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Scutiero G, Taliento C, Vizzielli G, Vitagliano A, Soraci G, Sabattini A, Spelzini F, Cappadona R, Tormen M, Arcieri M, Ercoli A, Greco P. Evolving trends in the management of pelvic inflammatory disease (PID) during SARS-CoV-2 pandemic: A multicenter retrospective cohort study. J Obstet Gynaecol Res 2024; 50:1362-1367. [PMID: 38866395 DOI: 10.1111/jog.15970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/01/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND AIM Pelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo-ovarian abscess (TOA), surgical management is a recognized treatment option. We compared the trends in managing PID and short-term outcomes before and during the SARS-CoV-2 pandemic. METHODS This is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS-CoV-2 pandemic. RESULTS One hundred nineteen PID patients were screened, eighty-one before the SARS-CoV-2 pandemic, and thirty-eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm3, p-value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS-CoV-2 pandemic, but the difference did not reach statistically significance (p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic (p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01). CONCLUSIONS In this retrospective cohort study, we found that the SARS-CoV-2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS-CoV-2 pandemic had higher inflammatory markers.
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Affiliation(s)
- G Scutiero
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - C Taliento
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
- Department of Development and Regeneration-Woman and Child, KU Leuven, Leuven, Belgium
| | - G Vizzielli
- Department of Medical Area (DAME), University of Udine, Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
| | - A Vitagliano
- Department of Women and Children's Health, Unit of Gynecology and Obstetrics, University of Padua, Padua, Italy
| | - G Soraci
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - A Sabattini
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - F Spelzini
- AUSL Romagna, Ospedale Infermi, Rimini, Italy
| | - R Cappadona
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - M Tormen
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
| | - M Arcieri
- Department of Medical Area (DAME), University of Udine, Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - A Ercoli
- Department of Human Pathology in Adult and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - P Greco
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy
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Bhandoria GP, Jayraj AS, Tiwari S, Migliorelli F, Nelson G, van Ramshorst GH, Kacperczyk-Bartnik J, Angeles MA, Nair N, El Hajj H, Bizzarri N. Use of social media for academic and professional purposes by gynecologic oncologists. Int J Gynecol Cancer 2024:ijgc-2024-005573. [PMID: 38955373 DOI: 10.1136/ijgc-2024-005573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To investigate the prevalence and patterns of social media use among gynecologic oncologists for professional and academic purposes. METHODS A prospective online survey between November and December 2022 targeted gynecologic oncology practitioners (gynecologic oncologists, surgical oncologists, medical oncologists, radiation/clinical oncologists, and onco-pathologists/pathologists). The survey, distributed via various social media platforms, included 40 questions to capture qualitative and quantitative data on social media use. RESULTS Of 131 respondents from 32 countries, 106 (80.9%) were gynecologic oncologists and affiliated with academic institutions (84.7%). Facebook (n=110, 83.9%), Twitter (n= 108, 82.4%), and Instagram (n=100, 76.3%) were the most used platforms. Respondents used social media to stay updated (n=101, 77.1%), network (n=97, 74%), learn about conferences and webinars (n=97, 74%), and engage in academic discussions (n=84, 64.1%). Following the COVID-19 pandemic, 100/129 (77.5%) reported increased social media use. However, only 32 (24.4%) used it to connect with patients, and concerns were raised about privacy and the need for separate professional and personal accounts. A quarter of respondents hesitated to share their opinions on social media due to the fear of controversy, with 26 (20%) experiencing cyberbullying, yet 120/130 (92.3%) believed it enabled junior professionals to express their views. Concerns about differentiating valid content, information reliability, and the professional perception of sourcing knowledge from social media were noted. Gender, age, specialty, and income level influenced patterns of social media use, with variations in preferences for platforms, content engagement, and purposes, highlighting a complex landscape of social media interaction among gynecologic oncologists. CONCLUSION While the use of social media among gynecologic oncologists is prevalent, particularly for academic and professional development, challenges such as cyberbullying, privacy concerns, and the need for formal training in social media navigation persist. Tailored training programs and guidelines could enhance social media's effective and ethical use in this field, promoting a safe environment for professional expression and engagement.
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Affiliation(s)
- Geetu Prakash Bhandoria
- Department of Obstetrics and Gynecology, Command Hospital Kolkata, Kolkata, West Bengal, India
| | - Aarthi S Jayraj
- South Tees NHS Foundation Trust, James Cook University, Middlesbrough, UK
| | - Shyamji Tiwari
- Department of Obstetrics and Gynaecology, Military Hospital Patiala, Patiala, Punjab, India
| | - Federico Migliorelli
- Maternal-Fetal Medicine Department, Hospital Clinic Barcelona, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Barcelona, Spain
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
| | - Gabriëlle H van Ramshorst
- Department of Gastrointestinal Surgery, University Hospital Ghent, Ghent, Belgium
- Human Structure and Repair, Ghent University, Ghent, Belgium
| | | | - Martina Aida Angeles
- Department of Gynecologic Oncology, Centro Sociosanitario y Residencial de la Vall d'Hebron de Barcelona, Barcelona, Spain
| | - Navya Nair
- Division of Gynecologic Oncology, Dept of Obstetrics and Gynecology, University of Miami Sylvester Cancer Center, Miami, Florida, USA
| | - Houssein El Hajj
- Department of Gynecologic Oncology, Institute Curie, Paris, France
| | - Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Policlinico Agostino Gemelli IRCCS, Rome, Italy
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Nasser S, Fotopoulou C, Gültekin M, Dimitrova D, Bilir E, Inci G, Morice P, Mirza MR, Martin AG, Berek J, Sehouli J. Patient care and access to clinical trials in gynaecological oncology: global implications of the early phase of the COVID-19 pandemic. Arch Gynecol Obstet 2024; 310:577-586. [PMID: 38836928 PMCID: PMC11168972 DOI: 10.1007/s00404-024-07511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/07/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Our prospective international survey evaluated the impact of the early phase of the COVID-19 pandemic on the management gynaecological malignancies from the multidisciplinary physicians' perspective with particular focus on clinical infrastructures and trial participation. METHODS Our survey consisted of 53 COVID-related questions. It was sent to healthcare professionals in gynaecological oncology centres across Europe and Pan-Arabian region via the study groups and gynaecological societies from April 2020 to October 2020. All healthcare professionals treating gynaecological cancers were able to participate in our survey. RESULTS A total of 255 answers were collected from 30 countries. The majority (73%) of participants were gynaecological oncologists from university hospitals (71%) with at least an Intensive Care Unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years (range 0-12 weeks). Most cases that were prioritised for surgical intervention across all gynaecological tumours were early-stage disease (74%), primary situation (61%) and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumour types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. Almost half of the participants stated the pandemic negatively impacted the financial structure and support for clinical trials. Approximately 20% of clinicians did not feel well-informed regarding clinical algorithm for COVID-19 patients throughout the pandemic. Thirty percent stated that they are currently having trouble in providing adequate medical care due to staff shortage. CONCLUSION Despite well-established guidelines, pandemic clearly affected clinical research and patientcare. Our survey underlines the necessity for building robust emergency algorithms tailored to gynaecological oncology to minimise negative impact in crises and to preserve access to clinical trials.
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Affiliation(s)
- Sara Nasser
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.
| | - Christina Fotopoulou
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
- Department of Gynecological Oncology, Queen Charlotte's Hospital, Imperial College London, London, UK
| | - Murat Gültekin
- Department of Gynecology and Obstetrics, Hacettepe University Hospitals, Ankara, Turkey
| | - Desislava Dimitrova
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Esra Bilir
- Department of Global Health, Koç University Graduate School of Health Sciences, Istanbul, Turkey
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Gülhan Inci
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | | | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jonathan Berek
- Stanford Women´S Cancer Center, Stanford University, Palo Alto, CA, USA
| | - Jalid Sehouli
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
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Bravo CA, Walker MJ, Papadopoulos A, McWhirter JE. Social media use in HPV-, cervical cancer-, and cervical screening-related research: A scoping review. Prev Med 2024; 179:107798. [PMID: 38065338 DOI: 10.1016/j.ypmed.2023.107798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/20/2023] [Accepted: 12/03/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE In response to the World Health Organization's global call to eliminate cervical cancer, many countries have targets to implement human papillomavirus (HPV) primary screening. Social media may offer opportunities to promote uptake of HPV screening. We aimed to describe the extent of the scientific literature regarding social media research on HPV, cervical cancer and cervical screening. METHODS Seven databases were searched for peer-reviewed English-language studies related to social media research and HPV, cervical cancer and cervical screening published up to November 2023. One reviewer completed the title/abstract screening and two reviewers independently reviewed full-text articles. Data extraction was carried out by one reviewer and verified by a second reviewer. Information such as the research topic, social media platform of interest, participant characteristics, methods, analysis type, outcome measures, and key findings were collected. RESULTS In the 58 articles included, researchers used social media in the following ways: evaluate content, recruit participants or disseminate a survey/questionnaire, disseminate health communication content, examine the relationship between social media use and outcomes, and to conduct experiments testing the effects of social media content on outcomes. Twitter and Facebook were the most common platforms mentioned. Four articles explicitly mentioned theory. CONCLUSIONS Opportunities for research are identified such as further exploration of how newer social media platforms such as Instagram and TikTok can be used to share HPV content, examination of appropriate images for effective communication, and determining key features of social media content to promote information sharing and improve cervical screening knowledge, attitudes and behaviours.
