Impact of the COVID-19 pandemic on health care activities at a Uruguayan mastology teaching unit: Preliminary results.
Authors: Castillo Cecilia , Camejo Natalia , Amarillo Dahiana , Rodriguez Florencia , Vitureira Florencia , Krygier Gabriel David , Delgado Lucia Beatriz 
Published: June 2021

e12502

Background: After the government declared a health emergency due to COVID-19 on March, 2020, the Mastology Teaching Unit (UDAM) providing care to breast cancer patients tried to ensure adequate oncological care, and to protect patients from the virus infection and serious complications due to a possible state of immunosuppression. Towards this objective, the Department of Clinical Oncology developed guidelines with some treatment modifications. Objective: To assess the health care activities of the UDAM during the period considered as the “peak” of the pandemic, since its beginning to June 30, 2020. Methods: This is an observational study that collected data from the electronic clinical record system called Oncology Electronic Health Record (HCEO) during the aforementioned period. Results: There werea total of 293 medical appointments (221 in person), through which 131 patients were attended to. The number of medical appointments decreased by 16.7% compared to the same period in 2019 (352 appointments). Of the patients who were attended to during the “peak” period, 109 (83.2%) were on systemic onco-specific treatment and 22 (16.8%) were attended to for disease control. The medical appointments were scheduled to evaluate the continuity of treatment and treatment modifications if necessary (95 patients; 72.5%), for disease control (17; 12.9%), for first-time consultation (12; 9.1%) and to assess paraclinical studies (7; 5.3%). The patients were on hormone therapy (HT) (81 patients; 74%), chemotherapy (CT) (21; 19%), and anti-HER2 therapies (9; 8%). A total of 20 treatments were initiated, 14 with HT and 6 with CT. Of the 21 patients on CT, 14 (66.6%) were on adjuvant/neoadjuvant therapy. Of these, 9 (64.3%) continued with the same regimen with the addition of prophylactic granulocyte colony stimulating factors (G-CSF), and 5 (35.7%), who were receiving weekly paclitaxel, continued the treatment with no changes. The remaining 7 of 21 patients (33.3%) were on palliative CT. Of these, 2 (28.5%) continued the treatment with the addition of G-CSF, 3 (42.8%) continued with weekly capecitabine or paclitaxel with no treatment changes, and 2 (28.5%) changed their treatment regimen (a less myelosuppressive regimen was selected for one of them and this decision was due to the progression of the disease in the other patient). The 90 patients who were receiving adjuvant, neoadjuvant, or palliative criteria HT and/or anti-HER2 therapies, continued the treatment with no changes Conclusions: Although these are preliminary results, the available evidence suggests that, although medical appointments decreased by approximately 17%, the UDAM was able to maintain its healthcare activities and continued most of the treatments. The most modified treatment was CT, with the addition of prophylactic G-CSF, to avoid myelosuppression and potential complications from COVID-19 infection.