Prevention of healthcare-associated respiratory viral infections amongst oncology inpatients: infection prevention outcomes during COVID-19 pandemic
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
We read with interest the paper by Elkrief et al. that reported high mortality amongst healthcare-associated cases of coronavirus-disease-2019 (COVID-19) infection in oncology inpatients, with almost one-fifth of cases attributed to healthcare-associated transmission. Indeed, healthcare-associated transmission of SARS-CoV-2 poses a substantial problem in cancer centres; in a study describing the impact of COVID-19 on a large cancer centre during the first wave of the pandemic, the majority of patients tested COVID-19-positive after an emergent or elective hospital attendance.The ongoing pandemic has provided the impetus for introduction of extensive infection-prevention measures in cancer centres, including segregated isolation wards for symptomatic patients, screening of visitors for fever and respiratory symptoms, and heightened COVID-19 surveillance for healthcare workers (HCWs). Outside the pandemic setting, however, patients with cancer are more likely to experience prolonged illness from respiratory-viral-infections (RVIs) and outbreaks of healthcare-associated-RVI (HA-RVI) sporadically occur on inpatient oncology units. The impetus for implementation of aggressive infection-prevention measures against COVID-19 on inpatient oncology units may potentially reduce healthcare-associated-RVI (HA-RVI) as an additional positive consequence. From January 2020 onwards, a COVID-19 containment strategy was implemented on the inpatient wards of the Singapore General Hospital (SGH), which hosts the inpatient wards of the National Cancer Centre, Singapore (NCCS). Approximately 70 % of all cancer cases in Singapore are seen at the National Cancer Centre Singapore (NCCS), with more than 9000 new cancer cases and over 1 million patient visits yearly] Pre-pandemic, oncology inpatients were predominantly nursed in multi-bedded open-plan cohorted cubicles, with single rooms prioritized for patients with neutropenia. During the COVID-19 outbreak, universal masking was extended hospital-wide and additional infection-prevention measures were introduced, including screening of visitors for fever and respiratory symptoms and improved segregation of patients with respiratory symptoms.] All HCWs monitored fever twice-daily; HCWs with fever or acute respiratory illness (ARI) underwent mandatory COVID-19 testing and were given 5 days of mandatory medical leave.A one-visitor policy was in-place throughout the COVID-19 outbreak; from 7th April 2020 to 2nd June 2020, no visitors were allowed, during the “lockdown” period when all schools and workplaces were closed to mitigate COVID-19 transmission.VPrior to the pandemic, symptomatic inpatients were tested for 16 common RVIs via multiplex PCR; during the pandemic, respiratory specimens were additionally sent for SARS-CoV-2 testing. Cases of RVI were categorized as HA-RVI if the RVI was identified beyond the maximum incubation period for that virus, from the time of admission.
European Journal of Cancer , éditorial en libre accès, 2020