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Affiliation(s)
- Caroline A Bravo
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Meghan J Walker
- Ontario Health (Cancer Care Ontario), Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Henderson I, Black N, Khattak H, Gupta JK, Rimmer MP. Diagnosis and management of endometrial hyperplasia: A UK national audit of adherence to national guidance 2012-2020. PLoS Med 2024; 21:e1004346. [PMID: 38421942 PMCID: PMC10903889 DOI: 10.1371/journal.pmed.1004346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Endometrial hyperplasia (EH) is a precusor lesion for endometrial cancer (EC), the commonest gynaecological malignancy in high-income countries. EH is a proliferation of glandular tissue, classified as either non-atypical endometrial hyperplasia (NEH) or, if the cytological features are abnormal, atypical endometrial hyperplasia (AEH). The clinical significance of AEH is that patients face both a high risk of having occult EC and a high risk of progression to EC if untreated. Recommendations on the care of women with EH were introduced by United Kingdom-wide guidance (Green-top Guide No. 67, 2016). National adherence to guidance is unknown. We aimed to describe the care of patients with EH; to compare the patterns of care for those with EH with national guidance to identify opportunities for quality improvement; and to compare patterns of care prior to and following the introduction of national guidance to understand its impact. METHODS AND FINDINGS In this UK-wide patient-level clinical audit, we included 3,307 women who received a new histological diagnosis of EH through a gynaecology service between 1 January 2012 and 30 June 2020. We described first-line management, management at 2 years, and surgical characteristics prior to and following national guidance for EH using proportions and 95% confidence intervals (CIs) and compared process measures between time periods using multilevel Poisson regression. Of the 3,307 patients, 1,570 had NEH and 1,511 had AEH between 2012 and 2019. An additional 85 patients had NEH and 141 had AEH during 2020. Prior to national guidance, 9% (95% CI [6%, 15%]) received no initial treatment for NEH compared with 3% (95% CI [1%, 5%]) post-guidance; 31% (95% CI [26%, 36%]) and 48% (95% CI [43% 53%]) received an intrauterine progestogen, respectively, in the same periods. The predominant management of women with AEH did not differ, with 68% (95% CI [61%, 74%]) and 67% (95 CI [63%, 71%]) receiving first-line hysterectomy, respectively. By 2 years, follow-up to histological regression without hysterectomy increased from 38% (95% CI [33%, 43%]) to 52% (95% CI [47%, 58%]) for those with NEH (rate ratio (RR) 1.38, 95% CI [1.18, 1.63] p < 0.001). We observed an increase in the use of total laparoscopic hysterectomy among those with AEH (RR 1.26, 95% CI [1.04, 1.52]). In the later period, 37% (95% CI [29%, 44%]) of women initially diagnosed with AEH who underwent a first-line hysterectomy, received an upgraded diagnosis of EC. Study limitations included retrospective data collection from routine clinical documentation and the inability to comprehensively understand the shared decision-making process where care differed from guidance. CONCLUSIONS The care of patients with EH has changed in accordance with national guidance. More women received first-line medical management of NEH and were followed up to histological regression. The follow-up of those with AEH who do not undergo hysterectomy must be improved, given their very high risk of coexistent cancer and high risk of developing cancer.
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Affiliation(s)
- Ian Henderson
- The United Kingdom Audit and Research Collaborative in Obstetrics and Gynaecology, London, United Kingdom
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Naomi Black
- The United Kingdom Audit and Research Collaborative in Obstetrics and Gynaecology, London, United Kingdom
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Hajra Khattak
- The United Kingdom Audit and Research Collaborative in Obstetrics and Gynaecology, London, United Kingdom
- Elizabeth Garret Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | | | - Janesh K. Gupta
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Birmingham Women’s and Children’s NHS Hospital Trust, Birmingham, United Kingdom
| | - Michael P. Rimmer
- The United Kingdom Audit and Research Collaborative in Obstetrics and Gynaecology, London, United Kingdom
- Medical Research Council Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, United Kingdom
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Gracia M, Rodríguez E, Diestro MD, Spagnolo E, García V, Siegrist J, Pérez Y, Zapardiel I, Hernández A. Impact of the Covid-19 pandemic on the management of gynecologic cancer: a Spanish survey. Observational, multicenter study. BMC Womens Health 2023; 23:488. [PMID: 37710231 PMCID: PMC10500789 DOI: 10.1186/s12905-023-02633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) pandemic changed the distribution of healthcare resources, leading in many cases to the suspension of all non-essential treatments and procedures and representing a challenge for medical professionals. The objective of this study was to evaluate whether clinical protocols in gynecologic oncology care were modified as a result of the pandemic and to assess surgeons' perceptions regarding the management of gynecologic cancers". METHODS Data were collected through an anonymous and voluntary survey sent via email to healthcare professionals in the field of gynecologic oncology in Spain. RESULTS A total of 75 gynecologic oncologists completed the online survey. Of these, 93.2% (69) reported working in public hospitals and 62.5% (45) in tertiary care hospitals. 97.3% (71) were affiliated with hospitals treating patients infected with SARS-CoV-2. 85.1% (63) of the respondents expressed concern about the SARS-CoV-2 pandemic and 52.1% (38) indicated that the pandemic impacted the diagnostic and therapeutic quality of care for oncology patients. SARS-CoV-2 nasopharyngeal swab PCR (Polymerase Chain Reaction) testing was always performed before surgical interventions by 97.3% (71), being considered a best practice in triage by 94.4% (68). 87.5% (63) reported no change in the type of surgical approach during the pandemic. 62.5% (45) experienced limitations in accessing special personal protective equipment for SARS-CoV-2. An impact on the follow-up of patients with gynecologic cancers due to the pandemic was reported by 70.4% (50). CONCLUSIONS Most of the Spanish gynecologic oncologists who responded to our survey reported that the SARS-CoV-2 pandemic had affected their clinical practice. The primary measures implemented were an increase in telemedicine, restricting outpatient visits to high-risk or symptomatic patients and the use of SARS-CoV-2 screening prior to surgery. No major changes in the surgical approach or management of the treatment of ovarian, endometrial or cervical cancer during the pandemic were reported.
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Affiliation(s)
- Myriam Gracia
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
| | - Elena Rodríguez
- Department of Gynecology, La Paz University Hospital Hospital Universitario La Paz, Madrid, Spain, 28046, Paseo de la Castellana, 261
| | | | - Emanuela Spagnolo
- Department of Gynecology, La Paz University Hospital Hospital Universitario La Paz, Madrid, Spain, 28046, Paseo de la Castellana, 261.
| | - Virginia García
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
| | - Jaime Siegrist
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
| | - Yolanda Pérez
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
| | - Ignacio Zapardiel
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
| | - Alicia Hernández
- Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
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Varlas VN, Borș RG, Crețoiu R, Bălescu I, Bacalbașa N, Cîrstoiu M. Fertility-sparing surgery: a hopeful strategy for young women with cancer. J Med Life 2023; 16:974-980. [PMID: 37900072 PMCID: PMC10600681 DOI: 10.25122/jml-2023-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/25/2023] [Indexed: 10/31/2023] Open
Abstract
Fertility preservation in cancer patients is currently based on either assisted reproductive technology or fertility-sparing surgery. Loss of fertility may be caused by excisional surgery associated with an adnexal or uterine pathology or secondary to gonadal insufficiency caused by chemotherapy or radiation. The counseling of these patients is very important, being carried out jointly by the oncologist, gynecologist, and reproductive medicine specialist. Reproductive surgery usually requires avoiding laparotomy to significantly reduce the formation of adhesions and trauma or tissue damage. This is done using standard laparoscopic surgery or robotic surgery (computer-assisted laparoscopy), a method increasingly used and accessible to all specialists who want to maintain the fertility of their patients with various oncological diseases.
