Abstract
Since its first detection in China in late 2019 the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious disease COVID-19 continue to have a major impact on global healthcare and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.
Highlights
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a betacoronavirus first described in China in late 2019 as the causative agent of a coronavirus disease (COVID-19) [1,2]
For diagnosis of SARS-CoV-2 infection, the AGIHO guideline panel categorised the following clinical situations: a) asymptomatic cancer patients scheduled for antineoplastic treatment in whom delay is likely to increase risk of death, b) asymptomatic cancer patients scheduled for antineoplastic treatment in whom delay is unlikely to increase risk of death, and c) cancer patients presenting with respiratory symptoms compatible with COVID-19
Cancer patients are especially vulnerable to SARS-CoV2 infection and severe COVID-19 disease
Summary
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a betacoronavirus first described in China in late 2019 as the causative agent of a coronavirus disease (COVID-19) [1,2]. In case of viral pneumonia, rapidly progressing impairment of oxygenation and life-threatening respiratory failure may occur [4]. Cancer patients on active therapy, e.g. those receiving intravenous chemotherapy, may require more frequent interactions with healthcare providers than the general population, potentially increasing the opportunity of exposure to SARS-CoV-2. This guideline aims to help clinicians make informed decisions with regard to prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as devising strategies towards safe antineoplastic care during the current pandemic. These recommendations apply to adult patients with solid tumours or haematological malignancies. For specific considerations regarding stem cell transplantation, we kindly refer to the current guidelines by the European Society for Blood and Marrow Transplantation [22]
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