Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies
Background Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect...
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| Veröffentlicht in: | The oncologist (Dayton, Ohio) Ohio), 2021-12, Vol.26 (12), p.1035-1043 |
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| creator | Arrieta, Oscar Lara‐Mejía, Luis Bautista‐GonzÁlez, Elysse Heredia, David Turcott, Jenny G. BarrÓn, Feliciano Ramos‐Ramírez, Maritza Cabrera‐Miranda, Luis Salinas Padilla, Miguel Ángel Aguerrebere, Mercedes Cardona, Andrés F. Rolfo, Christian Arroyo‐HernÁndez, Marisol Soto‐Pérez‐de‐Celis, Enrique Baéz‐Saldaña, Renata |
| description | Background
Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID‐19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis.
Materials and Methods
This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS‐2) was applied to evaluate and identify more common psychological disorders.
Results
The mean age for the total cohort (n = 548) was 61.5 ± 12.9 years; non‐small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID‐19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression‐free survival and overall survival (hazard ratio [HR] 0.21, p |
| doi_str_mv | 10.1002/onco.13962 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8649017</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A780934072</galeid><sourcerecordid>A780934072</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5152-edc94634192f5707ebbfbcc62afa7a3910d0bf231b0c3ee2ad64d5e2f62b5e353</originalsourceid><addsrcrecordid>eNqNkc1u1DAQxyMEoh9w4QFQJC4IlMUfcRJfKlXha6WW5VAQnCzHGe8aJfYSZ1t64xF4Rp6E2WZZUQkh5INH49_8PTP_JHlEyYwSwl4Eb8KMclmwO8khFbnMckk-3cWYVDwrqZAHyVGMXwjBkLP7yQHPc1mVFTlMPted887oLp33a23GNNh0XEFaLz7OX_78_oPK9L32LfTOpM6n5_ANYY-50YEfY3rlxlV6sQqDNkic684tvfbGQXyQ3LO6i_Bwdx8nH16_uqjfZmeLN_P69CwzggqWQWtkXvCcSmZFSUpoGtsYUzBtdam5pKQljWWcNsRwAKbbIm8FMFuwRgAX_Dg5mXTXm6ZHNWxr0J1aD67Xw7UK2qnbL96t1DJcqqrANdESBZ7uBIbwdQNxVL2LBrpOewibqJgoKRE5LbZ_PZnQpe5AOW8DKpotrk5xnZLnpGRIzf5C4blZY_BgHeZvFTybCswQYhzA7runRG0tVluL1Y3FCD_-c949-ttTBJ5PwBU0wUb0whvYY4SQQoq8lAVGhCJd_T9duxGND74OGz9iKd2V4jzX_-hZLd7Vi6n7X0FW0l4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2571054165</pqid></control><display><type>article</type><title>Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies</title><source>MEDLINE</source><source>Access via Oxford University Press (Open Access Collection)</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Web of Science - Social Sciences Citation Index – 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Arrieta, Oscar ; Lara‐Mejía, Luis ; Bautista‐GonzÁlez, Elysse ; Heredia, David ; Turcott, Jenny G. ; BarrÓn, Feliciano ; Ramos‐Ramírez, Maritza ; Cabrera‐Miranda, Luis ; Salinas Padilla, Miguel Ángel ; Aguerrebere, Mercedes ; Cardona, Andrés F. ; Rolfo, Christian ; Arroyo‐HernÁndez, Marisol ; Soto‐Pérez‐de‐Celis, Enrique ; Baéz‐Saldaña, Renata</creator><creatorcontrib>Arrieta, Oscar ; Lara‐Mejía, Luis ; Bautista‐GonzÁlez, Elysse ; Heredia, David ; Turcott, Jenny G. ; BarrÓn, Feliciano ; Ramos‐Ramírez, Maritza ; Cabrera‐Miranda, Luis ; Salinas Padilla, Miguel Ángel ; Aguerrebere, Mercedes ; Cardona, Andrés F. ; Rolfo, Christian ; Arroyo‐HernÁndez, Marisol ; Soto‐Pérez‐de‐Celis, Enrique ; Baéz‐Saldaña, Renata</creatorcontrib><description>Background
Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID‐19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis.
