Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic
Open Access
- 31 October 2021
- journal article
- Published by Yeungnam University College of Medicine in Journal of Yeungnam Medical Science
- Vol. 38 (4), 344-349
- https://doi.org/10.12701/yujm.2021.01144
Abstract
Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic. Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.Keywords
Funding Information
- Daegu Metropolitan City (COVID19_DM11)
This publication has 19 references indexed in Scilit:
- Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, ChinaAnnals of Oncology, 2020
- Clinical characteristics of 3062 COVID‐19 patients: A meta‐analysisJournal of Medical Virology, 2020
- Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemicNature Reviews Clinical Oncology, 2020
- Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in ItalyJAMA, 2020
- Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysisTravel Medicine and Infectious Disease, 2020
- Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysisInternational Journal of Infectious Diseases, 2020
- A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other PneumoniasClinical Infectious Diseases, 2020
- Cancer patients in SARS-CoV-2 infection: a nationwide analysis in ChinaThe Lancet Oncology, 2020
- Fever in Patients with CancerCancer Control, 2017
- Malignant causes of fever of unknown originClinical Medicine, 2015