Franco Valenza1,2, Gabriele Papagni1, Alfonso Marchianò3, Maria Grazia Daidone4, Filippo DeBraud2,5, Mario Paolo Colombo6, Andrea Frignani7, Gustavo Galmozzi8, Vito Ladisa9, Giancarlo Pruneri2,10, Roberto Salvioni11, Pierangelo Spada12, Michele Torresani13, Oliviero Rinaldi14, Stefano Manfredi15, Marco Votta16, Giovanni Apolone17. 1. Department of Anesthesia and Critical Care, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 2. Department of Oncology and Oncohematology, University of Milan, Milan, Italy. 3. Department of Diagnostic Imaging and Radiotherapy, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 4. Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 5. Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 6. Molecular Immunology Unit, Department of Research, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 7. Managing Director, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 8. Medical Directorate, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 9. Pharmacy Unit, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 10. Department of Pathology and Laboratory Medicine University of Milan, School of Medicine, Milan, Italy. 11. Urology Unit, Department of Surgery, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 12. Director, Nursing and Rehabilitation Management Service (SITRA), Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 13. Health Directorate, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 14. Chief Medical Officer, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 15. General Director, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 16. President, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy. 17. Scientific Director, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy.
Abstract
BACKGROUND: The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degrees of respiratory failure, actions to preserve aliquots of the healthcare system to guarantee treatment to patients are mandatory. METHODS: In order to protect the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano from the spread of COVID-19, a number of to-hospital and within-hospital filters were applied. Among others, a triage process to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in patients with cancer was developed consisting of high-resolution low-dose computed tomography (CT) scan followed by reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 in nose-throat swabs whenever CT was suggestive of lung infection. To serve symptomatic patients who were already admitted to the hospital or in need of hospitalization while waiting for RT-PCR laboratory confirmation of infection, a COVID-19 surveillance zone was set up. RESULTS: A total of 301 patients were screened between March 6 and April 3, 2020. Of these, 47 were hospitalized, 53 needed a differential diagnosis to continue with their cancer treatment, and 201 were about to undergo surgery. RT-PCR was positive in 13 of 40 hospitalized patients (32%), 14 of 52 day hospital patients (27%), and 6 of 201 surgical patients (3%). CONCLUSION: Applying filters to protect our comprehensive cancer center from COVID-19 spread contributed to guaranteeing cancer care during the COVID-19 crisis in Milan. A surveillance area and surgical triage allowed us to protect the hospital from as many as 33 patients infected with SARS-CoV-2.
BACKGROUND: The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degrees of respiratory failure, actions to preserve aliquots of the healthcare system to guarantee treatment to patients are mandatory. METHODS: In order to protect the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano from the spread of COVID-19, a number of to-hospital and within-hospital filters were applied. Among others, a triage process to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in patients with cancer was developed consisting of high-resolution low-dose computed tomography (CT) scan followed by reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 in nose-throat swabs whenever CT was suggestive of lung infection. To serve symptomatic patients who were already admitted to the hospital or in need of hospitalization while waiting for RT-PCR laboratory confirmation of infection, a COVID-19 surveillance zone was set up. RESULTS: A total of 301 patients were screened between March 6 and April 3, 2020. Of these, 47 were hospitalized, 53 needed a differential diagnosis to continue with their cancer treatment, and 201 were about to undergo surgery. RT-PCR was positive in 13 of 40 hospitalized patients (32%), 14 of 52 day hospital patients (27%), and 6 of 201 surgical patients (3%). CONCLUSION: Applying filters to protect our comprehensive cancer center from COVID-19 spread contributed to guaranteeing cancer care during the COVID-19 crisis in Milan. A surveillance area and surgical triage allowed us to protect the hospital from as many as 33 patients infected with SARS-CoV-2.
Authors: Guilherme Haradaa; Fernanda F Antonacio; Aline Bl Gongora; Marina H Behar; Fernanda C Capareli; Diogo A Bastos; Rodrigo R Munhoz; Frederico P Costa; Denis L Jardim; Celso Arrais-Rodrigues; Yana Novis; Artur Katz; Gilberto de Castro Junior Journal: Ecancermedicalscience Date: 2020-09-09