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Affiliation(s)
- Valentin Nicolae Varlas
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
- Department of Obstetrics Gynecology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Rebeca Crețoiu
- Department of Pituitary and Neuroendocrine Disorders, C.I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Irina Bălescu
- Department of Surgery, Ponderas Academic Hospital, Bucharest, Romania
| | - Nicolae Bacalbașa
- Department of Visceral Surgery, Fundeni Clinical Institute, Bucharest, Romania
| | - Monica Cîrstoiu
- Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, Romania
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Țieranu ML, Dragoescu NA, Zorilă GL, Istrate-Ofițeru AM, Rămescu C, Berbecaru EIA, Drăguşin RC, Nagy RD, Căpitănescu RG, Iliescu DG. Addressing Chronic Gynecological Diseases in the SARS-CoV-2 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040802. [PMID: 37109760 PMCID: PMC10145652 DOI: 10.3390/medicina59040802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Introduction: the COVID-19 pandemic has had a considerable impact on healthcare systems worldwide. Since the actual influence of the pandemic on gynecological care is still unclear, we aim to evaluate the effect of the SARS-CoV-2 pandemic on gynecological procedures compared to the pre-pandemic period in Romania. Materials and Methods: this is a single-center retrospective observational study, involving patients hospitalized in the year before the SARS-CoV-2 pandemic (PP), in the first year of the pandemic (P1), and in the second year of the pandemic until February 2022 (P2). The percentages of interventions were analyzed globally but also according to the type of surgery applied on the female genital organs. Results: during pandemic, the number of gynecological surgeries dropped considerably, by more than 50% in some cases, or even decreased by up to 100%, having a major impact on women's health, especially in the first year of the pandemic (P1), before slightly increasing in the post-vaccination period (PV). Surgically treated cancer cases dropped by over 80% during the pandemic, and the consequences of this will be seen in the future. Conclusions: the COVID-19 pandemic played an important part in gynecological care management in the Romanian public health care system, and the effect will have to be investigated in the future.
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Affiliation(s)
- Maria-Loredana Țieranu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 20039 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Nicoleta Alice Dragoescu
- Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - George-Lucian Zorilă
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Anca-Maria Istrate-Ofițeru
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Research Centre for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cătălina Rămescu
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Elena-Iuliana-Anamaria Berbecaru
- Doctoral School, University of Medicine and Pharmacy of Craiova, 20039 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Roxana Cristina Drăguşin
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Rodica Daniela Nagy
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Răzvan Grigoraș Căpitănescu
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dominic-Gabriel Iliescu
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Trends in Hysterectomy Rates Associated With the Coronavirus Disease 2019 (COVID-19) Pandemic. Obstet Gynecol 2023; 141:592-601. [PMID: 36649321 DOI: 10.1097/aog.0000000000005087] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/08/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To compare nationwide trends in the rate of inpatient and outpatient hysterectomy between 2019 and 2020 during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Using weighted data from the National Inpatient Sample and the National Ambulatory Surgery Sample, we examined the number of hysterectomies performed by month from 2019 through 2020. Monthly trends were compared between years overall, stratified by the route of surgery (abdominal, laparoscopic, and vaginal) and by indication for surgery (benign, preinvasive, cancer). Trends analyses were conducted using Joinpoint regression and reported as average monthly percentage change (AMPC). Differences in demographic characteristics between the years were compared using χ 2 tests. RESULTS From January 2019 through December 2020, after weighting, 1,029,792 hysterectomies were performed, including 548,802 (53.2%) in 2019 and 480,990 (46.7%) in 2020. Starting in January 2020, monthly cases declined significantly, from 40,240 to a nadir of 10,566 hysterectomies in April 2020 (AMPC -29.2%, 95% CI -39.8% to -16.8%) ( P <.001). The subsequent months saw a significant increase in cases, from the nadir in April 2020 to 40,023 cases in July 2020 (AMPC 39.4%, 95% CI 18.6-63.9%) ( P =.001), which then stabilized to the end of the year (AMPC -1.3%, 95% CI -4.8% to 2.4%) ( P =.46). In March 2020 there was a 24.0% decrease, in April 2020 a 74.2% decrease, and in May 2020 a 35.1% decrease compared with the respective months in 2019. The rates of vaginal hysterectomy declined more than the rates of other routes of surgery, and procedures performed for benign and preinvasive disease decreased more than those for cancer. CONCLUSION The rate of hysterectomy in the United States decreased in 2020 compared with 2019, with the greatest decrease from March to May of 2020, corresponding with the initial wave of COVID-19.
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10
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Demirci PY, Tunuğ Ş, Vurgeç BA, Sürücü ŞG. Relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during the COVID-19 pandemic. J Obstet Gynaecol Res 2023; 49:1019-1027. [PMID: 36604851 DOI: 10.1111/jog.15537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
AIM The study aimed to determine the relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during COVID-19. METHODS The population of the study was women with gynecologic cancer who received chemotherapy in a university hospital. The study sample was calculated using G*Power 3.1.9.4 analysis program and completed with 64 patients who agreed to participate and met the research criteria. The personal information form, supportive care needs survey-short form (SCNS-SF29Tr ), coronavirus anxiety scale (CAS), and death anxiety scale (DAS) were used for data collection. RESULTS The participants' SCNS-SF29Tr mean score was 105.7 ± 17.26, CAS mean score was 11.19 ± 3.96, and DAS mean score was 40.13 ± 15.5. There was a positive, very high-level correlation between the health system and information and psychological needs subscales of SCNS-SF29Tr and CAS (r = 0.809, r = 0.878, respectively; p < 0.05). In addition, a high-level relationship was found between the daily life subscale of SCNS-SF29Tr and CAS (r = 0.674; p < 0.001). A positive low-level relationship was determined between the health system and information, daily life, and psychological needs (except for the sexuality) subscales of SCNS-SF29Tr and DAS (r = 0.357, r = 0.252, r = 0.353 respectively; p < 0.05). CONCLUSION Gynecologic cancer participants had unmet supportive care needs in all subscales except for the sexuality. The participants had higher supportive care needs, high-level coronavirus anxiety, and medium-level death anxiety. In addition, the participants' all supportive care needs have increased as their coronavirus anxiety levels have increased. The participants' supportive care needs have increased, except for sexuality, as their death anxiety levels have increased.
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Affiliation(s)
- Pınar Y Demirci
- Nursing Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Şule Tunuğ
- Gyne-Oncology Service, Cukurova University Faculty of Medicine Balcalı Hospital, Adana, Turkey
| | - Burcu A Vurgeç
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Şule G Sürücü
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
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11
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Wong J, Gonzalez R, Albright B, Hayes T, Swartz A, Havrilesky LJ, Lee PS, Previs RA. Telemedicine and gynecologic oncology: caring for patients remotely during a global pandemic. AJOG GLOBAL REPORTS 2022; 2:100124. [DOI: 10.1016/j.xagr.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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12
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Di Cosimo S, Susca N, Apolone G, Silvestris N, Racanelli V. The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic. Front Oncol 2022; 12:961380. [PMID: 36249038 PMCID: PMC9556993 DOI: 10.3389/fonc.2022.961380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/12/2022] [Indexed: 01/19/2023] Open
Abstract
Background The rapid and global spread of COVID-19 posed a massive challenge to healthcare systems, which came across the need to provide high-intensity assistance to thousands of patients suffering from SARS-CoV-2 infection while assuring continuous care for all other diseases. This has been of particular importance in the oncology field. This study explores how oncology centers responded to the pandemic at a single center level by assessing surveys addressing different aspects of cancer care after the pandemic outbreak. Methods We performed a systematic review and meta-analysis of the cancer care surveys published until December 11th, 2020. Data were analyzed according to three main areas of interest, namely health care organization, including cancellation/delay and/or modification of scheduled treatments, cancellation/delay of outpatient visits, and reduction of overall cancer care activities; routine use of preventive measures, such as personal protective equipment (PPE) by both patients and health care workers, and systematic SARS-CoV-2 screening by nasopharyngeal swabs; and implementation of telemedicine through remote consultations. Findings Fifty surveys reporting data on 9150 providers from 121 countries on 5 continents were included. Cancellation/delay of treatment occurred in 58% of centers; delay of outpatient visits in 75%; changes in treatment plans in 65%; and a general reduction in clinical activity in 58%. Routine use of PPE by patients and healthcare personnel was reported by 81% and 80% of centers, respectively; systematic SARS-CoV-2 screening by nasopharyngeal swabs was reported by only 41% of centers. Virtual visits were implemented by the majority (72%) of centers. Interpretation These results describe the negative impact of COVID-19 on cancer care, the rapid response of cancer centers in terms of preventive measures and alternative treatment approaches such as telemedicine, and confirm that surveys can provide the valuable, low-cost and immediate information that critical situations require.
