Head and Neck Cancer Treatment during COVID-19 Pandemic: A Central Experience in Rome. Emergency Management, Infection Prevention and Control.

Abstract

Simple SummaryThe COVID-19 or SARS-CoV-2 pandemic has been spreading in our country since the beginning of 2020. Despite the emergency patients with head and neck cancer could not wait for treatment. Surgery in head and neck tumors, which consists of resection and reconstruction, must be timely, considering crucial further adjuvant treatments. Furthermore, the therapeutic results and morbidity depend on the size and progression of the disease. The management protocol included: telephone triage, nasopharyngeal swab tested for SARS-CoV-2 RNA before hospitalization, application of infection prevention and control (IPC) policies. This preliminary study reports our experience in managing oncological patients during the COVID-19 pandemic, evaluating the efficacy of the safety and containment measures implemented in our unit for the protection of the whole staff as well. In our opinion, even though restrictions have to be developed first and foremost for the patient’s safety, medical and paramedical staff need to be protected as well.The COVID-19 pandemic has significantly affected the surgical units, especially those operating on the airways. This study evaluates the series of patients with tumors of the head and neck treated by our unit during Phase-1 of the pandemic and the efficacy of the preventive measures implemented for protecting both the patients and staff. A screening program was administered to all the patients who had to undergo surgery. None of the patients tested and operated during Phase 1, between 10 March and 18 May 2020, were positive for COVID-19. A significant portion of the patients was suffering from tumors in advanced stages (T3 and T4). Two patients developed respiratory symptoms during their stay at the unit, so they were put in precautionary isolation and tested, but resulted negative for COVID-19. All the surgical department staff followed the Italian Ministry of Health’s prevention protocol and underwent serological testing. IgG and IgM were negative in everyone, thus confirming that nobody had been exposed to the virus. This study highlights the commitment to efficiently treating patients suffering from tumors of the head and neck region and confirms the effectiveness of the safety measures used to protect our patients and staff’s health.