Materials and Methods
This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS‐2) was applied to evaluate and identify more common psychological disorders.
Results
The mean age for the total cohort (n = 548) was 61.5 ± 12.9 years; non‐small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID‐19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression‐free survival and overall survival (hazard ratio [HR] 0.21, p < .001 and HR 0.28, p < .001, respectively). The mean DASS‐21 score was 10.45 in 144 evaluated patients, with women being more affected than men (11.41 vs. 9.08, p < .001). Anxiety was reported in 30.5% of cases, followed by depression and distress in equal proportions (18%). Depressed and stressed patients had higher odds of experiencing delays in treatment than patients without depression (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.53–13.23, p = .006 and OR 3.18, 95% CI 1.2–10.06, p = .006, respectively).
Conclusion
Treatment adjustments in patients with thoracic malignancies often occurred to avoid COVID‐19 contagion with detrimental effects on survival. Psychological disorders could have a role in adherence to the original treatment regimen.
Implications for Practice
The pandemic has placed an enormous strain on health care systems globally. Patients with thoracic cancers represent a vulnerable population, with increased morbidity and mortality rates. In Mexico, treatment modifications were common during the pandemic, and those who experienced delays had worse survival outcomes. Most treatment modifications were related to a patient decision rather than a lockdown of health care facilities in which mental health impairment plays an essential role. Moreover, the high case fatality rate highlights the importance of improving medical care access. Likewise, to develop strategies facing future threats that may compromise health care systems in non‐developed countries.
Patients with thoracic neoplasms, with cancer symptoms that can mimic those of COVID‐19, might suffer from misdiagnosis or diagnostic delays, leading to detrimental effects on prognosis. This article describes the clinical and social effect of COVID‐19 on patients with thoracic cancer and the outcomes in those with a confirmed diagnosis.</description><identifier>ISSN: 1083-7159</identifier><identifier>EISSN: 1549-490X</identifier><identifier>DOI: 10.1002/onco.13962</identifier><identifier>PMID: 34498780</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Anxiety ; Carcinoma, Non-Small-Cell Lung ; Care and treatment ; Cohort Studies ; Communicable Disease Control ; Coronavirus disease 2019 ; COVID-19 ; Demographic aspects ; Depression - epidemiology ; Diagnosis ; Epidemics ; Female ; Global Health and Cancer ; Humans ; Influence ; Life Sciences & Biomedicine ; Lung cancer ; Lung Neoplasms - epidemiology ; Male ; Mexico ; Mexico - epidemiology ; Middle Aged ; Oncology ; Pandemic ; Pandemics ; SARS-CoV-2 ; Science & Technology ; Severe acute respiratory syndrome coronavirus 2 ; Thoracic cancer ; Thoracic Neoplasms</subject><ispartof>The oncologist (Dayton, Ohio), 2021-12, Vol.26 (12), p.1035-1043</ispartof><rights>2021 AlphaMed Press.