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Affiliation(s)
- Serena Di Cosimo
- Platform of Integrated Biology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nicola Susca
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Vito Racanelli
- School of Medicine: Interdisciplinary of Medicine, Aldo Moro University of Bari, Bari, Italy
- *Correspondence: Vito Racanelli,
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13
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands. .,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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14
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Giannone G, Castaldo D, Tuninetti V, Scotto G, Turinetto M, Valsecchi AA, Bartoletti M, Mammoliti S, Artioli G, Mangili G, Salutari V, Lorusso D, Cormio G, Zamagni C, Savarese A, Di Maio M, Ronzino G, Pisano C, Pignata S, Valabrega G. Management of Metastatic Endometrial Cancer: Physicians' Choices Beyond the First Line. A MITO Survey. Front Oncol 2022; 12:880008. [PMID: 35692798 PMCID: PMC9185800 DOI: 10.3389/fonc.2022.880008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background Endometrial cancer (EC) therapeutic and diagnostic approaches have been changed by the development of a new prognostic molecular classification, the introduction of dostarlimab in microsatellite instability (MSI) high pre-treated advanced EC patients with further expected innovation deriving from lenvatinib plus pembrolizumab regardless MSI status. How this is and will be translated and embedded in the clinical setting in Italy is not known; this is why we developed Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies (MITO) survey on the current practice and expected future changes in EC. Methods We designed a self-administered, multiple-choice online questionnaire available only for MITO members for one month, starting in April 2021. Results 75.6% of the respondents were oncologists with a specific focus on gynaecologic malignancies and 73.3% of the respondents declared the availability of clinical trials in second line treatment for advanced EC. The therapeutic algorithm in second line was heterogeneous, being the most frequent choice administering anthracyclines followed by endocrine therapy or enrolling in clinical trials. While more than half of the clinicians declared that they performed the molecular classification, only six/45 respondents (13.3%) ran all the tests needed for it. On the other hand, 80% of them declared regular assessment of MSI status with IHC as recommended. The therapeutic approach in MSI high advanced EC patients has changed since dostarlimab approval. Indeed the most frequent choice in second line has been chemotherapy (53.3%) before its availability, while dostarlimab has been preferred in more than three-fourths of the cases (75.6%) after its approval. As for MSS patients, 77.8% of clinicians would choose lenvatinib plus pembrolizumab for them in second line once approved. Conclusions Despite the selected sample of respondents from Italian MITO centres showing good knowledge of diagnostic and therapeutic innovations in EC, these are not fully implemented in everyday clinics, except for MSI status assessment.
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Affiliation(s)
- Gaia Giannone
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy.,Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Daniele Castaldo
- Segreteria Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) Group, Naples, Italy
| | - Valentina Tuninetti
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Giulia Scotto
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Margherita Turinetto
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Anna Amela Valsecchi
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Michele Bartoletti
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Serafina Mammoliti
- Ospedale Policlinico San Martino - Department of Medical Oncology 1- L.go Rosanna Benzi, IRCCS, Genoa, Italy
| | - Grazia Artioli
- Oncologia Medica, Unità locale socio sanitaria n2 (ULSS2) Marca Trevigiana, Treviso, Italy
| | - Giorgia Mangili
- Obstet-Gynecol Department, San Raffaele Scientific Institute, IRCCS, Milan, Italy
| | - Vanda Salutari
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Domenica Lorusso
- Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Gennaro Cormio
- Department of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Claudio Zamagni
- Azienda Ospedaliero-universitaria di Bologna, IRCCS, Bologna, Italy
| | - Antonella Savarese
- Department of Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Massimo Di Maio
- Department of Oncology, Mauriziano Hospital, University of Turin, Turin, Italy
| | | | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy
| | - Giorgio Valabrega
- Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia (FPO) - IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
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15
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COVID-19 Pandemic Impact on Surgical Treatment Methods for Early-Stage Cervical Cancer: A Population-Based Study in Romania. Healthcare (Basel) 2022; 10:healthcare10040639. [PMID: 35455816 PMCID: PMC9024750 DOI: 10.3390/healthcare10040639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 12/30/2022] Open
Abstract
Being one of the most common malignancies in young women, cervical cancer is frequently successfully screened around the world. Early detection enables for an important number of curative options that allow for more than 90% of patients to survive more than three years without cancer relapse. Unfortunately, the COVID-19 pandemic put tremendous pressure on healthcare systems and access to cancer care, determining us to develop a study on the influence the pandemic had on surgical care of cervical cancer, and to assess changes in its management and outcomes. A retrospective study design allowed us to compare cervical cancer trends of the last 48 months of the pre-pandemic period with the first 24 months during the COVID-19 pandemic, using the database from the Timis County Emergency Clinical Hospital. New cases of cervical cancer presented to our clinic in more advanced stages (34.6% cases of FIGO stage III during the pandemic vs. 22.4% before the pandemic, p-value = 0.047). These patients faced significantly more changes in treatment plans, postponed surgeries, and postponed radio-chemotherapy treatment. From the full cohort of cervical cancer patients, 160 were early stages eligible for curative intervention who completed a three-year follow-up period. The disease-free survival and overall survival were not influenced by the surgical treatment of choice, or by the SARS-CoV-2 infection (log-rank p-value = 0.449, respectively log-rank p-value = 0.608). The individual risk factors identified for the three-year mortality risk were independent of the SARS-CoV-2 infection and treatment changes during the COVID-19 pandemic. We observed significantly fewer cases of cervical cancer diagnosed per year during the first 24 months of the COVID-19 pandemic, blaming the changes in healthcare system regulations that failed to offer the same conditions as before the pandemic. Even though we did not observe significant changes in disease-free survival of early-stage cervical cancers, we expect the excess of cases diagnosed in later stages to have lower survival rates, imposing the healthcare systems to consider different strategies for these patients while the pandemic is still ongoing.
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16
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Bhatia RK, Lichter KE, Gurram L, MacDuffie E, Lombe D, Sarria GR, Grover S. Gynecologic radiation therapy in low and middle income countries during the COVID-19 pandemic. Int J Gynecol Cancer 2022; 32:446-450. [PMID: 35256435 PMCID: PMC9997715 DOI: 10.1136/ijgc-2021-003039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has forever affected healthcare and posed an incredible challenge to our society to care for our sick. Patients with cancer were found early on to have higher rates of complications with COVID-19. Radiation therapy is an integral part of treatment for many types of gynecologic cancer and adaptation on its utilization during the pandemic varied across the globe. In this review, we detail certain guidelines for the use of radiation in gynecologic cancers during the pandemic as well as real world accounts of how different countries adapted to these guidelines or created their own based on individualized resources, staffing, government restrictions, and societal norms. Critically, this review demonstrates the breadth of fractionation schemes and technologies used when resources were limited but highlights the importance of long term follow-up for many of our patients during this time.
