Abstract
BackgroundCoronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is a current pandemic. We initiated a program of systematic SARS-CoV-2 polymerase chain reaction (PCR) testing in all asymptomatic patients receiving radiotherapy (RT) at a large radiation oncology network in the Charlotte, NC metropolitan region and report adherence and results of the testing program.MethodsPatients undergoing simulation for RT between May 18, 2020 and July 10, 2020 within the Levine Cancer Institute radiation oncology network who were asymptomatic for COVID-19 associated symptoms, without previous positive SARS-CoV-2 testing, and without recent high-risk contacts were included. PCR testing was performed on nasal cavity or nasopharyngeal swab samples. Testing was performed within 2 weeks of RT start (pre-RT) and at least every 4 weeks during RT for patients with prolonged RT courses (intra-RT). An automated task based process using the oncology electronic medical record (EMR) was developed specifically for this purpose.ResultsA total of 604 unique patients were included in the cohort. Details on testing workflow and implementation are described herein. Pre-RT PCR testing was performed in 573 (94.9%) patients, of which 4 (0.7%) were positive. The adherence rate to intra-RT testing overall was 91.6%. Four additional patients (0.7%) tested positive during their RT course, of whom 3 were tested due to symptom development and 1 was asymptomatic and identified via systematic testing. A total of 8 (1.3%) patients tested positive overall. There were no known cases of SARS-CoV-2 transmission from infected patients to clinic staff and/or other patients.ConclusionsWe detailed the workflows used to implement systematic SARS-CoV-2 for asymptomatic patients at a large radiation oncology network. Adherence rates for pre-RT and intra-RT testing were high using this process. This information allowed for appropriate delay in initiating RT, minimizing the occurrence of RT treatment interruptions, and no known cases of transmission from infected patients to clinic staff and/or other patients.
Highlights
Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is a current pandemic
The Levine Cancer Institute (LCI) of Atrium Health initiated a comprehensive program for care of patients with cancer during the COVID19 pandemic, which included social distancing initiatives, telephone and in-person screening of patients for symptoms and temperature, visitor restrictions, expanded use of telemedicine care, systematic use of personal protection equipment (PPE) by both staff and patients, alternating staff schedules, and triaging care based on severity of the cancer condition [5]
As part of this approach, we initiated a program of systematic SARS-CoV-2 polymerase chain reaction (PCR) testing in all asymptomatic patients receiving radiotherapy (RT) at a large multicenter radiation oncology network in the Charlotte, North Carolina (NC) metropolitan region
Summary
Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is a current pandemic. The Levine Cancer Institute (LCI) of Atrium Health initiated a comprehensive program for care of patients with cancer during the COVID19 pandemic, which included social distancing initiatives, telephone and in-person screening of patients for symptoms and temperature, visitor restrictions, expanded use of telemedicine care, systematic use of personal protection equipment (PPE) by both staff and patients, alternating staff schedules, and triaging care based on severity of the cancer condition [5] As part of this approach, we initiated a program of systematic SARS-CoV-2 polymerase chain reaction (PCR) testing in all asymptomatic patients receiving radiotherapy (RT) at a large multicenter radiation oncology network in the Charlotte, NC metropolitan region. We detail the processes and workflows used to implement systematic pre-radiotherapy (pre-RT) and intra-radiotherapy (intra-RT) SARS-CoV-2 PCR testing of asymptomatic patients receiving RT in a large regional radiation oncology network as well report the results and adherence to the testing program
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