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Background:The COVID-19 pandemic has a tangible impact on the health care systems globally and is represented by interruption of the usual services in many health facilities and exposing vulnerable patients to significant risks.Objectives:We aimed to evaluate this pandemic’s impact on Iraq’s cancer care.Materials and methods:We conducted an exploratory study using a validated web-based questionnaire of 51 items. The questionnaire collected information on the capacity and services offered at the Iraqi cancer centers, the magnitude of care disruption, reasons for the disruption,challenges faced, patient harm estimation, and the interventions implemented during the pandemic.Results:18 cancer centers from 11 Iraqi governorates took part between 21stApril and 8thMay2020. These centers were serving around 18,867 new patients per year. Most of them (72.2%)were facing challenges in delivering their care during the pandemic. Although 44.4% of the centers reduced their services as part of a pre-emptive strategy, other reported reasons included lack of personal protective equipment (22.2%), an overwhelmed system (11.1%), and a restricted approach to medications (11.1%). Missing at least one therapy cycle by>10% of the patients was reported in 38.9% of the centers. Participants have reported that their patients were exposed to potential harm from interruption of cancer-specific care (44.4%) and non-cancer-related care (33.3%). Conclusion:The negative impact of the COVID-19 pandemic on cancer care in Iraq is evident.Additional research to estimate such an effect at the patients’ level and the required measures to counteract this problem is vital. [ABSTRACT FROM AUTHOR]

Introduction: Despite extensive studies of the impact of COVID-19 on patients with cancer, there is a dearth of information from the Middle East and North Africa (MENA) region. Our study aimed to report pertinent MENA COVID-19 and Cancer Registry (MCCR) findings on patient management and outcomes. Methods: MCCR was adapted from the American Society of Clinical Oncology COVID-19 Registry to collect data specifically from patients with cancer and SARS-CoV-2 infection from 12 centers in eight countries including Saudi Arabia, Jordan, Lebanon, Turkey, Egypt, Algeria, United Arab Emirates, and Morocco. The Registry included data on patients and disease characteristics, treatment, and patient outcomes. Logistic regression was used to assess associations with mortality. Results: Between November 29, 2020, and June 8, 2021, data were captured on 2008 patients diagnosed with COVID-19 from the beginning of the pandemic. Median age was 56 years (16–98), 56.4% were females, and 26% were current or ex-smokers. Breast cancer (28.5%) was the leading diagnosis and 50.5% had metastatic disease. Delays of planned treatment (.14 days) occurred in 80.3% for surgery, 48.8% for radiation therapy, and 32.9% for systemic therapy. Significant reduction in the delays of all three treatment modalities occurred after June 1, 2020. All-cause mortality rates at 30 and 90 days were 17.1% and 23.4%, respectively. All-cause mortality rates at 30 days did not change significantly after June 1, 2020; however, 90-day mortality increased from 33.4% to 42.9% before and after that date (p ¼ 0.015). Multivariable regression analysis showed the following predictors of higher 30- and 90-day mortality: age older than 70 years, having metastatic disease, disease progression, and being off chemotherapy. Conclusion: Patients with cancer in the MENA region experienced similar risks and outcome of COVID-19 as reported in other populations. Although there were fewer treatment delays after June 1, 2020, 90-day mortality increased, which may be attributed to other risk factors such as disease progression or new patients who presented with more advanced disease. [ABSTRACT FROM AUTHOR]