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Affiliation(s)
- Rohini K Bhatia
- Department of Radiation Oncology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Katie E Lichter
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA
| | - Lavanya Gurram
- Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Emily MacDuffie
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Gustavo R Sarria
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Surbhi Grover
- Department of Radiation Oncology, Botswana-University of Pennsylvania Partnership, Philadelphia, Pennsylvania, USA .,University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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17
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Javellana M, Hlubocky FJ, Somasegar S, Sorkin M, Kurnit KC, Jani I, Stock E, Mills K, Lengyel E, Lee NK. Resilience in the Face of Pandemic: The Impact of COVID-19 on the Psychologic Morbidity and Health-Related Quality of Life Among Women With Ovarian Cancer. JCO Oncol Pract 2022; 18:e948-e957. [PMID: 35201895 DOI: 10.1200/op.21.00514] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The COVID-19 pandemic has created new challenges for ovarian cancer survivors. This study aims to evaluate the psychologic morbidity and alterations in medical care caused by the pandemic. METHODS Advanced-stage ovarian cancer survivors at our institution were contacted for participation in a cross-sectional telephone-based quantitative survey study assessing pandemic-related psychologic morbidity. Psychologic domains using validated measures were explored: health-related quality of life (HRQOL; functional assessment of cancer therapy [FACT-G7]), anxiety (generalized anxiety disorder-7 [GAD7]), depression (Patient Health Questionnarie-2 [PHQ2]), global health Patient-Reported Outcomes Measurement Information System - Global Physical Health/Global Mental Health (PROMIS-GMH/GPH), resilience (brief resilience scale), and loneliness (English Longitudinal Study on Aging). Novel COVID-19 pandemic questions were drawn from a larger survey developed in our department. RESULTS Fifty-nine percent (61 of 104) of contacted patients completed the survey. One quarter of respondents had high resilience, with only 10% reporting low resilience. Only one patient screened positive for depression, and two for anxiety. Increased loneliness was reported by 43% of respondents. Patients' overall HRQOL was good (median = 21; range = 6-28). Few patients experienced treatment delays, with only four experiencing chemotherapy interruption and two reporting surgical delays. Multiple regression analyses revealed that high FACT-G7 HRQOL was predicted by age > 65 years, high self-reported mental health, high resilience, and being off chemotherapy. Lower COVID-19 concern was predicted by recurrent cancer and high resilience. CONCLUSION Despite the far-reaching impact of the COVID-19 pandemic, ovarian cancer survivors' HRQOL has been maintained. Older age, high resilience, high mental health, and being off chemotherapy predicted better HRQOL. Ovarian cancer survivors remain resilient in the face of the pandemic, and the support of clinicians to preserve this invaluable personal resource is critical for well-being.
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Affiliation(s)
- Melissa Javellana
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Fay J Hlubocky
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL.,Department of Medicine, Section of Hematology/Oncology, MacLean Center for Clinical Medical Ethics, Cancer Research Center, Supportive Oncology Program, Chicago, IL
| | - Sahana Somasegar
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Mia Sorkin
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Katherine C Kurnit
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Ina Jani
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Elizabeth Stock
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Kathryn Mills
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Ernst Lengyel
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
| | - Nita K Lee
- The University of Chicago Medicine, Department of Gynecology/ Obstetrics, Section of Gynecologic Oncology, Chicago, IL
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18
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Bruce SF, Huysman B, Bharucha J, Massad LS, Mullen MM, Hagemann AR, Fuh KC, McCourt CK, Thaker PH, Khabele D, Powell MA, Mutch DG, Kuroki LM. Impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care. Gynecol Oncol Rep 2022; 39:100928. [PMID: 35024405 PMCID: PMC8739812 DOI: 10.1016/j.gore.2022.100928] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/15/2021] [Accepted: 01/03/2022] [Indexed: 12/30/2022] Open
Abstract
The COVID-19 pandemic has significantly impacted gynecologic cancer care. Referrals to gynecologic oncology decreased in the early months of the pandemic. Referral time to gynecologic oncology evaluation was not impacted by the pandemic. Time to cancer treatment initiation decreased significantly during the pandemic. Disparities in time to cancer treatment initiation improving during the pandemic.
Objective To evaluate the impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care at a National Cancer Institute-designated Comprehensive Cancer Center. Methods We conducted a retrospective cohort study of patients referred for evaluation by a gynecologic oncologist at Washington University in St. Louis from October 2019 – February 2020 (pre-COVID-19), and April - August 2020 (COVID-19). The primary outcome, time from referral to evaluation by a gynecologic oncologist, was compared between the two time periods. Secondary outcomes included time from initial evaluation to treatment and delays/interruptions in care due to the pandemic. Sub-group analyses were performed on patients with a cancer diagnosis to evaluate the impact of COVID-19 on treatment decision making. Results 884 patients were referred during the study period. Total referrals fell by 32% (526 to 358 patients, p < 0.001) and referrals for cancer fell by 18% (228 to 188 patients, p = 0.049). The pandemic did not impact time from referral to initial gynecologic oncology appointment overall (pre-COVID-19: 19.1 vs. COVID-19: 17.4 days, p = 0.315) or among patients with cancer (14.4 vs. 13.9 days, p = 0.662). Time from initial appointment to cancer treatment decreased by 9 days (34 days to 25 days, p = 0.001). Conclusion Referrals to gynecologic oncology decreased significantly during the early months of COVID-19. Though time from referral to evaluation was not impacted by the pandemic, time to treatment initiation decreased despite institutional changes related to COVID-19.
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Affiliation(s)
- Shaina F Bruce
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Bridget Huysman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Jinai Bharucha
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - L Stewart Massad
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Mary M Mullen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Andrea R Hagemann
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Katherine C Fuh
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Carolyn K McCourt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Dineo Khabele
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Matthew A Powell
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - David G Mutch
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
| | - Lindsay M Kuroki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Barnes Jewish Hospital, Washington University, St. Louis, MO, United States
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Bizzarri N, Nero C, Sillano F, Ciccarone F, D’Oria M, Cesario A, Fragomeni SM, Testa AC, Fanfani F, Ferrandina G, Lorusso D, Fagotti A, Scambia G. Building a Personalized Medicine Infrastructure for Gynecological Oncology Patients in a High-Volume Hospital. J Pers Med 2021; 12:jpm12010003. [PMID: 35055317 PMCID: PMC8778422 DOI: 10.3390/jpm12010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
Gynecological cancers require complex intervention since patients have specific needs to be addressed. Centralization to high-volume centers improves the oncological outcomes of patients with gynecological cancers. Research in gynecological oncology is increasing thanks to modern technologies, from the comprehensive molecular characterization of tumors and individual pathophenotypes. Ongoing studies are focusing on personalizing therapies by integrating information across genomics, proteomics, and metabolomics with the genetic makeup and immune system of the patient. Hence, several challenges must be faced to provide holistic benefit to the patient. Personalized approaches should also recognize the unmet needs of each patient to successfully deliver the promise of personalized care, in a multidisciplinary effort. This may provide the greatest opportunity to improve patients' outcomes. Starting from a narrative review on gynecological oncology patients' needs, this article focuses on the experience of building a research and care infrastructure for personalized patient management.
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Affiliation(s)
- Nicolò Bizzarri
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
| | - Camilla Nero
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
- Correspondence:
| | - Francesca Sillano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
| | - Francesca Ciccarone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
| | - Marika D’Oria
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
| | - Alfredo Cesario
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
| | - Simona Maria Fragomeni
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
| | - Antonia Carla Testa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Fanfani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriella Ferrandina
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Domenica Lorusso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
| | - Anna Fagotti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (N.B.); (F.S.); (F.C.); (S.M.F.); (A.C.T.); (F.F.); (G.F.); (D.L.); (A.F.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.D.); (A.C.)
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20
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Struck JP, Schnoor M, Schulze A, Hupe MC, Ozimek T, Oppolzer IA, Schnabel MJ, Burger M, Darr C, Gruenwald V, Hadaschik B, Weinke M, Kuebler H, Klockenbusch JC, Grabbert MT, Gratzke C, Kramer MW, Katalinic A, Merseburger AS. Impact of COVID-19 crisis on medical care of patients with metastasized uro-oncologic disease under systemic cancer therapy: a multicenter study in German university hospitals. World J Urol 2021; 40:409-418. [PMID: 34850270 PMCID: PMC8631559 DOI: 10.1007/s00345-021-03868-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To date, over 4.2 million Germans and over 235 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Uro-oncology (UO) patients are particularly vulnerable but in urgent need of life-saving systemic treatments. Our multicentric study examined the impact of the COVID-19 crisis on the medical care of UO patients in German university hospitals receiving ongoing systemic anti-cancer treatment and to detect the delay of medical care, defined as deferred medical treatment or deviation of the pre-defined follow-up assessment. Methods Data of 162 UO patients with metastatic disease undergoing systemic cancer treatment at five university hospitals in Germany were included in our analyses. The focus of interest was any delay or change in treatment between February 2020 and May 2020 (first wave of the COVID-19 crisis in Germany). Statistical analysis of contingency tables were performed using Pearson’s chi-squared and Fisher’s exact tests, respectively. Effect size was determined using Cramér’s V (V). Results Twenty-four of the 162 patients (14.8%) experienced a delay in systemic treatment of more than 2 weeks. Most of these received immuno-oncologic (IO) treatments (13/24, 54.2%, p = 0.746). Blood tests were delayed or canceled significantly more often in IO patients but with a small effect size (21.1%, p = 0.042, V = 0.230). Treatment of patients with renal cell carcinoma (12/73, 16.4%) and urothelial carcinoma (7/32, 21.9%) was affected the most. Conclusions Our data show that the COVID-19 pandemic impacted the medical care of UO patients, but deferment remained modest. There was a tendency towards delays in IO and ADT treatments in particular.
