key: cord-0908573-s4potubf authors: Pastorino, A.; Negru, M. E.; Vigani, A.; Vaira, F.; Tognoni, A.; Ferrari, A.; Ricci, I.; Rondini, M.; Olcese, F.; Milano, A.; Cozzani, F.; Aschele, C. title: Development and validation of telematic follow-up for cancer patients during the COVID-19 outbreak date: 2020-09-30 journal: Annals of Oncology DOI: 10.1016/j.annonc.2020.08.1789 sha: 3fb4994e5cf0952f76c5c39cdb97b668d1fff6ce doc_id: 908573 cord_uid: s4potubf nan We tracked down oncological activity from January 1 st to March 31 st , 2020, in relationship to the organizational changes implemented and in comparison to the same period of 2019. We also recorded cases of SARS-CoV-2 infections observed in oncology health professionals and hospital admissions of active oncology patients for SARS-CoV-2 infection. Results: Progressive restrictions in patients', visitors', and caregivers' access to the inpatient and outpatient facilities of the Oncology section and organizational changes were adopted early on during the epidemic peak. Since March 13 th , segregated personnel teams were created, one dedicated to the COVID unit and a "clean" one dedicated to oncological patients, resulting in an overall 40% and 43% reduction in oncology-dedicated medical and nursing/auxiliary staff, respectively. As compared with the same trimester in 2019, the overall reduction in total numbers of inpatient admissions, chemotherapy administrations, and specialty visits in the period 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. Patient's acceptance of adopted measures was very high (see abstract by Tregnago D). Overall, 8/85 (9%) health professionals tested positive for SARS-CoV-2 (no hospital admissions and no treatment required) and 7/525 (1.3%) active oncology patients were admitted for SARS-CoV-2 infection (of whom, 2 died of infection-related complications). Conclusions: A minimal (<10%) reduction in Oncology activity was registered during the peak of SARS-CoV-2 epidemic in Verona, Italy. Organizational and protective measures adopted appear to have contributed to keep infections in both health professionals and oncological patients to a minimum. Legal entity responsible for the study: University of Verona. Funding: Has not received any funding. Methods: Patients applying the outpatient clinic and outpatient palliative care (OPC) clinic for the first time and patients admitted to wards in the first 30 days after the first case of COVID-19 in Turkey were evaluated. This data was compared to data from the same time frame in the previous three years. Results: A total of 868 inpatient and 809 outpatient admissions were evaluated in the study with a 114 OPC clinic admissions. The mean number of daily new patient applications to the outpatient clinic (9.87AE3.87 vs. 6.43AE4.03, p<0.001) and OPC clinic (3.87AE1.49 vs. 1.13AE1.46, p<0.001) was significantly reduced compared to the previous years. The reduction in new patient numbers was observed for all tumor types with the exception of lung and head and neck cancers. While the number of inpatient admissions was similar for a month frame (228 vs. 213), the median duration of hospitalization was significantly reduced (2 vs. 3 days). The frequency of hospitalizations for chemotherapy was higher than in previous years (p<0.001). By comparison, the rate of hospitalizations for palliative care (P¼0.028) or elective interventional procedures (P¼0.001) was significantly reduced. Conclusions: In our experience, continuing the patients' treatment with simple precautions was possible with simple measures. There were significant drops in the numbers of newly diagnosed patients and patients having palliative care services and these problems should be incorporated into the risk mitigation algorithms. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Background: The reorganization of oncologic follow-up was crucial to maintain oncologic care and reduce patient exposure during SARS-CoV-2 pandemic. Methods: Patients scheduled for follow-up oncologic visits during the lockdown period (March 9th -May 4th 2020) were included in a program of telematic follow-up (TFU) developed at the Medical Oncology Unit of Sant'Andrea and San Bartolomeo Hospital in La Spezia, Italy. Eligibility for TFU was determined through a pre-screening of medical charts based on tumor type, risk of relapse, geographic accessibility and DFS. Pre-calls were made by skilled nurses to assess pts' availability for next-day phone call and to assess availability of laboratory test and imaging results. A TFU form was conceived to collect pts' clinical history, symptoms, body weight, ongoing medical therapies, DFS, blood tests and imaging results (from Hospital imaging repository or acquired in the pre-call). Pts without signs/symptoms of relapse were scheduled for the next follow-up visit and the filled-in TFU form was attached to the clinical chart. When a suspected disease relapse was found, an ambulatory visit was performed. Results: There were 547 pts previously scheduled for in-hospital follow-up visit between March 9th and May 4th, 2020. 82 of 547 pts (15%) were considered not eligible for TFU according to the pre-screening assessment. 