ABSTRACT
Background: cancer have been reported to experience severe complications and poor outcomes to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)-related disease (COVID-19). Anti-SARS-CoV-2 immunoglobulin-G (IgG) can be detected within three weeks after infection. However, scant information is available on the seroconversion rates of patients with cancer and COVID-19. Material: This is a multicenter, observational, prospective study that enrolled patients and oncology health professionals with SARS-CoV-2 infection confirmed by RT-PCR assay, patients and oncology health professionals with clinical or radiological suspicious of infection by SARS-CoV-2, and patients with cancer who are considered at high risk for infection. All subjects were tested with the 2019-nCoV IgG/IgM Rapid Test Cassett, which is a qualitative membrane-based immunoassay for the detection of IgG and IgM antibodies to SARS-CoV-2. The aim of the study was to evaluate anti-SARS-CoV-2 seroconversion rate in patients with cancer and healthcare professionals with confirmed or clinically suspected COVID-19. Results: Between March 30 and May 11, 2020, 166 subjects were enrolled in the study. Cancer patients and health workers were 61 (36.7%) and 105 (63.3%), respectively. Seventyfour subjects (44.6%) had confirmed SARS-CoV-2 diagnosis by RT-PCR testing on nasopharyngeal swab specimen, while 49 (29.5%) had a clinical suspicious of COVID-19 in absence of RT-PCR confirmation. Median time between symptom onset/ RT-PCR confirmation to serum antibody test was 17 days (IQR, 26). Considering the population with confirmation by RT-PCR, 83.8% was IgG positive. Neither differences in terms of IgG positivity rate nor in median time from SARS-CoV-2 diagnosis to IgG detection were observed between cancer patients and health workers (87.9% vs 80.5%;P=0.39;23.0 vs 28.0 days;P=0.21). Conclusions: Our data indicate that SARS-CoV-2-specific IgG antibody detection does not differ between cancer patients and healthy subjects. Fast test for antibody detection can be complementary to RNA RT-PCR testing for the diagnosis of COVID-19 in this vulnerable patient population.
ABSTRACT
BACKGROUND: Patients with cancer have high risk for severe complications and poor outcome to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease [coronavirus disease 2019 (COVID-19)]. Almost all subjects with COVID-19 develop anti-SARS-CoV-2 immunoglobulin G (IgG) within 3 weeks after infection. No data are available on the seroconversion rates of cancer patients and COVID-19. PATIENTS AND METHODS: We conducted a multicenter, observational, prospective study that enrolled (i) patients and oncology health professionals with SARS-CoV-2 infection confirmed by real-time RT-PCR assays on nasal/pharyngeal swab specimens; (ii) patients and oncology health professionals with clinical or radiological suspicious of infection by SARS-CoV-2; and (iii) patients with cancer who are considered at high risk for infection and eligible for active therapy and/or major surgery. All enrolled subjects were tested with the 2019-nCoV IgG/IgM Rapid Test Cassette, which is a qualitative membrane-based immunoassay for the detection of IgG and IgM antibodies to SARS-CoV-2. The aim of the study was to evaluate anti-SARS-CoV-2 seroconversion rate in patients with cancer and oncology health care professionals with confirmed or clinically suspected COVID-19. RESULTS: From 30 March 2020 to 11 May 2020, 166 subjects were enrolled in the study. Among them, cancer patients and health workers were 61 (36.7%) and 105 (63.3%), respectively. Overall, 86 subjects (51.8%) had confirmed SARS-CoV-2 diagnosis by RT-PCR testing on nasopharyngeal swab specimen, and 60 (36.2%) had a clinical suspicious of COVID-19. Median time from symptom onset (for cases not confirmed by RT-PCR) or RT-PCR confirmation to serum antibody test was 17 days (interquartile range 26). In the population with confirmed RT-PCR, 83.8% of cases were IgG positive. No difference in IgG positivity was observed between cancer patients and health workers (87.9% versus 80.5%; P = 0.39). CONCLUSIONS: Our data indicate that SARS-CoV-2-specific IgG antibody detection do not differ between cancer patients and healthy subjects.
Subject(s)
COVID-19 , Neoplasms , Antibodies, Viral , Health Personnel , Humans , Immunoglobulin M , Neoplasms/epidemiology , Prospective Studies , SARS-CoV-2 , Sensitivity and Specificity , SeroconversionABSTRACT
Background: Poor outcomes for patients with cancer and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19) have been reported so far. Although anti-SARS-CoV-2 IgG response is usually detectable within three weeks after infection, limited information on the seroconversion rate of patients with cancer infected by SARS-CoV-2 is available. Methods: This is a multicenter, observational, prospective study that included patients and oncology healthcare workers (HCWs) with SARS-CoV-2 infection confirmed by RT-PCR or clinical/radiological suspicious of infection as well as patients with cancer who are considered at high risk for infection. All subjects were tested with the 2019-nCoV IgG/IgM Rapid Test Cassett for the fast detection of IgG and IgM antibodies against SARS-CoV-2. The aim of the study was to evaluate anti-SARS-CoV-2 seroconversion rates by qualitative assay in patients with cancer and HCWs with confirmed or clinically suspected COVID-19. Results: At first interim analysis, 166 subjects were enrolled in the study. Cancer patients and HCWs were 61 (36.7%) and 105 (63.3%), respectively. HCWs were younger than patients with cancer (median age 41 vs 62 years;P<0.001). Eighty-six subjects (51.8%) had confirmed SARS-CoV-2 diagnosis by RT-PCR testing on nasopharyngeal swab specimen, while forty-nine (29.5%) had a clinical suspicious of COVID-19 in absence of RT-PCR confirmation. In patients with RT-PCR-confirmed SARS-CoV-2 infection, 62 (83.8%) were IgG-positive. Neither differences in terms of IgG positivity (87.9% vs 80.5%;P=0.39) nor in median time from COVID-19 diagnosis to IgG detection (23.0 vs 28.0 days;P=0.21) were found between patients with cancer and HCWs. Conclusions: Our data show that SARS-CoV-2-specific IgG antibody response is not different between cancer patients and healthy subjects. Qualitative rapid test for antibody detection represents an useful support to RNA RT-PCR testing for the diagnosis of COVID-19 in high-risk populations, including patients with cancer. Legal entity responsible for the study: Istituto Europeo di Oncologia IRCCS. Funding: This work was partially supported by the Italian Ministry of Health with Ricerca Corrente and 5x1000 funds. MEDnoTE srl (Spin-off of University of Trieste) supported the present study by providing the rapid test used for anti-SARS-CoV-2 antibody detection. Disclosure: D.G. Generali: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Novartis, Pfizer, Lilly. G. Curigliano: Speaker Bureau/Expert testimony: MSD;Advisory/Consultancy: Mylan, Daichii Sankyo;Advisory/Consultancy, Speaker Bureau/Expert testimony: Lilly, Pfizer, Merck, Foundation Medicine, Samsung, Celltrion;Advisory/Consultancy, Speaker Bureau/Expert testimony: Seattle Genetics, Nanostring;Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche;Speaker Bureau/Expert testimony: Novartis, BMS;Honoraria (self): Ellipsis. All other authors have declared no conflicts of interest.