Comprehensive Screening for COVID-19 at St. Petersburg Oncology Centre

Background. Clinical reports on the coronavirus disease 2019 (COVID-19) suggest its higher incidence and worse outcomes in cancer patients. Considering a rapid pace of the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) pandemic, more data on the risk of contagion and syndrome course is required with this patient group.

Aim. Estimation of the infection rate in cancer patients managed at the Oncology Centre.

Materials and methods. This retrospective study included cancer patients managed at the Oncology Centre between 9 April 2020 and 27 May 2020 and routinely tested for SARS-CoV-2 in polymerase chain reaction (PCR) assays and/or COVID-19 in chest computed tomography (CT).

Results and discussion. A total of 2,628 patients were included in the study, with 119 (4.5 %) confirmed to have COVID-19; 45/119 were PCR-positive, 95/119 had viral pneumonia in CT, 21/119 were positive for both tests. A total of 47.9 % cases were asymptomatic, 11.8 % revealed a mild single-symptom disease. COVID-19 ended in death in 2 (2.5 %) of 80 cases with a known outcome. In PCR results of both patient and staff screening, the virus detection rate was 3.0 % and 2.4 %, respectively (p = 0.33).

Conclusion. A COVID-19 screening revealed no significant difference in the risk of contagion between cancer patients and staff of the Oncology Centre. PCR tests may perform false negative for COVID-19 in cancer patients and should be coupled with CT scanning. The infection is asymptomatic or clinically mild in most other cases.

1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. DOI: 10.1056/NEJMoa2002032

2. WHO Director-General’s opening remarks at the media briefing on COVID-19 — 11 March 2020. [cited 2021 Feb 13]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

3. Docherty A.B., Harrison E.M., Green C.A., Hardwick H.E., Pius R., Norman L., et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369:m1985. DOI: 10.1136/bmj.m1985

4. Li X., Xu S., Yu M., Wang K., Tao Y., Zhou Y., et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110–8. DOI: 10.1016/j.jaci.2020.04.006

5. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–62. DOI: 10.1016/S0140-6736(20)30566-3

6. Hijano D.R., Maron G., Hayden R.T. Respiratory viral infections in patients with cancer or undergoing hematopoietic cell transplant. Front Microbiol. 2018;9:3097. DOI: 10.3389/fmicb.2018.03097

7. von Lilienfeld-Toal M., Berger A., Christopeit M., Hentrich M., Heussel C.P., Kalkreuth J., et al. Community acquired respiratory virus infections in cancer patients—guideline on diagnosis and management by the Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology. Eur J Cancer. 2016;67:200–12. DOI: 10.1016/j.ejca.2016.08.015

8. von Lilienfeld-Toal M., Vehreschild J.J., Cornely O., Pagano L., Compagno F., Hirsch H.H., et al. Frequently asked questions regarding SARS-CoV-2 in cancer patients—recommendations for clinicians caring for patients with malignant diseases. Leukemia. 2020;34(6):1487–94. DOI: 10.1038/s41375-020-0832-y

9. Hicks K.L., Chemaly R.F., Kontoyiannis D.P. Common community respiratory viruses in patients with cancer. Cancer. 2003;97(10):2576–87. DOI: 10.1002/cncr.11353

10. Oh W.K. COVID-19 infection in cancer patients: early observations and unanswered questions. Ann Oncol. 2020;31(7):838–9. DOI: 10.1016/j.annonc.2020.03.297

11. Sinitsyn V.E., Tyurin I.E., Mitkov V.V. Consensus Guidelines of Russian Society of Radiology (RSR) and Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM) “Role of imaging

12. (X-ray, CT and US) in diagnosis of COVID-19 pneumonia” (version 2). Journal of radiology and nuclear medicine. 2020;101(2):72–89 (In Russ.). DOI: 10.20862/0042-4676-2020-101-2-72-89

13. Zhang L., Zhu F., Xie L., Wang C., Wang J., Chen R., et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894–901. DOI: 10.1016/j.annonc.2020.03.296

14. Ferlay J., Ervik M., Lam F., Colombet M., Mery L., Pineros M., et al. Global cancer observatory: cancer today. Lyon: International Agency for Research on Cancer; 2018.

15. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–42. DOI: 10.1001/jama.2020.2648

16. Miyashita H., Mikami T., Chopra N., Yamada T., Chernyavsky S., Rizk D., et al. Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City. Ann Oncol. 2020;31(8):1088–9. DOI: 10.1016/j.annonc.2020.04.006

17. Reports of the Communication Center of the Government of the Russian Federation on the situation with the coronavirus [cited 2020 July 08]. Available from: http://stopcoronovirus.ru/info/ofdoc/reports/ (assessed: 08.07.2020) (In Russ.).