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

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.

A year of experience with COVID‐19 in patients with cancer: A nationwide study

“…[15][16][17] In addition, it was previously shown that in patients with cancer, the presence of other comorbidities and older ages significantly changes the rate of RT-PCR positivity, and these subgroups may benefit from routine COVID-19 testing. 18 On the other hand, studies have confirmed the high possibility of asymptomatic disease in patients with cancer who were diagnosed with serologic tests lacking a confirmed COVID-19 history. 19,20 Given that healthcare resources are limited, understanding the mortality and severity risk factors of the patients who can be at increased risk for COVID-19 prepares us for potential future attacks of infectious diseases and help us to manage cancer patients better.…”

“…In addition, it was previously shown that in patients with cancer, the presence of other comorbidities and older ages significantly changes the rate of RT‐PCR positivity, and these subgroups may benefit from routine COVID‐19 testing. 18 On the other hand, studies have confirmed the high possibility of asymptomatic disease in patients with cancer who were diagnosed with serologic tests lacking a confirmed COVID‐19 history. 19 , 20 …”

Antigen rapid diagnostic test monitoring for SARS‐CoV‐2 in asymptomatic and fully vaccinated cancer patients: Is it cost‐effective?

“…A previous study which tested 537 cancer patients with no COVID‐19 symptoms confirmed a low rate of SARS‐CoV‐2 test positivity (0.64%) as well as a low rate of infection‐related complications in the same group 23 . Another study compared 150 cancer patients versus 920 non‐cancer patients who had undergone routine test for SARS‐CoV‐2, showing that the cohort of patients with cancer has a lower probability of having a positive test than the control population, leading to the conclusion that routinely screening all cancer patients for SARS‐CoV‐2 may not be worth doing 24 . The opportunity of continuing cancer treatment despite SARS‐CoV‐2 infection in cancer patients with no COVID‐19‐related symptoms also remains controversial.…”

“…23 Another study compared 150 cancer patients versus 920 non-cancer patients who had undergone routine test for SARS-CoV-2, showing that the cohort of patients with cancer has a lower probability of having a positive test than the control population, leading to the conclusion that routinely screening all cancer patients for SARS-CoV-2 may not be worth doing. 24 The opportunity of continuing cancer treatment despite SARS-CoV-2 infection in cancer patients with no COVID-19-related symptoms also remains controversial. Results from a German study in which 1227 cancer patients were tested showed that 14 out of 75 asymptomatic SARS-CoV-2 positive received chemotherapy, with none of these presenting complications from infection.…”

Safety and Immunogenicity of Inactivated and Recombinant Protein SARS-CoV-2 Vaccines in Patients With Thyroid Cancer

“…Taghizadeh-Hesary et al found that COVID-19 patients with cancer history had a higher rate of mechanical ventilation and mortality than non-cancer history patients (13). A previous study reported that routine COVID-19 testing may be necessary for cancer patients with comorbidities or older age but may not benefit for most cancer patients (14). A multicenter, prospective observational study in Iran analyzed the seroprevalence of the SARS-CoV-2 IgG antibody in a cancer population referred for vaccination, which indicated that almost 20% of cancer patients may suffer from an asymptomatic disease only in serological assessment, and seropositivity was significantly greater in women consistent with higher rates in breast cancer and gynecologic cancers patients.…”