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Affiliation(s)
- Julian P. Struck
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - Maike Schnoor
- Department of Social Medicine and Epidemiology and Department of Cancer Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany
| | - Andrea Schulze
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - Marie C. Hupe
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - Tomasz Ozimek
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - Immanuel A. Oppolzer
- Department of Urology, University Hospital of Regensburg, Landshuter Straße 65, 93053 Regensburg, Germany
| | - Marco J. Schnabel
- Department of Urology, University Hospital of Regensburg, Landshuter Straße 65, 93053 Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, University Hospital of Regensburg, Landshuter Straße 65, 93053 Regensburg, Germany
| | - Christopher Darr
- Department of Urology, Pediatric Urology and Uro-Oncology, University Hospital of Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Viktor Gruenwald
- Department of Urology, Pediatric Urology and Uro-Oncology, University Hospital of Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Boris Hadaschik
- Department of Urology, Pediatric Urology and Uro-Oncology, University Hospital of Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Maximilian Weinke
- Department of Urology and Pediatric Urology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany
| | - Hubert Kuebler
- Department of Urology and Pediatric Urology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany
| | - Jonas C. Klockenbusch
- Department of Urology, University Hospital of Freiburg, Hugstetterstraße 55, 79106 Freiburg im Breisgau, Germany
| | - Markus T. Grabbert
- Department of Urology, University Hospital of Freiburg, Hugstetterstraße 55, 79106 Freiburg im Breisgau, Germany
| | - Christian Gratzke
- Department of Urology, University Hospital of Freiburg, Hugstetterstraße 55, 79106 Freiburg im Breisgau, Germany
| | - Mario W. Kramer
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - Alexander Katalinic
- Department of Social Medicine and Epidemiology and Department of Cancer Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562 Luebeck, Germany
| | - Axel S. Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
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Santos LD, Stevanato KP, Roszkowski I, Pedroso RB, Pelloso FC, Freitas KMS, Carvalho MDDB, Pelloso SM. Impact of the Covid-19 Pandemic on Women's Health in Brazil. J Multidiscip Healthc 2021; 14:3205-3211. [PMID: 34819731 PMCID: PMC8607988 DOI: 10.2147/jmdh.s322100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/28/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim is to verify the impact of the Covid-19 pandemic on women’s healthcare and medical assistance in Brazil. Patients and Methods This exploratory cross-sectional study evaluated a non-probabilistic sample of women above 20 years old, carried out between August and September of 2020, through a snowball sampling using a Google Forms application. Results From a total of 2495 women, more than 70% have not been screened for cervical cancer (77.8% of 2244 women aged for screening), and more than 80% have not been screened for breast cancer (80.2% from 1325 women aged for mammography) during the pandemic. Also, 55.2% of the women did not undergo routine blood tests during the same period. The most frequent reasons for not performing screening and routine tests were: they were up to date; fear of contracting Covid-19; they decided to postpone it until after the end of the pandemic; they were unable to schedule the appointment at the healthcare center for whatever reason; and the healthcare center was only attending Covid-19 patients. Women with no comorbidities have performed significantly more mammograms and routine blood tests than women with comorbidities. In addition, women with comorbidities who were used to perform periodic medical follow-up have done it substantially more than women with no comorbidities during the pandemic. Conclusion As observed, there was a significant decrease in women’s access to the healthcare system during this pandemic. Many participants reported that they had not attended any screening tests, and some reasons included fear of getting infected and due to the public measures of social distancing. The consequences are late diagnoses and a worse prognosis. It might impact the healthcare systems around the world in the next few years. Further studies should be done to follow these consequences.
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Affiliation(s)
| | | | | | | | | | | | | | - Sandra Marisa Pelloso
- State University of Maringá, Maringá, Parana, Brazil.,Faculdade Ingá, Maringá, Parana, Brazil
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22
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Nikolopoulos M, Maheshwari MK, Doumouchtsis SK. Impact of COVID-19 in gynaecological oncology care: a systematic rapid review. Arch Gynecol Obstet 2021; 305:555-565. [PMID: 34729631 PMCID: PMC8563355 DOI: 10.1007/s00404-021-06295-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/13/2021] [Indexed: 12/30/2022]
Abstract
Purpose Synthesis of available evidence on clinical practice in gynaecological oncology during the COVID-19 pandemic is highly warranted, as women with cancer are at increased risk due to their systemic immunosuppressed state and changes in their care are inevitable. Rapid review of available data is a quick way of providing useful information and insight into the way medical practice has been affected by the COVID pandemic. Methods We conducted a systematic rapid review, based on a literature search of MEDLINE/PubMed, Embase, and Cochrane CENTRAL. We considered all studies on gynaecological oncology care during the COVID-19 pandemic using relevant keywords and MeSH terms. Selection criteria were English language, studies with more than five cases and publication in peer-review journal. Results Nine retrospective studies, one systematic review and five questionnaire surveys were included. Quality of the studies has been assessed. Development of higher quality evidence is warranted. Mortality of COVID-19 infection is higher in patients with gynaecological cancer than in non-cancer patients. Reported delays in diagnosis and management of cancer and changes in treatments, may affect the natural history of cancer and increase patients’ anxiety and fear of disease progression while causing concerns to healthcare professionals affecting their clinical practice. The number of new diagnoses has declined. Prioritization is important, face-to-face interactions should be limited, and appropriate protective measures are essential. Cancer surgery, chemotherapy, and radiotherapy should continue as high priority practices. Conclusion The COVID-19 pandemic has affected clinical practice significantly. Adaptations in clinical practice may improve mortality and complication rates.
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Affiliation(s)
- Manolis Nikolopoulos
- Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
| | - Manish K Maheshwari
- Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | - Stergios K Doumouchtsis
- Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
- St George's University of London, London, UK
- Laboratory of Experimental Surgery and Surgical Research N S Christeas, University of Athens, Medical school, Athens, Greece
- School of Medicine, American University of the Caribbean, Pembroke Pines, FL, USA
- School of Medicine, Ross University, Miramar, FL, USA
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23
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Collateral damage of COVID-19 pandemic: The impact on a gynecologic surgery department. J Gynecol Obstet Hum Reprod 2021; 51:102255. [PMID: 34757223 PMCID: PMC8555111 DOI: 10.1016/j.jogoh.2021.102255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/03/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022]
Abstract
Objective This study focuses on changes in gynecologic surgical activity at Hospital Foch, Paris, France during the first French COVID lockdown in 2020. Additional goals include the evaluation the extent of the postponement suffered for each type of surgery and estimate the possible negative impact for patients. Study design Single-center, retrospective, chart-review cohort study in the gynecology department of Hospital Foch. Comparison of all patients scheduled, postponed and operated during the first COVID lockdown (March 14, to May 11, 2020) versus the same period in 2019. Postponed surgeries were classified into 4 scheduling interval categories according to the Society of Gynecology Oncology (SGO) recommendations: urgent (without delay), semi-urgent (1–4 weeks), non-urgent (>4–12 weeks) and elective (>3 months) and evaluated to determine whether COVID-19-related delays of surgeries fell within guidelines. The potential “loss of chance” or medical risk associated with postponed surgeries was estimated according to a composite criterion including death, aggravation of expected tumor stages/grades in cancers, increase in surgical complexity compared to that initially planned, need for preoperative transfusions, start of morphine consumption during preoperative treatment for opiate-naive patients, additional hospitalization or consultations in emergency room and delay in treatment when surgery was urgent. Results During the 2020 French COVID lockdown, 61 patients had a surgical procedure and 114 were postponed; in the comparator 2019 group, 232 patients underwent surgical procedures, indicating an overall decrease of 65% of activity. Analysis of differences between the two years revealed a reduction of 64% in emergency procedures, 90% of functional pathologies, and 13% of cancers. According to SGO guidelines, the only type of surgical procedures that had excessive delay was the semi-urgent group, where time to surgery was 6.7 weeks [range 5.4–10 weeks] instead of the recommended interval of 1–4 weeks. Among postponed surgeries there were 10 patients (8.7%) with a potential “loss of chance” according to the composite criteria, all included in the semi-urgent group. Conclusion The COVID 19 pandemic was responsible for a significant decrease of activity in the surgical department of Hospital Foch. Difficulty of rescheduling surgeries was responsible for an increased delay in semi-urgent operations. In almost 9% of postponed surgeries, there was a potential “loss of chance”, which likely represents only the tip of iceberg of collateral damages due to COVID 19 pandemic in this surgical unit. These data show the importance of continuing to treat pathologies requiring urgent or semi-urgent surgery during pandemics.
