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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.


ABSTRACT: 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.

SUBMITTER: Ning MS 

PROVIDER: S-EPMC7256609 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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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 MS   McAleer Mary Frances MF   Jeter Melenda D MD   Minsky Bruce D BD   Ghafar Robert A RA   Robinson Ivy J IJ   Nitsch Paige L PL   Zaebst Denise J DJ   Todd Sarah E SE   Nguyen Jennifer J   Lin Steven H SH   Liao Zhongxing Z   Lee Percy P   Gunn G Brandon GB   Klopp Ann H AH   Dabaja Bouthaina S BS   Nguyen Quynh-Nhu QN   Chronowski Gregory M GM   Bloom Elizabeth S ES   Koong Albert C AC   Das Prajnan P  

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 20200529


<h4>Background and purpose</h4>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.<h4>Materials and methods</h4>Prospective cohort tested for SARS-COV-2 infection over 35 consecutive da  ...[more]

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