Abstract
PurposeTo date, over 4.2 million Germans and over 235 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Uro-oncology (UO) patients are particularly vulnerable but in urgent need of life-saving systemic treatments. Our multicentric study examined the impact of the COVID-19 crisis on the medical care of UO patients in German university hospitals receiving ongoing systemic anti-cancer treatment and to detect the delay of medical care, defined as deferred medical treatment or deviation of the pre-defined follow-up assessment.MethodsData of 162 UO patients with metastatic disease undergoing systemic cancer treatment at five university hospitals in Germany were included in our analyses. The focus of interest was any delay or change in treatment between February 2020 and May 2020 (first wave of the COVID-19 crisis in Germany). Statistical analysis of contingency tables were performed using Pearson’s chi-squared and Fisher’s exact tests, respectively. Effect size was determined using Cramér’s V (V).ResultsTwenty-four of the 162 patients (14.8%) experienced a delay in systemic treatment of more than 2 weeks. Most of these received immuno-oncologic (IO) treatments (13/24, 54.2%, p = 0.746). Blood tests were delayed or canceled significantly more often in IO patients but with a small effect size (21.1%, p = 0.042, V = 0.230). Treatment of patients with renal cell carcinoma (12/73, 16.4%) and urothelial carcinoma (7/32, 21.9%) was affected the most.ConclusionsOur data show that the COVID-19 pandemic impacted the medical care of UO patients, but deferment remained modest. There was a tendency towards delays in IO and ADT treatments in particular.
Highlights
To date, over 4.2 million people in Germany, over 71 million in Europe and over 235 million people worldwide have been infected with the betacoronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
The key clinical and diagnostic parameters assessed were: age, sex, patient’s performance status by measuring patient’s level of functioning in terms of their ability to care for themselves, daily activity, and physical ability using the Eastern Cooperative Oncology Group (ECOG) classification, comorbidities, immunosuppressing treatments, tumor stage and entity, systemic anti-cancer therapy, previous radiation and surgical therapies, SARS-CoV-2 and influenza status, medical care including delays in therapy or restaging of more than 2 weeks
Our data revealed that 30/161 patients (18.6%) experienced a therapeutic change due to the COVID-19 pandemic (Tables 2 and 3)
Summary
Over 4.2 million people in Germany, over 71 million in Europe and over 235 million people worldwide have been infected with the betacoronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With almost 94,000 confirmed deaths and a case fatality ratio of 2.2% [2], Germany seems to be less affected by the Extended author information available on the last page of the article crisis than many other countries around Europe like France (over 7 million cases, over 117,000 deaths) or the United Kingdom (over 8 million cases, over 137,000 deaths) and around the globe [2] Still, it changed daily life of medical professionals and other groups in Germany and around Europe, including several lockdowns of amusement places, swimming pools, churches, restaurants, schools, universities and other meeting places to avoid a spread of infection, severe hygienic measures being taken, and led to numerous overloads of hospital capacity [3]. Planned operations had to be delayed [8], video consultations were introduced [3], special hygienic
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