Resumen
Introducción: La frecuencia combinada de cáncer y COVID-19 es baja. Los pacientes con cáncer son más susceptibles a presentar complicaciones graves por la COVID-19. En todo el mundo se han adoptado estrategias para mantener los servicios oncológicos libres de COVID-19. Objetivo: Realizar una revisión bibliográfica sobre los aspectos prácticos relevantes en la atención médica de la dualidad cáncer y COVID-19 desde la perspectiva del proceso diagnóstico del área de triage respiratorio COVID-19 de unidades médicas con servicios oncológicos. Material y Métodos: Se llevó a cabo una revisión de la literatura biomédica nacional e internacional (68 citas seleccionadas) publicada desde febrero de 2020 a septiembre de 2021. Se utilizaron las bases de datos PubMed e Hinari Programa de Acceso a la Investigación para la Salud, para la localización y selección del material. Se seleccionaron estudios de diseño retrospectivo, artículos originales, revisiones sistemáticas y metaanálisis, utilizando los términos de búsqueda: “cáncer”, “triage”, “diagnóstico” y “COVID-19”. Resultados: En pandemia, la disponibilidad de servicios de prevención, diagnóstico y tratamiento oncológico es limitada. El triage respiratorio COVID-19 permite priorizar la atención del paciente con cáncer. La tomografía axial computarizada tiene alta sensibilidad y baja especificidad para identificar lesiones sospechosas. El “estándar de oro” en el diagnóstico de la COVID-19 es la RT-qPCR. Las pruebas rápidas de antígeno COVID-19 son rentables en entornos con recursos limitados. Las guías oncológicas para la COVID-19 podrían mostrar un bajo nivel de evidencia. En pacientes con alta prioridad no deben retrasarse los tratamientos oncológicos. Conclusiones: El proceso diagnóstico del triage respiratorio y la priorización de los diversos aspectos de la atención oncológica en el marco de una pandemia actual o futura, se convierten en herramientas poderosas para mitigar el impacto de la COVID-19 en el paciente con cáncer.
Cancer in COVID-19 times. Practical approach from the diagnostic process of respiratory triage
Abstract
Introduction: The combined frequency of cancer and COVID-19 is low. Cancer patients are more susceptible to severe complications from COVID-19. General measures to keep COVID-19–free cancer divisions have been adopted worldwide. Objective: To perform a biomedical literature review regarding the relevant practical aspects in medical care of cancer and COVID-19 duality, from the perspective of an oncology center. Material and Methods: A review of the national and international biomedical literature (68 selected citations) published from February 2020 to September 2021 was carried out. The pubMed and Hinari Health Research Access Program databases were used to locate and select the material. Retrospective design studies, original articles, systematic reviews and meta-analyzes were selected, using the search terms: “cancer”, “triage”, “diagnosis” and “COVID-19”. Results: In pandemic, the availability of cancer prevention, diagnosis and treatment services is limited. COVID-19 respiratory triage allows prioritizing cáncer patient care. Computed tomography has high sensitivity and low specificity for identifying suspicious lesions. Diagnostic gold standard for COVID-19 is RT-qPCR. COVID-19, rapid antigen detection tests are cost-effective in resource-limited settings. Cancer guidelines for COVID-19 may show a low level of evidence. Cancer treatments should not be delayed in high priority patients. Conclusions: The diagnostic process of COVID-19 respiratory triage and the prioritization of the various aspects of cancer care in the context of a current and future pandemic, became powerful tools to mitigate the impact of COVID-19.
Citas
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