1Department of Oncology/Hematology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
2Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea
3Department of Oncology/Hematology, Daegu Fatima Hospital, Daegu, Korea
4Division of Hematology/Oncology, Department of Internal Medicine, Daegu Catholic University Shcool of Medicine, Daegu, Korea
5Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea
6Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
Copyright © 2021 Yeungnam University College of Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical statements
All procedures were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of five hospitals (Kyungpook National University Chilgok Hospital, Yeungnam University Medical Center, Daegu Fatima Hospital, Daegu Catholic University Medical Center, and Keimyung University Dongsan Medical Center) in Daegu (No. KNUH 2020-03-044, CR21-024, 2020-09-100, 2020-10-006), which waived the requirement for informed consent.
Conflicts of interest
No potential conflict of interest relevant to this article was reported.
Funding
This work was supported by the Research Program of Medicity Daegu Council funded by Daegu Metropolitan City (fund code COVID19_DM11).
Author contributions
Conceptualization: IHL, JYK; Data curation: IHL, SAK, SJL, SAL, YYC, JYL; Formal analysis: IHL, SAK, SJL, YYC, JYL, JYK; Supervision, Funding acquisition: JYK; Writing-original draft: IHL; Writing-review & editing: SAL.
Factor | Data (n=328) |
---|---|
Type of malignancy | |
Solid tumors | |
Lung cancer | 65 (19.8) |
Hepatobiliary | 61 (18.6) |
Stomach | 16 (4.9) |
Colorectal | 26 (7.9) |
Breast | 19 (5.8) |
Head and neck | 18 (5.5) |
Gynecological | 26 (7.9) |
Genitourinary | 19 (5.8) |
Othersa) | 16 (4.9) |
Hematological malignancies | 62 (18.9) |
History of cancer treatment | |
Yes | 300 (91.5) |
No | 28 (8.5) |
Type of cancer treatment | |
Surgery | 111 (33.8) |
Cytotoxic chemotherapy | 244 (74.4) |
Target therapy | 61 (18.6) |
Immune checkpoint inhibitor | 37 (11.3) |
Radiation | 77 (23.5) |
Othersb) | 9 (2.7) |
Response evaluation | |
CR | 22 (6.7) |
PR | 39 (11.9) |
SD | 58 (17.7) |
PD | 92 (28.0) |
iRECIST CR | 0 (0) |
iRECIST PR | 0 (0) |
iRECIST SD | 1 (0.3) |
iRECIST PD | 1 (0.3) |
Unknown | 115 (35.1) |
Values are presented as number (%).
CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; iRECIST, Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) in cancer immunotherapy trials.
a)Sarcoma, primary unknown cancer.
b)Transarterial chemoembolization.
Factor | Data (n=328) |
---|---|
Cause of fever (n=256)a) | |
COVID-19 | 3 (1.2) |
Other infection | |
Pneumonia | 10 (3.9) |
Bloodstream infection | 3 (1.2) |
Urinary tract infection | 1 (0.4) |
Body fluid infectionb) | 2 (0.8) |
Neutropenic fever | 33 (12.9) |
Delay of cancer treatment due to fever | |
Delay | 20 (6.1) |
Discontinuation | 18 (5.5) |
No | 290 (88.4) |
Major event during delay period | |
Death | 9 (2.7) |
Cancer progression | 5 (1.5) |
Delay of admission | 17 (5.2) |
Major organ dysfunction | 9 (2.7) |
Cause of death | |
COVID-19 | 2 (0.6) |
Cancer progression | 28 (8.5) |
Sepsis | 3 (0.9) |
Pneumonia | 5 (1.5) |
Hemorrhage | 3 (0.9) |
Sex | Age (yr) | Comorbidity | Cancer (date of diagnosis) | Cancer treatment | COVID-19 symptom and sign | Treatment delay | Outcome | Routes of transmission |
---|---|---|---|---|---|---|---|---|
Male | 71 | Hypertension, COPD, heart disease | NSCLC, stage II (January 2020) | Cytotoxic chemotherapy | Fever (38.1°C), lymphopenia, pneumonic infiltration | Postponed | Death | Religious gathering |
Male | 82 | Hypertension, chronic liver disease | Laryngeal cancer, stage II (June 2016) | Surgery | Fever (38.4°C), pneumonic infiltration | On schedule | Alive | Religious gathering |
Female | 73 | Heart disease | DLBCL, stage IE (March 2020) | No treatment | Fever (38.4°C), cough, pneumonic infiltration | No treatmenta) | Death | Unknown |
