Collateral effects of the SARS-CoV-2 pandemic on oncologic surgery in Bavaria

Effects of the COVID-19 pandemic on the providers of oncological abdominal surgery services- a scoping review

INTRODUCTION

The COVID-19 pandemic, led to significant global health challenges. Medical services worldwide had to reconfigure to manage the surge in COVID-19 cases, including oncological abdominal surgery (OAS). This study investigates the impact of the pandemic on the OAS workforce and aims to enhance future healthcare preparedness to potential pandemics.

METHODS

This scoping review followed the methodologies from Arksey & O'Malley and the Joanna Briggs Institute. The search included the databases MEDLINE, CINAHL, Cochrane Library, and Web of Science, with backward citation tracking using Google Scholar™. The results were reported narratively and divided in categories and sub-categories. The reporting followed the PRISMA-ScR guidelines.

RESULTS

Fifteen studies were included in this scoping review. Seven studies were conducted in the United Kingdom and eight in the European Union. Key findings include treatment plan alterations such as postponing or cancelling surgeries, referring patients to alternative treatments, and changes in surgical techniques. Organizational challenges included patient and healthcare professionals' reallocation, resource shortages, and cold site availability. Measures to handle COVID-19 included adherence to guidelines, patient prioritization, and nursing roles. Testing and contamination prevention involved routine testing and the use of protective equipment. Communication shifted to virtual formats, with the introduction of telemedicine and video conferences. The pandemic induced significant psychological stress among surgical teams and highlighted lessons for future pandemics.

DISCUSSION AND CONCLUSION

The COVID-19 pandemic required substantial adjustments in oncological surgery. Keeping up with rapidly changing recommendations was challenging, yet provided valuable lessons for future healthcare management and crisis response. Future pandemic preparedness strategies should include innovative solutions that unburden healthcare professionals.

Impact of the COVID-19 pandemic on oncological care in Germany: rapid review

OBJECTIVES

The COVID-19 pandemic affected medical care for chronic diseases. This study aimed to systematically assess the pandemic impact on oncological care in Germany using a rapid review.

METHODS

MEDLINE, Embase, study and preprint registries and study bibliographies were searched for studies published between 2020 and 2 November 2022. Inclusion was based on the PCC framework: population (cancer), concept (oncological care) and context (COVID-19 pandemic in Germany). Studies were selected after title/abstract and full-text screening by two authors. Extracted data were synthesized using descriptive statistics or narratively. Risk of bias was assessed and summarized using descriptive statistics.

RESULTS

Overall, 77 records (59 peer-reviewed studies and 18 reports) with administrative, cancer registry and survey data were included. Disruptions in oncological care were reported and varied according to pandemic-related factors (e.g., pandemic stage) and other (non-pandemic) factors (e.g., care details). During higher restriction periods fewer consultations and non-urgent surgeries, and delayed diagnosis and screening were consistently reported. Heterogeneous results were reported for treatment types other than surgery (e.g., psychosocial care) and aftercare, while ongoing care remained mostly unchanged. The risk of bias was on average moderate.

CONCLUSIONS

Disruptions in oncological care were reported during the COVID-19 pandemic in Germany. Such disruptions probably depended on factors that were insufficiently controlled for in statistical analyses and evidence quality was on average only moderate. Research focus on patient outcomes (e.g., longer term consequences of disruptions) and pandemic management by healthcare systems is potentially relevant for future pandemics or health emergencies.

Effects of the COVID-19 pandemic on elderly patients with head and neck squamous cell carcinoma

Background

The 2019 novel coronavirus disease (COVID-19) strongly affects health care activities in countries around the world. The diagnosis and treatment of cancer have also been involved, and elderly head and neck squamous carcinoma is one of them. This study aimed to assess the impact of COVID-19 on elderly patients with head and neck squamous cell carcinoma (HNSCC) in our center.

Methods

This retrospective study analyzed the clinical characteristics of 400 HNSCC patients over 65 years of age, calculated their treatment interruption rates, and compared the time of delayed diagnosis.

Results

The rate of elderly patients with HNSCC with a delayed diagnosis was higher in the “during COVID-19 pandemic” group (DCOV19 group) than in the “during COVID-19 pandemic” group (BCOV19 group), and the difference was statistically significant (p=0.0017). There was a substantial difference in the rate of treatment interruption between the two groups (p=0.002).

Conclusions

This is the first study to explore the effect of the COVID-19 pandemic on visits and treatment interruptions in elderly patients with HNSCC. The current impact of the COVID-19 pandemic on HNSCC treatment has resulted in reductions and delays in diagnosing cancer and providing treatment.