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Momenimovahed Z, Salehiniya H, Hadavandsiri F, Allahqoli L, Günther V, Alkatout I. Psychological Distress Among Cancer Patients During COVID-19 Pandemic in the World: A Systematic Review. Front Psychol 2021; 12:682154. [PMID: 34650469 PMCID: PMC8506116 DOI: 10.3389/fpsyg.2021.682154] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/10/2021] [Indexed: 11/24/2022] Open
Abstract
Aim: Patients with malignancies, experience high rates of psychological distress. Fear of Corona-infection combined with the interruptions in some treatment programs might affect the psychological health of cancer patients. This review study was conducted to investigate the psychological distress among cancer patients during COVID-19 pandemic to offer system-adapted individual solutions. Materials and methods: To identify the psychological distress of cancer patients, a comprehensive search was carried out in PubMed, Web of Science, and Scopus. English language and original articles were included in this study. Articles that addressed any psychological distress among cancer patients during COVID-19 pandemic were included. Results: At first 1,410 articles, were included in the study. After removing duplicate articles and reviewing the title and abstract, 55 articles were selected for the review. The findings of this study revealed COVID-19 greatly affects psychological health of cancer patients. Fear of COVID-19, fear of disease progression, disruption of oncology services, cancer stage, and immunocompromised status were the most common causes of psychological distress in oncology patients which can influence patients' decisions about treatment. Conclusion: The COVID-19 related anxiety is an expected reaction to the current situation. Although psychological distress affects many people, it can confuse cancer patients to the point that they refuse to continue treatment for the fear of infection and worsening of their condition. Since the end of this pandemic is unknown, this action can endanger the health and prognosis of this group of patients, so it seems that using psychological interventions and intensive counseling in the current situation is one of the main priorities for cancer patients.
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Affiliation(s)
- Zohre Momenimovahed
- Department of Reproductive Health, Qom University of Medical Sciences, Qom, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Hadavandsiri
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Veronika Günther
- Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - Ibrahim Alkatout
- Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
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25
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Li L, Cao Y, Fan J, Li T, Lang J, Zhang H, Lv J, Zhu L. Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China. Front Med (Lausanne) 2021; 8:633477. [PMID: 34395457 PMCID: PMC8360866 DOI: 10.3389/fmed.2021.633477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Few studies have quantified the influence of coronavirus disease 2019 (COVID-19) pandemic on medical providers. This is the first national study to investigate the impact of the pandemic on physicians practicing obstetrics and gynecology in China. Methods: A two-stage, stratified, cluster sampling method was performed based on the city categories (category 1, fewer than 10,000 beds; category 2, 10,000–30,000; and category 3, more than 30,000) and public hospital levels (primary, secondary, and tertiary). Physicians practicing obstetrics and gynecology reported the relevant changes in their general clinical activities and changes in the management of specific diseases or conditions occurring during the periods that they were most strongly affected. These changes were compared by municipal and hospital characteristics. Results: Questionnaires were collected from a representative sample of 11,806 physicians actively practicing obstetrics and gynecology in 779 hospitals from 157 cities of 31 provinces. Except emergency visits and online consultations, category 3 cities, tertiary hospitals and general hospitals had greater reductions in overall clinical activities than category 1 cities, primary hospitals and specialized hospitals (all adjusted p < 0.05), respectively. The differences also existed in the management of specific diseases and conditions, especially for less urgent conditions, including cervical cancer screening, instructions regarding contraception and miscarriage, and assisted reproduction (all p < 0.05). Conclusions: During the COVID-19 pandemic, the clinical obstetrics and gynecology activities in China markedly decreased, with significant differences across municipal and hospital characteristics. Trial Registration: This study was registered with ClinicalTrials.gov on July 27, 2020 (NCT04491201).
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Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Yang Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Junning Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ting Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
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Piedimonte S, Li S, Laframboise S, Ferguson SE, Bernardini MQ, Bouchard-Fortier G, Hogen L, Cybulska P, Worley MJ, May T. Gynecologic oncology treatment modifications or delays in response to the COVID-19 pandemic in a publicly funded versus privately funded North American tertiary cancer center. Gynecol Oncol 2021; 162:12-17. [PMID: 33941382 PMCID: PMC8080163 DOI: 10.1016/j.ygyno.2021.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/23/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.
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Affiliation(s)
- Sabrina Piedimonte
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada
| | - Sue Li
- Division of Gynecologic Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA, USA
| | - Stephane Laframboise
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Sarah E. Ferguson
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Marcus Q. Bernardini
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Genevieve Bouchard-Fortier
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Liat Hogen
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Paulina Cybulska
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Michael J. Worley
- Division of Gynecologic Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA, USA
| | - Taymaa May
- Division of Gynecologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada,Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada,Corresponding author at: Division of Gynecologic Oncology, Princess Margaret Cancer Centre, 610 University Avenue, OPG Wing, 6-811, Toronto, ON M5G 2M9, Canada
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27
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Khazaeipour Z, Razavi E, Pahlevan-Fallahy MT. Indirect effects of COVID-19 in referring women to gynecologic oncology, perinatology and gynecology clinics in Iran. Arch Gynecol Obstet 2021; 304:679-686. [PMID: 34059957 PMCID: PMC8166368 DOI: 10.1007/s00404-021-06097-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
Purpose COVID-19 has captured the world. We hypothesized that this pandemic reduced referral of other non-COVID-19 patients to the hospitals or clinics, including gynecological and perinatological referrals. Women can be at risk in limited use of health services. Methods In this retrospective study, referrals from gynecologic oncology, perinatology, and gynecology clinics in a large teaching hospital of Tehran University of Medical Sciences (TUMS) were compared from February 20 to May 20, 2020, with the same period in 2019. Finally, referral trends in 2020 were compared with the COVID-19 admission pattern. Results Total admissions to all three clinics declined 63% in 2020 compared to 2019. There was a significant relationship between the number of visits to three clinics during these2 years (p < 0.001). The reduction in referrals to the gynecology clinic was more than gynecologic oncology and perinatology. The COVID-19 referral pattern was conversely linked to gynecology-related admissions. Conclusion As the pandemic situation makes patients hesitant to go to the hospitals or not, health policymakers should consider other non-COVID issues, including maternal and fetal concerns. Providing safe places for other patients to visit is a goal that can be achieved through developing guidelines for nosocomial hygiene and training informed healthcare staff. Moreover, non-urgent visits should be avoided or postponed. This issue calls for new strategies, including telemedicine in situations similar to the current pandemic to both identify and manage such conditions.
