Insights of COVID-19 pandemic impact on anesthetic management for patients undergoing cancer surgery in the National Can
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(2020) 12:59
REVIEW
Ain-Shams Journal of Anesthesiology
Open Access
Insights of COVID-19 pandemic impact on anesthetic management for patients undergoing cancer surgery in the National Cancer Institute, Egypt Walaa Y. Elsabeeny1* , Omnia Y. Abd El Dayem2, Ahmed Rabea3, Rania S. M. Ibrahim4, Heba G. M. Mahmoud5, Eman Kamal6, Randa A. Osman7 and Ayman Ghoneim1
Abstract: New corona virus disease COVID-19 is a pandemic outbreak viral infection that is highly contagious. The disease can affect any age groups. Majority of patients show mild or no symptoms. Immunocompromised patients and patients with co-morbidities are more vulnerable to have more aggressive affection with higher rate of complications. Thus, cancer patients carry a higher risk of infection. Diseased patient can transmit infection throughout the disease course starting from the incubation period to clinical recovery. All healthcare workers contacting COVID-19-positive patients are at great risk of infection, especially the anesthesiologists who can be exposed to high viral load during airway manipulation. In the National Cancer Institute of Egypt, we apply a protocol to prioritize cases where elective cancer surgeries that would not affect patient prognosis and outcome are postponed during the early phase and peak of the pandemic till reaching a plateau. However, emergency and urgent surgeries that can compromise cancer patient’s life and prognosis take place after the proper assessment of the patient’s condition. Aim: This review aims to spot the management of cancer patients undergoing surgery during the COVID-19 pandemic in the National Cancer Institute, Egypt.
Background The emergence and spread of the new coronavirus disease 2019 (COVID-19) is considered a community crisis that threatens the world nowadays (Singhal 2020). The World Health Organization (WHO) has recently stated COVID-19 as a pandemic outbreak (https://www.who. int). All age groups are susceptible to infection by COVID-19, but a high rate of complications usually occurs with immunocompromised patients and older patients with co-morbidities (Singhal 2020; Chen et al. 2020a, 2020b). Cancer patients are considered immunocompromised, either due to their underlying malignancy or due to receiving chemotherapeutic agents as well as * Correspondence: [email protected] 1 Department of Anesthesia and Pain management, National Cancer Institute, Cairo University, Kasr Al Eini Street, Fom El Khalig, Cairo 11796, Egypt Full list of author information is available at the end of the article
radiotherapy; thus, they carry a higher risk of infection that can reach two folds that in the normal healthy population (Al-Shamsi et al. 2020). The disease may present by variable clinical manifestations like fever, cough, shortness of breath, sore throat, rhinorrhea, headache, chest pain, diarrhea, nausea, and vomiting (Chen et al. 2020a, 2020b). The virus shows human to human transmission (Chan et al. 2020) mainly through droplet infection either by inhalation of aerosol droplets or touching
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