doi: 10.1016/j.ejca.2020.05.029., 08/2020.

Background: On  February 23rd, the 1st case of severe acute respiratory syndrome  coronavirus 2 (SARS-CoV-2) infection was diagnosed at the University  Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was  converted into a 22-inpatient bed coronavirus disease (COVID) Unit, and  we reshaped our organisation to face the SARS-CoV-2 epidemic, while  maintaining oncological activities.


Methods: We  tracked down (i) volumes of oncological activities (January 1st - March  31st, 2020 versus the same period of 2019), (ii) patients' and  caregivers' perception and (iii) SARS-CoV-2 infection rate in oncology  health professionals and SARS-CoV-2 infection-related hospital  admissions of "active"' oncological patients.


Results: As  compared with the same trimester in 2019, the overall reduction in  total numbers of inpatient admissions, chemotherapy administrations and  specialist visits in January-March 2020 was 8%, 6% and 3%, respectively;  based on the weekly average of daily accesses, reduction in some of the  oncological activities became statistically significant from week 11.  The overall acceptance of adopted measures, as measured by targeted  questionnaires administered to a sample of 241 outpatients, was high  (>70%). Overall, 8 of 85 oncology health professionals tested  positive for SARS-CoV-2 infection (all but one employed in the COVID  Unit, no hospital admissions and no treatment required); among 471  patients admitted for SARS-CoV-2 infection, 7 had an "active"'  oncological disease (2 died of infection-related complications).


Conclusions: A  slight, but statistically significant reduction in oncology activity  was registered during the SARS-CoV-2 epidemic peak in Verona, Italy.  Organisational and protective measures adopted appear to have  contributed to keep infections in both oncological patients and health  professionals to a minimum.


Keywords: Oncological activity; Patients' perception; Risk containing measures; SARS-CoV-2.