Updated clinical management guidance during the COVID-19 pandemic: thyroid nodules and cancer.

Evanthia Giannoula,Luca Giovanella,Ioannis Iakovou,Alexis Vrachimis

doi:10.1530/eje-21-0716

Abstract

Healthcare settings, including nuclear medicine (NM) departments, promptly adjusted their standard operating procedures to cope with the unprecedented crisis caused by coronavirus disease 19 (COVID-19) pandemic. Nuclear thyroidology has adopted changes and predicated on a careful risk–benefit analysis, in order to prevent a potential spread of the virus while being at the same time effective, safe and preserving their quality of essential services. Since most thyroid nodules (TNs) are benign, and malignant neoplasms are characterized by an indolent natural history, it is generally safe to delay diagnostic and therapeutic procedures. In this respect, the main adjustments that nuclear thyroidology has adopted are summarized into the following: general workplace adjustments including remote work for NM staff; postponing appointments for consultation, diagnostic and therapeutic purposes and rescheduling based on individualized risk stratification; telemedicine; preparation for possible issues on radiopharmaceuticals synthesis and delivery; preventing measures and protocols to minimize or avoid potential COVID-19 infection of patients and medical staff. This document should be considered as updated guidance on how clinical management of TNs and thyroid cancer has been altered, remodeled and adapted to the new circumstances in the COVID-19 era, based on the rapidly growing volume of scientific information regarding the new coronavirus.

Highlights

At the same time health care settings, including nuclear medicine departments promptly adjusted their standard operating procedures to cope with the pandemic cases and deliver their services
Several reports have been issued to serve as guidance on all aspects of nuclear medicine practice, including nuclear thyroidology[1, 2]with changes being predicated on a careful risk–benefit analysis, in order to prevent a potential spread of the virus while being at the same time effective, safe and preserving their quality of essential services
Early data from China suggests that COVID-19 does not worsen the outcome of cancer, but as the pandemic continues, with investigations and treatment delay, morbidity and mortality from thyroid cancer may increase[1, 6]

Summary

Introduction

At the same time health care settings, including nuclear medicine departments promptly adjusted their standard operating procedures to cope with the pandemic cases and deliver their services.

Objectives

Results

Conclusion