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Raffaelli M, Sessa L, De Crea C, Cerviere MP, Marincola G, Zotta F, Ambrosini CE, Gjeloshi B, De Napoli L, Rossi L, Elisei R, Pontecorvi A, Basolo F, Rossi ED, Bellantone R, Materazzi G. Impact of COVID-19 pandemic on thyroidectomy for malignant diseases in high-volume referral centers. Updates Surg 2024; 76:1073-1083. [PMID: 38351271 DOI: 10.1007/s13304-024-01771-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/29/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has limited the availability of healthcare resources for non-COVID patients and decreased elective surgeries, including thyroidectomy. Despite the prioritization of surgical procedures, it has been reported that thyroidectomy for thyroid cancer (TCa) was adversely impacted. We assessed the impact of the pandemic on the surgical activities of two high-volume referral centers. MATERIALS AND METHODS Patients operated at two National Referral Centers for Thyroid Surgery between 03/01/2020 and 02/28/2021 (COVID-19 period) were included (P-Group). The cohort was compared with patients operated at the same Centers between 03/01/2019 and 02/29/2020 (pre-COVID-19 pandemic) (C-Group). RESULTS Overall, 7017 patients were included: 2782 in the P-Group and 4235 in the C-Group. The absolute number of patients with TCa was not significantly different between the two groups, while the rate of malignant disease was significantly higher in the P-Group (1103/2782 vs 1190/4235) (P < 0.0001). Significantly more patients in the P-Group had central (237/1103 vs 232/1190) and lateral (167/1103 vs 140/1190) neck node metastases (P = 0.001). Overall, the complications rate was significantly lower (11.9% vs 15.1%) and hospital stay was significantly shorter (1.7 ± 1.5 vs 1.9 ± 2.2 days) in the P-Group (P < 0.05). CONCLUSION The COVID-19 pandemic significantly decreased the overall number of thyroidectomies but did not affect the number of operations for TCa. Optimization of management protocols, due to limited resource availability for non-COVID patients, positively impacted the complication rate and hospital stay.
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Affiliation(s)
- Marco Raffaelli
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" - IRCCS, 00168, Rome, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Luca Sessa
- Division of Endocrine and Obesity Surgery, Fondazione Istituto G. Giglio, Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy.
| | - Carmela De Crea
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Division of Endocrine Surgery, Fatebenefratelli Isola Tiberina - Gemelli Isola, 00186, Rome, Italy
| | - Milena Pia Cerviere
- Division of Endocrine Surgery, Fatebenefratelli Isola Tiberina - Gemelli Isola, 00186, Rome, Italy
| | - Giuseppe Marincola
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" - IRCCS, 00168, Rome, Italy
| | - Francesca Zotta
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" - IRCCS, 00168, Rome, Italy
| | - Carlo Enrico Ambrosini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Benard Gjeloshi
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Luigi De Napoli
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Leonardo Rossi
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, Endocrine Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Alfredo Pontecorvi
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Division of Endocrinology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168, Rome, Italy
| | - Fulvio Basolo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Pathology Unit, Pisa University Hospital, 56124, Pisa, Italy
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00168, Rome, Italy
| | - Rocco Bellantone
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" - IRCCS, 00168, Rome, Italy
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Gabriele Materazzi
- Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, 56124, Pisa, Italy
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Hu S, Wu X, Jiang H. Trends and projections of the global burden of thyroid cancer from 1990 to 2030. J Glob Health 2024; 14:04084. [PMID: 38751316 PMCID: PMC11109522 DOI: 10.7189/jogh.14.04084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024] Open
Abstract
Background We aimed to explore the burden of thyroid cancer worldwide from 1990 to 2019 and to project its future trends from 2020 to 2030. Methods Based on annual data on thyroid cancer cases from 1990 to 2019 available in the Global Burden of Disease (GBD) database, we calculated the age-standardised incidence, death, and disability-adjusted life year (DALY) rates for thyroid cancer. We used the estimated annual percentage change (EPAC) to quantify the temporal trends in these age-standardised rates from 1990 to 2019 and applied generalised additive models to project the disease burden from 2020 to 2030. Results The global age-standardised incidence rate (ASIR) of thyroid cancer increased from 1990 to 2019, with a higher overall disease burden in women than in men at both study time points. The male-to-female ratios for the ASIR increased from 0.41 in 1990 to 0.51 in 2019, while the ratio for the age-standardised death rate (ASDR) increased from 0.60 to 0.82. The models predicted the United Arab Emirates would have the fastest rising trend in both the ASIR (estimated annual percentage changes (EAPC) = 4.19) and age-standardised DALY rate (EAPC = 4.36) in 2020-30, while Saint Kitts and Nevis will have the fastest rising trend in the ASDR (EAPC = 2.29). Meanwhile, the growth trends for the ASDR and age-standardised DALY rate are projected to increase across countries in this period. A correlation analysis of the global burden of thyroid cancer between 1990-2019 and 2020-30 showed a significant positive correlation between the increase in the ASIR and socio-demographic index (SDI) in low-SDI and low-middle-SDI countries. Conclusions The global burden of thyroid cancer is increasing, especially in the female population and in low-middle-SDI regions, underscoring a need to target them for effective prevention, diagnosis, and treatment.
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Affiliation(s)
- Supei Hu
- Department of General Practice, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- Research and Education department, Ningbo No.2 Hospital, Ningbo, China
| | - Xianjiang Wu
- Department of Thyroid Surgery, Ningbo No.2 Hospital, Ningbo, China
| | - Hua Jiang
- Department of General Practice, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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Liu Q, Song M, Zhang H. Choice of management strategy for papillary thyroid microcarcinoma: active surveillance or immediate surgery? J Cancer 2024; 15:1009-1020. [PMID: 38230222 PMCID: PMC10788711 DOI: 10.7150/jca.91612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024] Open
Abstract
Overdiagnosis of papillary thyroid microcarcinoma (PTMC) is prevalent, and effective management of PTMC is an important matter. The high incidence and low mortality rate of papillary thyroid carcinoma (PTC) justify the preference for active surveillance (AS) over immediate surgery (IS), particularly in cases of low-risk PTMC. Japan began AS in the 1990s as an alternative surgical option for PTMC and it has shown promising results. The safety and efficacy of AS management in PTMC have been verified. However, AS may not be suitable for all PTMC cases. How to find the balance between the decision-making of AS and IS requires careful consideration. Therefore, we collected and analyzed the relevant evidence on the clinical strategies for PTC and discussed AS and IS from the perspectives of health, economic, and psychological aspects, to help clinicians in choosing a more appropriate clinical strategy for PTC.
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Affiliation(s)
| | | | - Hao Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, China
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Legge H, Toohey K, Kavanagh PS, Paterson C. Exploring Experiences Among People Diagnosed With Cancer During the COVID-19 Pandemic: A Qualitative Descriptive Study. Semin Oncol Nurs 2023; 39:151508. [PMID: 37827903 DOI: 10.1016/j.soncn.2023.151508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/28/2023] [Accepted: 09/06/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES To describe the experiences of people diagnosed with cancer during the COVID-19 pandemic. DATA SOURCES Qualitative data were collected through semistructured interviews conducted with people affected by cancer in the Australian context. Following institutional ethical approval, interviews were conducted over Microsoft Teams and Zoom platforms and complied with confidentiality requirements. Data were transcribed verbatim and analyzed, and emergent themes were developed using thematic analysis to understand patient experiences of cancer care during the COVID-19 pandemic. CONCLUSIONS The COVID-19 pandemic was disruptive to the daily experiences of supportive care. Four overarching themes were identified related to: 1) the impact on accessing healthcare services, 2) encounters with healthcare professionals, 3) the impact on daily living, and 4) the impact of COVID on psychological well-being. IMPLICATIONS FOR NURSING PRACTICE As the COVID-19 pandemic held global consequences on cancer practices, it is recommended that nursing and other multidisciplinary healthcare professionals reflect upon these findings, in the context of planning for future pandemics. We encourage further exploration into the sustainability of telehealth services universally, given the issues highlighted in this study.
