Download PDF
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(04): e610-e615
DOI: 10.1055/s-0041-1736425
Original Research
Special Article COVID-19

COVID-19 Pandemic and its Impact on the Management of Head and Neck Cancer in the Spanish Healthcare System.

Miguel Mayo-Yáñez 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
2   Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
3   Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
,
José M. Palacios-García 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
4   Otorhinolaryngology – Head and Neck Surgery Department, Hospital Universitario Virgen Macarena (HUVM), Sevilla, Andalucía, Spain
,
Christian Calvo-Henríquez 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
3   Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
7   Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
,
Tareck Ayad
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
8   Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
,
Nadim Saydy 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
8   Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
,
Xavier León 
9   Otorhinolaryngology – Head and Neck Surgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
10   Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España
,
Pablo Parente 
2   Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
,
Carlos Miguel Chiesa-Estomba 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
11   Otorhinolaryngology – Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia, Gipuzkoa, Spain
,
Jérôme R. Lechien 
1   Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
2   Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
5   Human Anatomy & Experimental Oncology Department, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract:

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has represented a major challenge for healthcare systems worldwide, changing the habits of physicians. A reorganization of healthcare activity has been necessary, limiting surgical activity to essential cases (emergencies and oncology), and improving the distribution of health resources.

Objective To analyze the impact of the COVID-19 pandemic on head and neck cancer surgery management in Spain.

Methods A cross-sectional study, through an anonymous and voluntary online survey distributed to 76 Spanish otorhinolaryngology departments.

Results A total of 44 centers completed the survey, 65.9% of which were high-volume. A total of 45.5% of them had to stop high-priority surgery and 54.5% of head and neck surgeons were relocated outside their scope of practice. Surgeons reported not feeling safe during their usual practice, with a decrease to a 25% of airway procedures. A total of 29.5% were “forced” to deviate from the “standard of care” due to the epidemiological situation.

Conclusions Approximately half of the departments decreased their activity, not treating their patients on a regular basis, and surgeons were reassigned to other tasks. It seems necessary that the head and neck surgeons balance infection risk with patient care. The consequences of the reported delays and changes in daily practice should be evaluated in the future in order to understand the real impact of the pandemic on the survival of head and neck cancer patients.

Keywords

COVID-19 - coronavirus - otolaryngology - aerosol generating procedures - personal protective equipment - cancer treatment - head neck surgery - mortality - morbidity


