Among these risk groups, the most vulnerable are patients undergoing chemotherapy and bone marrow transplantation, patients with oncohematological diseases, and patients who have recently undergone surgical treatment.
In today’s difficult situation, oncological patients (and their attending physicians) have questions about the need for special protection measures against the virus and the specifics of treatment. Is it worth postponing treatment until the normalization of the epidemiological situation, is it possible to carry out therapy if there is a suspicion of infection with SARS-nCOV2 (virus causing COVID-19), is it possible to pause in treatment, is it possible to postpone surgery?
There are still few answers to these questions, so it is recommended to make decisions individually – for each patient.
The most comprehensive data reflecting the mortality rate of cancer patients with confirmed COVID-19 are presented in the WHO report published on February 28, 2020. The report indicates that in China, at the time of data cut-off (February 20), the mortality rate among patients with confirmed COVID-19 differed, depending on the presence of comorbid conditions:
- the total mortality rate was 3.8%;
- for patients with cancer – 7.6%;
- for patients with cardiovascular diseases – 13.2%;
- for patients with diabetes mellitus – 9.2%;
- for patients with chronic respiratory diseases – 8%;
- for patients without associated chronic diseases – 1.4%.
There are also not many publications on the course of coronavirus infection in cancer patients, and all of them have too small a sample. The most significant and detailed publication is that of Liang et al, Lancet Oncol. It presents the results of a prospective study of 1,590 Chinese patients with COVID-19 and shows that patients with cancer in the history (18 people) had a higher incidence of severe events (percentage of admission to the intensive care unit, need for SRI, fatal outcome) compared to other patients. However, even this study can not reliably indicate a significant (in comparison with other risk groups) incidence of COVID-19 in cancer patients. Data from 18 patients cannot be extrapolated to the entire population of cancer patients.
We have no doubt that you are already familiar with COVID-19 prevention measures (in particular, from the WHO), but once again we remind you of the main points:
- Wash your hands regularly with soap and/or treat with an orderly (alcohol-containing);
- keep at least 1.5 m away from coughing or sneezing people;
- avoid crowded areas;
- avoid direct contact – do not shake hands or kiss when meeting;
- try not to touch the face with your hands at all – do not rub your nose and eyes, for dental hygiene after meals use toothpicks;
- form a habit of sneezing and coughing in a paper handkerchief (napkin) or elbow, the used handkerchief (napkin) should be immediately disposed of;
- in case of symptoms (fever, cough, difficulty breathing) stay at home and call a doctor.
As for the specific recommendations for cancer patients, we can highlight the following:
- if it is necessary to visit the clinic, for example, to perform chemotherapy on schedule, we recommend you to use your own car or cab (not forgetting the protection measures), travel by public transport should be avoided;
- all scheduled observation visits after treatment should be postponed or transferred to online format if possible.
- Take advantage of the Dawn Remote Counseling service:
Dawn works in a special mode, observing all safety conditions during the coronavirus pandemic for doctors and patients. All our specialists are on site.
Oncology doctors will consult you, determine a plan of necessary examinations or select chemotherapy and schedule it for you.
- the day before your planned visit, inform your doctor about your health, temperature, complaints (by phone, e-mail or otherwise);
- Doctors in cancer patients (who do not have COVID-19) should encourage measures that allow for home treatment, including remote consultations and telephone calls to replace physical visits, replacement of intravenous drugs with oral ones.