Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

  • Lee, In Hee (Department of Oncology/Hematology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital) ;
  • Koh, Sung Ae (Department of Hematology-Oncology, Yeungnam University College of Medicine) ;
  • Lee, Soo Jung (Department of Oncology/Hematology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital) ;
  • Lee, Sun Ah (Department of Oncology/Hematology, Daegu Fatima Hospital) ;
  • Cho, Yoon Young (Division of Hematology/Oncology, Department of Internal Medicine, Daegu Catholic University Shcool of Medicine) ;
  • Lee, Ji Yeon (Department of Infectious Diseases, Keimyung University Dongsan Medical Center) ;
  • Kim, Jin Young (Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center)
  • Received : 2021.05.18
  • Accepted : 2021.07.29
  • Published : 2021.10.31
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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

Acknowledgement

This work was supported by the Research Program of Medicity Daegu Council funded by Daegu Metropolitan City (fund code COVID19_DM11).

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