Prise en charge des patients en radiologie interventionnelle oncologique en période de pandémie au SARS-CoV-2

INTRODUCTION: Interventional oncology should remain a priority among interventional radiology procedures during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) global pandemic. It should be adapted to anesthetic resources and hospital beds capacity. Oncology patients not affected by coronavirus disease 2019 (COVID-19) should be treated in a safe environment to reduce the risk of exposure. TAKE-HOME POINTS: Diagnostic and interventional radiology in oncology should remain a priority consideration during the SARS-CoV-2 global pandemic. Health status, comorbidities and risk of being severely affected by COVID-19 should be taken into consideration for post postponement of elective procedures or patient referral to a hospital not specialized in the fight against COVID-19. The different steps of the oncology clinical pathway including pluridisciplinary tumor board, pre and post-interventional office visits, pre and post-procedural imaging and interventional radiology procedures should be reorganized in order to provide appropriate services (hygiene practices and physical barriers) to reduce the risk of transmission of COVID-19 to patients et healthcare personnel. Phone calls to patients planned to be admitted the following days should be organized to ensure these patients do not present any symptoms suggestive of COVID-19. Telemedicine or phone calls should replace office visits unless an ultrasound examination is scheduled for the pre-intervention evaluation. If CT examination is necessary for the oncological evaluation, pulmonary lesions compatible with COVID-19 may be accidentally diagnosed. Careful attention should be paid to the indications and types of drugs used for general anesthesia in patients with COVID-19 because of medication shortage and to prevent cross-contamination of patients and medical staff. Locoregional anesthesia should be favored. Minimally-invasive interventional oncology procedures should be favored as an alternative to surgery to spare medical resources and medications in accordance with the recommendations of national oncological societies. Institutional healthcare policies and protocols must be organized with identification of dedicated COVID-19 transportation and care sections. CONCLUSION: Oncological procedures should be prioritized during the COVID-19 pandemic. Protective measures must be in place throughout the hospital and the radiology department to reduce the risks of exposure of the patients and the staff. Interventional radiology procedures offered as alternative treatments to surgery may optimize medical resources, anesthetic drugs and critical care unit beds.