TY - JOUR
T1 - Outcomes of COVID-19 in patients with cancer
T2 - A closer look at pre-emptive routine screening strategies
AU - Xie, Zhuoer
AU - Saliba, Antoine N.
AU - Abeykoon, Jithma
AU - Majeed, Umair
AU - Almquist, Daniel R.
AU - Wiedmeier-Nutor, Julia E.
AU - Bezerra, Evandro
AU - Andrade-Gonzalez, Xavier
AU - Hickman, Ashley
AU - Sorenson, Karl
AU - Rakshit, Sagar
AU - Wee, Christopher
AU - Tella, Sri Harsha
AU - Kommalapati, Anuhya
AU - Abdallah, Nadine
AU - Pritchett, Joshua
AU - de Andrade, Mariza
AU - Uprety, Dipesh
AU - Badley, Andrew
AU - Manochakian, Rami
AU - Ailawadhi, Sikander
AU - Bryce, Alan H.
AU - Hubbard, Joleen M.
AU - Gangat, Naseema
AU - Thompson, Carrie A.
AU - Witzig, Thomas E.
AU - McWilliams, Robert R.
AU - Leventakos, Konstantinos
AU - Halfdanarson, Thorvardur R.
N1 - Funding Information:
We acknowledge the University of Iowa/Mayo Clinic Lymphoma SPORE (CA97274) support for this work.
Publisher Copyright:
Copyright © 2021 American Society of Clinical Oncology. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - PURPOSE The benefit of routine pre-emptive screening for severe acute respiratory syndrome coronavirus 2 infections in patients with cancer before cancer-directed therapies is unclear. Herein, we characterize the outcomes of a cohort of patients with cancer who were diagnosed with COVID-19 by routine screening (RS) in comparison with those diagnosed on the basis of clinical suspicion or exposure history (nonroutine screening [NRS]). METHODS A multisite prospective observational study was conducted at three major and five satellite campuses of the Mayo Clinic Cancer Center between March 18 and July 31, 2020. The primary outcome was COVID-19–related hospital admission. Secondary outcomes included intensive care unit admissions and all-cause mortality. RESULTS Five thousand four hundred fifty-two patients underwent RS in the outpatient setting only, and 44 (0.81%) were diagnosed with COVID-19. RS detected 19 additional patients from the scheduled inpatient admissions for surgical or interventional procedures or inpatient chemotherapy. One hundred sixty-one patients were diagnosed with COVID-19 on the basis of NRS. COVID-19–related hospitalization rate (17.5% v 26.7%; P 5 .14), intensive care unit admission (1.6% v 5.6%; P 5 .19), and mortality (4.8% v 3.7%; P 5 .72) were not significantly different between the RS and NRS groups. In the multivariable analysis, age $ 60 years (odds ratio, 4.4; P 5 .023) and an absolute lymphocyte count # 1.4 3 109/L (odds ratio, 9.2; P 5 .002) were independent predictors of COVID-19–related hospital admission. CONCLUSION The COVID-19 positivity rate was low on the basis of RS. Comparing the hospital admission and mortality outcomes with the NRS cohort, there were no significant differences. The value of routine pre-emptive screening of asymptomatic patients with cancer for COVID-19 remains low.
AB - PURPOSE The benefit of routine pre-emptive screening for severe acute respiratory syndrome coronavirus 2 infections in patients with cancer before cancer-directed therapies is unclear. Herein, we characterize the outcomes of a cohort of patients with cancer who were diagnosed with COVID-19 by routine screening (RS) in comparison with those diagnosed on the basis of clinical suspicion or exposure history (nonroutine screening [NRS]). METHODS A multisite prospective observational study was conducted at three major and five satellite campuses of the Mayo Clinic Cancer Center between March 18 and July 31, 2020. The primary outcome was COVID-19–related hospital admission. Secondary outcomes included intensive care unit admissions and all-cause mortality. RESULTS Five thousand four hundred fifty-two patients underwent RS in the outpatient setting only, and 44 (0.81%) were diagnosed with COVID-19. RS detected 19 additional patients from the scheduled inpatient admissions for surgical or interventional procedures or inpatient chemotherapy. One hundred sixty-one patients were diagnosed with COVID-19 on the basis of NRS. COVID-19–related hospitalization rate (17.5% v 26.7%; P 5 .14), intensive care unit admission (1.6% v 5.6%; P 5 .19), and mortality (4.8% v 3.7%; P 5 .72) were not significantly different between the RS and NRS groups. In the multivariable analysis, age $ 60 years (odds ratio, 4.4; P 5 .023) and an absolute lymphocyte count # 1.4 3 109/L (odds ratio, 9.2; P 5 .002) were independent predictors of COVID-19–related hospital admission. CONCLUSION The COVID-19 positivity rate was low on the basis of RS. Comparing the hospital admission and mortality outcomes with the NRS cohort, there were no significant differences. The value of routine pre-emptive screening of asymptomatic patients with cancer for COVID-19 remains low.
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U2 - 10.1200/OP.21.00177
DO - 10.1200/OP.21.00177
M3 - Article
C2 - 34125579
AN - SCOPUS:85115437550
SN - 2688-1527
VL - 17
SP - E1382-E1393
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 9
ER -