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      The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

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          Abstract

          Introduction

          The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology.

          Methods

          Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system.

          Results

          The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to “functional” pathology, such as thyroidectomies and gastric biopsies.

          Conclusions

          Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for “deconfinement” health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.

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          Most cited references 17

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          Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic.

          The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated disease (COVID-19) outbreak seriously challenges globally all health care systems and professionals. Expert projections estimate that despite social distancing and lockdown being practiced, we have yet to feel the full impact of COVID-19. In this manuscript we provide guidance to prepare for the impact of COVID-19 pandemic on breast cancer patients and advise on how to triage, prioritize and organize diagnostic procedures, surgical, radiation and medical treatments.
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            Covid-19: preparedness, decentralisation, and the hunt for patient zero

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              Is Open Access

              Cytology in the time of coronavirus disease (covid-19): an Italian perspective

              Introduction The coronavirus disease 2019 (covid-19) is changing the way we practice pathology, including fine needle aspiration (FNA) diagnostics. Although recommendations have been issued to prioritise patients at high oncological risk, postponing those with unsuspicious presentations, real world data have not been reported yet. Methods The percentages of the cytological sample types processed at the University of Naples Federico II, during the first 3 weeks of Italian national lockdown were compared with those of the same period in 2019. Results During the emergency, the percentage of cytology samples reported as malignant increased (p<0.001), reflecting higher percentages of breast (p=0.002) and lymph nodes FNAs (p=0.008), effusions (p<0.001) and urine (p=0.005). Conversely, thyroid FNAs (p<0.001) and Pap smears (p=0.003) were reduced. Conclusions Even in times of covid-19 outbreak, cytological examination may be safely carried out in patients at high oncological risk, without the need to be postponed.
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                Author and article information

                Journal
                Pathobiology
                Pathobiology
                PAT
                Pathobiology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                1015-2008
                1423-0291
                7 July 2020
                : 1-10
                Affiliations
                aDepartment of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
                bInstitut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
                Author notes
                *Mieke Rosalie Van Bockstal, Department of Pathology, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, BE–1200 Brussels (Belgium), mieke.vanbockstal@ 123456uclouvain.be

                Christine Galant and Mieke Rosalie Van Bockstal contributed equally to this work.

                Article
                pat-0001
                10.1159/000509546
                7445376
                32634799
                Copyright © 2020 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                Page count
                Figures: 3, Tables: 4, References: 35, Pages: 10
                Categories
                Research Article

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