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Affiliation(s)
- H Legge
- Faculty of Health, University of Canberra, Bruce ACT, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce ACT, Australia; Southern Cross University, Gold Coast, QLD, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce ACT, Australia; Justice and Society, University of South Australia, Magill SA, Australia
| | - C Paterson
- Faculty of Health, University of Canberra, Bruce ACT, Australia; Caring Futures Institute, Flinders University, Australia; Central Adelaide Local Health Network, Adelaide; Robert Gordon University, Aberdeen, Scotland, UK.
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Rodriguez-Gonzalez A, Hernández R, Cruz-Castellanos P, Fernández-Montes A, Castillo-Trujillo O, Muñoz MM, Cano-Cano JM, Corral MJ, Esteban E, Jiménez-Fonseca P, Calderon C. Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer. Health Qual Life Outcomes 2023; 21:15. [PMID: 36800957 PMCID: PMC9936733 DOI: 10.1186/s12955-023-02099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients. METHODS This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated. RESULTS The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85. CONCLUSION This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.
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Affiliation(s)
- Adán Rodriguez-Gonzalez
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Raquel Hernández
- grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Patricia Cruz-Castellanos
- grid.81821.320000 0000 8970 9163Department of Oncology Medical. Hospital, Universitario La Paz, Madrid, Spain
| | - Ana Fernández-Montes
- grid.418883.e0000 0000 9242 242XDepartment of Medical Oncology, Complejo Hospitalario Universitario de Ourense – CHUO, Orense, Spain
| | - Oscar Castillo-Trujillo
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - María M. Muñoz
- Department of Medical Oncology, Hospital General Virgen de La Luz, Cuenca, Spain
| | - Juana M. Cano-Cano
- grid.411096.bDepartment of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - María J. Corral
- grid.5841.80000 0004 1937 0247Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Esteban
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Paula Jiménez-Fonseca
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.
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Grani G, Ciotti L, Del Gatto V, Montesano T, Biffoni M, Giacomelli L, Sponziello M, Pecce V, Verrienti A, Filetti S, Durante C. The legacy of the COVID-19 pandemics for thyroid cancer patients: towards the application of clinical practice recommendations. Endocrine 2023; 79:45-48. [PMID: 35857273 PMCID: PMC9298162 DOI: 10.1007/s12020-022-03132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/30/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Ciotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Del Gatto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Teresa Montesano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Pecce
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Sebastiano Filetti
- School of Health, UNITELMA Sapienza University of Rome, Piazza Sassari, 4, 00161, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Grani G, Ciotti L, Del Gatto V, Montesano T, Biffoni M, Giacomelli L, Sponziello M, Pecce V, Lucia P, Verrienti A, Filetti S, Durante C. The COVID-19 outbreak and de-escalation of thyroid cancer diagnosis and treatment. Endocrine 2022; 78:387-391. [PMID: 35802229 PMCID: PMC9264748 DOI: 10.1007/s12020-022-03131-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/27/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Ciotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Del Gatto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Teresa Montesano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Pecce
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Piernatale Lucia
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Sebastiano Filetti
- School of Health, UNITELMA Sapienza University of Rome, Piazza Sassari, 4, 00161, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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The unmet supportive care needs of people affected by cancer during the COVID-19 pandemic: an integrative review. J Cancer Surviv 2022:10.1007/s11764-022-01275-z. [DOI: 10.1007/s11764-022-01275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 10/31/2022]
Abstract
Abstract
Purpose
To critically synthesise evidence regarding the supportive care needs of those living with cancer during the COVID-19 pandemic.
Methods
An integrative systematic review followed a pre-registered protocol, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guidelines. We searched three databases (CINAHL, MEDLINE, and APA PsycINFO) using keywords and included all qualitative, quantitative, and mixed methods studies irrespective of research design published between December 2019 and February 2022. All articles were double screened according to a pre-determined eligibility criterion with reference lists of the final included studies checked for further studies. The review process was managed using Covidence systematic review software. Data from the studies were extracted, methodological quality appraisal conducted, and a narrative synthesis conducted.
Results
Eighteen publications were included. The findings identified that individuals affected by cancer reported a range of physical, psychological, social, and health system unmet needs during the global pandemic. Unique to the pandemic itself, there was fear of the unknown of the longer-term impact that the pandemic would have on treatment outcomes, cancer care follow-up, and clinical service delays.
Conclusion
Many individuals living with cancer experienced unmet needs and distress throughout the different waves of the COVID-19 pandemic, irrespective of cancer type, stage, and demographic factors.
Implications for Cancer Survivors
We recommend clinicians use these findings to identify the individual person-centred needs to optimise recovery as we transition to the post-pandemic cancer care.
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Nguyen HTH, Duong KL, Nguyen ST, Trinh Q, Hoang HTL, Phung TQ, Lin HW, Nguyen HTL. Quality of Life and Its Associated Factors Among Cancer Patients Receiving Chemotherapy at Oncology Hospitals in Vietnam After the Third Wave of the COVID-19 Pandemic. Cancer Manag Res 2022; 14:2429-2444. [PMID: 35979066 PMCID: PMC9377346 DOI: 10.2147/cmar.s370034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/30/2022] [Indexed: 12/19/2022] Open
Abstract
Purpose This study aimed to evaluate the health-related quality of life (HRQOL) of cancer patients receiving chemotherapy and identify associated factors affecting the HRQOL after the third wave of the COVID-19 pandemic in Vietnam. Patients and Methods Patients with solid cancers receiving chemotherapy at two oncology hospitals in Vietnam during April and May 2021 were included. The European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire version 3 was used to measure the HRQOL. Three questions were asked to explore patients’ concern levels about contracting COVID-19, delaying chemotherapy, or not controlling cancer well. One question was used to explore whether patients were concerned about cancer progression or COVID-19 infection more, or equally, or had no concern about both. Multiple regression models were conducted to examine factors associated with the global health status (GHS) score. Results Of 270 included patients, mean (Standard deviation [SD]) GHS was 56.7 (20.8). Among the functional statuses, social functioning (SF) had the lowest score of 63.6 (29.2). The symptoms with the highest means were insomnia and fatigue, obtaining the score of 38.5 (31.7) and 37.3 (29.2), respectively. The mean of financial difficulties was 54.1 (32.2). In univariate analysis, high concerns about contracting COVID-19, delaying chemotherapy, not controlling cancer well, or more concern about either cancer or COVID-19 over the other were associated with worse GHS, physical functioning, emotional functioning, and SF. In multivariate analysis, those concerns and no income were significantly related to lower GHS scores besides the non-modifiable factors, such as female gender and some cancer types. Conclusion Patients at the high concern levels, or with more concern about either cancer or COVID-19 over the other had poorer HRQOL. Interventions to address the concerns are required to improve their HRQOL, particularly for women, those without income, or with some specific cancers.
