A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group
A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group
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DOI：
10.1634/theoncologist.2020-0213
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发表时间：
2020-04-27
期刊：
影响因子：
5.8
通讯作者：
Xie, Conghua
中科院分区：
文献类型：
--
作者：
Al-Shamsi, Humaid O.;Alhazzani, Waleed;Xie, Conghua
自2019冠状病毒病（COVID-19）被确定为国际重大关注的突发公共卫生事件以来，疫情在全球迅速蔓延，现已被世界卫生组织（WHO）宣布为大流行病。2019年12月，中国武汉爆发了被称为COVID-19的非典型肺炎。新发现的人畜共患冠状病毒，严重急性呼吸综合征冠状病毒-2（SARS-CoV-2），其特征是人与人之间的快速传播。许多癌症患者经常到医院接受治疗和疾病监测。他们可能由于潜在的恶性肿瘤或抗癌治疗而免疫功能低下，并且发生感染的风险较高。有几个因素会增加感染的风险，癌症患者通常有多种风险因素。据估计，癌症患者感染SARS-CoV-2的风险似乎比一般人群高出两倍。随着世卫组织宣布新型冠状病毒爆发为大流行，迫切需要解决这种大流行对癌症患者的影响。这包括在大流行期间对资源分配、临床护理和同意程序的改变。目前，由于数据有限，没有国际指南来解决任何传染性大流行中癌症患者的管理问题。对实践的启示在COVID-19疫情期间治疗癌症患者的主要管理策略包括明确的沟通和教育，包括手部卫生，感染控制措施，高风险暴露以及COVID-19的体征和症状。对癌症人群进行积极干预的风险和获益的考虑必须个体化。对于进展风险低的癌症患者，应根据具体情况考虑推迟择期手术或辅助化疗。尽量减少门诊就诊可以帮助减少暴露和可能的进一步传播。远程医疗可用于支持患者尽量减少就诊次数和接触风险。需要更多的研究来更好地了解SARS-CoV-2病毒学和流行病学。
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is characterized by rapid human-to-human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS-CoV-2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID-19 infection pandemic will be addressed, with suggestions of some practical approaches.Implications for Practice The main management strategies for treating cancer patients during the COVID-19 epidemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of COVID-19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case-by-case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS-CoV-2 virology and epidemiology.