Covid 19

Covid 19 Coronavirus may also be referred to as SARS-CoV-2 or Coronovirus

Acute Oncology Services play a key role in the assessment and management of those cancer patients who have been identified as most vulnerable and are more at risk of becoming seriously ill if they contract the coronavirus (COVID-19) infection:

• People with cancer who are undergoing active chemotherapy or radiotherapy

• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

• People having immunotherapy or other continuing antibody treatments for cancer

• People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors

• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs

• People on non-steroid immunosuppression for immunotherapy related toxicity including mycophenolate mofitil (MMF) and tacrolimus

They also have a continuing responsibility for patients who are admitted with an acute complication of their cancer and those patients who have a new diagnosis of cancer made in the emergency setting.

Highest Risk Patients lateral flow guidance and access to COVID-19 treatments - NHS England and NHS Improvement guidance issued on the 31st March 2022

The interim clinical commissioning policy: neutralising monoclonal antibodies or antivirals for non-hospitalised patients with COVID-19

Advises the following actions:

• Familiarise yourself with the latest policy for non-hospitalised individuals at highest risk from COVID infection – especially the annex detailing who is considered ‘highest risk’.
• Familiarise yourself with the process for referring patients for assessment for COVID treatments, and the new CMDU directory.

Guidance for the Management of Acute Oncology Patients During the Coronavirus Pandemic.

The information contained in this guidance is a consensus of the development and review groups’ views on best acute oncology practice. The guidance aims to clarify and support the continued provision of acute oncology services in light of the current COVID-19 pandemic and the extreme pressures being experienced within the NHS   

RCR- Coronavirus (COVID-19): cancer treatment documents

UK Chemotherapy Board - CLINICIAN FAQS AND GUIDANCE ON COVID-19 VACCINE FOR PATIENTS RECEIVING SYSTEMIC ANTI-CANCER THERAPY (SACT). VERSION 5.0 Updated on website 24th Sept 2021

ESMO Guidelines - Cancer Patient Management During the COVID-19 Pandemic  SUPPORTIVE CARE STRATEGIES DURING THE COVID-19 PANDEMIC

ESMO Guidelines - COVID-19 ADAPTED RECOMMENDATIONS SLIDE SETS

CORONET COVID-19 Risk in ONcology Evaluation Tool  an online tool to support decisions regarding hospital admissions or discharge in cancer patients presenting with symptoms of COVID-19 and the likely severity of illness.

 COVID fever temperature should be adjusted for age, new study finds

Working with data gathered from the ZOE COVID Symptom Study app, the TwinsUK cohort and two hospital cohorts, the team found that basal body temperature was lower in older people and those with a lower body mass index (BMI). Older people with COVID-19 were also less likely to have a fever reaching 37.8°C or more, with the chances dropping by 1% with every additional year of age.

Emerging challenges in the evaluation of fever in cancer patients at risk of febrile neutropenia in the era of COVID-19: a MASCC position paper | SpringerLink - Supportive Care in Cancer

Abstract

Patients with cancer are at higher risk of more severe COVID-19 infection and have more associated complications. The position paper describes the management of cancer patients, especially those receiving anticancer treatment, during the COVID-19 pandemic. Dyspnea is a common emergency presentation in patients with cancer with a wide range of differential diagnoses, including pulmonary embolism, pleural disease, lymphangitis, and infection, of which SARS-CoV-2 is now a pathogen to be considered. Screening interviews to determine whether patients may be infected with COVID-19 are imperative to prevent the spread of infection, especially within healthcare facilities. Cancer patients testing positive with no or minimal symptoms may be monitored from home. Telemedicine is an option to aid in following patients without potential exposure. Management of complications of systemic anticancer treatment, such as febrile neutropenia (FN), is of particular importance during the COVID-19 pandemic where clinicians aim to minimize patients’ risk of infection and need for hospital visits. Outpatient management of patients with low-risk FN is a safe and effective strategy. Although the MASCC score has not been validated in patients with suspected or confirmed SARS-CoV-2, it has nevertheless performed well in patients with a range of infective illnesses and, accordingly, it is reasonable to expect efficacy in the clinical setting of COVID-19. Risk stratification of patients presenting with FN is a vital tenet of the evolving sepsis and pandemic strategy, necessitating access to locally formulated services based on MASCC and other national and international guidelines. Innovative oncology services will need to utilize telemedicine, hospital at home, and ambulatory care services approaches not only to limit the number of hospital visits but also to anticipate the complications of the anticancer treatments.