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000695479600001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c5152-edc94634192f5707ebbfbcc62afa7a3910d0bf231b0c3ee2ad64d5e2f62b5e353</citedby><cites>FETCH-LOGICAL-c5152-edc94634192f5707ebbfbcc62afa7a3910d0bf231b0c3ee2ad64d5e2f62b5e353</cites><orcidid>0000-0001-5951-4047 ; 0000-0003-3798-5950 ; 0000-0003-3525-4126 ; 0000-0003-0115-811X ; 0000-0002-1164-3779 ; 0000-0002-7301-2163 ; 0000-0002-1401-4011 ; 0000-0002-7860-8417 ; 0000-0001-8101-4604 ; 0000-0003-2614-1656</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649017/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649017/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,887,1419,27931,27932,39264,39265,45581,45582,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34498780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arrieta, Oscar</creatorcontrib><creatorcontrib>Lara‐Mejía, Luis</creatorcontrib><creatorcontrib>Bautista‐GonzÁlez, Elysse</creatorcontrib><creatorcontrib>Heredia, David</creatorcontrib><creatorcontrib>Turcott, Jenny G.</creatorcontrib><creatorcontrib>BarrÓn, Feliciano</creatorcontrib><creatorcontrib>Ramos‐Ramírez, Maritza</creatorcontrib><creatorcontrib>Cabrera‐Miranda, Luis</creatorcontrib><creatorcontrib>Salinas Padilla, Miguel Ángel</creatorcontrib><creatorcontrib>Aguerrebere, Mercedes</creatorcontrib><creatorcontrib>Cardona, Andrés F.</creatorcontrib><creatorcontrib>Rolfo, Christian</creatorcontrib><creatorcontrib>Arroyo‐HernÁndez, Marisol</creatorcontrib><creatorcontrib>Soto‐Pérez‐de‐Celis, Enrique</creatorcontrib><creatorcontrib>Baéz‐Saldaña, Renata</creatorcontrib><title>Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies</title><title>The oncologist (Dayton, Ohio)</title><addtitle>ONCOLOGIST</addtitle><addtitle>Oncologist</addtitle><description>Background
Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID‐19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis.
Materials and Methods
This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS‐2) was applied to evaluate and identify more common psychological disorders.
Results
The mean age for the total cohort (n = 548) was 61.5 ± 12.9 years; non‐small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID‐19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression‐free survival and overall survival (hazard ratio [HR] 0.21, p < .001 and HR 0.28, p < .001, respectively). The mean DASS‐21 score was 10.45 in 144 evaluated patients, with women being more affected than men (11.41 vs. 9.08, p < .001). Anxiety was reported in 30.5% of cases, followed by depression and distress in equal proportions (18%). Depressed and stressed patients had higher odds of experiencing delays in treatment than patients without depression (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.53–13.23, p = .006 and OR 3.18, 95% CI 1.2–10.06, p = .006, respectively).
Conclusion
Treatment adjustments in patients with thoracic malignancies often occurred to avoid COVID‐19 contagion with detrimental effects on survival. Psychological disorders could have a role in adherence to the original treatment regimen.
Implications for Practice
The pandemic has placed an enormous strain on health care systems globally. Patients with thoracic cancers represent a vulnerable population, with increased morbidity and mortality rates. In Mexico, treatment modifications were common during the pandemic, and those who experienced delays had worse survival outcomes. Most treatment modifications were related to a patient decision rather than a lockdown of health care facilities in which mental health impairment plays an essential role. Moreover, the high case fatality rate highlights the importance of improving medical care access. Likewise, to develop strategies facing future threats that may compromise health care systems in non‐developed countries.
