Impact of the coronavirus disease 2019 pandemic on cancer care delivery: A single-center retrospective study

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic and the resultant nationwide lockdown have adversely affected all the aspects of human life, including the access to health-care facilities. However, there is currently a lack of information on the impact of this pandemic on the delivery of routine cancer care. Objectives: In this study, we aimed to evaluate the changes in the number of patients in the day care chemotherapy (DCC) unit and outpatient department (OPD) because of the nationwide COVID-19 lockdown. Materials and Methods: This retrospective audit was conducted at the Department of Medical Oncology of the Indira Gandhi Institute of Medical Sciences in Patna, India. The demographic details and data related to the diagnosis and type and frequency of chemotherapy delivered in the DCC between February 1, 2020, and July 31, 2020, were retrieved. Patient numbers were recorded. Descriptive statistics, odds ratio, Chi-squared test, and Student's t-test were used to assess the changes in the pattern of DCC and OPD patient numbers because of the imposition of a nationwide lockdown on March 24, 2020. The Pearson correlation coefficient was used to assess the correlation between the number of COVID-19 cases and the number of patients visiting the DCC and OPD. Results: A total of 3192 DCCs and 8209 OPD visits were recorded in 126 working days. The median age of the patients was 47 years (interquartile range [34–58]). Cancers of the breast (17%) and gall bladder (15%) were the most common cancers receiving chemotherapy. There was a significant decrease in the number of DCCs delivered after the imposition of the COVID-19 lockdown (mean, 21.97 [±9.7]) compared to pre-lockdown period (mean, 33.30 [±11.4]), (t = 4.11, P = 0.001). Similarly, there was a significant decrease in the number of OPD visits after the imposition of the lockdown (mean, 47.13 [±18.8]) compared to the pre-lockdown period (mean, 89.91 [±30.0]), (t = 7.09, P = 0.001). The odds of receiving weekly chemotherapy over non-weekly regimes significantly decreased after the imposition of the lockdown with an odds ratio of 0.52 (95% confidence interval, 0.36–0.75) and Chi-square value of 12.57(P = 0.001). The daily number of COVID-19 cases reported in the state and the number of patients visiting the OPD was found to be moderately positively correlated (Pearson correlation coefficient, r = 0.35, P = 0.001). Conclusions: There was a significant decrease in the number of patients visiting the OPD and the number of chemotherapy cycles immediately after the imposition of lockdown. The number increased later despite a rise in the number of COVID-19 cases.