Routine COVID-19 testing may not be necessary for most cancer patients

Ali Motlagh,Reza Malekzadeh,Fatemeh Elmi,Afshin Ostovar,Marzeyeh Soleymani Nejad,Mehrdad Azmin,Asmus Hammerich,Farzaneh Moshiri,Nadia Tavakoli,Maisa Yamrali,Maryam Aghajanizadeh,Christoph Hamelmann,Nasim Pourghazian,Alireza Raeisi,Mansour Ranjbar,Ahmad Mafi,Payam Azadeh,Slim Slama

doi:10.1038/s41598-021-02692-3

Abstract

Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15–0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.

Highlights

Cancer patients are at risk for severe complications or death from COVID-19 infection
One of the first reports describing the characteristics of COVID-19 infection in cancer patients reviewed 1524 cancer patients and found 12 patients infected with SARS-CoV-2, only 5 of them receiving treatment at the time of contracting the infection
Regular hospital visits increase their interaction with infected p atients[11], and as a result, the percentage of coronavirus tests that come back positive is expected to be higher in the cancer population compared to the public, urging physicians to modify their strategies for cancer treatment[17]

Summary

Introduction

Cancer patients are at risk for severe complications or death from COVID-19 infection. There may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. These results could not be subjected to multivariate analysis. One of the first reports describing the characteristics of COVID-19 infection in cancer patients reviewed 1524 cancer patients and found 12 patients infected with SARS-CoV-2, only 5 of them receiving treatment at the time of contracting the infection. In this study severe complications happened in 53.6% (15 patients) and the mortality rate was 28.6% They reported that receiving anti-tumor treatment within 14 days of COVID-19 diagnosis was associated with an increased risk of developing severe e vents[7]

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