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SARS-CoV-2 Infection Among Patients in Italy Undergoing Active Cancer Treatment


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In a retrospective study reported as a research letter in JAMA Oncology, Aschele et al found that the incidence of SARS-CoV-2 infection was 0.68% among a large population of patients receiving anticancer treatment in Italy over an approximately 3.5-month period in 2020.

Study Details

The study included data from patients with cancer treated at 118 medical oncology units affiliated with the Collegio Italiano dei Primari Oncologi Medici Ospedalieri. Aggregate data were collected for each center on all patients who received at least one course of an active anticancer treatment between January 15 and May 4, 2020. SARS-CoV-2 infection was diagnosed based on positive nasopharyngeal polymerase chain reaction testing.

"From a clinical point of view, the low probability of SARS-CoV-2 infection among these patients (< 1%) supports the continuation of most oncologic treatments in the adjuvant and metastatic setting. Based on the present data, delaying active antitumor treatment to avoid SARS-CoV-2 transmission should not be routinely recommended."
— Aschele et al

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Key Findings

A total of 59,989 patients received antitumor treatment between January 15, 2020, and May 4, 2020. Of these, 406 (0.68%, 95% confidence interval [CI] = 0.61%–0.75%) were found to have been infected with SARS-CoV-2.

Infected patients had a median age of 68 years (range = 28–89 years). Infection was symptomatic in 339 patients (83%), and 314 (77%) required hospitalization.

Among patients infected with the virus, the most common tumor types were lung cancer (22%), breast cancer (18.5%), and upper gastrointestinal cancers (10.3%); 62% were receiving chemotherapy (with or without biologics), 18.2% were receiving targeted therapy, and 10.1% were receiving immunotherapy.

The incidence of infection during the study period was higher in the population of patients with cancer than in the general Italian population (0.68% vs 0.39%, relative risk [RR] = 1.42, 95% CI = 1.29–1.56). By region, incidence rates were 0.96% vs 0.68% (RR = 1.40, 95% CI = 1.26–1.55) in Northern Italy, 0.32% vs 0.22% (RR = 1.47, 95% CI = 1.0–2.04) in Central Italy, and 0.13% vs 0.08% (RR = 1.65, 95% CI = 0.94–2.68) in Southern Italy/Islands.

The investigators concluded, “To our knowledge, this study provides the first estimate of the rate of SARS-CoV-2 infection among patients receiving antitumor treatment on a large population of approximately 60,000 patients treated at more than 110 oncology units. From a clinical point of view, the low probability of SARS-CoV-2 infection among these patients (< 1%) supports the continuation of most oncologic treatments in the adjuvant and metastatic setting. Based on the present data, delaying active antitumor treatment to avoid SARS-CoV-2 transmission should not be routinely recommended.”

Carlo Aschele, MD, PhD, of the Department of Oncology, Ospedale Sant'Andrea, La Spezia, is the corresponding author for the JAMA Oncology article.

Disclosure: For full disclosures of the study authors, visit jamanetwork.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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