MA10.10 Lung Cancer Admission Rates During the COVID-19 Pandemic to a Tertiary Cancer Centre in South East Scotland.

Abstract

Introduction: Lung cancer is associated with a lower socio-economic status, major co-morbidities and a poorer performance status These factors, and the negative association often affiliated with lung cancer, can create barriers to healthcare engagement Anecdotally patients admitted during the lockdown phase of the COVID-19 pandemic were more unwell and required more intervention than normal We examined acute admissions during the pandemic to establish the impact of the COVID-19 pandemic on patients with lung cancer Methods: We identified all patients admitted with suspected or previously diagnosed lung cancer admitted acutely to Edinburgh Cancer Centre between 29th of March and 29th June 2020 In Scotland, lockdown was eased from 29th of May, so we divided our analysis into early lockdown (29th March-April), late lockdown (May) and recovery (June) We gathered patient demographics (age, gender), duration of admission (days), admission route (referral from routine contact with oncology specialist for emergency care, self-presentation to oncology patient helpline, self-presentation to GP or A&E, and planned admission for specialist oncology treatment) and outcomes from the admission, including mortality and palliative care involvement We compared this with admissions in April 2019 Results: During the three months evaluated, 77 patients were admitted, of whom 46 were male and 31 were female The mean age of patients was 65 8 (range 42 to 87), with no significant difference between each month assessed The number of admissions in the 3 assessment periods were 29 (early lockdown), 21 (late lockdown) and 27 (recovery), compared with 10 admissions in April 2019 Patients were admitted for a longer period of time in early lockdown (mean 7 4 days) and late lockdown (mean 7 0 days), but less in the recovery period (mean 2 7 days) There were 3 inpatient deaths in early lockdown, 2 in late lockdown and none during the recovery period, suggesting patients may have been presenting with more advanced acute illness during lockdown Admission route shifted from being prompted by a routine remote consultation to patient-driven self-presentation as the pandemic progressed During early and late lockdown, around half of patients were admitted after a scheduled remote consultation (48% (14/29) in early lockdown, 57% (12/21) in late lockdown) In contrast, 19% (5/27) patients were admitted via this route during the recovery period, with 41% (11/27) being admitted via patients self-presenting to the patient helpline and 37% (10/27) self-presenting to A+E/GP Conclusion: Our data suggests that there were more patients with lung cancer admitted acutely with cancer, non-COVID-19-related illness during the COVID-19 pandemic The early and late lockdown phase was particularly characterised by a reduction in self-presentation and longer resulting admissions, suggesting patients were admitted with more complex pathology and consequently longer admission from acute illness Overall, our experience highlights the need to make acute cancer services accessible to patients as the COVID-19 pandemic continues, and that patients with lung cancer may be a particularly vulnerable group Keywords: COVID-19, Oncology, Admissions