Importance of standard precautions to febrile neutropenia prevention in patients with cancer during COVID 19 outbreak

Abstract

Purpose Intensive cytotoxic chemotherapy increases the risk of infection in patients with cancer by inducing bone marrow suppression and mucosal injury. Febrile neutropenia (FN) is the most important clinical adverse event in patients with cancer who receiving cytotoxic chemotherapy. To prevent FN, prophylactic antibiotics, colony stimulating factors (CSFs) and also standard precautions including hand and respiratory hygiene are generally recommended but the exact effect of non-pharmacologic intervention such as standard precaution has not been clearly proven in the clinical setting. we aimed to compare the incidence of FN between pre-coronavirus disease 19 (COVID 19) era versus post-COVID 19 era. Material and methods We retrospectively enrolled patients with breast cancer who received adjuvant adriamycin and cyclosphosphamide (AC) chemotherapy at Jeju national university hospital. Results In total, 149 patients well enrolled, including 94 who received AC chemotherapy in pre-COVDI 19 era and 55 who received at post-COVID 19 era. Sixteen (10.7%) patients experienced the FN. Fourteen events (14.9%) and two events (3.6%) were occurred in pre-COVID 19 and post-COVDI 19 era, respectively. The post-COVID 19 era was the only risk factor for FN. (p = 0.032) Conclusion We found an association between FN occurrence and COVID 19 outbreak; thus, providing indirect evidence of the importance of non-pharmacological measure to reduce FN risk in patients with cancer. Further research is required to confirm the standard precautions for FN prevention in patients with cancer.