Publication History

Received: 10 December 2020

Accepted: 04 August 2021

Article published online:
29 October 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Coronavirus [Internet]. Available in: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 [cited 03.10.20]
    Google Scholar
  • 2 Mayo-Yánez M. Research during SARS-CoV-2 pandemic: To “Preprint” or not to “Preprint”, that is the question. Med Clin (Barc) 2020; 155: 86-87
    CrossrefPubMedGoogle Scholar
  • 3 Situación de COVID-19 o Coronavirus en España. Available in: https://covid19.isciii.es/ [cited 03.10.20]
    Google Scholar
  • 4 Spiteri G, Fielding J, Diercke M. et al. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill 2020; 25 (09) 2000178
    CrossrefPubMedGoogle Scholar
  • 5 Coimbra R, Edwards S, Kurihara H. et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg 2020; 46 (03) 505-510
    CrossrefPubMedGoogle Scholar
  • 6 Finley C, Prashad A, Camuso N. et al. Guidance for management of cancer surgery during the COVID-19 pandemic. Can J Surg 2020; 63 (22) S2-S4
    CrossrefPubMedGoogle Scholar
  • 7 Mayo-Yánez M, Calvo-Henríquez C, Lechien JR, Fakhry N, Ayad T, Chiesa-Estomba CM. Is the ultrasonic scalpel recommended in head and neck surgery during the COVID-19 pandemic? State-of-the-art review. Head Neck 2020; 42 (07) 1657-1663 DOI: 10.1002/hed.26278.
    CrossrefPubMedGoogle Scholar
  • 8 Zhao C, Viana Jr A, Wang Y, Wei H-Q, Yan A-H, Capasso R. Otolaryngology during COVID-19: Preventive care and precautionary measures. Am J Otolaryngol 2020; 41 (04) 102508
    CrossrefPubMedGoogle Scholar
  • 9 Fakhry N, Schultz P, Morinière S. et al; French Society of Otorhinolaryngology, Head and Neck Surgery (SFORL), French Society of Head and Neck Carcinology (SFCCF). French consensus on management of head and neck cancer surgery during COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137 (03) 159-160
    CrossrefPubMedGoogle Scholar
  • 10 Di Martino M, García Septiem J, Maqueda González R. et al. [Elective surgery during the SARS-CoV-2 pandemic (COVID-19): a morbimortality analysis and recommendations on patient prioritisation and security measures]. Cir Esp (Engl Ed) 2020; Nov; 98 (09) 525-532
    CrossrefPubMedGoogle Scholar
  • 11 Iacobucci G. Covid-19: all non-urgent elective surgery is suspended for at least three months in England. BMJ 2020; 368: m1106
    CrossrefPubMedGoogle Scholar
  • 12 Givi B, Schiff BA, Chinn SB. et al. Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg 2020; 146 (06) 579-584
    CrossrefPubMedGoogle Scholar
  • 13 Kowalski LP, Sanabria A, Ridge JA. et al. COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology and head and neck surgery practice. Head Neck 2020; 42 (06) 1259-1267
    CrossrefPubMedGoogle Scholar
  • 14 Aminian A, Safari S, Razeghian-Jahromi A, Ghorbani M, Delaney CP. COVID-19 Outbreak and Surgical Practice: Unexpected Fatality in Perioperative Period. Ann Surg 2020; 272 (01) e27-e29
    CrossrefPubMedGoogle Scholar
  • 15 Lei S, Jiang F, Su W. et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine 2020; 21: 100331
    CrossrefPubMedGoogle Scholar
  • 16 Brar S, Ofo E, Hyde N. et al. Outcomes of elective head and neck confirmed or suspected cancer surgery during the COVID-19 pandemic. Eur Arch Otorhinolaryngol 2020; ••• : DOI: 10.1007/s00405-020-06194-2.
    CrossrefPubMedGoogle Scholar
  • 17 Riva G, Pizzo C, Fassone E, Pecorari G. Head and neck cancer surgery in COVID-19 pandemic in Northern Italy. Oral Oncol 2020; 107: 104835
    CrossrefPubMedGoogle Scholar
  • 18 Sistiaga Suárez JA, López Álvarez F, Ferrandis Perepérez E. et al. Head and neck cancer in times of COVID-19: Emotion-based medicine. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72 (01) 1-2
    CrossrefPubMedGoogle Scholar
  • 19 Day AT, Sher DJ, Lee RC. et al. Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks. Oral Oncol 2020; 105: 104684
    CrossrefPubMedGoogle Scholar
  • 20 Sowerby LJ, Stephenson K, Dickie A. et al. International registry of otolaryngologist-head and neck surgeons with COVID-19. Int Forum Allergy Rhinol 2020; 10 (11) 1201-1208 DOI: 10.1002/alr.22677.
