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ASH 2020: Environmental Surface Testing for Presence of SARS-CoV-2 in Inpatient and Outpatient Hematology/Oncology Settings


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A research team from Rutgers Cancer Institute of New Jersey evaluated the presence of SARS-CoV-2 on various environmental surfaces in outpatient and inpatient hematology/oncology settings. The study revealed extremely low detection of SARS-CoV-2 on environmental surfaces across multiple outpatient and inpatient oncology areas, including an active COVID-19 floor. These findings were presented by Shah et al at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 2478).

Evidence suggests that mortality due to COVID-19 is higher in patients with cancer due to frequent visits to health-care settings. While COVID-19 is transmitted person-to-person through respiratory droplets, it has been hypothesized that there is a potential risk of SARS-CoV-2 spreading via contact with contaminated surfaces and equipment, especially in health-care settings, creating additional concern for patients with blood cancers.

Andrew M. Evens, DO, MMSc, FACP

Andrew M. Evens, DO, MMSc, FACP

“Compared with other [patients with] cancer, those with hematologic cancers have demonstrated a potential higher mortality in conjunction with SARS-CoV-2 infection, so further understanding about COVID-19 transmission in high-impact areas where these patients receive their care is needed,” noted senior author Andrew M. Evens, DO, MMSc, FACP. “Our findings suggest that contamination by SARS-CoV-2 on surfaces and equipment in hematology/oncology areas is extremely low, demonstrating that enhanced safety policies are effective and patients with blood cancers frequenting these areas should have minimal concerns.”

Study Findings

Environmental swabbing took place in two outpatient clinics, including the malignant hematology and medical oncology units and infusion suites, as well as inpatient areas, which included the leukemia/lymphoma/chimeric antigen receptor (CAR) T-cell therapy unit, and an inpatient unit caring for patients actively infected with COVID-19. Surfaces were sampled on Mondays, Wednesdays, and Fridays from June 17 through June 29, 2020.

Areas included waiting rooms, infusion areas, bathrooms, floors, elevator banks, doors, and exam rooms, computer equipment, pneumatic tubing stations, pharmacy benches, and medication rooms. Medical equipment was also swabbed from these areas, including intravenous poles, chemotherapy bags, vital monitors, telemetry stations, and linen carts.

KEY POINTS

  • In the two outpatient clinics and inpatient leukemia/lymphoma/CAR T-cell unit, no SARS-CoV-2 was detected on any swabbed surfaces.
  • In the inpatient COVID unit, one patient/public sample was positive for detection of SARS-CoV-2 in an area where a patient with recent infection was receiving treatment.
  • The overall positive test rate for SARS-CoV-2 across all surfaces in the combined outpatient and inpatient hematology/oncology units was 0.5%.

Analysis of the 130 samples collected were separated into three categories: patient/public areas (n = 85), staff areas (n = 22), and medical equipment (n = 23). In the two outpatient clinics and inpatient leukemia/lymphoma/CAR T-cell unit, no SARS-CoV-2 was detected on any swabbed surfaces. In the inpatient COVID unit, one patient/public sample was positive for detection of SARS-CoV-2 in an area where a patient with recent infection was receiving treatment. The overall positive test rate for SARS-CoV-2 across all surfaces in the combined outpatient and inpatient hematology/oncology units was 0.5%.

The authors noted the study’s limitations, including the inability to analyze the complete surface area of the varied locations, which may have reduced sensitivity. In addition, researchers did not attempt to culture SARS-CoV-2 from the one positive sample; it is unknown if it contained live virus.

Continued studies are needed to monitor rates of virus transmission and the environmental factors involved in the propagation of the SARS-CoV-2 infection.

Disclosure: This work was supported in part by a National Cancer Institute Cancer Center Support Grant. For full disclosures of the study authors, visit ash.confex.com.

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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