RESUMO
Background: The health emergency caused by the SarS-Cov-2 pandemic has been strongly impacting on oncological patients’ (pts). The purpose of this study was to explore the emotional impact and perception of cancer pts who received the vaccine against COVID-19 at the University Hospital and Trust of Verona (Italy). Methods: After the first dose of COVID-19 vaccine an anonymously questionnaire was proposed to cancer pts (March-May 2021). The survey investigated anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS), psychological distress with the Distress Thermometer (DT). Additionally, four specific items regarding the awareness about: i) infection risks, ii) interference with chemotherapy treatment, and iii) adverse effects, were developed. Descriptive analyses were performed. Results: A total of 736 patients (mean age 63 yrs) completed the questionnaire. Breast (23%) and gastrointestinal (40%) were the most represented cancer sites. The majority of pts (65%) reported mild levels of distress (DT ≤4), while moderate (DT 5-7) and severe (DT ≥8) levels were identified in 26% and 9% of participants, respectively. A total of 11% and 8% of pts experienced clinically significant symptoms of anxiety and depression (HADS ≥11), whereas 15% were borderline (HADS score 8-10). Two thirds of pts (67%) thought that the vaccination may reduce the infection risks and 56% felt safer. Overall, 59% of pts did not believe that vaccine-related side effects may interfere with the oncological treatment and 49% considered the vaccination safe. Conclusions: Most cancer pts undergoing COVID-19 vaccination presented mild levels of anxiety, depression and distress. Oncological pts undergoing vaccination felt safe and judged the benefits of COVID-19 vaccination to overweight the potential side effects. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
RESUMO
Background: COVID-19 pandemic has represented a historic challenge to healthcare systems. The management of cancer care has become a crucial issue for clinical services to cancer patients. During the COVID-19 pandemic, raising evidence has been published on lung cancer care but no data have been presented on the integrated care pathways (ICP) impact. Materials and methods: We retrospectively reviewed the ICPs of consecutive lung cancer patients who accessed two Centres before and after COVID-19 pandemic: the Veneto Institute of Oncology (IOV)/University Hospital of Padua and University Hospital of Verona. Sixteen indicators about oncology, radiaton therapy, thoracic surgery, pathology and pneumology were developed using groupfacilitation techniques taking into account their reproducibility, significance, measurability. We report data extracted from electronic medical records and linked softwares, about MDT performance at the two participating Centres, and preliminary data about pathological and oncological indicators in Padua. Additional data about both complete ICPs will be presented at the Conference. Results: We compared data about ICP performance in two window periods: 1/3/2019-30/4/2019 and 1/3/2020- 30/4/2020. MDT meetings were reshaped in order to discuss those cases where more than two specialists were required and whenever possible on a web-basis;therefore, it determined an average reduction of patients discussed of 57.5%. Preliminary data from Padua showed that median time between diagnostic procedure and diagnosis was reduced from 11 days in 2019 to 7.5 days in 2020, mostly due to a prioritization of oncological procedures over any other. Moreover, a 39% reduction of first oncological visits was observed between the two time frames;this was linked to a reduction of out of region second opinion and to optimization of outpatient access. Among patients under oncological treatment, 12(4%) and 8(2%) patients received treatment within 30 days from death in 2019 and 2020, respectively. Conclusions: Based on the experience the two Centres went through, we identified the key steps in ICP impacted by a pandemic such COVID-19 so to proactively put in place robust service provision in thoracic oncology.