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A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group.
Oncologist. 2020 06; 25(6):e936-e945.O

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by rapid human-to-human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS-CoV-2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID-19 infection pandemic will be addressed, with suggestions of some practical approaches.

IMPLICATIONS FOR PRACTICE:

The main management strategies for treating cancer patients during the COVID-19 epidemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of COVID-19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case-by-case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS-CoV-2 virology and epidemiology.

Authors+Show Affiliations

Medical Oncology Department, Alzahra Hospital Dubai, Dubai, United Arab Emirates. Department of Medicine, University of Sharjah, Sharjah, United Arab Emirates. Emirates Oncology Society, Dubai, United Arab Emirates.Department of Health Research Methods, Evidence, and Impact, Medicine, McMaster University, Hamilton, Ontario, Canada. Medicine, McMaster University, Hamilton, Ontario, Canada.Department of Hematology, Kuwait Cancer Control Center, Kuwait.Division of Infectious Disease, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Min-Sheng General Hospital, Taoyuan City, Taiwan.Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.Divisions of Radiation Oncology and Medical Sciences, National Cancer Center Singapore, Singapore. Oncology Academic Program, Duke-NUS Medical School, Singapore. Cong Hua's Institute, Singapore.Department of Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.Department of Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.Windsor Regional Cancer Center, Windsor, Ontario, Canada. Department of Oncology, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.Department of Oncology and Hemato-Oncology University of Milan, Milan, Italy. Division of Early Drug Development for Innovative Therapy, University of Milan, Milan, Italy. European Institute of Oncology, Milan, Italy. IRCCS, University of Milano, Milan, Italy.Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.West Cancer Center, University of Tennessee, Memphis, Tennessee, USA.Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32243668

Citation

Al-Shamsi, Humaid O., et al. "A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: an International Collaborative Group." The Oncologist, vol. 25, no. 6, 2020, pp. e936-e945.
Al-Shamsi HO, Alhazzani W, Alhuraiji A, et al. A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group. Oncologist. 2020;25(6):e936-e945.
Al-Shamsi, H. O., Alhazzani, W., Alhuraiji, A., Coomes, E. A., Chemaly, R. F., Almuhanna, M., Wolff, R. A., Ibrahim, N. K., Chua, M. L. K., Hotte, S. J., Meyers, B. M., Elfiki, T., Curigliano, G., Eng, C., Grothey, A., & Xie, C. (2020). A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group. The Oncologist, 25(6), e936-e945. https://doi.org/10.1634/theoncologist.2020-0213
Al-Shamsi HO, et al. A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: an International Collaborative Group. Oncologist. 2020;25(6):e936-e945. PubMed PMID: 32243668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group. AU - Al-Shamsi,Humaid O, AU - Alhazzani,Waleed, AU - Alhuraiji,Ahmad, AU - Coomes,Eric A, AU - Chemaly,Roy F, AU - Almuhanna,Meshari, AU - Wolff,Robert A, AU - Ibrahim,Nuhad K, AU - Chua,Melvin L K, AU - Hotte,Sebastien J, AU - Meyers,Brandon M, AU - Elfiki,Tarek, AU - Curigliano,Giuseppe, AU - Eng,Cathy, AU - Grothey,Axel, AU - Xie,Conghua, Y1 - 2020/04/27/ PY - 2020/03/16/received PY - 2020/03/26/accepted PY - 2020/4/4/pubmed PY - 2020/6/24/medline PY - 2020/4/4/entrez KW - COVID-19 KW - Coronavirus KW - Influenza KW - Neoplasm KW - Pandemic KW - SARS-CoV-2 SP - e936 EP - e945 JF - The oncologist JO - Oncologist VL - 25 IS - 6 N2 - The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by rapid human-to-human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS-CoV-2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID-19 infection pandemic will be addressed, with suggestions of some practical approaches. IMPLICATIONS FOR PRACTICE: The main management strategies for treating cancer patients during the COVID-19 epidemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of COVID-19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case-by-case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS-CoV-2 virology and epidemiology. SN - 1549-490X UR - https://www.unboundmedicine.com/medline/citation/32243668/A_Practical_Approach_to_the_Management_of_Cancer_Patients_During_the_Novel_Coronavirus_Disease_2019__COVID_19__Pandemic:_An_International_Collaborative_Group_ L2 - https://doi.org/10.1634/theoncologist.2020-0213 DB - PRIME DP - Unbound Medicine ER -