Researchers: Galit Hirsh-Yehezkel¹, Ido Wolf¹, Angela Shitrit¹

Background: The COVID-19 pandemic, directly and indirectly affected cancer patients. These patients were found to be at an increased risk of severe form of the disease, and of death. Therefore, during the pandemic, oncology centers implemented revised protocols in order to reduce the risk of infection among cancer patients.

Objectives: To map the guidelines of the professional oncology organizations, during the COVID19 pandemic, and to describe the measures implemented in the oncology institutes in Israel and around the world.
To estimate the case fatality rate of COVID-19 among cancer patients, and to evaluate the characteristics associated with severe COVID-19 or mortality, among cancer patients.

Method: The description of the treatment policy for oncology patients was carried out through a survey performed among oncology doctors in Israel, a literature review of articles regarding the use of measures, and a structured summary of the guidelines of international health organizations.
To assess the demographic and clinical characteristics associated with severe COVID19 or specific mortality, clinical variables were abstracted from medical files of cancer patients diagnosed with COVID-19, in several hospitals in Israel. Logistic and Cox proportional hazard models were applied.

Findings: During the COVID-19 pandemic, health organizations published guidelines for oncology institutes, including recommendation such as symptoms monitoring, oral therapy, telemedicine and postponing appointments. Most centers in Israel and around the world have adjusted their routine activities to reduce possibilities of infection. Moreover, preventing the entry of patients with symptoms, and the use of telemedicine, are measures that were reported by 49% and 59% of the doctors who participated in the Israeli survey, as measures that should be taken routinely. This study included 226 active cancer patients diagnosed with COVID-19. Fifty (22%) patients developed severe illness and 39 (17%) died from the disease. The case fatality rate was significantly higher than the one in the general population. Older patients, those who underwent cancer treatments one month before the Coronavirus diagnosis, and patients with hematological or lung cancer; were at higher risk of severe disease or mortality.

Conclusions: This study provides important information on the effect of the COVID-19 pandemic on cancer patients

Recommendations: The results will help in developing strategies for cancer care in future epidemic situations and will reduce the risk for infectious morbidity among cancer patients in other situations.

Research end date: 06/2024