A Retrospective audit comparing the neutropenic complications in the Pre-COVID and COVID era from a tertiary care center

Warrier, N.; Chandramohan, D.; Vallathol, D. H.; Parameswaran, P. V.; Sajeevan, K. V.; Sreedharan, P. S.

Background: The COVID era has shown a rise in Intensive Care Unit (ICU) admissions. This is mainly due to COVID related complications. On the contrary, the public around the world have become more aware about maintaining proper hygiene by wearing masks , using hand wash and keeping themselves clean. As an audit, we conducted a retrospective analysis comparing neutropenic complications during the pre COVID and COVID times at our tertiary care cancer hospital. Methods: We collected data of febrile neutropenia admissions in ICU from March to July 2019-Non Covid (NC) and March to July 2020-Covid (C). The data collection was done including data on nadir total WBC count, use of GCSF, positive cultures, type of malignancy and deaths. The statistical analysis was done using SPSS software version 22. Results: There were 15 patients in the NC dataset and 18 patients in the C dataset. The mean age of NC was 59 (SD-9.2) and that of C was 57. 3 (SD-14). The age and sex were comparable in both the groups. The number of solid organ malignancies constituted 5 (33.33%) in NC set and 8 (44.44%) in C set. The hematological malignancies constituted 10 in each of C and NC sets. Gram negative sepsis was seen in 26.67% and 22.22% in NC and C dataset respectively. There were 4 (26.67%) deaths in NC group and 5 (27.28%) C group. Growth factors were received by 9 (60%) patients in NC group and 15 (83.3%) patients in the C group (p=0.0005). There was no significant difference in the admission, complication and death rates in ICU when comparing the two groups. These results have been depicted in Table. Conclusions: Despite the precautions taken by community during the COVID times, we conclude that there was no significant difference in the neutropenic complications. It also suggests that most of the neutropenic infections are related to the person's immunity rather than community transmission. The study limitation is that this is a single center study but further audits and prospective studies are warranted in this regard. (Table Presented).