    CrossrefPubMedGoogle Scholar
  • 21 EQ-5D. Available in: https://euroqol.org/ [cited 04.10.20]
    Google Scholar
  • 22 Radulesco T, Lechien JR, Sowerby LJ. et al. Sinus and anterior skull base surgery during the COVID-19 pandemic: systematic review, synthesis and YO-IFOS position. Eur Arch Otorhinolaryngol 2020; ••• : DOI: 10.1007/s00405-020-06236-9.
    CrossrefPubMedGoogle Scholar
  • 23 Mehanna H, Hardman JC, Shenson JA. et al. Recommendations for head and neck surgical oncology practice in a setting of acute severe resource constraint during the COVID-19 pandemic: an international consensus. Lancet Oncol 2020; 21 (07) e350-e359
    CrossrefPubMedGoogle Scholar
  • 24 Balibrea JM, Badia J, Rubio Pérez I. et al. Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos. Cir Esp 2020; 98: 251-259
    CrossrefPubMedGoogle Scholar
  • 25 Chiesa-Estomba CM, Lechien JR, Calvo-Henríquez C. et al. Systematic review of international guidelines for tracheostomy in COVID-19 patients. Oral Oncol 2020; 108: 104844
    CrossrefPubMedGoogle Scholar
  • 26 Morrison DR, Gentile C, McCammon S, Buczek E. Head and neck oncologic surgery in the COVID-19 pandemic: Our experience in a deep south tertiary care center. Head Neck 2020; 42 (07) 1471-1476 DOI: 10.1002/hed.26262.
    CrossrefPubMedGoogle Scholar
  • 27 Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol 2020; 6 (07) 1108-1110
    CrossrefPubMedGoogle Scholar
  • 28 Chen MM, Harris JP, Orosco RK, Sirjani D, Hara W, Divi V. Association of Time between Surgery and Adjuvant Therapy with Survival in Oral Cavity Cancer. Otolaryngol Head Neck Surg 2018; 158 (06) 1051-1056
    CrossrefPubMedGoogle Scholar
  • 29 COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet 2020; 396 (10243): 27-38
    CrossrefPubMedGoogle Scholar
  • 30 Glasbey JC, Bhangu A. et al; COVIDSurg Collaborative. Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study. J Clin Oncol 2020; 6: JCO2001933
    Google Scholar
  • 31 COVIDSurg Collaborative. Delaying surgery for patients with a previous SARS-CoV-2 infection. Br J Surg 2020; 25 : DOI: 10.1002/bjs.12050.
    CrossrefPubMedGoogle Scholar
  • 32 Guidelines NCCN. Head and Neck Cancer. Available in: https://www.nccn.org/ [cited 04.10.20]
    Google Scholar
  • 33 Radulesco T, Verillaud B, Béquignon E. et al; French Association of Rhinology (AFR), French Society of Otorhinolaryngology, Head and Neck Surgery (SFORL). COVID-19 and rhinology, from the consultation room to the operating theatre. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137 (04) 309-314
    CrossrefPubMedGoogle Scholar
  • 34 Farneti P, Sorace F, Tasca I. Personal protective equipment for ENT activity during COVID-19 pandemic. Eur Arch Otorhinolaryngol 2020; 277 (10) 2933-2935
    CrossrefPubMedGoogle Scholar
  • 35 Sayin İ, Devecioğlu İ, Yazıcı ZM. A Closed Chamber ENT Examination Unit for Aerosol-Generating Endoscopic Examinations of COVID-19 Patients. Ear Nose Throat J 2020; 99 (09) 594-596
    CrossrefPubMedGoogle Scholar
  • 36 Paleri V, Hardman J, Tikka T, Bradley P, Pracy P, Kerawala C. Rapid implementation of an evidence-based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow-up after treatment during the COVID-19 pandemic: Model for international collaboration. Head Neck 2020; 42 (07) 1674-1680
    CrossrefPubMedGoogle Scholar
  • 37 Singh HK, Patil V, Chaitanya G, Nair D. Preparedness of the cancer hospitals and changes in oncosurgical practices during COVID-19 pandemic in India: A cross-sectional study. J Surg Oncol 2020; 122 (07) 1276-1287
    CrossrefPubMedGoogle Scholar
  • 38 Guo T, Kiong KL, Yao CMKL. et al. Impact of the COVID-19 pandemic on Otolaryngology trainee education. Head Neck 2020; 42 (10) 2782-2790
    CrossrefPubMedGoogle Scholar
  • 39 Mannelli G, Ralli M, Bonali M. et al. Impact of COVID-19 pandemic on Italian Otolaryngology Units: a nationwide study. Acta Otorhinolaryngol Ital 2020; 40 (05) 325-331
    CrossrefPubMedGoogle Scholar
  • 40 Eskander A, Merdad M, Irish JC. et al. Volume-outcome associations in head and neck cancer treatment: a systematic review and meta-analysis. Head Neck 2014; 36 (12) 1820-1834
    CrossrefPubMedGoogle Scholar