Systemic anti cancer therapy during COVID-19 pandemic, Dubai hospital experience


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Muhammad Farooq Latif1, Syed Hammad Hassan Tirmazy, Dalia Mahmoud El Shourbagy, Abdul Basit, Dina Hamza, Kaltar Das, Mohamed Hussien, Susheel Kumar, S Sajan, S Anto
1North wales cancer Treatment Centre

Abstract

Background

In March 2020, the World Health Organization (WHO) characterized COVID-19 as a pandemic. Many countries worldwide introduced public health measures to reduce social exposure and more social distancing. Disruption of diagnostic and treatment services have affected cancer treatment. In response to pandemic, the oncology services in Dubai hospital have undergone major changes to ensure safe and effective cancer care with an emphasis on service delivery as normal as possible. Aim of this study is to analyse the effect of COVID-19 pandemic on timely delivery of chemotherapy and assess complication rate.

Method

We identified number of chemotherapy sessions administered in infusion therapy centre, Dubai hospital from January 2020 to July 2020 through a retrospective review of electronic medical records and infusion centre log. Data regarding treatment delays, treatment interruption or discontinuation and adverse events including febrile neutropenia was collected retrospectively.

Results

A total of 1553 systemic treatment sessions were recorded in the oncology infusion therapy centre, Dubai Hospital from January 2020 to July 2020 with an average of 221 treatment sessions per month. Physician recorded delays were observed in ninety (5.79%) treatment sessions over 7 months period. Average duration of treatment delay was 7 days. Overall treatment and disease related factors (toxicities, disease progression) were the common reasons for delays. Highest number of treatment delays (n=23,10.2%) were recorded in the month of April at the peak of Covid 19 pandemic likely representing implementation of extreme precautionary measures. There were no treatment interruptions or discontinuations.

Eight (<1%) patients developed febrile neutropenia and fully recovered after treatment. We did not observe any significant change in systemic treatment related complications during the pandemic.

Conclusion

This study did not show any significant increase in systemic anticancer treatment delays or complication rate during COVID-19 pandemic. Our experience suggests that systemic chemotherapy may be administered safely with infection control and precautionary measures during pandemic. However further studies with larger sample size are required for better guidance in this situation.

Impact statement

The results of our study suggest that chemotherapy delivery during a pandemic is safe with no significant increase in treatment related delays or toxicities.