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


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In an Austrian study reported in the Journal of Clinical Oncology, Berghoff et al found that 0.4% of consecutive patients with cancer treated at Medical University of Vienna tested positive for SARS-CoV-2 between March 21 and May 4, 2020, after implementation of institutional and governmental safety measures.

Study Details

The study involved testing of 1,016 consecutive patients with cancer at the division of oncology between March 21 and May 4, 2020. Measures to prevent the spread of SARS-CoV-2 in Austria were implemented starting March 16 by the Austrian government. To prevent transmission within the Medical University of Vienna, some measures were established as early as March 5.

The prevalence of SARS-CoV-2 infection in patients with cancer treated at the institution was compared with that in an Austrian general population cohort determined by a representative nationwide random sample study over the period April 1–6, 2020. The investigators also compared prevalence of the infection in those with cancer vs that in a cohort of all patients without cancer consecutively presenting at the entrance of the institution who were not hospitalized due to safety reasons, nonurgent medical procedures, or according to treating physician recommendation between March 21 and May 4, 2020.

Findings

KEY POINTS

  • The prevalence of SARS-CoV-2 in patients with cancer was similar to the general population and lower than in patients without cancer.
  • Routine SARS-CoV-2 testing of patients is recommended to detect asymptomatic carriers and prevent uncontrolled viral spread.

Among the 1,016 patients with cancer, 270 (26.6%) were undergoing active cancer treatment in a neoadjuvant/adjuvant setting and 560 (55.1%) in a palliative setting. A total of 904 patients (88.0%) were treated in the outpatient department, and 112 (11.0%) received treatment during hospitalization.

A total of 53 patients (5.2%) self-reported symptoms associated with COVID-19. A total of four patients (0.4%) tested positive for SARS-CoV-2. At the time of testing, all four were asymptomatic and two had recovered from symptomatic infection. Viral clearance occurred in three patients at 14 to 56 days after the positive test. The remaining patient had not achieved clearance after > 28 days at last observation.

In the general population cohort, 6 (0.4%) of 1,544 individuals tested positive. The odds ratio (OR) for positive testing for the cancer cohort vs the general population cohort was 1.01 (95% confidence interval [CI] = 0.21–4.27). In the cohort of patients without cancer presenting to the institution, there were 20 positive cases (6.8%) among 296 tested, yielding an OR vs the cancer cohort of 18.33 (95% CI = 6.06-74.16).

The investigators concluded: “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.”

Matthias Preusser, MD, of the Division of Oncology, Medical University of Vienna, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was supported by Future Operations Clearing Board, Institute for Social Research and Consulting, and The Austrian Social Science Data Archive. For full disclosures of the study authors, visit ascopubs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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