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Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium
AIM OF THE STUDY: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were stu...
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
The Authors. Published by Elsevier Ltd.
2022
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| Materias: | |
| Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542445/ https://www.ncbi.nlm.nih.gov/pubmed/34799210 http://dx.doi.org/10.1016/j.ejca.2021.10.009 |
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| author | de Joode, Karlijn Tol, Jolien Hamberg, Paul Cloos, Marissa Kastelijn, Elisabeth A. Borgers, Jessica S.W. Nuij, Veerle J.A.A. Klaver, Yarne Herder, Gerarda J.M. Mutsaers, Pim G.N.J. Dumoulin, Daphne W. Oomen-de Hoop, Esther van Diemen, Nico G.J. Libourel, Eduard J. Geraedts, Erica J. Bootsma, Gerben P. van der Leest, Cor H. Peerdeman, Anne L. Herbschleb, Karin H. Visser, Otto J. Bloemendal, Haiko J. van Laarhoven, Hanneke W.M. de Vries, Elisabeth G.E. Hendriks, Lizza E.L. Beerepoot, Laurens V. Westgeest, Hans M. van den Berkmortel, Franchette W.P.J. Haanen, John B.A.G. Dingemans, Anne-Marie C. van der Veldt, Astrid A.M. |
| author_facet | de Joode, Karlijn Tol, Jolien Hamberg, Paul Cloos, Marissa Kastelijn, Elisabeth A. Borgers, Jessica S.W. Nuij, Veerle J.A.A. Klaver, Yarne Herder, Gerarda J.M. Mutsaers, Pim G.N.J. Dumoulin, Daphne W. Oomen-de Hoop, Esther van Diemen, Nico G.J. Libourel, Eduard J. Geraedts, Erica J. Bootsma, Gerben P. van der Leest, Cor H. Peerdeman, Anne L. Herbschleb, Karin H. Visser, Otto J. Bloemendal, Haiko J. van Laarhoven, Hanneke W.M. de Vries, Elisabeth G.E. Hendriks, Lizza E.L. Beerepoot, Laurens V. Westgeest, Hans M. van den Berkmortel, Franchette W.P.J. Haanen, John B.A.G. Dingemans, Anne-Marie C. van der Veldt, Astrid A.M. |
| author_sort | de Joode, Karlijn |
| collection | PubMed |
| description | AIM OF THE STUDY: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. METHODS: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. RESULTS: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. CONCLUSION: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic. |
| format | Online Article Text |
| id | pubmed-8542445 |
| institution | National Center for Biotechnology Information |
| language | English |
| publishDate | 2022 |
| publisher | The Authors. Published by Elsevier Ltd. |
| record_format | MEDLINE/PubMed |
| spelling | pubmed-85424452021-10-25 Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium de Joode, Karlijn Tol, Jolien Hamberg, Paul Cloos, Marissa Kastelijn, Elisabeth A. Borgers, Jessica S.W. Nuij, Veerle J.A.A. Klaver, Yarne Herder, Gerarda J.M. Mutsaers, Pim G.N.J. Dumoulin, Daphne W. Oomen-de Hoop, Esther van Diemen, Nico G.J. Libourel, Eduard J. Geraedts, Erica J. Bootsma, Gerben P. van der Leest, Cor H. Peerdeman, Anne L. Herbschleb, Karin H. Visser, Otto J. Bloemendal, Haiko J. van Laarhoven, Hanneke W.M. de Vries, Elisabeth G.E. Hendriks, Lizza E.L. Beerepoot, Laurens V. Westgeest, Hans M. van den Berkmortel, Franchette W.P.J. Haanen, John B.A.G. Dingemans, Anne-Marie C. van der Veldt, Astrid A.M. Eur J Cancer Original Research AIM OF THE STUDY: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. METHODS: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. RESULTS: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. CONCLUSION: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic. The Authors. Published by Elsevier Ltd. 2022-01 2021-10-25 /pmc/articles/PMC8542445/ /pubmed/34799210 http://dx.doi.org/10.1016/j.ejca.2021.10.009 Text en © 2021 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
| spellingShingle | Original Research de Joode, Karlijn Tol, Jolien Hamberg, Paul Cloos, Marissa Kastelijn, Elisabeth A. Borgers, Jessica S.W. Nuij, Veerle J.A.A. Klaver, Yarne Herder, Gerarda J.M. Mutsaers, Pim G.N.J. Dumoulin, Daphne W. Oomen-de Hoop, Esther van Diemen, Nico G.J. Libourel, Eduard J. Geraedts, Erica J. Bootsma, Gerben P. van der Leest, Cor H. Peerdeman, Anne L. Herbschleb, Karin H. Visser, Otto J. Bloemendal, Haiko J. van Laarhoven, Hanneke W.M. de Vries, Elisabeth G.E. Hendriks, Lizza E.L. Beerepoot, Laurens V. Westgeest, Hans M. van den Berkmortel, Franchette W.P.J. Haanen, John B.A.G. Dingemans, Anne-Marie C. van der Veldt, Astrid A.M. Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title | Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title_full | Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title_fullStr | Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title_full_unstemmed | Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title_short | Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium |
| title_sort | life-prolonging treatment restrictions and outcomes in patients with cancer and covid-19: an update from the dutch oncology covid-19 consortium |
| topic | Original Research |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542445/ https://www.ncbi.nlm.nih.gov/pubmed/34799210 http://dx.doi.org/10.1016/j.ejca.2021.10.009 |
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