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Tashkandi E, Al-Abdulwahab A, Basulaiman B, Alsharm A, Al-Hajeili M, Alshadadi F, Halawani L, Al-Mansour M, Alquzi B, Barnawi S, Alghamdi M, Abdelaziz N, Azher R. Mortality and morbidity of curative and palliative anticancer treatments during the COVID-19 pandemic: A multicenter population-based retrospective study. Mol Clin Oncol 2021; 14:82. [PMID: 33758663 PMCID: PMC7947946 DOI: 10.3892/mco.2021.2244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 01/08/2023] Open
Abstract
Administration of effective anticancer treatments should continue during pandemics. However, the outcomes of curative and palliative anticancer treatments during the coronavirus disease (COVID-19) pandemic remain unclear. The present retrospective observational study aimed to determine the 30-day mortality and morbidity of curative and palliative anticancer treatments during the COVID-19 pandemic. Between March 1 and June 30, 2020, all adults (n=2,504) with solid and hematological malignancies irrespective of cancer stage and type of anticancer treatments at five large comprehensive cancer centers in Saudi Arabia were included. The 30-day mortality was 5.1% (n=127) for all patients receiving anticancer treatment, 1.8% (n=24) for curative intent, 8.6% (n=103) for palliative intent and 13.4% (n=12) for COVID-19 cases. The 30-day morbidity was 28.2% (n=705) for all patients, 17.9% (n=234) for curative intent, 39.3% (n=470) for palliative intent and 75% (n=77) for COVID-19 cases. The 30-day mortality was significantly increased with male sex [odds ratio (OR), 2.011; 95% confidence interval (CI), 1.141-3.546; P=0.016], body mass index (BMI) <25 (OR, 1.997; 95% CI, 1.292-3.087; P=0.002), hormone therapy (OR, 6.315; 95% CI, 0.074-2.068; P=0.001) and number of cycles (OR, 2.110; 95% CI, 0.830-0.948; P=0.001), but decreased with Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0-1 (OR, 0.157; 95% CI, 0.098-0.256; P=0.001), stage I-II cancer (OR, 0.254; 95% CI, 0.069-0.934; P=0.039) and curative intent (OR, 0.217; 95% CI, 0.106-0.443; P=0.001). Furthermore, the 30-day morbidity significantly increased with age >65 years (OR, 1.420; 95% CI, 1.075-1.877; P=0.014), BMI <25 (OR, 1.484; 95% CI, 1.194-1.845; P=0.001), chemotherapy (OR, 1.397; 95% CI, 1.089-5.438; P=0.032), hormone therapy (OR, 1.527; 95% CI, 0.211-1.322; P=0.038) and immunotherapy (OR, 1.859; 95% CI, 0.648-4.287; P=0.038), but decreased with ECOG-PS of 0-1 (OR, 0.502; 95% CI, 0.399-0.632; P=0.001), breast cancer (OR, 0.569; 95% CI, 0.387-0.836; P=0.004) and curative intent (OR, 0.410; 95% CI, 0.296-0.586; P=0.001). The mortality risk was lowest with curative treatments. Therefore, such treatments should not be delayed. The morbidity risk doubled with palliative treatments and was highest among COVID-19 cases. Mortality appeared to be driven by male sex, BMI <25, hormonal therapy and number of cycles, while morbidity increased with age >65 years, BMI <25, chemotherapy, hormonal therapy and immunotherapy. Therefore, oncologists should select the most effective anticancer treatments based on the aforementioned factors.
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Affiliation(s)
- Emad Tashkandi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah 21421, Saudi Arabia.,Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah 24246, Saudi Arabia
| | - Amal Al-Abdulwahab
- Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah 24246, Saudi Arabia
| | - Bassam Basulaiman
- Department of Medical Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 11564, Saudi Arabia
| | - Abdullah Alsharm
- Department of Medical Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh 11564, Saudi Arabia
| | - Marwan Al-Hajeili
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Faisal Alshadadi
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lamis Halawani
- Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mubarak Al-Mansour
- Department of Medical Oncology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia.,Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Bushra Alquzi
- Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Samar Barnawi
- Department of Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah 21423, Saudi Arabia
| | - Mohammed Alghamdi
- Department of Medical Oncology, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Nashwa Abdelaziz
- Department of Medical Oncology, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ruqayya Azher
- Community Medicine Department, Umm Al-Qura University, Makkah 21421, Saudi Arabia
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Elsamany S, Hassanin F, Al-Abdulwahab A, Tashkandi E. Suggested modifications in oncology/hematology inpatient service in Saudi Arabia during coronavirus disease-2019 (COVID-19) pandemic. Avicenna J Med 2021; 10:208-214. [PMID: 33437692 PMCID: PMC7791282 DOI: 10.4103/ajm.ajm_166_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Management of cancer patients in the current era of coronavirus disease-2019 (COVID-19) pandemic poses significant challenges on health-care systems. However, it is mandatory to keep the required level of care of cancer patients while taking the necessary precautions to maintain the safety of both patients and health-care professionals (HCPs). The present survey explores suggested modifications of inpatient oncology/hematology care during the COVID-19 pandemic. Materials and Methods: A web-based questionnaire using SurveyMonkey was distributed to HCPs taking care of inpatient hematology/oncology service including oncologists, hematologists, and inpatient nurses in Saudi Arabia. The 25 items selected for the survey focused on five domains including characteristics of HCPs, COVID-19 infection risk among admitted patients, possible modifications related to physicians/nursing practice, and suggested infection control measures. Clinical sensibility assessment was conducted to evaluate the comprehensiveness, clarity, and face validity of our instrument on a scale of 1–5. The percentages of HCP responses to the suggested modifications in the survey were assessed in descriptive statistics to summarize data and report views of participants. Results: Of 215 HCPs, 195 responded and completed the survey. Of the respondents, 30.4% were medical oncologists, whereas hematologists and nurses constituted 6.7% and 62.9% of the participants, respectively. The majority of respondents (87.6%) work in governmental hospitals. The majority of participants (82%) have diagnosed patients with COVID-19 in their hospitals and modifications in inpatient practice during the COVID-19 pandemic were supported by 95% of respondents. The supported modifications by participants include enhanced use of oral medications (83.5%), phone calls to admitted stable patients by physicians, instead of physical interview (77%), decreasing frequency of vital signs assessment in stable patients (91%), decreasing the duration of stay in patients rooms (89%), using peripheral instead of central lines (76%), using video-based educational materials to patients through hospital TV network (91%), testing for COVID -19 before scheduled radiology imaging and procedures (74%), and performing routine nasopharyngeal swabs for HCPs (67%). Conclusion: Several modifications in inpatient oncology/hematology practice were supported by the survey participants. These suggestions need to be discussed on local basis considering local infrastructure, available resources, and level of required care.
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Affiliation(s)
- Shereef Elsamany
- Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.,Oncology Centre, Mansoura University, Egypt
| | - Fayza Hassanin
- Nursing Administration, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | - Emad Tashkandi
- Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.,College of Medicine, Umm AlQura University, Makkah, Saudi Arabia
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