Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
Add filters

Document Type
Year range
1.
Open forum infectious diseases ; 8(Suppl 1):S496-S497, 2021.
Article in English | EuropePMC | ID: covidwho-1602224

ABSTRACT

Background Wave one of the COVID-19 pandemic in Ontario, Canada, resulted in significant institutional outbreaks associated with high case fatality among older adults. Our hospital formally partnered with congregate care homes in north Toronto to support infection control and clinical management before wave two of the COVID-19 pandemic. Our aim was to evaluate the impact of this program on resident and healthcare worker (HCW) outcomes. Methods A multicentre quasi-experimental study was conducted comparing outcomes between wave one (March-June, 2020) and wave two (October-December, 2020) among 17 congregate care homes (4 long term care homes and 13 residential homes). During wave two, weekly meetings and 42 on-site visits were conducted along with on-site daily hospital presence for all COVID-19 outbreaks to support infection control and resident management. The primary outcomes included COVID-19-case fatality rate as well as overall resident fatality including COVID-19 and non-COVID-19 related causes. Secondary outcomes included healthcare worker COVID-19 infections, and infection control practices among homes with paired audits (n=6), including hand hygiene, use of personal protective equipment, environmental cleaning and physical distancing practices. Results Among 2203 residents during wave one and 2287 residents during wave two, there was reduction in COVID-19 case fatality rate (38.1% vs. 13.4%;p< 0.01), overall COVID-19-related fatality (2.3% vs. 1.0%;p< 0.01) and non COVID-19 related fatality (8.3% vs. 3.5%;p< 0.01). Weekly staff testing and increased syndromic surveillance was implemented during wave two. Among 2590 staff, there were 2.6% vs.4.2% staff who tested positive for COVID-19 during wave one and two, respectively. Changes in infection control practice were observed in regard to directly observed hand hygiene (83.3% vs. 100%), use of personal protective equipment (16.7% vs. 83.3%), environmental cleaning (66.7% vs. 100%) and physical distancing (66.7% vs. 83.3%). Conclusion Integration of hospital with community congregate care homes was associated with improvements in resident outcomes during wave two of the pandemic. Further longitudinal support and evaluation is needed to ensure sustainability. Disclosures All Authors: No reported disclosures

2.
CMAJ Open ; 9(4): E1175-E1180, 2021.
Article in English | MEDLINE | ID: covidwho-1575909

ABSTRACT

BACKGROUND: Reliable reports on hand hygiene performance throughout the COVID-19 pandemic are lacking as most hospitals continue to rely on direct observation to measure this quality indicator. Using group electronic hand hygiene monitoring, we sought to assess the impact of COVID-19 on adherence to hand hygiene. METHODS: Across 12 Ontario hospitals (5 university and 7 community teaching hospitals), a group electronic hand hygiene monitoring system was installed before the pandemic to provide continuous measurement of hand hygiene adherence across 978 ward and 367 critical care beds. We performed an interrupted time-series study of institutional hand hygiene adherence in association with a COVID-19 inpatient census and the Ontario daily count of COVID-19 cases during a baseline period (Nov. 1, 2019, to Feb. 29, 2020), the pre-peak period of the first wave of the pandemic (Mar. 1 to Apr. 24, 2020), and the post-peak period of the first wave (Apr. 25 to July 5, 2020). We used a Poisson regression model to assess the association between the hospital COVID-19 census and institutional hand hygiene adherence while adjusting for the correlation within inpatient units. RESULTS: At baseline, the rate of hand hygiene adherence was 46.0% (6 325 401 of 13 750 968 opportunities) and this improved beginning in March 2020 to a daily peak of 79.3% (66 640 of 84 026 opportunities) on Mar. 30, 2020. Each patient admitted with COVID-19 was associated with improved hand hygiene adherence (incidence rate ratio [IRR] 1.0621, 95% confidence interval [CI] 1.0619-1.0623). Increasing Ontario daily case count was similarly associated with improved hand hygiene (IRR 1.0026, 95% CI 1.0021-1.0032). After peak COVID-19 community and inpatient numbers, hand hygiene adherence declined and returned to baseline. INTERPRETATION: The first wave of the COVID-19 pandemic was associated with significant improvement in hand hygiene adherence, measured using a group electronic monitoring system. Future research should seek to determine whether strategies that focus on health care worker perception of personal risk can achieve sustainable improvements in hand hygiene performance.


