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Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

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Author(s)
In Hee LeeSung Ae KohSoo Jung LeeSun Ah LeeYoon Young ChoJi Yeon LeeJin Young Kim
Keimyung Author(s)
Lee, Ji YeonKim, Jin Young
Department
Dept. of Internal Medicine (내과학)
Journal Title
Yeungnam University Journal of Medicine
Issued Date
2021
Volume
38
Issue
4
Keyword
COVID-19FeverNeoplasmsNeoplastic fever
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.
Keimyung Author(s)(Kor)
이지연
김진영
Publisher
School of Medicine (의과대학)
Citation
In Hee Lee et al. (2021). Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic. Yeungnam University Journal of Medicine, 38(4), 344–349. doi: 10.12701/yujm.2021.01144
Type
Article
ISSN
2799-8010
Source
https://www.e-jyms.org/journal/view.php?doi=10.12701/yujm.2021.01144
DOI
10.12701/yujm.2021.01144
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43878
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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