Mitigating the impact of COVID-19 on oncology: Clinical and operational lessons from a prospective radiation oncology cohort tested for COVID-19

• Published in: Radiotherapy and oncology 2020-07, Vol.148, p.252-257
• Main Authors: Ning, Matthew S., McAleer, Mary Frances, Jeter, Melenda D., Minsky, Bruce D., Ghafar, Robert A., Robinson, Ivy J., Nitsch, Paige L., Zaebst, Denise J., Todd, Sarah E., Nguyen, Jennifer, Lin, Steven H., Liao, Zhongxing, Lee, Percy, Gunn, G. Brandon, Klopp, Ann H., Dabaja, Bouthaina S., Nguyen, Quynh-Nhu, Chronowski, Gregory M., Bloom, Elizabeth S., Koong, Albert C., Das, Prajnan
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Betacoronavirus; Cohort Studies; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronavirus Infections - prevention & control; COVID-19; Humans; Isolation precautions; Nasopharyngeal swab; Neoplasms - complications; Neoplasms - radiotherapy; Pandemic; Pandemics - prevention & control; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - prevention & control; Prospective Studies; Quarantine; Radiation Oncology - methods; Real-Time Polymerase Chain Reaction; SARS-CoV-2
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2020.05.037

•Prospective cohort of 121 cancer patients tested for SARS-CoV-2 over 35 days.•Of 7 positive cases, 6 were admitted with 4 warranting intensive care, and 2 died.•RT was delayed in one-third of patients while awaiting RT-PCR test results.•With a dual PPE policy, newly quarantined employees decreased 6-fold per day.•Each patient was an exposure risk to 5 employees, most commonly RTTs (38%) The COVID-19 pandemic warrants operational initiatives to minimize transmission, particularly among cancer patients who are thought to be at high-risk. Within our department, a multidisciplinary tracer team prospectively monitored all patients under investigation, tracking their test status, treatment delays, clinical outcomes, employee exposures, and quarantines. Prospective cohort tested for SARS-COV-2 infection over 35 consecutive days of the early pandemic (03/19/2020–04/22/2020). A total of 121 Radiation Oncology patients underwent RT-PCR testing during this timeframe. Of the 7 (6%) confirmed-positive cases, 6 patients were admitted (4 warranting intensive care), and 2 died from acute respiratory distress syndrome. Radiotherapy was deferred or interrupted for 40 patients awaiting testing. As the median turnaround time for RT-PCR testing decreased from 1.5 (IQR: 1–4) to ≤1-day (P