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Affiliation(s)
- Hanh T H Nguyen
- School of Pharmacy and Graduate Institute, China Medical University, Taichung, Taiwan.,Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Khanh Linh Duong
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Son T Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Quy Trinh
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Hao T L Hoang
- Pharmacy Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Toan Q Phung
- Pharmacy Department, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, Taichung, Taiwan.,Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Huong T L Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
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Muls A, Georgopoulou S, Hainsworth E, Hartley B, O'Gara G, Stapleton S, Cruickshank S. The psychosocial and emotional experiences of cancer patients during the COVID-19 pandemic: A systematic review. Semin Oncol 2022; 49:371-382. [PMID: 36089413 PMCID: PMC9393184 DOI: 10.1053/j.seminoncol.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/29/2022] [Accepted: 08/13/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. Global social lockdowns were instigated to reduce spread and prevent health-services from becoming overwhelmed. People having treatment for cancer are known to have heightened psychological/emotional burden. The combined impact of managing pandemic regulations alongside this may present additional burden. The purpose of this systematic review is to examine current evidence of the psychological and emotional impact of COVID-19 on people with cancer, early in the pandemic. METHODS Five electronic databases were searched (Embase, Global Health, HMIC, PsychINFO, CINAHL) from September 2019 to October 2021. Qualitative, quantitative and mixed-method primary research studies exploring emotional and psychological impacts of COVID-19 on cancer patients, limited to English language, were included. Quality appraisal was conducted using the MMAT. RESULTS Fifty-one papers, with 27,356 people from 21 countries treated for cancer, were included. 43 studies were quantitative with a survey method approach, six studies qualitative and four used a mixed methods design. MMAT score was mostly two or three. Four themes were identified: Emotional aspects and Quality of Life; Psychosocial aspects; Impact of COVID-19 on self; Impact of COVID-19 on cancer, with themes overlapping. CONCLUSION Whilst emotional/psychological impacts such as anxiety, isolation, employment fears, and uncertainty about the future were potentially universal concerns early in the pandemic, they may have been particularly acute for people living with cancer and represent complex, overlapping factors. As COVID-19 continues to impact health-services and society, it is important to focus on any ongoing impact to the experience of cancer patients. Most of the studies reviewed used tools that do not provide deeper understanding of how and why emotional states of people with cancer were affected. Further qualitative work may reveal patterns of what was unique to cancer patients during the pandemic, compared to general populations.
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11
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Pavlatou MG, Žarković M, Hegedüs L, Priestley J, McMullan C, Perros P. A survey on the psychological impact and access to health care of thyroid patients during the first SARS-COV-2 lockdown. Clin Endocrinol (Oxf) 2022; 96:869-877. [PMID: 34881433 DOI: 10.1111/cen.14649] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Information on the impact of SARS-COV-2 on the daily life of thyroid patients during lockdown is sparse. The main objective was explorative, focusing on how SARS-COV-2 affected thyroid patients. DESIGN Cross-sectional, questionnaire-based, using an online platform. PATIENTS Patients >18 years with a history of thyroid disease. MEASUREMENTS Demographic data, psychological impact of SARS-COV-2, medical care during the pandemic. RESULTS Valid responses were received from 609 responders. The median age was 50 years, 94% were female and 98.5% were UK residents. The commonest diagnosis was primary hypothyroidism (52.2%). Negative psychological effects following the lockdown were reported by 45.6%-58.7%. Cancellations of appointments with thyroid specialists were reported by 43.8%, although cancellations of thyroid investigations and treatments were relatively infrequent (12.9%-14.1%). Overall satisfaction rates for thyroid services were low (satisfaction score 40.1-42.8 out of 100), but nearly 80% were satisfied with remote consultations. Responder ratings of online information sources about SARS-COV-2 and thyroid diseases were lowest for government sites. Unmet needs during lockdown were: more remote access to thyroid specialists, more online information in 'plain English', and psychological support. In multivariate analyses, younger age, female gender, history of depression, hyperthyroidism, not having contracted SARS-COV-2 and multiple comorbidities were risk factors for a negative psychological impact of lockdown. CONCLUSIONS This survey identified a significant negative impact of SARS-COV-2 and lockdown on psychological wellbeing, particularly in some groups of patients defined by demographic factors, history of hyperthyroidism and comorbidities. Low satisfaction with healthcare services among thyroid patients was noted, but remote consultations were rated favourably.
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Affiliation(s)
- Maria G Pavlatou
- Department of Endocrinology, Diabetes and Metabolism, Athens Medical Center, Athens, Greece
| | - Miloš Žarković
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia
- Department of Endocrinology, University of Belgrade, Belgrade, Serbia
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | | | | | - Petros Perros
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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12
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Quality of Life in Patients with Pancreatic Cancer before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063731. [PMID: 35329416 PMCID: PMC8948872 DOI: 10.3390/ijerph19063731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/13/2022] [Accepted: 03/18/2022] [Indexed: 01/05/2023]
Abstract
Background: Coronavirus disease 19 (COVID-19) substantially affects cancer patients due to adverse outcomes and disruptions in cancer care. Recent studies have indicated the additional stress and anxiety burden arising from the pandemic and impairing quality of life in this vulnerable group of patients. However, patients with cancer represent a heterogenous group. Therefore, we conducted a study on patients with pancreatic cancer, requiring demanding surgical interventions and chemotherapy regimens due to its aggressive tumor biology, to explore the pandemic’s impact on quality of life within this homogenous cohort. Methods: In a descriptive observational study, the quality of life of patients who had undergone pancreatic surgery for tumor resection at our institution between 2014 and the beginning of the pandemic in March 2020 was assessed. For HRQoL measurement, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), comparing their situation before the pandemic and since its beginning. An additional self-developed questionnaire was applied to assess the life circumstances during the pandemic. Results: Our cohort included 26 patients. Scores from the survey in HRQoL revealed no significant changes over time between before and during the pandemic. A medium deterioration in HRQoL was apparent in social functioning, as well as a small deterioration in role functioning and emotional functioning. Worries concerning a potential impact of COVID-19 on personal health were expressed. Psychological limitations in QoL were mainly attributed to the pandemic, whereas physical limitations in QoL were rather associated with the underlying disease of pancreatic cancer. Conclusion: The COVID-19 pandemic is causing considerable social and emotional distress among pancreatic cancer patients. These patients will benefit from psychological support during the pandemic and beyond. Long-time survivors of pancreatic cancer, such as those included in our cohort, appear to have improved resilience facing the psychosocial challenges of the pandemic. For pancreatic cancer, surgical care is considered the cornerstone of treatment. Prolonged delays in healthcare cause serious damage to mental and physical health. To date, the longer-term clinical consequences are not known and can only be estimated. The potential tragic outcome for the vulnerable group of pancreatic cancer patients highlights the urgency of timely healthcare decisions to be addressed in the future.
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Abstract
In this review, I aim to provide a complete overview of recent advances in knowledge regarding severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2)-induced thyroid dysfunction. I discuss the findings regarding the role of SARS-CoV-2 in the development of thyroid dysfunction, including subacute thyroiditis, Graves’ disease, non-thyroidal illness, thyrotoxicosis and Hashimoto’s thyroiditis during and subsequent to coronavirus disease 2019 (COVID-19). The thyroid gland and the entire hypothalamic–pituitary–thyroid (HPT) axis may represent key targets of SARS-CoV-2. Thyroid dysfunction during and subsequent to COVID-19 has been documented in clinical studies and is usually reversible. Most of the thyroid disorders, including Graves’ disease, euthyroid sick syndrome, Hashimoto’s thyroiditis and subacute thyroiditis, have been documented as sequelae to COVID-19, and the SARS-CoV-2 virus has been implicated in the aetiology of each. COVID-19 has been suggested to trigger the activation of pre-existing thyroid disease or autoimmunity. Furthermore, patients with uncontrolled thyrotoxicosis are at risk of SARS-CoV-2 infection-related consequences. Because of the neutropenia caused by antithyroid medications, which may obscure the signs of COVID-19, this group of patients should receive special attention. It is suggested that thyroid dysfunction during COVID-19 is caused by direct infection of the thyroid or “cytokine storm”-mediated autoimmune effects on the thyroid.
