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Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic.
Eur J Cancer. 2020 08; 135:159-169.EJ

Abstract

BACKGROUND

On 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.

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-related hospital admissions of "active"' oncological patients.

RESULTS

As 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).

CONCLUSIONS

A 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.

Authors+Show Affiliations

Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: serena.zuliani@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: ilariazampiva@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: danielatregnago@libero.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: mi.ma.casali@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: alessandro.cavaliere@studenti.univr.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: fumagalli.arianna@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: saramerler@yahoo.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: silviateresariva@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: ali.red@hotmail.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: francyzacchi@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: elisa.zaninotto@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: alessandra.auriemma@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: michele.pavarana@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: caterina.solda@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: lavibenini@hotmail.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: borghesanimichele@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: alberto.caldart@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: simonacasalino@hotmail.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: marinagaule@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: dzenete.kadrija@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: marta.mongi9@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: camilla.pesoni@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: pamela.biondani@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sara.cingarlini@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: elena.fiorio@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: davide.melisi@univr.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: veronica.parolin@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: luca.tondulli@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: lorenzo.belluomini08@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: camilla.zecchetto@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: b.avesani90@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: assunta.biasi@aovr.veneto.it.Medical Direction, Verona University Hospital Trust, Verona, Italy. Electronic address: chiara.bovo@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: elena.dazzani@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: alessandra.dodi92@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sara.gelmini@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: luigi.c.leta@gmail.com.Microbiology and Virology Unit, Verona University Hospital Trust, Verona, Italy. Electronic address: giuliana.locascio@aovr.veneto.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: fiorella.med@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: eleonora.lucin@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: ilariaasjamartinelli88@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: luisa.messineo@hotmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: viola.moscarda01@universitadipavia.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sarahpafumi@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: anna.reni9692@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sartorigmt@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: ilariascaglione@tiscali.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: yiftachshoval@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: marcosposito91@gmail.com.Section of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: evelina.tacconelli@univr.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: ilariatrestini92@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: valentina.zambonin87@gmail.com.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sara_zanelli@hotmail.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: sara.pilotto@univr.it.Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy. Electronic address: michele.milella@univr.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32580131

Citation

Zuliani, Serena, et al. "Organisational Challenges, Volumes of Oncological Activity and Patients' Perception During the Severe Acute Respiratory Syndrome Coronavirus 2 Epidemic." European Journal of Cancer (Oxford, England : 1990), vol. 135, 2020, pp. 159-169.
Zuliani S, Zampiva I, Tregnago D, et al. Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic. Eur J Cancer. 2020;135:159-169.
Zuliani, S., Zampiva, I., Tregnago, D., Casali, M., Cavaliere, A., Fumagalli, A., Merler, S., Riva, S. T., Rossi, A., Zacchi, F., Zaninotto, E., Auriemma, A., Pavarana, M., Soldà, C., Benini, L., Borghesani, M., Caldart, A., Casalino, S., Gaule, M., ... Milella, M. (2020). Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic. European Journal of Cancer (Oxford, England : 1990), 135, 159-169. https://doi.org/10.1016/j.ejca.2020.05.029
Zuliani S, et al. Organisational Challenges, Volumes of Oncological Activity and Patients' Perception During the Severe Acute Respiratory Syndrome Coronavirus 2 Epidemic. Eur J Cancer. 2020;135:159-169. PubMed PMID: 32580131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic. AU - Zuliani,Serena, AU - Zampiva,Ilaria, AU - Tregnago,Daniela, AU - Casali,Miriam, AU - Cavaliere,Alessandro, AU - Fumagalli,Arianna, AU - Merler,Sara, AU - Riva,Silvia Teresa, AU - Rossi,Alice, AU - Zacchi,Francesca, AU - Zaninotto,Elisa, AU - Auriemma,Alessandra, AU - Pavarana,Michele, AU - Soldà,Caterina, AU - Benini,Lavinia, AU - Borghesani,Michele, AU - Caldart,Alberto, AU - Casalino,Simona, AU - Gaule,Marina, AU - Kadrija,Dzenete, AU - Mongillo,Marta, AU - Pesoni,Camilla, AU - Biondani,Pamela, AU - Cingarlini,Sara, AU - Fiorio,Elena, AU - Melisi,Davide, AU - Parolin,Veronica, AU - Tondulli,Luca, AU - Belluomini,Lorenzo, AU - Zecchetto,Camilla, AU - Avesani,Barbara, AU - Biasi,Assunta, AU - Bovo,Chiara, AU - Dazzani,Elena, AU - Dodi,Alessandra, AU - Gelmini,Sara, AU - Leta,Luigi Carmine, AU - Lo Cascio,Giuliana, AU - Lombardo,Fiorella, AU - Lucin,Eleonora, AU - Martinelli,Ilaria Asja, AU - Messineo,Luisa, AU - Moscarda,Viola, AU - Pafumi,Sarah, AU - Reni,Anna, AU - Sartori,Giulia, AU - Scaglione,Ilaria Mariangela, AU - Shoval,Yiftach, AU - Sposito,Marco, AU - Tacconelli,Evelina, AU - Trestini,Ilaria, AU - Zambonin,Valentina, AU - Zanelli,Sara, AU - Pilotto,Sara, AU - Milella,Michele, Y1 - 2020/06/11/ PY - 2020/05/22/received PY - 2020/05/28/accepted PY - 2020/6/25/pubmed PY - 2020/7/29/medline PY - 2020/6/25/entrez KW - Oncological activity KW - Patients' perception KW - Risk containing measures KW - SARS-CoV-2 SP - 159 EP - 169 JF - European journal of cancer (Oxford, England : 1990) JO - Eur J Cancer VL - 135 N2 - BACKGROUND: On 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. 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-related hospital admissions of "active"' oncological patients. RESULTS: As 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). CONCLUSIONS: A 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. SN - 1879-0852 UR - https://www.unboundmedicine.com/medline/citation/32580131/Organisational_challenges_volumes_of_oncological_activity and_patients'_perception_during_the_severe_acute_respiratory_syndrome_coronavirus_2_epidemic_ DB - PRIME DP - Unbound Medicine ER -