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    Emerging challenges in the evaluation of fever in cancer patients at risk of febrile neutropenia in the era of COVID-19: a MASCC position paper

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    Authors
    Cooksley, Timothy J
    Font, C.
    Scotte, F.
    Escalante, C.
    Johnson, L.
    Anderson, R.
    Rapoport, B.
    Affiliation
    Department of Acute Medicine and Critical Care, The Christie, Wilmslow Road, Manchester, UK.
    Issue Date
    2020
    
    Metadata
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    Abstract
    Patients with cancer are at higher risk of more severe COVID-19 infection and have more associated complications. The position paper describes the management of cancer patients, especially those receiving anticancer treatment, during the COVID-19 pandemic. Dyspnea is a common emergency presentation in patients with cancer with a wide range of differential diagnoses, including pulmonary embolism, pleural disease, lymphangitis, and infection, of which SARS-CoV-2 is now a pathogen to be considered. Screening interviews to determine whether patients may be infected with COVID-19 are imperative to prevent the spread of infection, especially within healthcare facilities. Cancer patients testing positive with no or minimal symptoms may be monitored from home. Telemedicine is an option to aid in following patients without potential exposure. Management of complications of systemic anticancer treatment, such as febrile neutropenia (FN), is of particular importance during the COVID-19 pandemic where clinicians aim to minimize patients' risk of infection and need for hospital visits. Outpatient management of patients with low-risk FN is a safe and effective strategy. Although the MASCC score has not been validated in patients with suspected or confirmed SARS-CoV-2, it has nevertheless performed well in patients with a range of infective illnesses and, accordingly, it is reasonable to expect efficacy in the clinical setting of COVID-19. Risk stratification of patients presenting with FN is a vital tenet of the evolving sepsis and pandemic strategy, necessitating access to locally formulated services based on MASCC and other national and international guidelines. Innovative oncology services will need to utilize telemedicine, hospital at home, and ambulatory care services approaches not only to limit the number of hospital visits but also to anticipate the complications of the anticancer treatments.
    Citation
    Cooksley T. Editorial - COVID-19: Exemplifying the importance and challenges of Acute Medicine. Acute Med. 2020;19(4):174-5
    Journal
    Supportive Care in Cancer
    URI
    http://hdl.handle.net/10541/623631
    DOI
    10.1007/s00520-020-05906-y
    PubMed ID
    33230644
    Additional Links
    https://dx.doi.org/10.1007/s00520-020-05906-y
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00520-020-05906-y
    Scopus Count
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