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Affiliation(s)
- Rania Naguib
- Associate Professor of Medicine and Endocrinology, Department of Clinical Science, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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14
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Berger NF, Zimmerman BS, Seidman D, Cascetta KP, Moshier E, Nezolosky M, Trlica K, Ryncarz A, Keeton C, Tiersten A. Impact of the COVID-19 Pandemic on Cancer Care and Quality of Life for Patients With Breast and Gynecologic Malignancies: A Single-Center Survey-Based Study. J Patient Exp 2022; 9:23743735221077543. [PMID: 35187223 PMCID: PMC8850998 DOI: 10.1177/23743735221077543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
This study evaluated the mental health and cancer treatment-related impact of the first wave of the COVID-19 pandemic on patients with breast and gynecologic cancers. An 18-question survey was administered in June 2020 at a New York City-based cancer center to assess the quality of life (QOL) and overall health (OH) during both the pandemic time period from March 1, 2020, through June 30, 2020, and the pre-pandemic period (prior to March 1, 2020). Survey questions were answered on a 5-point Likert scale and a 7-point EORTC QLQ-C30 QOL scale. Differences in mean QOL and OH scores were evaluated using a paired t-test. QOL and OH were significantly worsened by the pandemic, with significant increases in anxiety, depression, and mood swings.
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Affiliation(s)
- Natalie F. Berger
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Natalie F. Berger, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.
| | - Brittney S. Zimmerman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Danielle Seidman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krystal P. Cascetta
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Nezolosky
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kara Trlica
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alisa Ryncarz
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Caitlin Keeton
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Tiersten
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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15
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The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review. Curr Oncol 2022; 29:589-601. [PMID: 35200553 PMCID: PMC8870801 DOI: 10.3390/curroncol29020053] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Older adults with cancer are amongst the most vulnerable population to be negatively impacted by COVID-19 due to their likelihood of comorbidities and compromised immune status. Considering the longevity of the pandemic, understanding the subjective perceptions and psychosocial concerns of this population may help ameliorate the psychological aftermath. In this review, we systematically analyze the literature surrounding the psychosocial impact and coping strategies among older adults with cancer within the context of COVID-19. Methods: We conducted a rapid review of literature following PRISMA guidelines between January 2020 to August 2021 using (1) MEDLINE, (2) Embase, (3) CINAHL, and (4) PsychINFO and keyword searches for “cancer” and “COVID-19” focused on adults 65 years or older. Results: Of the 6597 articles screened, 10 met the inclusion criteria. Based on the included articles, the psychosocial impact of COVID-19 was reported under four domains, (1) impact of COVID-19 on quality of life (QoL), (2) concerns related to COVID-19, (3) coping with the impact of COVID-19, and (4) recommendations for future care. Results pertaining to perceived quality of life were inconsistent across the included articles. The most common concerns related to: contracting COVID-19, survivorship transitions, and feelings of isolation. Coping strategies reported by older adults included: spiritual care, lived experience, acceptance, and positive reinterpretation. Conclusions: We found many psychosocial impacts of the pandemic on older adults with cancer. The findings from this review can inform interventions related to shared decision-making and tailored patient care in the future.
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16
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Zannella A, Fanella S, Marignani M, Begini P. COVID-19 emergency: Changes in quality of life perception in patients with chronic liver disease-An Italian single-centre study. World J Hepatol 2022; 14:274-286. [PMID: 35126854 PMCID: PMC8790390 DOI: 10.4254/wjh.v14.i1.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/08/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In December 2019, the coronavirus disease-2019 (COVID-19) emerged and rapidly spread worldwide, becoming a global health threat and having a tremendous impact on the quality of life (QOL) of individuals.
AIM To evaluate the awareness of patients with chronic liver disease (CLD) regarding the COVID-19 emergency and how it impacted on their QOL.
METHODS Patients with an established diagnosis of CLD (cirrhosis, autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis) who had been evaluated at our Outpatient Liver Disease Clinic during the 6-mo period preceding the start of Italian lockdown (March 8, 2020) were enrolled. Participants were asked to complete a two-part questionnaire, administered by telephone according to governmental restrictions: The first section assessed patients’ basic knowledge regarding COVID-19, and the second evaluated the impact of the COVID-19 emergency on their QOL. We used the Italian version of the CLD questionnaire (CLDQ-I). With the aim of evaluating possible changes in the QOL items addressed, the questionnaire was administered to patients at the time of telephone contact with the specific request to recall their QOL perceptions during two different time points. In detail, patients were asked to recall these perceptions first during time 0 (t0), a period comprising the 2 wk preceding the date of ministerial lockdown decree (from February 23 to March 7, 2020); then, in the course of the same phone call, they were asked to recall the same items as experienced throughout time 1 (t1), the second predetermined time frame encompassing the 2 wk (from April 6 to April 19) preceding our telephone contact and questionnaire administration. All data are expressed as number (%), and continuous variables are reported as the median (interquartile range). The data were compared using the Wilcoxon paired non-parametric test.
RESULTS A total of 111 patients were enrolled, of whom 81 completed the questionnaire. Forty-nine had liver cirrhosis, and all of them had compensated disease; 32 patients had autoimmune liver disease. The majority (93.8%) of patients were aware of COVID-19 transmission modalities and on how to recognize the most common alarm symptoms (93.8%). Five of 32 (15.6%) patients with autoimmune liver disease reported having had the need to receive more information about the way to manage their liver disease therapy during lockdown and nine (28.2%) thought about modifying their therapy without consulting their liver disease specialist. About the impact on QOL, all CLDQ-I total scores were significantly worsened during time t1 as compared to time t0.
CONCLUSION The COVID-19 epidemic has had a significant impact on the QOL of our population of patients, despite a good knowledge of preventive measure and means of virus transmission.
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Affiliation(s)
| | - Silvia Fanella
- Department of Gastroenterology, Sant’Andrea Hospital, Rome 00189, Italy
| | - Massimo Marignani
- Department of Gastroenterology, Sant’Andrea Hospital, Rome 00189, Italy
| | - Paola Begini
- Department of Gastroenterology, Sant’Andrea Hospital, Rome 00189, Italy
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17
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Petrović-Lazić M, Babac S, Ilić-Savić I. The impact of the COVID-19 pandemic on the quality of life of laryngectomized patients. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-36517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Introduction: Quality of life is a state of complete physical, mental and social well-being. Due to the COVID-19 pandemic, which led to changes in the daily routine, there was a change in the psychosocial functioning of individuals. Given that laryngectomized patients belong to a vulnerable group that requires psychological support after surgery, specific epidemiological measures during the COVID-19 pandemic could only further increase the fear and reluctance that is especially pronounced after surgery. Aim: The aim of this study was to investigate whether there was a link between the quality of life of laryngectomized patients and the COVID-19 pandemic. Method: The literature review was performed through the Google Scholar Advanced Search search engine and the Consortium of Libraries of Serbia for Unified Acqusition - KoBSON. Results: The first wave of the COVID-19 pandemic significantly disrupted the emotional well-being of patients with head and neck cancer. These patients became even more anxious due to the high mortality from the COVID-19 viral infection, hospital occupancy and missed therapeutic examinations. The need for togetherness, impaired concentration and attention, irritability and fear that family members might suffer from a deadly disease were the most common behavioral problems identified during the COVID-19 pandemic. Conclusion: The psychological burden associated with the direct and indirect effects of the COVID-19 pandemic should not be overlooked, given the fact that laryngectomized patients have twice the risk of suicide compared to patients who have undergone other types of cancer. Assessing the quality of life in laryngectomized patients is very important because it enables the timely identification of mental disorders and suggests the necessary support measures.