Patients with thoracic neoplasms, with cancer symptoms that can mimic those of COVID‐19, might suffer from misdiagnosis or diagnostic delays, leading to detrimental effects on prognosis. This article describes the clinical and social effect of COVID‐19 on patients with thoracic cancer and the outcomes in those with a confirmed diagnosis.</description><subject>Aged</subject><subject>Anxiety</subject><subject>Carcinoma, Non-Small-Cell Lung</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Communicable Disease Control</subject><subject>Coronavirus disease 2019</subject><subject>COVID-19</subject><subject>Demographic aspects</subject><subject>Depression - epidemiology</subject><subject>Diagnosis</subject><subject>Epidemics</subject><subject>Female</subject><subject>Global Health and Cancer</subject><subject>Humans</subject><subject>Influence</subject><subject>Life Sciences & Biomedicine</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - epidemiology</subject><subject>Male</subject><subject>Mexico</subject><subject>Mexico - epidemiology</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Pandemic</subject><subject>Pandemics</subject><subject>SARS-CoV-2</subject><subject>Science & Technology</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Thoracic cancer</subject><subject>Thoracic Neoplasms</subject><issn>1083-7159</issn><issn>1549-490X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>GIZIO</sourceid><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAQxyMEoh9w4QFQJC4IlMUfcRJfKlXha6WW5VAQnCzHGe8aJfYSZ1t64xF4Rp6E2WZZUQkh5INH49_8PTP_JHlEyYwSwl4Eb8KMclmwO8khFbnMckk-3cWYVDwrqZAHyVGMXwjBkLP7yQHPc1mVFTlMPted887oLp33a23GNNh0XEFaLz7OX_78_oPK9L32LfTOpM6n5_ANYY-50YEfY3rlxlV6sQqDNkic684tvfbGQXyQ3LO6i_Bwdx8nH16_uqjfZmeLN_P69CwzggqWQWtkXvCcSmZFSUpoGtsYUzBtdam5pKQljWWcNsRwAKbbIm8FMFuwRgAX_Dg5mXTXm6ZHNWxr0J1aD67Xw7UK2qnbL96t1DJcqqrANdESBZ7uBIbwdQNxVL2LBrpOewibqJgoKRE5LbZ_PZnQpe5AOW8DKpotrk5xnZLnpGRIzf5C4blZY_BgHeZvFTybCswQYhzA7runRG0tVluL1Y3FCD_-c949-ttTBJ5PwBU0wUb0whvYY4SQQoq8lAVGhCJd_T9duxGND74OGz9iKd2V4jzX_-hZLd7Vi6n7X0FW0l4</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Arrieta, Oscar</creator><creator>Lara‐Mejía, Luis</creator><creator>Bautista‐GonzÁlez, Elysse</creator><creator>Heredia, David</creator><creator>Turcott, Jenny G.</creator><creator>BarrÓn, Feliciano</creator><creator>Ramos‐Ramírez, Maritza</creator><creator>Cabrera‐Miranda, Luis</creator><creator>Salinas Padilla, Miguel Ángel</creator><creator>Aguerrebere, Mercedes</creator><creator>Cardona, Andrés F.</creator><creator>Rolfo, Christian</creator><creator>Arroyo‐HernÁndez, Marisol</creator><creator>Soto‐Pérez‐de‐Celis, Enrique</creator><creator>Baéz‐Saldaña, Renata</creator><general>John Wiley & Sons, Inc</general><general>Oxford Univ Press</general><general>Oxford University Press</general><scope>17B</scope><scope>BLEPL</scope><scope>DTL</scope><scope>DVR</scope><scope>EGQ</scope><scope>GIZIO</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5951-4047</orcidid><orcidid>https://orcid.org/0000-0003-3798-5950</orcidid><orcidid>https://orcid.org/0000-0003-3525-4126</orcidid><orcidid>https://orcid.org/0000-0003-0115-811X</orcidid><orcidid>https://orcid.org/0000-0002-1164-3779</orcidid><orcidid>https://orcid.org/0000-0002-7301-2163</orcidid><orcidid>https://orcid.org/0000-0002-1401-4011</orcidid><orcidid>https://orcid.org/0000-0002-7860-8417</orcidid><orcidid>https://orcid.org/0000-0001-8101-4604</orcidid><orcidid>https://orcid.org/0000-0003-2614-1656</orcidid></search><sort><creationdate>202112</creationdate><title>Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies</title><author>Arrieta, Oscar ; Lara‐Mejía, Luis ; Bautista‐GonzÁlez, Elysse ; Heredia, David ; Turcott, Jenny G. ; BarrÓn, Feliciano ; Ramos‐Ramírez, Maritza ; Cabrera‐Miranda, Luis ; Salinas Padilla, Miguel Ángel ; Aguerrebere, Mercedes ; Cardona, Andrés F. ; Rolfo, Christian ; Arroyo‐HernÁndez, Marisol ; Soto‐Pérez‐de‐Celis, Enrique ; Baéz‐Saldaña, Renata</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5152-edc94634192f5707ebbfbcc62afa7a3910d0bf231b0c3ee2ad64d5e2f62b5e353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Anxiety</topic><topic>Carcinoma, Non-Small-Cell Lung</topic><topic>Care and treatment</topic><topic>Cohort Studies</topic><topic>Communicable Disease Control</topic><topic>Coronavirus disease 2019</topic><topic>COVID-19</topic><topic>Demographic aspects</topic><topic>Depression - epidemiology</topic><topic>Diagnosis</topic><topic>Epidemics</topic><topic>Female</topic><topic>Global Health and Cancer</topic><topic>Humans</topic><topic>Influence</topic><topic>Life Sciences & Biomedicine</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - epidemiology</topic><topic>Male</topic><topic>Mexico</topic><topic>Mexico - epidemiology</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Pandemic</topic><topic>Pandemics</topic><topic>SARS-CoV-2</topic><topic>Science & Technology</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Thoracic cancer</topic><topic>Thoracic Neoplasms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arrieta, Oscar</creatorcontrib><creatorcontrib>Lara‐Mejía, Luis</creatorcontrib><creatorcontrib>Bautista‐GonzÁlez, Elysse</creatorcontrib><creatorcontrib>Heredia, David</creatorcontrib><creatorcontrib>Turcott, Jenny G.</creatorcontrib><creatorcontrib>BarrÓn, Feliciano</creatorcontrib><creatorcontrib>Ramos‐Ramírez, Maritza</creatorcontrib><creatorcontrib>Cabrera‐Miranda, Luis</creatorcontrib><creatorcontrib>Salinas Padilla, Miguel Ángel</creatorcontrib><creatorcontrib>Aguerrebere, Mercedes</creatorcontrib><creatorcontrib>Cardona, Andrés F.</creatorcontrib><creatorcontrib>Rolfo, Christian</creatorcontrib><creatorcontrib>Arroyo‐HernÁndez, Marisol</creatorcontrib><creatorcontrib>Soto‐Pérez‐de‐Celis, Enrique</creatorcontrib><creatorcontrib>Baéz‐Saldaña, Renata</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Social Sciences Citation Index</collection><collection>Web of Science Primary (SCIE, SSCI & AHCI)</collection><collection>Web of Science - Social Sciences Citation Index – 2021</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The oncologist (Dayton, Ohio)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arrieta, Oscar</au><au>Lara‐Mejía, Luis</au><au>Bautista‐GonzÁlez, Elysse</au><au>Heredia, David</au><au>Turcott, Jenny G.</au><au>BarrÓn, Feliciano</au><au>Ramos‐Ramírez, Maritza</au><au>Cabrera‐Miranda, Luis</au><au>Salinas Padilla, Miguel Ángel</au><au>Aguerrebere, Mercedes</au><au>Cardona, Andrés F.</au><au>Rolfo, Christian</au><au>Arroyo‐HernÁndez, Marisol</au><au>Soto‐Pérez‐de‐Celis, Enrique</au><au>Baéz‐Saldaña, Renata</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies</atitle><jtitle>The oncologist (Dayton, Ohio)</jtitle><stitle>ONCOLOGIST</stitle><addtitle>Oncologist</addtitle><date>2021-12</date><risdate>2021</risdate><volume>26</volume><issue>12</issue><spage>1035</spage><epage>1043</epage><pages>1035-1043</pages><issn>1083-7159</issn><eissn>1549-490X</eissn><abstract>Background
Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID‐19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis.
Materials and Methods
This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS‐2) was applied to evaluate and identify more common psychological disorders.
