Impact of COVID-19 on cancer services and patients' outcomes: a retrospective single-center study
Baijaeek Sain, Arnab Gupta, Aruni Ghose, Sudip Halder, Samir Bhattacharya, Radha Raman Mondal, Subhamoy Paul, Chandrakanth Are and Stergios Boussios 2023. Impact of COVID-19 on cancer services and patients' outcomes: a retrospective single-center study. Annals of Translational Medicine. 11 (9). https://doi.org/10.21037/atm-22-5876
|Authors||Baijaeek Sain, Arnab Gupta, Aruni Ghose, Sudip Halder, Samir Bhattacharya, Radha Raman Mondal, Subhamoy Paul, Chandrakanth Are and Stergios Boussios|
Background: Our main objective was to assess the impact of the coronavirus disease 2019 (COVID-19) on cancer services and cancer patients in terms of disease severity, morbidity and mortality. Secondary objectives were to characterize cancer type, affected age groups, gender, comorbidities, infectivity, and to identify cancer treatment delay and its complications after COVID-19 infection.
Methods: A retrospective analysis of electronic health records of polymerase chain reaction (PCR)-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected cancer patients from April 2020 to March 2021 was done. The following parameters were investigated upon—new and follow-up cases during the pandemic and its preceding years (2018–2019, 2019–2020), age, sex, type of cancer, comorbidities, presentation, symptomatology and treatment for COVID-19, time to recovery, complications, delay in treatment and survival outcome. Statistical analysis using chi-square testing was done on the above variables.
Results: There was a 50.49% reduction in the number of new and follow-up cases as compared to that of the previous years. Seventy-four out of 310 (23.87%) COVID-19 positive cancer patients were aged in their sixth decade with the commonest type being hematological malignancies. A proportion of 84.8% (n=263) patients were asymptomatic. Univariate analysis was statistically significant for mortality with regard to age ≥60 years (P=0.034), type of malignancy (P=0.000178), hypertension (P=0.0028), symptomatology of COVID-19 infection (P=0.0016), site of treatment and oxygen/intervention (P<0.0001). There was an average delay in treatment time of 5 to 6 weeks. Multivariate analysis showed that gastrointestinal (GI) and hepato-pancreato-biliary (HPB) malignancies and oxygen requirement (>2 L/min) were responsible for the 20.65% mortality rate.
Conclusions: The pandemic significantly affected the care of cancer patients with decreased cases, late presentation, delayed treatment with potentially worse mortality outcome. Although they have decreased immunity, majority were asymptomatic. Most of the fatalities were in the GI and HPB malignancies
|Keywords||Coronavirus disease 2019 (COVID-19); Cancer; Comorbidities; Morbidity; Mortality|
|Journal||Annals of Translational Medicine|
|Journal citation||11 (9)|
|Digital Object Identifier (DOI)||https://doi.org/10.21037/atm-22-5876|
|Online||15 Jun 2023|
|Publication process dates|
|Accepted||21 Apr 2023|
|Deposited||14 Sep 2023|
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