Influence of Covid-19 Pandemic on Safe and Timely Delivery of Systemic Anti-Cancer Therapy, Dubai Hospital Experience

Aims: To analyze the effect of COVID-19 pandemic on timely delivery of systemic anti-cancer treatment including chemotherapy, biological therapy and immunotherapy and assess complication rate. 
Place and Duration of Study: Department of Oncology, Dubai Hospital, Dubai, UAE from January 2020 to July 2020. 
Methods: This is a retrospective review of electronic medical records and infusion Centre log of the number of chemotherapy sessions administered in the infusion therapy Centre, Dubai hospital from January 2020 to July 2020. Data on treatment delays, interruptions or discontinuations, and adverse events such as febrile neutropenia were collected and analysed. 
Results: A total of 1553 systemic treatment sessions were recorded between January 2020 to July 2020 with an average of 222 treatment sessions per month. Physician recorded delays were observed in ninety (5.79%) treatment sessions. The average treatment delay was 7 (2-13) days. Delays were frequently caused by the overall treatment course and disease-related factors (toxicities, disease progression). The highest number of treatment delays (n=23,10.2%) were recorded in April, at the peak of the Covid-19 pandemic, most likely because of the implementation of extreme precautionary measures. There were no interruptions or discontinuations in treatment. 
Fourteen (<1%) patients developed febrile neutropenia. With treatment, all of them recovered fully. No significant change in systemic treatment related complications were observed during the pandemic. 
Conclusion: This study found no evidence of an appreciable rise in the number of complications or delays in systemic anticancer treatment during the COVID-19 pandemic. This experience indicates that systemic chemotherapy may be delivered successfully during a pandemic with infection control and safety precautions. However, more research with a larger sample size is needed for more accurate advice in this case.