Optimized Colorectal Cancer Patients, Management During the COVID-19 Pandemic: Triage and Treatment

Background: The outbreak of coronavirus disease 2019 (COVID-19) has created significant challenges in the management of oncology patients, including patients with colorectal cancer (CRC). We suspect that the COVID-19 pandemic had a major impact on the number of CRC inpatients and outpatients, which might leave many CRC patients unable to get timely medical treatment. At the time, the most important task was to satisfy the imperious demand for rapid optimization of processes and the development of efficient and effective triage and treatment strategies, as well as emergency distant clinical reasoning. Methods: The number of outpatients and inpatients, as well as surgeries performed in Shanghai East Hospital from December 2019 to February 2020 were collected. Using December 2019 data as the baseline status before the pandemic, the changes during this period were analyzed which can reflect the impact of COVID-19 on the treatment of CRC patients. In addition, a triage system and management strategy for patients with CRC during COVID-19 were designed and implemented. To evaluate their effectiveness, we assessed COVID-19 infection rates among CRC patients in relation to total patients and healthcare staff. Result: Compared with the pre-COVID-19 period (December 2019), a drastic decline in the number of outpatient visits (2,789 to 120) and inpatient hospitalizations (207 to 50) for all the CRC patients, as well as in non-emergency colorectal surgeries (133 to 23), was observed in February 2020 at our hospital. Conclusion: A multidisciplinary triage strategy aligned with regional guidance and digital, artificial intelligence (AI)-technology solutions can help increase the efficacy in patient management, allow efficient access to care and reduce the incidence of COVID-19 among CRC patients.