Results
The mean age for the total cohort (n = 548) was 61.5 ± 12.9 years; non‐small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID‐19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression‐free survival and overall survival (hazard ratio [HR] 0.21, p < .001 and HR 0.28, p < .001, respectively). The mean DASS‐21 score was 10.45 in 144 evaluated patients, with women being more affected than men (11.41 vs. 9.08, p < .001). Anxiety was reported in 30.5% of cases, followed by depression and distress in equal proportions (18%). Depressed and stressed patients had higher odds of experiencing delays in treatment than patients without depression (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.53–13.23, p = .006 and OR 3.18, 95% CI 1.2–10.06, p = .006, respectively).
Conclusion
Treatment adjustments in patients with thoracic malignancies often occurred to avoid COVID‐19 contagion with detrimental effects on survival. Psychological disorders could have a role in adherence to the original treatment regimen.
Implications for Practice
The pandemic has placed an enormous strain on health care systems globally. Patients with thoracic cancers represent a vulnerable population, with increased morbidity and mortality rates. In Mexico, treatment modifications were common during the pandemic, and those who experienced delays had worse survival outcomes. Most treatment modifications were related to a patient decision rather than a lockdown of health care facilities in which mental health impairment plays an essential role. Moreover, the high case fatality rate highlights the importance of improving medical care access. Likewise, to develop strategies facing future threats that may compromise health care systems in non‐developed countries.
Patients with thoracic neoplasms, with cancer symptoms that can mimic those of COVID‐19, might suffer from misdiagnosis or diagnostic delays, leading to detrimental effects on prognosis. This article describes the clinical and social effect of COVID‐19 on patients with thoracic cancer and the outcomes in those with a confirmed diagnosis.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>34498780</pmid><doi>10.1002/onco.13962</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5951-4047</orcidid><orcidid>https://orcid.org/0000-0003-3798-5950</orcidid><orcidid>https://orcid.org/0000-0003-3525-4126</orcidid><orcidid>https://orcid.org/0000-0003-0115-811X</orcidid><orcidid>https://orcid.org/0000-0002-1164-3779</orcidid><orcidid>https://orcid.org/0000-0002-7301-2163</orcidid><orcidid>https://orcid.org/0000-0002-1401-4011</orcidid><orcidid>https://orcid.org/0000-0002-7860-8417</orcidid><orcidid>https://orcid.org/0000-0001-8101-4604</orcidid><orcidid>https://orcid.org/0000-0003-2614-1656</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1083-7159 |
| ispartof | The oncologist (Dayton, Ohio), 2021-12, Vol.26 (12), p.1035-1043 |
| issn | 1083-7159 1549-490X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8649017 |
| source | MEDLINE; Access via Oxford University Press (Open Access Collection); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current); Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Web of Science - Social Sciences Citation Index – 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Aged Anxiety Carcinoma, Non-Small-Cell Lung Care and treatment Cohort Studies Communicable Disease Control Coronavirus disease 2019 COVID-19 Demographic aspects Depression - epidemiology Diagnosis Epidemics Female Global Health and Cancer Humans Influence Life Sciences & Biomedicine Lung cancer Lung Neoplasms - epidemiology Male Mexico Mexico - epidemiology Middle Aged Oncology Pandemic Pandemics SARS-CoV-2 Science & Technology Severe acute respiratory syndrome coronavirus 2 Thoracic cancer Thoracic Neoplasms |
| title | Clinical Impact of the COVID‐19 Pandemic in Mexican Patients with Thoracic Malignancies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-04T20%3A03%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20Impact%20of%20the%20COVID%E2%80%9019%20Pandemic%20in%20Mexican%20Patients%20with%20Thoracic%20Malignancies&rft.jtitle=The%20oncologist%20(Dayton,%20Ohio)&rft.au=Arrieta,%20Oscar&rft.date=2021-12&rft.volume=26&rft.issue=12&rft.spage=1035&rft.epage=1043&rft.pages=1035-1043&rft.issn=1083-7159&rft.eissn=1549-490X&rft_id=info:doi/10.1002/onco.13962&rft_dat=%3Cgale_pubme%3EA780934072%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2571054165&rft_id=info:pmid/34498780&rft_galeid=A780934072&rfr_iscdi=true |