Impact of coronaphobia on treatment and follow-up compliance of cancer patients

Impact of the Early Phase of the COVID-19 Pandemic on the Quality of Care for Colorectal and Anal Cancers at Comprehensive Cancer Centers on Two Continents

PURPOSE

The early phase of the COVID-19 pandemic affected cancer care globally. Evaluating the impact of the pandemic on the quality of cancer care delivery is crucial for understanding how changes in care delivery may influence outcomes. Our study compared care delivered during the early phase of the pandemic with the same period in the previous year at two institutions across continents (Princess Margaret Cancer Center [PM] in Canada and A.C. Camargo Cancer Center [AC] in Brazil).

METHODS

Patients newly diagnosed with colorectal or anal cancer between February and December 2019 and the same period in 2020 were analyzed. Sociodemographic and clinical characteristics and performance of individual indicators within and between centers and between the peri-COVID-19 and control cohorts were tested using Cohen's h test to assess the standardized differences between the two groups.

RESULTS

Among 925 patients, distinct effects of the early COVID-19 pandemic on oncology services were observed. AC experienced a 50% reduction in patient consultations (98 v 197) versus a 12.5% reduction at PM (294 v 336). Similarly, AC experienced a higher proportion of stage IV disease presentations (42.9% v 29.9%; P = .015) and an increase in treatment delay (61.9% v 9.7%; P < .001) compared with prepandemic. At PM, a 10% increase in treatment interruption (32.4% v 22.3%; P < .001) and a higher rate of discontinuation of radiotherapy (9.4% v 1.1%; P < .001) were observed during the pandemic. Postsurgical readmission rates increased in both AC (20.9% v 2.6%; P < .001) and PM (10.5% v 3.6%; P < .01).

CONCLUSION

The early phase of the COVID-19 pandemic affected the quality of care delivery for colorectal and anal cancers at both centers. However, the magnitude of this impact was greater in Brazil.

Coronaphobia: A barrier to ongoing cancer treatment?

INTRODUCTION

Increased stress levels caused by the pandemic might cause delays in cancer treatment. We conducted a survey among cancer patients undergoing treatment to evaluate their psychological wellbeing and treatment adherence during Coronavirus disease 19 (COVID-19) pandemic.

MATERIAL AND METHODS

Patients receiving active chemotherapy at a private oncology center between January and May 2021 were included. Healthy volunteers were employees of a district health directorate with no history of cancer or chronic disease. Treatment adherence was described as compliant if the prescribed treatment was received within a week and the information was gained from patient charts. Hospital anxiety and depression scale (HADS) and COVID-19 phobia scale (CP19-S) were administered to participants.

RESULTS

402 participants were included; 193 (48%) were cancer patients. The mean age of the participants was 44 years old and 68% of the participants were female. All participants' CP19-S mean score was 47.9. Patient group had significantly lower CP19-S (p = 0.006). Chronic disease and history of a shocking event were the factors associated with CP19-S. All participants reporting hospital anxiety were found to have significantly higher COVID-19 phobia levels (p < 0.05). Patients' mean HADS-anxiety score was significantly higher (7.3 vs. 6.5, p = 0.027). COVID-19 phobia was an independent factor increasing the level of anxiety and depression in both groups. Adherence to treatment was 100%.

CONCLUSION

The pandemic increased levels of anxiety, however, cancer treatment continued to be a priority in patients' lives. Strategies should be developed to support oncology patients cope with the pandemic and increase their courage to avoid treatment delays.

Impact of corona-phobia on attitudes and acceptance towards COVID-19 vaccine among cancer patients: a single-center study

Aim: This study aimed to assess the impact of COVID-19 phobia and related factors on attitude towards COVID-19 vaccine in cancer patients. Methods: A prospective cross-sectional descriptive study was conducted with 300 adult patients using a validated COVID-19 Phobia Scale (C19P-S) and related survey to determine the factors affecting vaccine acceptance between May-June 2021. Results: Regarding the COVID-19 vaccine willingness, 86.7% accepted vaccination, 6.3% were hesitant and 7% refused vaccination. Patients that accepted vaccination had significantly higher C19P-S scores in general, and in psychological and psychosomatic subdivisions. Univariate analysis revealed that increased age, being retired, and being married were significantly associated with willingness to be vaccinated against COVID-19. Conclusion: The majority of patients had high 'coronophobia' levels which were associated with increased willingness for the COVID-19 vaccines. Minimizing negative attitudes towards vaccines will most likely be achieved by raising awareness in the cancer population about COVID-19 vaccine.

Immunogenicity and safety of the CoronaVac vaccine in patients with cancer receiving active systemic therapy

Aim: To evaluate the immunogenicity and safety of the CoronaVac vaccine in patients with cancer receiving active systemic therapy. Methods: This multicenter, prospective, observational study was conducted with 47 patients receiving active systemic therapy for cancer. CoronaVac was administered as two doses (3 μg/day) on days 0 and 28. Antibody level higher than 1 IU/ml was defined as 'immunogenicity.' Results: The immunogenicity rate was 63.8% (30/47) in the entire patient group, 59.5% (25/42) in those receiving at least one cytotoxic drug and 100% (five of five) in those receiving monoclonal antibody or immunotherapy alone. Age was an independent predictive factor for immunogenicity (odds ratio: 0.830; p = 0.043). Conclusion: More than half of cancer patients receiving active systemic therapy developed immunogenicity.