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18
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Yang S, Xu X. Mental Health in Postoperative Thyroid Patients During the COVID-19 Pandemic. Front Endocrinol (Lausanne) 2022; 13:875325. [PMID: 35837317 PMCID: PMC9274260 DOI: 10.3389/fendo.2022.875325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about mental health in patients after thyroid surgery during the peak of the COVID-19 pandemic in China. This study aimed to assess the mental health of postoperative thyroid patients and to explore potential factors associated with psychological symptoms. METHODS In this study, we surveyed 241 patients who underwent thyroid surgery at Peking Union Medical College Hospital. Insomnia, anxiety, depression, and posttraumatic stress symptoms (PTSS) were measured using the Insomnia Severity Index (ISI), Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Impact of Event Scale-Revised (IES-R), respectively. RESULTS A significant proportion of postoperative patients reported experiencing insomnia, anxiety, depression, and PTSS. Patients that were older, single/divorced/widowed, and less educated; had lower income and poor general health; had undergone surgery within the past six months; had disrupted follow-up, and; searched social media for COVID-19-related information were associated with worse mental health. CONCLUSIONS During the COVID-19 pandemic, postoperative thyroid patients tended to develop mental health problems and have less psychological support, emphasizing the importance of patient education and psychological interventions.
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Affiliation(s)
| | - Xiequn Xu
- *Correspondence: Xiequn Xu, ; orcid.org/0000-0003-0347-5258
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19
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Silveira VB, Schwengber WK, Hetzel GM, Zanella AB, Scheffel RS, Maia AL, Dora JM. Effect of COVID-19 pandemic on diagnosis and treatment of thyroid cancer in Brazil. Front Endocrinol (Lausanne) 2022; 13:995329. [PMID: 36277724 PMCID: PMC9581141 DOI: 10.3389/fendo.2022.995329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic delayed the diagnosis, treatment, and follow-up visits of patients with thyroid cancer. However, the magnitude with which these restrictions affected the Brazilian health care is still unknown. METHODS Retrospective analysis of thyroid cancer-related procedures performed in the Brazilian public health system from 2019 to 2021. Data were retrieved from the Department of Informatics of the Unified Health System (DATASUS). The following procedures were evaluated: fine-needle aspiration biopsies (FNABs), oncologic thyroidectomies, and radioiodine (RAI) therapies for thyroid cancer. The year of 2019 served as baseline control. RESULTS Compared with 2019, FNABs, oncologic thyroidectomies, and RAI therapies performed in 2020 decreased by 29%, 17% and 28%, respectively. In 2021, compared with 2019, FNABs increased by 2%, and oncologic thyroidectomies and RAI therapies decreased by 5% and 25%, respectively. Most pronounced reductions were observed in the first months of the pandemic. In April 2020, FNABs decreased by 67%, oncologic thyroidectomies by 45%, and RAI therapies by 75%. In 2021, RAI therapies were the only procedure with a statistically significant decrease. CONCLUSION The restrictions to public health care during the COVID-19 pandemic resulted in a significant reduction in diagnostic and treatment procedures for thyroid cancer in Brazil. The effects of these transitory gaps in thyroid cancer care, due to COVID-19, are still unclear.
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Murugan AK, Alzahrani AS. SARS-CoV-2: Emerging Role in the Pathogenesis of Various Thyroid Diseases. J Inflamm Res 2021; 14:6191-6221. [PMID: 34853527 PMCID: PMC8628126 DOI: 10.2147/jir.s332705] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) is asymptomatic in most cases, but it is impartible and fatal in fragile and elderly people. Heretofore, more than four million people succumbed to COVID-19, while it spreads to every part of the globe. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) induces various dysfunctions in many vital organs including the thyroid by utilizing ACE2 as a receptor for cellular entry. Emerging reports clearly show the involvement of SARS-CoV-2 in diverse thyroid disorders. Thus, this review article aims to review comprehensively all the recent developments in SARS-CoV-2-induced pathogenesis of thyroid diseases. The review briefly summarizes the recent key findings on the mechanism of SARS-CoV-2 infection, the role of ACE2 receptor in viral entry, SARS-CoV-2-activated molecular signaling in host cells, ACE2 expression in the thyroid, cytokine storm, and its vital role in thyroid dysfunction and long-COVID in relation to thyroid and autoimmunity. Further, it extensively discusses rapidly evolving knowledge on the potential part of SARS-CoV-2 in emerging various thyroid dysfunctions during and post-COVID-19 conditions which include subacute thyroiditis, Graves' diseases, Hashimoto’s thyroiditis, thyrotoxicosis, and other recent advances in further discerning the implications of this virus within thyroid dysfunction. Unraveling the pathophysiology of SARS-CoV-2-triggered thyroid dysfunctions may aid pertinent therapeutic options and management of these patients in both during and post-COVID-19 scenarios.
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Affiliation(s)
- Avaniyapuram Kannan Murugan
- Division of Molecular Endocrinology, Department of Molecular Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Ali S Alzahrani
- Division of Molecular Endocrinology, Department of Molecular Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia.,Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
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21
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Scappaticcio L, Pitoia F, Esposito K, Piccardo A, Trimboli P. Impact of COVID-19 on the thyroid gland: an update. Rev Endocr Metab Disord 2021; 22:803-815. [PMID: 33241508 PMCID: PMC7688298 DOI: 10.1007/s11154-020-09615-z] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is the pandemic of the new millennium. COVID-19 can cause both pulmonary and systemic inflammation, potentially determining multi-organ dysfunction. Data on the relationship between COVID-19 and thyroid have been emerging, and rapidly increasing since March 2020. The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay. SARS-CoV-2 uses ACE2 combined with the transmembrane protease serine 2 (TMPRSS2) as the key molecular complex to infect the host cells. Interestingly, ACE2 and TMPRSS2 expression levels are high in the thyroid gland and more than in the lungs. Our literature search provided greater evidence that the thyroid gland and the entire hypothalamic-pituitary-thyroid (HPT) axis could be relevant targets of damage by SARS-CoV-2. Specifically, COVID-19-related thyroid disorders include thyrotoxicosis, hypothyroidism, as well as nonthyroidal illness syndrome. Moreover, we noticed that treatment plans for thyroid cancer are considerably changing in the direction of more teleconsultations and less diagnostic and therapeutical procedures. The current review includes findings that could be changed soon by new results on the topic, considering the rapidity of worldwide research on COVID-19.
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Affiliation(s)
- Lorenzo Scappaticcio
- Division of Endocrinology and Metabolic Diseases, University Hospital "Luigi Vanvitelli", University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabián Pitoia
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
- Diabetes Unit, University Hospital "Luigi Vanvitelli", University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Pierpaolo Trimboli
- Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
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22
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Wang L, Zhang Y, Zhang X, Fan X, Qiong L, Hu C. The Potential Impact of Childhood Traumatic Experiences on Coping Styles and Emotion Regulation of Nurse Practitioners During the COVID-19 Outbreak. Front Psychol 2021; 12:718780. [PMID: 34764907 PMCID: PMC8576184 DOI: 10.3389/fpsyg.2021.718780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: During an epidemic of a novel infectious disease, frontline medical staff suffer from high psychological stress. Previous studies have found that traumatic childhood experiences are associated with mental and physical health in adulthood. Anxiety and depression were measured and analyzed in relation to childhood trauma and coping styles. This study aims to explore the correlational study between traumatic childhood experiences and coping styles among nurse practitioners. Method: This study sampled 278 nurse practitioners from hospitals designated for the treatment of the novel coronavirus in Sichuan Province. The study measures included the Simplified Coping Style Questionnaire and the Childhood Trauma Questionnaire-Short Form. This research intends to use correlational study methods to explore the relationship between the two factors. Results: Statistical analysis showed that there was no statistically significant difference in the general demographic data between the two groups. Conclusion: Childhood traumatic experiences have a significant impact on the active coping of nurse practitioners, and active coping may be emotionally protective for nurse practitioners.
