Tumori Journal Abstract Book - October 2020 - 83

D - COVID-19	

83

algorithm, our daily activities have been guaranteed, without
any decrease, preserving the continuum of patients' care and
developing a quality approach to reduce distress.
Conclusions: Our institutional procedure of pre-triage and
triage sequence has proven to be effective and can serve as
model to safely reorganize working activities during the
pandemic, without hampering oncologists' desire to assist
their patients.

Table 1. (Continued)

D35

Life expectancy

The appropriateness of invasive
ventilation in COVID-19 positive
cancer patients: the hardest
decision for oncologists

Pts on treatment

Ghidini M.1, Indini A.2, Rijavec E.2, Bareggi C.2, Cattaneo M.2, Galassi
B.2, Gambini D.2, Grossi F.2
1
U.O. di Oncologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,
Milano; 2Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano

Background: Over the last two months we have frequently been contacted to estimate the prognosis of cancer
patients (pts) affected by COVID-19 infection. Until now,
there have been no clear markers to guide decision making
regarding the appropriateness of invasive ventilation (IV)
in COVID-19 cancer pts. Therefore, we developed a practical tool which encompasses a prognostic score in order to
identify a subgroup of pts likely to have a better outcome
and therefore may be potential candidates for IV.
Methods: The Milano Policlinico ONCOVID-ICU score
includes three different groups of variables. In the first
group we included sex, age, body mass index (BMI) and
comorbidities. The second group includes oncological
variables, such as the treatment intent (adjuvant or metastatic), life expectancy in months and treatment status (on/
off). Furthermore, we included the SOFA score [1] and the
d-dimer values, previously reported as risk factors for
mortality in the presence of COVID-19 infection.
Results: We identified three different groups. We recommend that pts with a low risk score should be offered IV if
necessary, while high-risk pts are best managed with best
supportive care. Pts in the intermediate-risk group deserve
a case-by-case discussion to derive a decision (Table 1).
Table 1.  The Milano Policlinico ONCOVID-ICU score.
Variables

Score

Linked to pts
Sex

 
F =0
M =1
<70 =0
>=70 =1

Age

(Continued)

Variables

Score

BMI

<30 =0
>=30 =1
NO =0
YES =1
YES>1 =2
 
Curative =0
Palliative =1
>6 mo =0
<6 mo =1
NO =0
YES =1
 
2-7 =0
>=8 =1
< 1µg/mL =0
> 1µg/mL =1

Comorbidities
Oncological
Treatment intent

Clinical + lab values
SOFA score
D-dimer

Category of risk for patients
Score <4: low risk -> ICU admission and IV.
Score 4-6: intermediate risk -> Case-by-case evaluation for
ICU admission and IV.
Score >=7: High risk -> Palliative care.
SOFA SCORE [1]
- PaO2 / FIO2 (P/F)
- Platelets
- Bilirubin
- Hypotension
- Glasgow coma score scale
- Creatinine
- Ventilatory support
Legend: IV: invasive ventilation; mo: months; pts: patients.

Conclusions: A considerable proportion of oncology pts may
experience clinical deterioration due to the worsening course
of the infection. These cases require a comprehensive evaluation before considering ICU admission and IV. The division
between groups is arbitrary and the score needs further validation. Therefore, we plan to assess the clinical history of all
cancer pts admitted to Milano Hospital Maggiore Policlinico's
ICU and retrospectively apply the score to this cohort.
[1] Ferreira FL et al. JAMA 2001; 286:1754-8.

D36
A study about stress, depression,
anxiety e insomnia in health workers
of oncology during covid -19
Marchi A.R.1, Podda F.1
1

Medical Oncology Unit, University Hospital and University of Cagliari,
Cagliari, Cagliari

Background: COVID-19 has shocked the entire planet,
leading each State to set ever stricter health regulations,



Tumori Journal Abstract Book - October 2020

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

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Tumori Journal Abstract Book - October 2020 - IV
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Tumori Journal Abstract Book - October 2020 - Cover3
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