Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 26;16(8):e0256544.
doi: 10.1371/journal.pone.0256544. eCollection 2021.

COVID-19 pandemic: Impact on the management of patients with hepatocellular carcinoma at a tertiary care hospital

Katharina Pomej  1   2 , Bernhard Scheiner  1   2   3   4 , Lukas Hartl  2   3 , Lorenz Balcar  2   3 , Tobias Meischl  1   2 , Mattias Mandorfer  1   3   4 , Thomas Reiberger  1   3   4   5 , Christian Müller  1   2 , Michael Trauner  1   4 , Matthias Pinter  1   2   4
Affiliations

COVID-19 pandemic: Impact on the management of patients with hepatocellular carcinoma at a tertiary care hospital

Katharina Pomej et al. PLoS One. .

Abstract

Background: Patients with hepatocellular carcinoma (HCC) represent a vulnerable population potentially negatively affected by COVID-19-associated reallocation of healthcare resources. Here, we report the impact of COVID-19 on the management of HCC patients in a large tertiary care hospital.

Methods: We retrospectively analyzed clinical data of HCC patients who presented at the Vienna General Hospital, between 01/DEC/2019 and 30/JUN/2020. We compared patient care before (period 1) and after (period 2) implementation of COVID-19-associated healthcare restrictions on 16/MAR/2020.

Results: Of 126 patients, majority was male (n = 104, 83%) with a mean age of 66±11 years. Half of patients (n = 57, 45%) had impaired liver function (Child-Pugh stage B/C) and 91 (72%) had intermediate-advanced stage HCC (BCLC B-D). New treatment, was initiated in 68 (54%) patients. Number of new HCC diagnoses did not differ between the two periods (n = 14 vs. 14). While personal visits were reduced, an increase in teleconsultation was observed (period 2). Number of patients with visit delays (n = 31 (30%) vs. n = 10 (10%); p = 0.001) and imaging delays (n = 25 (25%) vs. n = 7 (7%); p = 0.001) was higher in period 2. Accordingly, a reduced number of patients was discussed in interdisciplinary tumor boards (lowest number in April (n = 24), compared to a median number of 57 patients during period 1). Median number of elective/non-elective admissions was not different between the periods. One patient contracted COVID-19 with lethal outcome.

Conclusions: Changes in patient care included reduced personal contacts but increased telephone visits, and delays in diagnostic procedures. The effects on long-term outcome need to be determined.

PubMed Disclaimer

Conflict of interest statement

K.P. has nothing to declare; B.S. received travel support from Gilead, Ipsen and AbbVie; L.H. has nothing to declare; L.B. has nothing to declare; T.M. has nothing to declare; M.M. served as a speaker and/or consultant and/or advisory board member for AbbVie, Bristol-Myers Squibb, Collective Acumen, Gilead, and W. L. Gore & Associates and received travel support from AbbVie, Bristol-Myers Squibb, and Gilead; T.R. received travel support from Gilead, Roche, MSD, and Gore; grant support from Gilead, Abbvie, Philips, Boehringer Ingelheim, Phenex Pharmaceuticals, and Gore, and served as a consultant for MSD, Gilead, Abbvie, and Boehringer Ingelheim; C.M. has nothing to declare; M.T. received grant support from Albireo, Cymabay, Falk, Gilead, Intercept, MSD, and Takeda, honoraria for consulting from BiomX, Boehringer Ingelheim, Falk, Genfit, Gilead, Intercept, Janssen, MSD, Novartis, Phenex, Regulus and Shire, speaker fees from BMS, Falk, Gilead, Intercept and MSD, as well as travel support from Abbvie, Falk, Gilead and Intercept; M.P. is an investigator for Bayer, BMS, Lilly, and Roche; he received speaker honoraria from Bayer, BMS, Eisai, Lilly, and MSD; he is a consultant for Bayer, BMS, Ipsen, Eisai, Lilly, MSD, and Roche; he received travel support from Bayer and BMS. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Timeline of COVID-19-associated healthcare restrictions.
Measures implemented by A) the Austrian government and B) the Vienna General Hospital, Medical University of Vienna, Department of Internal Medicine, Division of Gastroenterology and Hepatology.
Fig 2
Fig 2. Patient flow-chart.
Fig 3
Fig 3. In- and outpatient frequencies at the department of Gastroenterology and Hepatology, including personal and telephone visits at the outpatient clinic and elective and non-elective admissions of patients with HCC to the ward.
Fig 4
Fig 4. Patients discussed in weekly interdisciplinary tumor board.
See this image and copyright information in PMC

References

    1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382:1708–1720. doi: 10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Jama 2020;323:1239–1242. doi: 10.1001/jama.2020.2648 - DOI - PubMed
    1. Timeline: the WHO’s COVID-19 response. In. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interact... World Health Organization; 2020.
    1. Numbers at a glance. In. https://www.who.int/emergencies/diseases/novel-coronavirus-2019: World Health Organization; 2020.
    1. Cancer Incidence Austria. In: Statistik Austria; 2021. p. Cancer Incidence Austria.

Publication types

MeSH terms

Substances