Frequency and characteristics of advanced cancer patients with COVID + ve status among inpatient supportive care consults during the pandemic: experience from a tertiary cancer center

Purpose: There is limited literature available regards the frequency and characteristics of COVID-19 + ve status among advanced cancer patients referred to an inpatient supportive care consultation(PC) at a tertiary cancer center. Our study aimed to determine the frequency and characteristics of COVID-19 + ve cancer patients seen by PC. Methods: Advanced cancer patients seen as a consult by PC between June 15 and September 25, 2020, at MD Anderson Cancer Center were eligible for the study. We evaluated the patient demographics, clinical characteristics including symptoms(ESAS), delirium(MDAS), COVID + status prior to, and after PC referral(converters), and type of PC delivery(in person or virtual care). Results: Sixty-six out of 1380 (4.8%) PC consults were COVID-19 + ve: 42 prior to PC (79%), and 14 (21%) were COVID-19 + ve after the PC (converters). COVID-19 + PC patients had lower depression (P =.035), spiritual distress (P =.003), and were more seen frequently virtually (P < 0.001). There was no significant difference between COVID-19-ve patients and converters. Converters had higher symptom distress (P = 0.007), lower delirium (P = 0.014), and were referred earlier (P =.011) compared to COVID + PC patients diagnosed prior to PC consult. Overall, patients seen virtually compared in-person by PC were younger (P = 0.02) and had lower delirium (P = 0.007). Conclusion: The burden of COVID-19 + status among patients referred to PC was low. COVID-19 + ve patients had more frequent virtual visits, lower depression, and spiritual distress scores. Patient seen virtually were significantly younger and had lower delirium. During a new pandemic, universal virtual care might be emphasized especially at initial encounters after admission and further research is needed on the potential efficacy of this intervention.