Abstract

BackgroundOn 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. MethodsWe 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. ResultsAs 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). ConclusionsA 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.

Highlights

  • The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has caused more than 8,242,000 cases and 445,535 deaths worldwide [1], translating into previously unseen challenges for healthcare systems, hospital resource overload and impairment of routine medical care [2e4].Patients with cancer are felt to be vulnerable, both in terms of risks of infection [5e7] and need to avoid undue delays in cancer treatment [3,8,9]

  • We retrospectively analysed the activity of our Section of Oncology at the University Hospital Trust of Verona (Italy) from January 1st to March 31st, 2020, to investigate how organisational changes related to the SARSCoV-2 epidemics impacted on (i) volumes of oncological activity, (ii) cases of SARS-CoV-2 infections observed in oncology health professionals and (iii) hospital admissions of ‘active’ oncological patients for SARS-CoV-2 infection

  • Patients with cancer admitted to the Verona University Hospital Trust for SARS-CoV-2 infection were identified by reviewing medical charts of all patients admitted to the institutional coronavirus disease (COVID) Units from February 1st (21 days before the first confirmed SARS-CoV-2epositive case) to April 14th, 2020 (14 days after the end of the observation period chosen to monitor oncological activity) (Supplementary Methods)

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Summary

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has caused more than 8,242,000 cases and 445,535 deaths worldwide [1], translating into previously unseen challenges for healthcare systems, hospital resource overload and impairment of routine medical care [2e4].Patients with cancer are felt to be vulnerable, both in terms of risks of infection [5e7] and need to avoid undue delays in cancer treatment [3,8,9]. To address the actual changes in oncological activity volumes in relationship to the organisational changes implemented, we tracked down protective/organisational measures, oncological activity, patient perception of adopted measures and confirmed SARS-CoV-2 cases among our healthcare professionals and patients with cancer during the peak of SARS-CoV-2 epidemics at the Verona University Hospital Trust (Italy). 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 erelated hospital admissions of “active”’ oncological patients. 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 SARSCoV-2 infection, 7 had an “active”’ oncological disease (2 died of infection-related complications).

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