SARS-CoV-2 Testing in Patients With Cancer Treated at a Tertiary Care Hospital During the COVID-19 Pandemic

Abstract

Purpose: To analyze the prevalence of SARS-CoV-2 infection in patients with cancer in hospital care after implementation of institutional and governmental safety measurements.

Methods: Patients 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).

Results: A 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).

Conclusion: Our 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.

FIG 1.

Characteristics of the cancer cohort. (A) Age distribution. (B) Type of primary tumor. (C) Distribution of comorbidities. (D) Prevalence of patient-reported COVID-19–suspicious symptoms.

FIG 2.

Characteristics of the cancer cohort. (A) Time from diagnosis of malignant disease to SARS-CoV-2 test. (B) Number of performed tests. (C) Number of SARS-CoV-2–positive test results. (D) Number of patients with SARS-CoV-2 infection.

FIG 3.

(A) Age distribution cancer cohort versus control cohort 1 and 2. (B) Portion tested positive and corresponding CIs, cancer cohort versus control cohort 1 and control cohort 2.

FIG A1.

Timeline illustrating the safety measurements and the screening time of the cancer cohort, control cohort 1, and control cohort 2.