- The implications of COVID-19 in radiation oncology in the United States

General Cancer and Radiological Treatment

- Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations
- Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic

Surgical Oncology Treatment Changes

- General Cancer and Radiological Treatment
- Surgical Oncology Treatment Changes

Ohio State University, Columbus

University of Michigan - Ann Arbor

During the COVID-19 era the regular treatment and communication between physicians and patients regarding preexisting comorbidities has been disrupted. New guidelines and safety precautions must be put in place in order for physicians to still treat their patients and treat them through the use of telehealth or other means. While there are a lot of similarities between new communication policies being implemented across different areas of medicine, there are also many differences due to comorbidity specific criteria which facilitates different levels of involvement and communication between physicians and patients.


The comorbidities addressed under this node include:
- Cancer
- Cardiovascular Diseases
- Digestive Diseases
- Elective Surgeries
- Liver Diseases
- Psychological Disorders
- Renal Diseases

Changes to COVID-19 Patient Comorbidity Treatment and Communication

- Many cancer treatments work by suppressing rapidly-dividing cells. Note that cancer cells divide rapidly, but some healthy cells (e.g., white blood cells) also divide rapidly. Hence, the immune system weakens, making the patient more likely to get infected and experience severe COVID-19 complications.

COVID-19 and Cancer Comorbidity

- Annals of Surgical Oncology
- Annals of Surgery
- Arab Journal of Gastroenterology
- Current Oncology
- Clinical Journal of the American Society of Nephrology 
- Endoscopy International Open
- International Journal of Pediatric Otorhinolaryngology
- International Journal of Surgery
- Irish Journal of Psychological Medicine
- Journal of Crohn's and Colitis
- Journal of the American College of Cardiology
- Nature
- Open Research Europe
- Psychiatry Research
- The Journal of Bone and Joint Surgery
- The Lancet
- World Journal for Pediatric and Congenital Heart Surgery

Changes to COVID-19 Patient Comorbidity Treatment and Communication References by Journal

- Restructuring Structural Heart Disease Practice During the COVID-19 Pandemic
- COVID-19: Crisis Management in Congenital Heart Surgery

Changes to Treatment and Communication Related to Cardiovascular Diseases in the COVID-19 Era

Changes to Treatment and Communication Related to Cancer in the COVID-19 Era

- New Endoscopic Practices Due to COVID-19
- Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period
- Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

Changes to Treatment and Communication Related to Digestive Diseases in the COVID-19 Era

- Mitigating Risk of COVID-19 in Dialysis Facilities
- The impact of COVID-19 on kidney transplantation

Changes to Treatment and Communication Related to Renal Diseases in the COVID-19 Era

- Liver transplantation in the era of COVID-19

Changes to COVID-19 Patient Comorbidity Treatment and Communication Related to Liver Diseases in the COVID-19 Era

The procedures covered under this node are those treat a pre-existing comorbidity, such as knee or hip problems, which may be fixed by an elective surgery or procedure.

- Resuming Elective Orthopaedic Surgery During the COVID-19 Pandemic
- Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic
- Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1

Changes to COVID-19 Patient Comorbidity Treatment and Communication Related to Elective Surgeries in the COVID-19 Era

- Addiction psychiatry and COVID-19: impact on patients and service provision
- COVID-19 Pandemic: Impact on psychiatric care in the United States

Changes to COVID-19 Patient Comorbidity Treatment and Communication Related to Psychological Disorders in the COVID-19 Era

The Centers for Disease Control and Prevention (CDC) in the U.S. recommend some guidelines for cancer patients, which they consider a high-risk population, and their caregivers to protect them from COVID-19. The basic recommendations are the same as what they suggested to the general public, which includes watching out for fever (38ºC or higher), knowing the signs and symptoms of infection, cleaning your hands often, avoiding touching one's face, using a face covering, avoiding people as much as possible, and keeping a distance of at least 6 feet (2 m).

Basic Recommendation

1. Due to the highly contagious nature of COVID-19, its spread in the general public is very rapid. It is highly likely that newly diagnosed and existing patients with cancer might not get treatment on time. Additionally, mental stress about getting the infection during this infectious disease outbreak could drastically impact cancer patients' decisions to go to the hospital for follow up visits and treatment. 
2. Ethical considerations 
3. Recommended to increase the use of telemedicine in cancer care. 



Treatment Challenges

- This analysis aimed to compare characteristics of COVID-19 patients with and without cancer and assess whether cancer is associated with COVID-19 morbidity or mortality.
- COVID-19-positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020, and May 27, 2020, were included and compared across cancer status on demographics and clinical characteristics. 
- Patients with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than noncancer COVID-19 patients.
- COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have statistically significantly higher risk of thromboembolism and sepsis.


Clinical Course of Cancer Patients With COVID-19: A Retrospective Cohort Study

- This node acts as a general summary of the comorbidity of cancer and COVID-19 from a paper that analyzed many other papers detailing the same thing at its time of release.
- Via a pooled meta-analysis of studies from around the globe analyzing the prevalence of cancer in COVID-19 patients, it was found that the prevalence of cancer in COVID-19 patients is about 2%, which is higher than the overall prevalence of cancer in the population (I think).
- This leads to a hypothesized conclusion that while there is not a lot of data for COVID-19 infection and cancer patients, there is an elevated risk for these patients. However, due to inconclusive and generally lacking data on this topic, this conclusion is not concrete.
- Many major cancer centers worldwide have taken extra precaution when it comes to the treatment of these patients as many cancer treatments (e.g., chemotherapy) weaken the immune system as a side effect.
- There has currently been no order to withhold chemotherapy, radiotherapy, immunotherapy, or delaying adjuvant therapy to treat cancer patients, however extra care must be taken by patients and physicians alike to not allow these high-risk patients to become infected.

Learn Before

Related

Learn After