The tele-transition of toxicity management in routine oncology care during the severe acute respiratory syndrome (SARS-CoV-2) pandemic

Br J Cancer. 2021 Apr;124(8):1366-1372. doi: 10.1038/s41416-020-01235-3. Epub 2021 Feb 9.

Abstract

Background: Telehealth modalities were introduced during the SARS-CoV-2 pandemic to assure continuation of cancer care and maintain social distance.

Methods: This is a retrospective cohort analysis of our telehealth expansion programme. We adapted two existing patient-reported outcome (PRO) telemonitoring tools that register and (self-)manage toxicities to therapy, while screening for SARS-CoV-2-related symptoms. Outpatients from a tertiary cancer centre were enrolled. The adapted PRO interface allowed for uniform registration of SARS-CoV-2-related symptoms and effective triage of patients at home where we also implemented systematic throat washings, when available.

Results: Three hundred and sixty patients registered to the telemonitoring systems from March 13 to May 15, 2020. Four prespecified SARS-CoV-2 alarms resulted in three patients with positive PCR testing. Other Covid-19 symptoms (fever 5× and cough 2×) led to pretreatment triage resulting in 1 seroconversion after initial negative testing. One of the 477 throat washings proved positive.

Conclusions: The rapid adoption of an amended PRO (self-)registrations and toxicity management system was feasible and coordinated screening for Covid-19. Continued clinical cancer care was maintained, with significant decreased waiting time. The systemic screening with throat washings offered no real improvement.

MeSH terms

  • Adult
  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 / virology
  • Female
  • Humans
  • Male
  • Mass Screening
  • Medical Oncology / trends
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / diagnosis*
  • Neoplasms / virology
  • Pandemics*
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / pathogenicity*
  • Telemedicine / trends