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COVID-19 pandemic: changes in cancer admissions
  1. Deniz Can Guven1,
  2. Burak Yasin Aktas1,
  3. Melek Seren Aksun2,
  4. Enes Ucgul2,
  5. Taha Koray Sahin2,
  6. Hasan Cagri Yildirim1,
  7. Gurkan Guner1,
  8. Neyran Kertmen1,
  9. Omer Dizdar3,
  10. Saadettin Kilickap3,
  11. Sercan Aksoy1,
  12. Suayib Yalcin1,
  13. Alev Turker1,
  14. Fatih Mehmet Uckun4 and
  15. Zafer Arik1
  1. 1 Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey
  2. 2 Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
  3. 3 Department of Preventive Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey
  4. 4 COVID-19 Task Force, Worldwide Clinical Trials, Wayne, Pennsylvania, USA
  1. Correspondence to Dr Deniz Can Guven, Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara 06100, Turkey; denizcguven{at}hotmail.com

Abstract

Background COVID-19 pandemic could create a collateral damage to cancer care denoting disruptions in care due to a significant burden on healthcare and resource allocations. Herein, we evaluate the early changes in the inpatient and outpatient oncology clinics to take a snapshot of this collateral damage at Hacettepe University Cancer Institute.

Methods Patients applying the outpatient clinic and outpatient palliative care (OPC) clinic for the first time and patients admitted to inpatient wards in the first 30 days after the first case of COVID-19 in Turkey were evaluated. These data were compared with data from the same time frame in the previous 3 years.

Results The mean number of daily new patient applications to the outpatient clinic (9.87±3.87 vs 6.43±4.03, p<0.001) and OPC clinic (3.87±1.49 vs 1.13±1.46, p<0.001) was significantly reduced compared with the previous years. While the number of inpatient admissions was similar for a month frame, the median duration of hospitalisation was significantly reduced. The frequency of hospitalisations for chemotherapy was higher than in previous years (p<0.001). By comparison, the rate of hospitalisations for palliative care (p=0.028) or elective interventional procedures (p=0.001) was significantly reduced.

Conclusion In our experience, almost all domains of care were affected during the pandemic other than patients’ systemic treatments. There were significant drops in the numbers of newly diagnosed patients, patients having interventional procedures and palliative care services, and these problems should be the focus points for the risk mitigation efforts for prevention of care disruptions.

  • supportive care
  • hospital care

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

http://dx.doi.org/10.1136/bmjspcare-2020-002468

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    Footnotes

    • Contributors DCG and ZA have planned the work. DCG, BYA, MSA, EU, TKS, HCY, GG, NK, OD, SK, SA, SY, AT and ZA participated in patient care and data collection. All authors, namely DCG, BYA, MSA, EU, TKS, HCY, GG, NK, OD, SK, SA, SY, AT, FMU and ZA, have made significant and substantive contributions to the reporting of the work. All authors have participated in the review of relevant literature, drafting of the manuscript, review and revisions of the final draft. DCG, FMU and ZA have analysed the data and determined the main conclusions. DCG has prepared the first draft of the manuscript. All authors reviewed and participated in the preparation of the revised and final version of the manuscript. DCG and ZA are responsible for the overall content as guarantors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Hacettepe University (Project No: GO 20/393).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.