COVID-19 pandemic impact on healthcare professionals treating patients with neuroendocrine tumors (NET): An international NET CONNECT survey

Abstract

Background COVID-19 pandemic has added a degree of complexity in the management of patients with NET. We have little information about the real impact of COVID-19 in current practice. The aim of this study is to capture if and how COVID-19 is changing the way in which healthcare professionals treat NET patients. Methods NET CONNECT taskforce designed an online anonymous survey addressing different aspects of NET. Survey was sent to nurses and physicians working in ENETS Centers of Excellence (CoE) and other hospitals with high volume of NET between March 24th and April 27th 2021. rResults 47 health professionals (47% female, 19% nurses, 72% >20 years of experience) from 37 institutions (79% ENETS CoE, 55% >500 ongoing NET patients; 51% EU, 38% UK, 11% US) completed the survey; 70% of responders worked in areas of high COVID prevalence and 11% tested positive for COVID themselves. According to responders, pandemic affected their relationship with patients (49%). Telemedicine was widely used by 62% and included phone calls (96%), video conference (43%), telemedicine apps (19%) and email (51%). Tumor boards kept their usual schedule (60%), but were held virtually in 79%. Among main patient worries perceived by clinicians were the risk of COVID-19-related complications (64%), difficulties in the management of their disease (74%), or oncological medication (87%). Watch and wait strategies were used more commonly (34%), while surgery was often (55%) delayed. Somatostatin analogs (SSA) were increasingly used as bridging strategy for delaying surgery (32%), and were self-injected or delivered by home care service in 36% and 49% of cases respectively. Treatment breaks of targeted therapies (17%), PRRT (13%), or chemotherapy (9%) were also proposed. Patients with advanced NET were considered a priority group for vaccination (94%), but not those with resected NET (19%). Conclusions COVID-19 pandemic paved the way towards telemedicine in many institutions. While systemic treatments were generally continued, surgical interventions were delayed in 55% of cases. Regarding SSA, home care service or self-injections have been used more frequently. As the pandemic evolves, new data will be needed to design future health policy measures.