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Affiliation(s)
- Zahra Khazaeipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Erfan Razavi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Taha Pahlevan-Fallahy
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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28
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Jouen T, Gauthier T, Azais H, Bendifallah S, Chauvet P, Fernandez H, Kerbage Y, Lavoue V, Lecointre L, Mimoun C, Ouldamer L, Seidler S, Siffert M, Vallin AL, Spiers A, Descamps P, Lacorre A, Legendre G. The impact of the COVID-19 coronavirus pandemic on the surgical management of gynecological cancers: Analysis of the multicenter database of the French SCGP and the FRANCOGYN group. J Gynecol Obstet Hum Reprod 2021; 50:102133. [PMID: 33789183 PMCID: PMC8004475 DOI: 10.1016/j.jogoh.2021.102133] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/15/2021] [Accepted: 03/23/2021] [Indexed: 11/19/2022]
Abstract
Introduction The coronavirus SARS-CoV-2 (COVID-19) pandemic has put tremendous pressure on the French healthcare system. Almost all hospital departments have had to profoundly modify their activity to cope with the crisis. In this context, the surgical management of cancers has been a topic of debate as care strategies were tailored to avoid any delay in treatment that could be detrimental to patient wellbeing while being careful not to overload intensive care units. The primary objective of this study was to observe changes in the surgical management of pelvic cancers during the COVID-19 pandemic in France. Material and Methods This study analyzed data from the prospective multi-center cohort study conducted by the French Society for Pelvic and Gynecological Surgery (SCGP) with methodological support from the French (FRANCOGYN) Group. All members of the SCGP received by e-mail a link allowing them to include patients who were scheduled to undergo gynecological carcinologic surgery between March 16th 2020 and May 11th 2020. Demographic data, the characteristics of cancers and the impact of the crisis in terms of changes to the usual recommended coarse of care were collected. Results A total of 181 patients with a median age 63 years were included in the cohort. In total, 31 patients had cervical cancer, 76 patients had endometrial cancer, 52 patients had ovarian or tubal cancer, 5 patients had a borderline tumor of the ovary, and 17 patients had vulvar cancer. During the study period, the care strategy was changed for 49 (27%) patients with postponed for 35 (19.3%) patients, and canceled for 7 (3.9%) patients. Surgical treatment was maintained for 139 (76.8%) patients. Management with neoadjuvant chemotherapy was offered to 19 (10,5%) patients and a change in surgical choice was made for 5 (2,8%) patients. In total, 8 (4,4%) patients tested positive for COVID-19. Data also shows a greater number of therapeutic changes in cases of ovarian cancer as well as a cancelation of a lumbo-aortic lymphadenectomy in one patient with cervical cancer. Hospital consultants estimated a direct detrimental impact of the COVID-19 pandemic for 39 patients, representing 22% of gynecological cancers. Conclusion This study provided observational data of the impact of the COVID-19 health crisis on the surgical management of gynecological cancers.
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Affiliation(s)
- Théo Jouen
- Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Tristan Gauthier
- Departement of Obstetrics and Gynecology, Limoges University Hospital, Limoges, France
| | - Henri Azais
- Departement of Obstetrics and Gynecology, Georges-Pompidou European Hospital AP-HP, Paris, France
| | - Sofiane Bendifallah
- Departement of Obstetrics and Gynecology, Tenon Hospital AP-HP, Paris, France
| | - Pauline Chauvet
- Departement of Obstetrics and Gynecology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Herve Fernandez
- Departement of Obstetrics and Gynecology, Bicêtre Hospital AP-HP, Paris, France
| | - Yohan Kerbage
- Departement of Obstetrics and Gynecology, Lille University Hospital, Lille, France
| | - Vincent Lavoue
- Departement of Obstetrics and Gynecology, Rennes University Hospital, Rennes, France
| | - Lise Lecointre
- Departement of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France
| | - Camille Mimoun
- Departement of Obstetrics and Gynecology, Lariboisière Hospital AP-HP, Paris, France
| | - Lobna Ouldamer
- Departement of Obstetrics and Gynecology, Tours University Hospital, Tours, France
| | - Stéphanie Seidler
- Departement of Obstetrics and Gynecology, Georges-Pompidou European Hospital AP-HP, Paris, France
| | - Marc Siffert
- Departement of Obstetrics and Gynecology, Bichat Hospital AP-HP, Paris, France
| | - Anne-Lyse Vallin
- Departement of Obstetrics and Gynecology, Creteil University Hospital, Créteil, France
| | - Andrew Spiers
- Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Philippe Descamps
- Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Aymeline Lacorre
- Departement of Obstetrics and Gynecology, Limoges University Hospital, Limoges, France
| | - Guillaume Legendre
- Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France; CESP-INSERM, U1018, Team 7, Reproductive and sexual health, Paris-Sud University, 94276 Villejuif, France.
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29
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Lee JE, Mohanty A, Albuquerque FC, Couldwell WT, Levy EI, Benzel EC, Wakhloo AK, Hirsch JA, Fiorella D, Fargen KM, Burkhardt JK, Srinivasan VM, Johnson J, Mokin M, Kan P. Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature. J Neurointerv Surg 2020; 12:1049-1052. [PMID: 32998982 PMCID: PMC7528313 DOI: 10.1136/neurintsurg-2020-016710] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/05/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Academic physicians aim to provide clinical and surgical care to their patients while actively contributing to a growing body of scientific literature. The coronavirus disease 2019 (COVID-19) pandemic has resulted in procedural-based specialties across the United States witnessing a sharp decline in their clinical volume and surgical cases. OBJECTIVE To assess the impact of COVID-19 on neurosurgical, stroke neurology, and neurointerventional academic productivity. METHODS The study compared the neurosurgical, stroke neurology, and neurointerventional academic output during the pandemic lockdown with the same time period in previous years. Editors from a sample of neurosurgical, stroke neurology, and neurointerventional journals provided the total number of original manuscript submissions, broken down by months, from the year 2016 to 2020. Manuscript submission was used as a surrogate metric for academic productivity. RESULTS 8 journals were represented. The aggregated data from all eight journals as a whole showed that a combined average increase of 42.3% was observed on original submissions for 2020. As the average yearly percent increase using the 2016-2019 data for each journal exhibited a combined average increase of 11.2%, the rise in the yearly increase for 2020 in comparison was nearly fourfold. For the same journals in the same time period, the average percent of COVID-19 related publications from January to June of 2020 was 6.87%. CONCLUSION There was a momentous increase in the number of original submissions for the year 2020, and its effects were uniformly experienced across all of our represented journals.
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Affiliation(s)
- Jae Eun Lee
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Alina Mohanty
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Felipe C Albuquerque
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | | | - Elad I Levy
- Neurosurgery, Jacobs School of Medicine University at Buffalo, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ajay K Wakhloo
- Neurointerventional Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Joshua A Hirsch
- NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David Fiorella
- Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Kyle M Fargen
- Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
- Department of Neurosurgery, Texas Children's Hospital, Houston, Texas, USA
| | | | - Jeremiah Johnson
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Maxim Mokin
- Department of Neurosurgery, University of South Florida, Tampa, Florida, USA
| | - Peter Kan
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA
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30
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Fargen KM, Leslie-Mazwi TM, Klucznik RP, Wolfe SQ, Brown P, Ansari SA, Dabus G, Spiotta AM, Mokin M, Hassan AE, Liebeskind D, Welch BG, Siddiqui AH, Hirsch JA. The professional and personal impact of the coronavirus pandemic on US neurointerventional practices: a nationwide survey. J Neurointerv Surg 2020; 12:927-931. [PMID: 32788389 PMCID: PMC7421723 DOI: 10.1136/neurintsurg-2020-016513] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is currently known about the effects of the coronavirus (COVID-19) pandemic on neurointerventional (NI) procedural volumes or its toll on physician wellness. METHODS A 37-question online survey was designed and distributed to physician members of three NI physician organizations. RESULTS A total of 151 individual survey responses were obtained. Reduced mechanical thrombectomy procedures compared with pre-pandemic were observed with 32% reporting a greater than 50% reduction in thrombectomy volumes. In concert with most (76%) reporting at least a 25% reduction in non-mechanical thrombectomy urgent NI procedures and a nearly unanimous (96%) cessation of non-urgent elective cases, 68% of physicians reported dramatic reductions (>50%) in overall NI procedural volume compared with pre-pandemic. Increased door-to-puncture times were reported by 79%. COVID-19-positive infections occurred in 1% of physician respondents: an additional 8% quarantined for suspected infection. Sixty-six percent of respondents reported increased career stress, 56% increased personal life/family stress, and 35% increased career burnout. Stress was significantly increased in physicians with COVID-positive family members (P<0.05). CONCLUSIONS This is the first study designed to understand the effects of the COVID-19 pandemic on NI physician practices, case volumes, compensation, personal/family stresses, and work-related burnout. Future studies examining these factors following the resumption of elective cases and relaxing of social distancing measures will be necessary to better understand these phenomena.
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Affiliation(s)
- Kyle M Fargen
- Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
| | | | | | - Stacey Q Wolfe
- Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Patrick Brown
- Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Sameer A Ansari
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Guilherme Dabus
- Interventional Neuroradiology and Neuroendovascular Surgery, Miami Neuroscience Institute and Miami Cardiac & Vascular Institute - Baptist Hospital, Miami, Florida, USA
| | - Alejandro M Spiotta
- Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Maxim Mokin
- Neurosurgery, University of South Florida, Tampa, Florida, USA
| | - Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley, Treasure Hills, Harlingen, Texas, USA
| | | | - Babu G Welch
- Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Joshua A Hirsch
- NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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