The SARS-COV-2 Seroprevalence among Oncology Patients

Abstract

Patients with cancer are presumed to be vulnerable to an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe clinical outcomes due to the immunocompromised state mediated by their underlying malignancies and therapy. The aim of this study was to estimate the SARS-CoV-2 seroprevalence, following second to fourth waves in solid tumour patients attending the Steve Biko Academic Hospital (SBAH) for diagnosis and treatment of cancer. We used the single-prick COVID-19 IgG/IgM Rapid Test Cassettes to detect SARS-CoV-2 IgG/IgM antibodies in 760 patients with solid tumours who were asymptomatic and who had never tested positive for coronavirus disease 2019 (COVID-19). Out of the 760 patients, 277 were male (36.4%), 483 were female (63.6%), and the mean age was 55 years (range 18−92). The estimated total seroprevalence was 33.2%. The seroprevalence status of the COVID-19 IgG/IgM antibodies rose significantly from the second wave (11.3%) to the third (67.38%) and then the fourth (69.81%) waves with roughly similar counts. A significant number of the seropositive patients were asymptomatic to COVID-19 (96%). There was a higher rate of seropositivity in cancer patients with hypertension (p < 0.05). Patients with breast, gynaecologic, and prostate cancers exhibited increased SARS-CoV-2 seropositivity. Although oncology patients may be susceptible to SARS-CoV-2 infection, our data indicate that these patients remained asymptomatic throughout various waves with an overall COVID-19 IgG/IgM antibody seropositivity of 33.16%, suggesting no risk of severe or fatal cases of COVID-19.

Keywords: COVID-19; IgG/IgM antibodies; SARS-CoV-2; South Africa; cancer.

Figure 1

Study profile.

Figure 2

(A) The COVID-19 IgG/IgM seroprevalence percentage of cancer patients per wave represented with grey colours. The positive seroprevalence of COVID-19 IgG/IgM antibodies rises with waves. (B) The total number of COVID-19 cumulative cases per waves reported nationally and in Gauteng Province.

Figure 3

The vaccination percentage per wave. A comparison of vaccination percentage in the South African population, Gauteng Province, and our cancer patient’s data represented in blue, orange, and grey colours, respectively. Vaccination percentage is seen to be increased with waves. Our test is specific for detecting SARS-CoV-2 anti-nucleocapsid than anti-spike antibodies associated with vaccines.