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Affiliation(s)
- Liyuanke Wang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Yan Zhang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Xiaoli Zhang
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Xiwang Fan
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Luo Qiong
- Suining Central Hospital, An Affiliated Hospital of Chongqing Medical University, Suining, China
| | - Chengping Hu
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
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Liu H, Zhan L, Guo L, Yu X, Li L, Feng H, Yang D, Xu Z, Tu Y, Chen C, Sun S. More Aggressive Cancer Behaviour in Thyroid Cancer Patients in the Post-COVID-19 Pandemic Era: A Retrospective Study. Int J Gen Med 2021; 14:7197-7206. [PMID: 34737615 PMCID: PMC8558635 DOI: 10.2147/ijgm.s339998] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose Many thyroid cancer patients have suffered from treatment delays caused by the coronavirus disease 2019 pandemic. Although there have been many reviews, recommendations, or clinical experiences, clinical evidence that evaluates patient disease status is lacking. The aim of our research was to evaluate thyroid cancer behaviour in the post-COVID-19 era. Patients and Methods A retrospective study was conducted and thyroid cancer patient data from February 1, 2017 to September 15, 2020 were pooled for analysis. The demographic, ultrasound and pathological data of the pre- and post-COVID-19 groups were compared. Lymph node metastases, tumour size, extrathyroidal extension, and multifocality were compared year-by-year to evaluate annual changes in patient characteristics. Regression analyses were adopted to reveal cancer behaviour along with the admission date interval and to reveal risk factors for lymph node metastasis. Patient ultrasound data were compared before and after the lockdown to assess tumour progression. The outcomes of delays in treatment ≤180 days were then studied. Results The post-lockdown patients were more likely to have multiple lesions (31.2% vs 36.5%, p = 0.040), extrathyroidal extension (65.5% vs 72.2%, p = 0.011) and lymph node metastases (37.7% vs 45.0%, p = 0.007), while tumour size remained stable (1.01cm vs.1.02cm, p = 0.758). The lymph node metastasis rate increased by year (p < 0.001). The tumour size correlated negatively with the post-lockdown admission date (p = 0.002). No significant difference in tumour size, multifocality or lymph node metastasis on ultrasound was revealed between the pre- and post-lockdown group. No significant difference in tumour size, multifocality, extrathyroidal extension or lymph node metastasis was revealed among patients with a delayed treatment time ≤180 days. Conclusion Patients with a COVID-19-induced treatment delay had more aggressive cancer behaviour. Rebound medical visits and annually increasing aggressiveness may be potential reasons for this observation, as individual patient tumour did not progress during the delay.
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Affiliation(s)
- Hanqing Liu
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Ling Zhan
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Liantao Guo
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Xizi Yu
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Lingrui Li
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Hongfang Feng
- Department of Thyroid and Breast Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, 435000, Hubei, People's Republic of China
| | - Dan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Zhiliang Xu
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Yi Tu
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Chuang Chen
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Shengrong Sun
- Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
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Yang S, Wang J, Xu X. Psychological health status among thyroid cancer patients during the COVID-19 epidemic in China. Support Care Cancer 2021; 30:2111-2119. [PMID: 34671859 PMCID: PMC8528476 DOI: 10.1007/s00520-021-06624-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/08/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate the psychological health status and explore the impact of different factors among thyroid cancer patients during the peak period of the COVID-19 epidemic in China. METHODS With thyroid cancer patients who had attended Peking Union Medical College Hospital included, we collected their demographic and clinical characteristics, COVID-19-related factors, and outcomes of 4 psychological scales (Insomnia Severity Index [ISI], Generalized Anxiety Disorder Questionnaire [GAD-7], Patient Health Questionnaire [PHQ-9], and Impact of Events Scale-Revised [IES-R]) through an online questionnaire and used multiple linear regression to find independent risk factors for each psychological symptom. RESULTS A total of 219 patients were included. Insomnia, anxiety, depression, and clinically relevant post-traumatic stress symptoms (PTSS) were reported by 69 (31.5%), 87 (39.7%), 74 (33.8%), and 44 (20.1%) patients, respectively. Based on multiple linear regression, being single/divorced/widowed, having a lower level of education, receiving resources of science lectures during the epidemic, and experiencing disruption of routine treatment or follow-up were associated with poorer psychological health among patients with thyroid cancer. CONCLUSIONS High rates of psychological symptoms and potential risk factors were found in thyroid cancer patients during the peak period of COVID-19 in China. Based on these findings, the psychological status of these patients should be a focus, and the psychological support systems need to be strengthened for the prevention of psychological crises during the epidemic.
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Affiliation(s)
- Shijie Yang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinhui Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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The impact of the Covid-19 pandemic on quality of life in skin cancer patients. PLoS One 2021; 16:e0255501. [PMID: 34407086 PMCID: PMC8372941 DOI: 10.1371/journal.pone.0255501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/18/2021] [Indexed: 12/29/2022] Open
Abstract
With more than 82 million cases worldwide and almost two million deaths, the Covid-19 global pandemic shows little sign of abating. However, its effect on quality of life (QoL) in skin cancer patients has not been systematically evaluated to date. Given that QoL impairments may be associated with increased psychological morbidity, and may interfere with engagement with cancer therapy and follow-up, we prospectively evaluated quality of life in skin cancer patients using the Covid-19 Emotional Impact Survey (C-19EIS) and the EORTC QLQ-C30 questionnaires. 101 patients (48 females and 53 males) completed both questionnaires. The mean C-19EIS score was 3.8 on a scale from 0 (no impact) to 12 (severe impact). Patients undergoing systemic therapy showed significantly impaired physical (p = 0.006) and social functioning (p = 0.003). However, when compared to the published normative EORTC QLQ-C30 data, there was no evidence that the Covid-19 pandemic had significantly impacted upon overall quality of life. Subscales of the EORTC QLQ-C30 were significantly inversely correlated with the C-19EIS, validating its use in skin cancer patients. Despite the Covid-19 pandemic, skin cancer patients in our tertiary referral center were surprisingly resilient. However, given the geographical variations in the rates of Sars-CoV-2 infection it is possible that the low incidence in Northern Germany may have resulted in a lack of general QoL impairments. Multi-center studies are required to further determine the impact of Covid-19 on psychological wellbeing in skin cancer patients in order to develop supportive interventions and to ensure that engagement with cancer care services is maintained in order to enable early detection of cancer progression and/or recurrence.
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Dhada S, Stewart D, Cheema E, Hadi MA, Paudyal V. Cancer Services During the COVID-19 Pandemic: Systematic Review of Patient's and Caregiver's Experiences. Cancer Manag Res 2021; 13:5875-5887. [PMID: 34349561 PMCID: PMC8328387 DOI: 10.2147/cmar.s318115] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/10/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Cancer patients have faced intersecting crises during the COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the pandemic and its perceived impact on their psychological wellbeing. PATIENTS AND METHODS A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020 and 12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. RESULTS A total of 1110 articles were screened, of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Extracted data were categorised into seven themes. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services due to infection worries contributed to the delay. Financial and social distress, isolation, and spiritual distress were also commonly reported. Caregivers in addition felt anxious about infecting cancer patients with COVID-19. CONCLUSION Patients and caregivers experienced delays in cancer screening, treatment and care during the COVID-19 pandemic and negatively affected their psychological wellbeing. Their views and preferences should be accounted to minimise the impact of the current and any future pandemics and ensure resilient cancer services. PROTOCOL REGISTRATION Published protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906).
