Telemonitoring system may help identify COVID-19 in people with cancer
medwireNews: Digital health systems that allow patients to self-report toxicities related to cancer therapies can be successfully adapted to screen for COVID-19, Belgian researchers report.
Marika Rasschaert (Antwerp University Hospital) and colleagues also used data from the BAPIC and AMTRA toxicity registration and (self-)management systems to show that, between 13 March and 15 May 2020, clinical cancer care was maintained at their institution, with a significant decrease in waiting time at the clinic relative to the same period in 2019.
Writing in the British Journal of Cancer, the investigators explain that “the AMTRA system provides patients with the possibility to self-register (and manage) toxicities through a RemeCare® app, [while] BAPIC will ensure intervention of the care team in case of severe toxicity scored by a trained nurse of a home care service, while blood is drawn at home.”
At the start of the SARS-CoV-2 pandemic the two patient-reported outcome (PRO) tools were adapted to screen for and trigger an alarm if a patient reported fever (>38°C) alone or in combination with muscular pain, cough, or dyspnea, each regardless of severity. When the alarm was triggered, patients were contacted by the care team and screened for COVID-19 by polymerase chain reaction (PCR) testing.
During the study period, 360 patients were registered to use the telemonitoring systems. Of these, 11 were referred for COVID-19 testing.
Five patients were referred with fever alone, all of whom initially tested negative, with one patient ultimately seroconverting to positive after hospitalization.
Four of the 11 patients triggered the COVID alarm due to multiple symptoms and three of these patients had positive PCR tests.
Of the remaining two patients, who had cough and dyspnea, one tested positive for COVID-19 and the other was not tested.
From 14 April 2020, the researchers’ institution offered routine COVID-19 testing to cancer therapy outpatients every 2 weeks through the use of throat washings. They found one positive result among the 477 throat washings tested and note that the patient was already known to be infected.
Looking at chemotherapy administration at the outpatient’s facility during the study period, Rasschaert and team found that there was no significant difference in the mean number of FOLFOX/FOLFIRI (3.21 vs 3.15) and paclitaxel (3.88 vs 4.25) administrations in March–May 2020 versus March–May 2019. There was, however, a significant reduction in the average waiting times before administration of each treatment, of 36.3 and 48.0 minutes, respectively.
For nivolumab, there was a significant reduction during versus before the pandemic in both the mean number of administrations (2.52 vs 3.53) and the mean waiting time (46.6 minutes shorter).
Rasschaert et al conclude that the adapted PRO registration and toxicity management apps “provided an efficient screening and triage tool, coordinating appropriate care for a particularly vulnerable patient group, while maintaining scheduled therapy appointments” during the COVID-19 pandemic.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
1 March 2021: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.