Subject(s)
COVID-19/epidemiology , Hand Hygiene , Health Personnel , Hospitals , Infection Control/statistics & numerical data , COVID-19/virology , Hand Hygiene/methods , Health Impact Assessment , Humans , Infection Control/methods , Public Health Surveillance
6.
Open forum infectious diseases ; 8(Suppl 1):S311-S312, 2021.
Article in English | EuropePMC | ID: covidwho-1565005

ABSTRACT

Background Hand hygiene (HH) is a standard infection prevention and control precaution to be applied in healthcare settings to prevent transmission of COVID-19. Many healthcare institutions observed significant improvements in HH performance during wave one of the COVID-19 pandemic but the sustainability of this change is unknown. Our aim was to evaluate long-term HH performance throughout subsequent waves of the pandemic across acute care hospitals in Ontario, Canada. Methods HH adherence was measured using a previously validated group electronic monitoring system which was installed on all alcohol handrub and sink soap dispensers inside and outside each patient room across 56 inpatient units (35 wards and 21 critical care units) spanning 13 acute care hospitals (6 university and 7 community teaching hospitals) from 1 November 2019 to 31 May 2021. Daily HH adherence was compared with daily COVID-19 case count across Ontario. During this period, weekly performance continued to be reported to units but unit-based quality improvement discussions were inconsistent due to the COVID-19 response. Results Figure 1 depicts daily aggregate HH adherence plotted against the new daily COVID-19 case count across Ontario. An elevation in HH adherence was seen prior to the start of the first wave, rising almost to 80% and then remained above 70% for the peak of wave one. During waves two and three, peak COVID-19 case counts were associated with a maximum HH adherence of 51%, only marginally above the pre-pandemic baseline. After the end of wave one (from 1 July 2020 to 31 May 2021) the median HH performance was only 49% (interquartile range 47%-50%). Figure 1. Hand hygiene adherence across 13 acute care hospitals in comparison to overall new daily COVID-19 cases in Ontario Conclusion Initial improvements in HH adherence preceding the start of the COVID-19 pandemic were not sustained, possibly due to increasing comfort and reduced anxiety associated with providing care to COVID-19 patients leading to a perception of reduced COVID-19 transmission risk. These findings highlight the need for HH monitoring to be tied to longitudinal unit-led quality improvement in order to achieve durable changes in practice. Disclosures Susy S. Hota, MSc MD FRCPC, Finch Therapeutics (Research Grant or Support) Susy S. Hota, MSc MD FRCPC, Finch Therapeutics (Individual(s) Involved: Self): Grant/Research Support

7.
Open forum infectious diseases ; 8(Suppl 1):S312-S312, 2021.
Article in English | EuropePMC | ID: covidwho-1564710

ABSTRACT

Background In April 2021, Sunnybrook Health Sciences Centre opened a Mobile Health Unit (MHU, i.e. medical tents) under the direction of the Ontario Ministry of Health and Long Term Care in response to a surge in hospitalized patients with COVID-19 during wave three of the pandemic. Providing care to patients in non-conventional spaces is not new, however, experience in safely caring for COVID-19 patients in these settings is lacking. Our aim is to describe the implementation of our MHU and associated outcomes of these COVID-19 patients. Methods A multidisciplinary clinical and operations team was created to plan, execute and operate a safe environment for COVID-19 patients and healthcare workers within the MHU. Patient selection was restricted to patients with COVID-19 who were clinically recovering from severe COVID-19 pneumonia. Ventilation was optimized with air flow directed away from patient areas, velocity reduced to below 0.25 meters per second, and air exchanges of 24-28 per hour. All healthcare workers working in the MHU were offered COVID-19 vaccine and required to complete mandatory education if they declined (vaccination rate of 87% was achieved among dedicated staff). Universal masking and eye protection was used throughout the MHU with designated areas for donning and doffing personal protective equipment. Results In total, 32 patients with COVID-19 were managed in the MHU between 26 April and 21 May, 2021. Table 1 provides the summary of patient characteristics. All patients had a median of one-day of transmission-based precautions remaining in their course and were infected with Alpha variant with exception of one patient with the Gamma variant. Among those patients with genotyping available, all were infected with SARS-CoV-2 carrying the N501Y mutation. Four of the 32 patients required transfer to the main hospital for medical indication while the others were discharged home or to rehabilitation. None of the healthcare workers who worked within the MHU developed COVID-19 infection. Conclusion We safely cared for patients recovering from COVID-19 infection in an MHU to support system healthcare capacity. Our experience, including the specific hierarchy of controls implemented, may be helpful for future pandemic planning. Disclosures All Authors: No reported disclosures

