Tumori Journal Abstract Book - October 2020 - 76

76	

Tumori Journal 106(2S)

Cereda V.1, Formica V.2, Corona M.1, Falbo P.T.1, Iannace A.1,
Semenova D.1, Menghi A.1, Manna G.1, Lanzetta G.1

Bastianelli L.1, Merloni F.1, Ranallo N.1, Cantini L.1, Mariotti L.1,
Lucarelli A.1, Ballatore Z.1, Berardi R.1

1

1
Clinica Oncologica e Centro Regionale di Genetica Oncologica, Università
Politecnica delle Marche, Ancona, AOU Ospedali Riuniti-Ancona - Ancona,
Ancona

INI-Grottaferrata, Roma; 2Policlinico Tor Vergata, Roma

In December 2019, coronavirus disease 2019 (COVID-19)
emerged in Wuhan and rapidly spread all over the world.
Several studies have described the clinical characteristics of
patients (pts) with novel coronavirus (SARS-CoV-2) pneumonia, demonstrating that severe pts tend to have higher
neutrophil-to-lymphocyte ratio (NLR). A cohort of 61 cancer pts, admitted to the Oncology Unit of INI Grottaferrata
(Rome) from March 24th to May 10th and undergoing nasopharyngeal swab and serological tests for COVID-19, was
retrospectively analyzed. Age, gender, type of cancer, laboratory tests and electrocardiographic (EKG)/echocardiographic abnormalities were investigated as potential
predictors of COVID-19 positivity. Potential linearity in the
association with test positivity was assessed by means of
logistic regression analysis (LRA) with restricted cubic
splines with 3 knots. When not linearly associated with outcome, variables were dichotomized using cut-off values
determined by receiver operating curve (ROC) analysis.
Multivariate LRA was applied to identify independent predictors of COVID-19 positivity. Wilcoxon rank-sum test
was used to estimate differences of continuous variables
according to COVID-19 positivity. P<0.05 was defined as
statistically significant. The median age was 72 years, and
41 pts (67%) were male. The majority of pts had colorectal
cancer (21/61) and lung cancer (18/61). 18 out of 61 cancer
pts had a confirmed diagnosis of COVID-19. 13 out of 18
COVID-19 positive pts died within 40 days from nasopharyngeal swab. NLR was found to be significantly associated with COVID-19 positivity (16 out of 24 vs. 2 out of 37
pts for NLR >10 vs. <10, respectively; odds ratio [OR]=35,
95% CI: 6.7-183.8, P<0.001). COVID-19 positive pts had a
significantly higher NLR (median 21.2 vs. 4.9, P<0.001)
compared with negative cases. Multivariate LRA confirmed
that NLR and fibrinogen were significantly and independently associated with COVID-19 infection (OR=17.68,
P<0.05 and OR=13.2, P<0.05, respectively). At univariate
analysis also incidence of EKG abnormalities, including
T-wave inversion and S-T segment elevation, was significantly associated with COVID-19 diagnosis (33% vs. 5%,
OR=10.25, P<0.05); however this significance was lost at
the multivariate LRA. NLR may be significantly associated
with the presence of COVID-19 infection in cancer pts.
Whether baseline NLR could be an independent predictor of
mortality needs to be investigated.

Background: The spread of Coronavirus disease brought
the need to reorganize clinical activity in oncology. Cancer
patients are very vulnerable and it is well known that their
treatment has to be strictly planned. The most critical considerations still relate to the entry of the virus into hospitals,
the heart of healthcare, where cancer patients are protected.
Instead, during COVID19 pandemic the oncologic department had to limit access to care to protect patients from a
more dangerous disease for them, witnessing a paradox of
health care. This brought with it worries in oncologic healthcare professionals in replanning activities in order to guarantee therapeutic continuity and quality of care. It is well
known that physicians and nurses have different role concepts and role expectations. The purpose of our study was to
investigate doctors and nurses' perception on cancer patient
reorganization during the COVID19 pandemic in a sample
of Italian healthcare professionals in oncology.
Methods: We submitted a survey to oncologic healthcare
workers (physicians and nurses) of Italian National Health
Care System during Pandemic to investigate clinical activity reorganization and cancer patient management through
12 closed questions. The survey promoted by Clinica
Oncologica, AOU Riuniti di Ancona-Università Politecnica
delle Marche was electronic and anonymous.
Results: A total of 383 oncology health workers completed
the survey, 60 nurses (15%) and 323 physicians (85%). 60%
of interviewed physicians perceived qualitatively lower
than usual the therapeutic path of patients taken in charge in
this historical moment, while 45% of nurses declared it was
the same (p<0.01). The continuity of the multidisciplinary
team was defined as guaranteed for 68% of oncologists,
while almost 40% of nurses declared to not know it. Almost
all physicians (95%) answered that their clinical activity
was reorganized, compared to a lower portion of nurses
(80%) that replanned their care role (p<0.01). Deferring
treatments caused fear and anxiety in 62% of physicians and
46% of nurses (p=0.027).
Conclusions: The survey underlined the need to integrate
skills and involve all professional figures in planning cancer patients' treatment to guarantee optimal therapeutic
strategies and a global take in charge in all its details, even
during emergencies.

D22

D23

Doctors and nurses during
COVID19 pandemic: a different
perception of cancer care

Scientia Potentia Est: how the
italian world of oncology
changes in the COVID19 pandemic



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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