Negative Effects On Cancer Care Due To COVID-19 Implications: Observations From A Cancer Center In The UAE
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Abstract: In 2019, the World Health Organization declared the novel coronavirus disease (COVID-19) to be a public health emergency of international concern that rapidly escalated to pandemic status in 2020 (1). As of August 2, 2020, there have been approximately 17.6 million confirmed cases worldwide, with over 680,000 deaths from this disease (1). A particularly vulnerable cohort due to immunosuppression are those that suffer from cancer. On the 14th of February 2020 a nationwide analysis was published of patients suffering from COVID-19 in China that indicated that 18 of 1590 patients (1%) had a history of cancer and had higher risk of respiratory complications, more time spent in the intensive care unit, and a shorter time to deterioration compared to patients who did not have cancer (2). On the 28th of May 2020 we saw the results of the COVID-19 and Cancer Consortium (CCC19) database that reported a 30 day all-cause mortality of 13 % among patients with either active or previous history of cancer who had contracted COVID-19 with higher rates observed among those who were older, had poor performance status or were receiving active cancer related therapy (3). Various groups have made recommendations that include modifications in adjuvant therapy, delay in surgery and chemotherapy if feasible, and de-prioritizing patients with metastatic cancer and delayed screening s rategies (4). Although these recommendations were sensible in light of the pandemic, the clinical care pathway for patients with cancer that have been built. over the years in an effort to ensure early detection and therapy have been severely disrupted. As we pass the peak of the pandemic, the negative impact of our decisions will now become more visible.