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Affiliation(s)
- Symran Dhada
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ejaz Cheema
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Muhammad Abdul Hadi
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Vibhu Paudyal
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
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Quality of Life and Psychosocial Impacts of the Different Restrictive Measures during One Year into the COVID-19 Pandemic on Patients with Cancer in Italy: An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137161. [PMID: 34281098 PMCID: PMC8297179 DOI: 10.3390/ijerph18137161] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
Background: The aim of the study was to assess the perceived quality of life and the psychosocial impact of the various restrictive measures due to COVID-19 pandemic on cancer patients in Italy, as well as their perception of the relationship with doctors and caregivers. Methods: This study compares three population-based observational studies of patients with cancer carried out in three consecutive time periods characterized by different restrictive measures using a self-administered online questionnaire. Results: Among the basic needs, psychological and medical support appeared to be prevalent; so did the need for safe transportation to reach the treatment facilities. Internet was the main source of information on the coronavirus. Although 74.6% of the total number of patients did not give up hospital therapies, 34.8% complained about variations in the continuity of treatment, with different percentages in the three samples. The majority of the sample (73.8%) was worried of being infected, but 21.9% did not share their anxieties and worries with others. The multivariate regression analysis showed that a pessimistic perception of quality of life was influenced by living in extra-urban areas and alone (OR = 1.4; OR = 2.1); while a perception of a reduced physical function result affected by the state of anxiety and stress (OR = 1.9) and the difficulties in continuity of medical assistance (OR = 2.2). The scoring of the SF-12 in the Physical Component Summary and Mental Component Summary scores showed a fluctuating trend throughout the three periods investigated. Conclusions: It is important for health professionals, caregivers and social workers to identify the new needs in order to enhance home care interventions, personalize and optimize care, ensure continuity of care and guarantee a high quality of life even in a health emergency situation.
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Koinig KA, Arnold C, Lehmann J, Giesinger J, Köck S, Willenbacher W, Weger R, Holzner B, Ganswindt U, Wolf D, Stauder R. The cancer patient's perspective of COVID-19-induced distress-A cross-sectional study and a longitudinal comparison of HRQOL assessed before and during the pandemic. Cancer Med 2021; 10:3928-3937. [PMID: 33973411 PMCID: PMC8209623 DOI: 10.1002/cam4.3950] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background To permit timely mitigation of adverse effects on overall clinical outcome, it is essential to understand how the pandemic influences distress and health‐related quality of life (HRQOL) in cancer patients during the coronavirus disease 2019 (COVID‐19) pandemic. Methods In this cross‐sectional study, adult cancer patients, without COVID‐19 symptoms, completed a 13‐item questionnaire about the pandemic's impacts on distress and everyday‐life; associations with age, sex, or impaired HRQOL were then assessed by binary logistic regressions. In a subsample of patients with HRQOL assessment available from both before and during the pandemic, we evaluated the pandemic's impact on longitudinal changes in HRQOL reported within 6 months before versus during the COVID‐19 lockdown using McNemar's test, and thresholds for clinical importance. Results We consecutively enrolled 240 patients with solid (50%) or hematological (50%) cancers. Median age was 67 years, 46% were females. The majority ranked heeding their health (80%) and keeping their appointment schedule in hospital (78%) as important. Being younger than 60, or aged 60–70 was independently associated with limitations in everyday life (OR = 3.57, p < 0.001; and 2.05, p = 0.038); female individuals and those with restricted emotional functioning were more distressed by the COVID‐19 situation (OR = 2.47, p = 0.040; and 3.17, p = 0.019); the latter group was also significantly more concerned about being a patient at risk (OR = 2.21, p = 0.029). Interestingly, in a subsample of patients (n = 47), longitudinal comparisons pre‐ versus during the pandemic revealed that HRQOL was not substantially affected by the pandemic. Conclusion Particularly younger and female cancer patients, and those with impaired emotional functioning are distressed by COVID‐19. During the first COVID‐19 lockdown, cancer patients remained predominantly resilient. This analysis highlights the need to mitigate distress situations in vulnerable patients and thereby enhance resilience during pandemics.
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Affiliation(s)
- Karin A Koinig
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Arnold
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Jens Lehmann
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Johannes Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Köck
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Roman Weger
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Bernhard Holzner
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ute Ganswindt
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Dominik Wolf
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Reinhard Stauder
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
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Gallo O, Bruno C, Locatello LG, Martelli F, Cilona M, Orlando P, Fancello G, Maggiore G, Viberti F, Ciabatti P, Boccuzzi S, Mandalà M. The impact of the COVID-19 pandemic on the quality of life of head and neck cancer survivors. Support Care Cancer 2021; 29:6297-6304. [PMID: 33860361 PMCID: PMC8049620 DOI: 10.1007/s00520-021-06198-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Head and neck cancer (HNC) survivors are particularly vulnerable to the deleterious consequences of lockdown and social distancing. The psychosocial effects of the COVID-19 pandemic on this group are still unknown, and we want to explore how their quality of life (QoL) has changed in this unique situation. MATERIALS AND METHODS An online survey, composed of pandemic-specific items, plus the EORTC QLQ-C30, was administered to a cohort of HNC survivors. Using previously published reference values as a control group, we have evaluated the impact of the pandemic on their QoL. We have also explored the differences between those who had received a total laryngectomy (LP, laryngectomized population) vs other HNC patients, in order to assess the role of tracheostomy in this regard. RESULTS One hundred and twenty-one HNC patients completed the survey. The scores of the physical (80.5 vs 85, p = 0.028), role (78 vs 84, p = 0.030), and emotional functioning (76 vs 81, p = 0.041) were significantly different in the two groups, with worse functioning in our patients. Comparing LP with the other HNC patients, social (76.6 vs 88.9, p = 0.008) and physical functioning (75.5 vs 86.1, p = 0.006) were significantly worse in the former group. LP also reported a greater perception that others are afraid to be close to them (1.67 vs 1.32, p = 0.020). No differences were found between LP with and without voice prosthesis. CONCLUSIONS Our results show how HNC patients are at high risk for a worsening in QoL because of the ongoing COVID-19 global pandemic.
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Affiliation(s)
- Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - Chiara Bruno
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Luca Giovanni Locatello
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Federica Martelli
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Maria Cilona
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Pietro Orlando
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giuseppe Fancello
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giandomenico Maggiore
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesca Viberti
- Department of Otorhinolaryngology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Simone Boccuzzi
- Department of Otorhinolaryngology, Ospedale della Misericordia, Grosseto, Italy
| | - Marco Mandalà
- Department of Otorhinolaryngology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Satisfaction among Cancer Patients Undergoing Radiotherapy during the COVID-19 Pandemic: An Institutional Experience. ACTA ACUST UNITED AC 2021; 28:1507-1517. [PMID: 33920247 PMCID: PMC8167586 DOI: 10.3390/curroncol28020142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has shifted oncology practices to prioritize patient safety while maintaining necessary treatment delivery. We obtained patient feedback on pandemic-based practices in our radiotherapy department to improve quality of patient care and amend policies as needed. We developed a piloted questionnaire which quantitatively and qualitatively assessed patients’ pandemic-related concerns and satisfaction with specific elements of their care. Adult patients who were treated at our Centre between 23 March and 31 May 2020, had initial consultation via telemedicine, and received at least five outpatient fractions of radiotherapy were invited to complete the survey by telephone or online. Relative frequencies of categorical and ordinal responses were then calculated. Fifty-three (48%) out of 110 eligible patients responded: 32 patients by phone and 21 patients online. Eighteen participants (34%) admitted to feeling anxious about hospital appointments, and only five (9%) reported treatment delays. Forty-eight patients (91%) reported satisfaction with their initial telemedicine appointment. The majority of patients indicated that healthcare workers took appropriate precautions, making them feel safe. Overall, all 53 patients (100%) reported being satisfied with their treatment experience during the pandemic. Patient feedback is needed to provide the highest quality of patient care as we adapt to the current reality.
