Outcomes of COVID-19 in Patients With Cancer: A Closer Look at Pre-Emptive Routine Screening Strategies
Autor: | Carrie A. Thompson, Andrew D. Badley, Christopher E. Wee, Thomas E. Witzig, Anuhya Kommalapati, Antoine N. Saliba, Julia E Wiedmeier-Nutor, Jithma P. Abeykoon, Nadine Abdallah, Zhuoer Xie, Sri Harsha Tella, Joshua C. Pritchett, Robert R. McWilliams, Daniel R. Almquist, Sagar Rakshit, Xavier Andrade-Gonzalez, Ashley Hickman, Naseema Gangat, Dipesh Uprety, Umair Majeed, Mariza de Andrade, Konstantinos Leventakos, Karl Sorenson, Rami Manochakian, Thorvardur R. Halfdanarson, Joleen M. Hubbard, Evandro D. Bezerra, Alan H. Bryce, Sikander Ailawadhi |
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Rok vydání: | 2021 |
Předmět: |
2019-20 coronavirus outbreak
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) MEDLINE QUALITY IN ACTION 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Humans In patient 030212 general & internal medicine Intensive care medicine Early Detection of Cancer Routine screening Oncology (nursing) business.industry SARS-CoV-2 Health Policy Cancer COVID-19 Middle Aged medicine.disease Hospitalization Intensive Care Units Oncology 030220 oncology & carcinogenesis business |
Zdroj: | JCO Oncol Pract |
ISSN: | 2688-1535 |
Popis: | 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 = .14), intensive care unit admission (1.6% v 5.6%; P = .19), and mortality (4.8% v 3.7%; P = .72) were not significantly different between the RS and NRS groups. In the multivariable analysis, age ≥ 60 years (odds ratio, 4.4; P = .023) and an absolute lymphocyte count ≤ 1.4 × 109/L (odds ratio, 9.2; P = .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. |
Databáze: | OpenAIRE |
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