SARS-CoV-2 Testing in Patients With Cancer Treated at a Tertiary Care Hospital During the COVID-19 Pandemic
SARS-CoV-2 Testing in Patients With Cancer Treated at a Tertiary Care Hospital During the COVID-19 Pandemic
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DOI：
10.1200/jco.20.01442
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发表时间：
2020-10-20
影响因子：
45.3
通讯作者：
Preusser, Matthias
中科院分区：
文献类型：
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作者：
Berghoff, Anna S.;Gansterer, Margaretha;Preusser, Matthias
方法2020年3月21日至5月4日期间，通过鼻拭子和实时聚合酶链反应对癌症患者进行SARS-CoV-2 RNA常规检测。该癌症队列的结果与奥地利人群中SARS-CoV-2的患病率进行了统计学比较，该患病率是通过一项代表性的全国随机样本研究（对照队列1）和一项在我们医院就诊的无癌症患者队列（对照队列2）确定的。1，016例患者中共有270例（26.6%）在新辅助/辅助治疗中接受活性抗癌治疗，1，016例患者中有560例（55.1%）在姑息治疗中接受活性抗癌治疗。1,016名患者中共有53名（5.2%）自我报告了可能与COVID-19相关的症状。在1，016名患者中有4名（0.4%）检测到SARS-CoV-2。在我科检测时，所有4名SARS-CoV-2阳性患者均无症状，其中2人已从有症状的COVID-19中康复。在检测阳性后14-56天，4名患者中有3名实现了病毒清除。癌症队列和对照队列1之间SARS-CoV-2患病率的估计比值比为1.013（95% CI，0.209 ~ 4.272; P = 1），对照队列2与癌症队列之间的差异为18.333（95%可信区间，结论：我们的数据表明，继续积极的抗癌治疗和随访-在当前COVID-19大流行期间实施严格的全民和机构安全措施后，在大型三级护理医院进行随访是可行和安全的。对癌症患者进行常规SARS-CoV-2检测似乎是明智的，可以检测出无症状的病毒携带者，避免不受控制的病毒传播。
PURPOSETo analyze the prevalence of SARS-CoV-2 infection in patients with cancer in hospital care after implementation of institutional and governmental safety measurements.METHODSPatients with cancer routinely tested for SARS-CoV-2 RNA by nasal swab and real-time polymerase chain reaction between March 21 and May 4, 2020, were included. The results of this cancer cohort were statistically compared with the SARS-CoV-2 prevalence in the Austrian population as determined by a representative nationwide random sample study (control cohort 1) and a cohort of patients without cancer presenting to our hospital (control cohort 2).RESULTSA total of 1,688 SARS-CoV-2 tests in 1,016 consecutive patients with cancer were performed. A total of 270 of 1,016 (26.6%) of the patients were undergoing active anticancer treatment in a neoadjuvant/adjuvant and 560 of 1,016 (55.1%) in a palliative setting. A total of 53 of 1,016 (5.2%) patients self-reported symptoms potentially associated with COVID-19. In 4 of 1,016 (0.4%) patients, SARS-CoV-2 was detected. At the time of testing at our department, all four SARS-CoV-2-positive patients were asymptomatic, and two of them had recovered from symptomatic COVID-19. Viral clearance was achieved in three of the four patients 14-56 days after testing positive. The estimated odds ratio of SARS-CoV-2 prevalence between the cancer cohort and control cohort 1 was 1.013 (95% CI, 0.209 to 4.272; P = 1), and between control cohort 2 and the cancer cohort it was 18.333 (95% CI, 6.056 to 74.157).CONCLUSIONOur data indicate that continuation of active anticancer therapy and follow-up visits in a large tertiary care hospital are feasible and safe after implementation of strict population-wide and institutional safety measures during the current COVID-19 pandemic. Routine SARS-CoV-2 testing of patients with cancer seems advisable to detect asymptomatic virus carriers and avoid uncontrolled viral spread.