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Rajan S, Akhtar N, Tripathi A, Kumar V, Chaturvedi A, Mishra P, Sharma S, Misra S, Gupta S, Singh M. Impact of COVID-19 pandemic on cancer surgery: Patient's perspective. J Surg Oncol 2021; 123:1188-1198. [PMID: 33592128 PMCID: PMC8013664 DOI: 10.1002/jso.26429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/16/2022]
Abstract
Background Coronavirus disease 2019 (COVID‐19) has impacted cancer care globally. The aim of this study is to analyze the impact of COVID‐19 on cancer healthcare from the perspective of patients with cancer. Methods A cross‐sectional survey was conducted between June 19, 2020, to August 7, 2020, using a questionnaire designed by patients awaiting cancer surgery. We examined the impact of COVID‐19 on five domains (financial status, healthcare access, stress, anxiety, and depression) and their relationship with various patient‐related variables. Factors likely to determine the influence of COVID‐19 on patient care were analyzed. Results A significant adverse impact was noted in all five domains (p = < 0.05), with the maximal impact felt in the domain of financial status followed by healthcare access. Patients with income levels of INR < 35 K (adjusted odds ratio [AOR] = 1.61, p < 0.05), and 35K‐ 100 K (AOR = 1.96, p < 0.05), married patients (AOR = 3.30, p < 0.05), and rural patients (AOR = 2.82, p < 0.05) experienced the most adverse COVID‐19‐related impact. Conclusion Delivering quality cancer care in low to middle‐income countries is a challenge even in normal times. During this pandemic, deficiencies in this fragile healthcare delivery system were exacerbated. Identification of vulnerable groups of patients and strategic utilization of available resources becomes even more important during global catastrophes, such as the current COVID‐19 pandemic. Further work is required in these avenues to not only address the current pandemic but also any potential future crises.
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Affiliation(s)
- Shiv Rajan
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Naseem Akhtar
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Abhilasha Tripathi
- Department of Pharmacology, King George's Medical University, Lucknow, India
| | - Vijay Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Arun Chaturvedi
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Prabhaker Mishra
- Department of Biostatistics & Health Informatics, Sanjay Gandhi Postgraduate Institute, Lucknow, India
| | - Sonali Sharma
- Department of Gynecology & Obstetrics, King George's Medical University, Lucknow, India
| | - Sanjeev Misra
- All India Institute of Medical Sciences, Jodhpur, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
| | - Mohit Singh
- Department of Surgical Oncology, King George's Medical University, Lucknow, India
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Kathuria-Prakash N, Mosaferi T, Xie M, Antrim L, Angell TE, In GK, Su MA, Lechner MG. COVID-19 Outcomes of Patients With Differentiated Thyroid Cancer: A Multicenter Los Angeles Cohort Study. Endocr Pract 2021; 27:90-94. [PMID: 33551317 PMCID: PMC7831810 DOI: 10.1016/j.eprac.2020.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
Objective Cancer may be a risk factor for worse outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections. However, there is a significant variability across cancer types in the extent of disease burden and modalities of cancer treatment that may impact morbidity and mortality from coronavirus disease-19 (COVID-19). Therefore, we evaluated COVID-19 outcomes in patients with a differentiated thyroid cancer (DTC) history. Methods This is a retrospective cohort study of patients with a history of DTC and SARS-CoV2 infection from 2 academic Los Angeles healthcare systems. Demographic, thyroid cancer, and treatment data were analyzed for associations with COVID-19 outcomes. Results Of 21 patients with DTC and COVID-19, 8 (38.1%) were hospitalized and 2 (9.5%) died from COVID-19. Thyroid cancer initial disease burden and extent, treatment, or current response to therapy (eg, excellent vs incomplete) were not associated with COVID-19 severity in DTC patients. However, older age and the presence of a comorbidity other than DTC were significantly associated with COVID-19 hospitalization (P = .047 and P = .024, respectively). COVID-19–attributed hospitalization and mortality in DTC patients was lower than that previously reported in cancer patients, although similar to patients with nonthyroid malignancies in these centers. Conclusion These data suggest that among patients with DTC, advanced age and comorbid conditions are significant contributors to the risk of hospitalization from SARS-CoV2 infection, rather than factors associated with thyroid cancer diagnosis, treatment, or disease burden. This multicenter report of clinical outcomes provides additional data to providers to inform DTC patients regarding their risk of COVID-19.
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Affiliation(s)
| | - Tina Mosaferi
- Division of Endocrinology, Diabetes, and Metabolism, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Mindy Xie
- Department of Medicine, USC Keck School of Medicine, Los Angeles, California
| | - Lauren Antrim
- Department of Medicine, USC Keck School of Medicine, Los Angeles, California
| | - Trevor E Angell
- Division of Endocrinology and Diabetes, USC Keck School of Medicine, Los Angeles, California
| | - Gino K In
- Division of Medical Oncology, USC Keck School of Medicine, Los Angeles, California
| | - Maureen A Su
- Department of Microbiology, Immunology, and Molecular Genetics, UCLA David Geffen School of Medicine, Los Angeles, California; Division of Pediatric Endocrinology, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Melissa G Lechner
- Division of Endocrinology, Diabetes, and Metabolism, UCLA David Geffen School of Medicine, Los Angeles, California.
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Younger E, Smrke A, Lidington E, Farag S, Ingley K, Chopra N, Maleddu A, Augustin Y, Merry E, Wilson R, Benson C, Miah A, Zaidi S, McTiernan A, Strauss SJ, Dileo P, Gennatas S, Husson O, Jones RL. Health-Related Quality of Life and Experiences of Sarcoma Patients during the COVID-19 Pandemic. Cancers (Basel) 2020; 12:cancers12082288. [PMID: 32823999 PMCID: PMC7547383 DOI: 10.3390/cancers12082288] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023] Open
Abstract
Sarcomas are rare cancers with a spectrum of clinical needs and outcomes. We investigated care experiences and health-related quality of life (HRQoL) in sarcoma patients during the COVID-19 pandemic. Patients with appointments during the first two months of the UK lockdown were invited to complete a survey. Questions included views on care modifications, COVID-19 worry and psychosocial impact, and EORTC-QLQ-C30 items. 350 patients completed the survey; median age 58 (16–92) years. Care modifications included telemedicine (74%) and postponement of appointments (34%), scans (34%) or treatment (10%). Most felt the quality of care was not affected (72%), however, social life (87%) and emotional wellbeing (41%) were affected. Worry about COVID-19 infection was moderately high (mean 5.8/10) and significantly related to higher cancer-related worry; associated with lower emotional functioning irrespective of treatment intent. Curative patients (44%) with low resilient coping scores had significantly higher COVID-19 worry. Patients who did not know their treatment intent (22%) had significantly higher COVID-19 worry and insomnia. In summary, care experiences were generally positive; however, cancer-related worry, low resilient coping and uncertainty about treatment intent were associated with COVID-19 worry. These patients may benefit from additional psychological support during the pandemic and beyond.
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Affiliation(s)
- Eugenie Younger
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Alannah Smrke
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Emma Lidington
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Sheima Farag
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Katrina Ingley
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Neha Chopra
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Alessandra Maleddu
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Yolanda Augustin
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Eve Merry
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Roger Wilson
- Sarcoma Patients EuroNet e.V./Association, D-61200 Wolfersheim, Germany;
| | - Charlotte Benson
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Aisha Miah
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
- Institute of Cancer Research, London SM2 5NG, UK;
| | - Shane Zaidi
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Anne McTiernan
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Sandra J. Strauss
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Palma Dileo
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; (K.I.); (N.C.); (A.M.); (A.M.); (S.J.S.); (P.D.)
| | - Spyridon Gennatas
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
| | - Olga Husson
- Institute of Cancer Research, London SM2 5NG, UK;
| | - Robin L. Jones
- The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.Y.); (A.S.); (E.L.); (S.F.); (Y.A.); (E.M.); (C.B.); (A.M.); (S.Z.); (S.G.)
- Institute of Cancer Research, London SM2 5NG, UK;
- Correspondence: ; Tel.: +44-207-352-8171
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