465 pts out of 547 (85%) were included in the TFU program. All these pts accepted calls with a compliance rate of 100%.The median age was 73 years (34-95); 152 male (33%) and 313 female (67%). The distribution by tumor type was: 179 breast cancer (38%), 86 colorectal (18%), 55 urinary tract (12%), 39 melanoma and skin (9%), 31 gynecologic (6%), 26 lung cancer(6%), 16 GEP (3%), 15 head and neck (3%), and 18 other tumors (4%). Ten patients with signs/symptoms of tumor recurrence were detected at TFU: 1 had clinical symptoms, 3 abnormal blood tests and 6 suspicious radiological findings. These patients were called for live visit and tumor relapse/progression was confirmed in 10 out of 10 cases. Medical or surgical treatment was started, or planned to start, in all 10 patients. Conclusions: TFU proved to be feasible with an eligibility rate of 85% and 100% patients' compliance. The detection rate for tumor recurrence was 2.1%. Legal entity responsible for the study: The authors. Background: Cancer patients (pts) have been associated with severe SARS-CoV2 infection and higher mortality compared with the general population. This could be related to the limitation of therapeutic effort based on their prognosis and healthcare prioritization towards non-cancer pts. The oncologist's role could be crucial for providing high-quality care. We aim to assess the impact of oncologists (ONC) on COVID-19 management. Methods: Multicentre retrospective analysis of cancer pts diagnosed with COVID-19 between Mar-Apr 2020. We classified pts according to an estimated life expectancy (based on tumor/stage/line) in 3 groups: favourable group (FG) mOS >5 years (y), intermediate (IG) 1-5y and poor (PG) <1y. We studied COVID-19 management based on oncologist's involvement: mainly-ONC vs. mainly other specialists (Other). Primary endpoint: COVID-19 30-day mortality (early-M). Secondary outcomes: intensive care unit admission (ICUa), the incidence of acute respiratory distress syndrome (ARDS) and antiretroviral treatment (ARVt) and immunomodulatory drugs (ImD) administered. Results: 287 pts were enrolled, median age 69 (35-98), 52% male, 67% with an active tumor (of them 76% had advanced stage). Mostly thoracic tumors (26%), followed by gastrointestinal (21%) and breast (19%). Among 170 pts under treatment, 89 (52%) received chemotherapy (CHT). By prognostic group: 49% were included in FG (n¼135), 40% in IG (n¼113), and 11% in PG (n¼30). Overall early-M rate was 27% (ONC 22% vs. Other 27%). Prognostic groups were associated with early-M: 19% (FG) vs. 31% (IG) vs. 37% (PG) (p¼0.022). No significant differences regarding rate of ARDS (23% FG vs. 19% IG vs. 17% PG). The ONC-group (n¼18) included 4 PG and 14 IG, 94% had an advanced stage disease, 83% receive CHT and 65% had PS!2 (p¼0.05 compared to Other group). In IG (ONC vs. Other): 7% vs. 2% ICUa, 100% vs. 34% ARVt and 57% vs. 7% ImD (all p<0.001). In PG (ONC vs. Other): 25% vs. 0% ICUa, 75% vs. 34% ARVt and 25% vs. 0% ImD (all p<0.001). Finally, FP managed only by Other: 13% ICUa; 33% ARVt and 13% ImD. Conclusions: Oncologist mostly treated complex pts compared to other specialists. During COVID-19 crisis, setting prognostic groups helped to individualized therapeutic approaches, reflected by less mortality rate and no differences in terms of complications. Background: The COVID 19 pandemic is a healthcare crisis leading to unprecedented impact upon healthcare services, notable morbidity and mortality of the public and healthcare professionals Methods: A questionnaire was developed and delivered via Survey Monkey relevant to doctors in training during the COVID-19 pandemic. The Perceived Stress Scale was incorporated to gauge participant stress in the weeks leading up to the expected surge of COVID-19 patients Almost 86% of respondents had been trained in donning and doffing personal protective equipment (PPE) and nearly 85% felt significantly confident in the process. Overall, most respondents felt somewhat prepared (60%) or well prepared (20%) to treat COVID-19 patients. However, 42% of respondents worried that their hospital would struggle, or could not cope at all, with COVID-19 patients. Nearly 91% of respondents were concerned that their hospital might run out of PPE. When asked to report their concerns, family health (86%), personal health (72%) and social life (47%) topped the list Conclusions: This survey is the first known effort to gauge the concerns of doctors in training in Ireland with regard to the COVID-19 pandemic. Our results show that most junior doctors were trained and relatively confident in donning and doffing PPE and managing COVID-19 patients. However, significant percentage of doctors in training worried that their hospital might run out of PPE and would struggle with COVID-19 the study: The authors Disclosure: D. Collins: Honoraria (self Travel/Accommodation/Expenses: Genmab; Honoraria (self), Travel/Accommodation/Expenses: Astra Zeneca; Honoraria (self) Honoraria (self), Travel/Accommodation/Expenses: Roche Travel/Accommodation/Expenses: MSD Advisory/Consultancy: Seattle Genetics. All other authors have declared no conflicts of interest Legal entity responsible for the study: Aleix Prat.Funding: Has not received any funding.