Abstract
At the time of the first wave of the COVID-19 pandemic, patients with cancer were considered to be at high risk of serious illness and had a higher exposure risk since they needed frequent and nondeferrable hospital visits. Serological tests were not routinely used, and seroprevalence in this population was unknown.A single-center, cross-sectional study was developed to determine the seroprevalence of anti-SARS-CoV-2 antibodies (Abs) in patients with cancer undergoing systemic antineoplastic treatment. One hundred patients were consecutively recruited in a two-week period (6th-20th May 2020), and serum samples were tested for the presence of immunoglobulin M (IgM) and immunoglobulin G (IgG) Abs directed against both spike (S) and nucleocapsid (N) SARS-CoV-2 proteins in two distinct time points (at recruitment and 4-8 weeks later). IgG-positive results were subject to confirmation, in the same serum sample, using two distinct assays.At the time of the first study visit, no patient had a previously confirmed diagnosis of COVID-19, one reported previous contact with a COVID-19 patient, and all had a baseline SARS-CoV-2-negative RT-PCR. Two patients tested positive for SARS-CoV-2 IgG in the first study visit, which was not confirmed in either of the two confirmatory assays. Seventy-two patients were tested at the second study visit, all with negative IgG tests. IgM was persistently positive at both study visits in one patient and was positive in another patient at the second study visit, both with negative RT-PCR and serum IgG. No patient tested positive for RT-PCR within the study timeframe.No evidence of prior or acute SARS-CoV-2 infection was documented in this cohort of patients with cancer undergoing systemic treatment, and no additional exposure risk was documented compared to general population seroprevalence studies. The study was inconclusive regarding the role of SARS-CoV-2 serology in patients with cancer in the early phase of the pandemic. This study did show that, with adherence to recommended preventive measures, it was safe to maintain systemic cancer therapy.
Highlights
The majority of patients with COVID-19 develop antibodies (Abs) against SARS-CoV-2 [1]
One hundred patients were consecutively recruited in a two-week period (6th-20th May 2020), and serum samples were tested for the presence of immunoglobulin M (IgM) and immunoglobulin G (IgG) Abs directed against both spike (S) and nucleocapsid (N) SARS-CoV-2 proteins in two distinct time points
While the gold standard for acute COVID-19 diagnosis remains the detection of SARS-CoV-2 virus in respiratory tract swab specimens by RT-PCR [2], serological tests detecting Abs, immunoglobulin G (IgG), and immunoglobulin M (IgM) may identify patients who have been infected in the past, including prior asymptomatic infections, and can be used to measure herd immunity to the disease [3]
Summary
The majority of patients with COVID-19 develop antibodies (Abs) against SARS-CoV-2 [1]. While the gold standard for acute COVID-19 diagnosis remains the detection of SARS-CoV-2 virus in respiratory tract swab specimens by RT-PCR [2], serological tests detecting Abs, immunoglobulin G (IgG), and immunoglobulin M (IgM) may identify patients who have been infected in the past, including prior asymptomatic infections, and can be used to measure herd immunity to the disease [3]. Since April 2020, the Portuguese National Health Authority recommendations determined that molecular nucleic acid amplification tests for SARS-CoV-2 detection in upper respiratory tract swab specimens should be performed prior to each treatment cycle in patients with cancer undergoing chemotherapy, even in asymptomatic patients [6]. How to cite this article Fernandes G, Paixão P, Brum L, et al (February 21, 2022) SARS-CoV-2 Antibody Seroprevalence in Patients With Cancer on Systemic Antineoplastic Treatment in the First Wave of the COVID-19 Pandemic in Portugal.
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