KS02.5.A COVID19 impact on the neuro-oncological population. evaluation of critical issues and resources of patients and caregivers
Authors: Anghileri E , Tramacere I , Morlino S , Leuzzi C , Pareja Gutierrez L , Fariselli L , Silvani A , Berrini F 
Published: September 2022

Abstract

Background
The COVID-19 pandemic has inferred on patients (PTS) with cancer regarding disease evolution as well as the emotional and social functioning. The assessment of the needs and perceptions of PTS and their caregivers, is a priority to ensure an adequate standard in taking care and to promote the compliance to the treatments.
The aim of this study is to understand how COVID-19 affects the emotional state and medical relationship in neuro-oncology.

Material and Methods
From Apr 2020 to Dec 2021 a prospective study was conducted on neuro-oncological PTS and their caregivers, including a 41-question and 16-question survey respectively.

Results
162 PTS and 66 caregivers completed the questionnaire. 57.5% of PTS perceived grater risk , 37.5% the same risk and 5% lower risk of contracting the COVID-19 disease compared to the general population. 9.6% of PTS got SARS-CoV2 infection.Using a scale 0-10 for the assessment of anxiety, PTS experienced 5.8 (standard deviation, sd 2.6) as anxiety level related to tumor and 4.6 (sd 2.5) level about COVID-19 risk. For the most part there was no change in the treatment of cancer (81.5%). Due to the COVID-19 pandemic, 9.2% of PTS decided to delay anti-tumoral therapeutic schedule and 27.9% referred to be worried about going to hospital for consultation. Overall, 93.5% of PTS was satisfied with the treatments received. 52.6% of PTS felt different perception of the future during COVID-19, mostly referred like more uncertain. Caregivers experienced 7.7 (sd 2.1) anxiety level about tumor and 5.5 (sd 2.4) about COVID-19 risk. In 67.7% of caregivers the perception of the future has been changed, mostly towards greater insecurity. 75.0% of PTS described at least good Quality of Life (QoL), 65.4% of PTS declared to have sufficient resources to deal with the situation. There was a correlation between QoL and resources (P = 0.000). 77.3% of caregivers defined their care burden increased during the pandemic and 73.4% defined their QoL at least as good. We found a correlation between COVID-19 anxiety and anxiety for tumor diagnosis (ρ=0.53%, P = 0.000) as well as with future perception (Mann Whitney U test between PTS with different versus unchanged future perception, P = 0.001) in the PTS population.

Conclusion
The WHO definition of health refers to the biopsychosocial model. This model attributes the outcome of disease, as well as health, to the intricate and variable interaction of biological, psychological factors and social factors. In line with this model, it is essential to guarantee and improve the standard of care, also based to the real needs perceived by PTS and caregivers and to historical and social context. This is especially important in a pandemic period like COVID-19 is in which the good QoL can be compromised. An appropriate health-system organization and a special attention to patient doctor communication can make the different on QoL and the future perception.