Factor | Data |
---|---|
Patient | 328 (100) |
Age (yr) | |
≤70 | 202 (61.6) |
>70 | 126 (38.4) |
Sex | |
Male | 191 (58.2) |
Female | 137 (41.8) |
ECOG PS | |
0 | 12 (3.7) |
1 | 146 (44.5) |
2 | 83 (25.3) |
3 | 59 (18.0) |
4 | 28 (8.5) |
Comorbidity | |
Hypertension | 134 (40.9) |
Diabetes mellitus | 91 (27.7) |
Tuberculosis | 5 (1.5) |
Hepatitis | 1 (0.3) |
Hyperlipidemia | 9 (2.7) |
COPD | 11 (3.4) |
Heart disease | 20 (6.1) |
Cerebrovascular disease | 11 (3.4) |
Chronic kidney disease | 9 (2.7) |
Chronic liver disease | 13 (4.0) |
Organ transplantation | 9 (2.7) |
Symptom | |
Fever | 256 (78.0) |
Cough | 52 (15.9) |
Sore throat | 6 (1.8) |
Rhinorrhea | 5 (1.5) |
Diarrhea | 19 (5.8) |
Myalgia | 17 (5.2) |
Arthritis | 2 (0.6) |
Factor | Data (n=328) |
---|---|
Type of malignancy | |
Solid tumors | |
Lung cancer | 65 (19.8) |
Hepatobiliary | 61 (18.6) |
Stomach | 16 (4.9) |
Colorectal | 26 (7.9) |
Breast | 19 (5.8) |
Head and neck | 18 (5.5) |
Gynecological | 26 (7.9) |
Genitourinary | 19 (5.8) |
Others |
16 (4.9) |
Hematological malignancies | 62 (18.9) |
History of cancer treatment | |
Yes | 300 (91.5) |
No | 28 (8.5) |
Type of cancer treatment | |
Surgery | 111 (33.8) |
Cytotoxic chemotherapy | 244 (74.4) |
Target therapy | 61 (18.6) |
Immune checkpoint inhibitor | 37 (11.3) |
Radiation | 77 (23.5) |
Others |
9 (2.7) |
Response evaluation | |
CR | 22 (6.7) |
PR | 39 (11.9) |
SD | 58 (17.7) |
PD | 92 (28.0) |
iRECIST CR | 0 (0) |
iRECIST PR | 0 (0) |
iRECIST SD | 1 (0.3) |
iRECIST PD | 1 (0.3) |
Unknown | 115 (35.1) |
Factor | Data (n=328) |
---|---|
Cause of fever (n=256) |
|
COVID-19 | 3 (1.2) |
Other infection | |
Pneumonia | 10 (3.9) |
Bloodstream infection | 3 (1.2) |
Urinary tract infection | 1 (0.4) |
Body fluid infection |
2 (0.8) |
Neutropenic fever | 33 (12.9) |
Delay of cancer treatment due to fever | |
Delay | 20 (6.1) |
Discontinuation | 18 (5.5) |
No | 290 (88.4) |
Major event during delay period | |
Death | 9 (2.7) |
Cancer progression | 5 (1.5) |
Delay of admission | 17 (5.2) |
Major organ dysfunction | 9 (2.7) |
Cause of death | |
COVID-19 | 2 (0.6) |
Cancer progression | 28 (8.5) |
Sepsis | 3 (0.9) |
Pneumonia | 5 (1.5) |
Hemorrhage | 3 (0.9) |
Sex | Age (yr) | Comorbidity | Cancer (date of diagnosis) | Cancer treatment | COVID-19 symptom and sign | Treatment delay | Outcome | Routes of transmission |
---|---|---|---|---|---|---|---|---|
Male | 71 | Hypertension, COPD, heart disease | NSCLC, stage II (January 2020) | Cytotoxic chemotherapy | Fever (38.1°C), lymphopenia, pneumonic infiltration | Postponed | Death | Religious gathering |
Male | 82 | Hypertension, chronic liver disease | Laryngeal cancer, stage II (June 2016) | Surgery | Fever (38.4°C), pneumonic infiltration | On schedule | Alive | Religious gathering |
Female | 73 | Heart disease | DLBCL, stage IE (March 2020) | No treatment | Fever (38.4°C), cough, pneumonic infiltration | No treatment |
Death | Unknown |
Values are presented as number (%). ECOG PS, Eastern Cooperative Oncology Group performance status; COPD, chronic obstructive pulmonary disease.
Values are presented as number (%). CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; iRECIST, Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) in cancer immunotherapy trials. Sarcoma, primary unknown cancer. Transarterial chemoembolization.
Values are presented as number (%). COVID-19, coronavirus disease 2019. Number of patients with fever. Ascites, pleural effusion, bile.
COVID-19, coronavirus disease 2019; COPD, chronic obstructive pulmonary disease; NSCLC, non-small cell lung cancer; DLBCL, diffuse large B-cell lymphoma. This patients was diagnosed with lymphoma and COVID-19 at the same time. She was not treated for lymphoma because of treatment for COVID-19.