8.
Open forum infectious diseases ; 8(Suppl 1):S493-S493, 2021.
Article in English | EuropePMC | ID: covidwho-1564432

ABSTRACT

Background Transmission of Vancomycin Resistant Enterococcus (VRE) from environment to patient and patient to patient can both occur in healthcare settings. Due to the COVID-19 pandemic, a cohort of exposed patients on an inpatient unit with an extensive VRE outbreak needed to switch physical locations with a non-exposed patient population. By comparing outcomes of both cohorts, we aimed to determine the role of the physical environment (both direct and indirect contact) as compared to the patient population, in ongoing VRE transmission. Methods From 10 March to 21 April 2021, 41 new nosocomial acquisitions of VRE were detected as part of a VRE outbreak on a 34-bed acute care unit. Prior to the switch of units, extensive cleaning of the unit was conducted including electrostatic adjuncts to standard cleaning and environmental swabbing for VRE yielded no positive surfaces. The exposed cohort included 3 of 30 patients with VRE while the non-exposed cohort had 0 of 28 VRE positive patients based on prevalence testing on 21 April 2021. Following the physical relocation of both cohorts on 22 April, 2021, prospective VRE screening was performed on both units for one month including on admission, discharge and weekly prevalence screening. Hand hygiene compliance rates on both units was measured using group electronic monitoring. Results Figure 1 depicts the timeline and number of VRE cases before and after the unit switch. Following relocation of the VRE exposed cohort to the new unit, no further VRE transmission was detected (0/235 VRE screens;0 VRE cases per 1000 patient days). Conversely, there were new VRE transmissions (3/99 VRE screens, 5 VRE cases per 1000 patient days) in the non-exposed cohort. When the units resumed their original location, one additional case of VRE was identified in the exposed cohort upon return to their original location. These transmissions occurred despite HH compliance of 94% (141,610/150,706) during the entire study period on the outbreak unit, which was consistently higher than on the non-outbreak unit (141,589/227,136, 62%).Figure 1. Conclusion The environmental reservoir for VRE may be more important in transmission than the patient reservoir. These findings underscore the importance of environmental cleaning to contain VRE outbreaks. Disclosures All Authors: No reported disclosures

9.
Open forum infectious diseases ; 8(Suppl 1):S319-S319, 2021.
Article in English | EuropePMC | ID: covidwho-1563944

ABSTRACT

Background The emergence of the E484K mutation of SARS-CoV-2 poses a risk of immune evasion but the risk of re-infection during acute infection is not well defined. Our aim was to assess the risk of re-infection among patients with existing acute E484K mutation negative COVID-19 infection who were exposed to an E484K mutation positive SARS-CoV-2 infected patient. Methods We performed a retrospective cohort study of patients admitted with acute E484K negative COVID-19 infection and shared a hospital room with a patient who was E484K mutation positive during their period of communicability. The primary outcome was laboratory confirmed and/or clinical evidence of re-infection within the E484K negative population within 30 days of exposure and the secondary outcome was the 30-day risk of death or re-admission to hospital due to COVID-19. Results We identified 41 patients who were E484K mutation negative who shared a hospital room with some of the identified 34 E484K positive patients. Six (14%) underwent repeat COVID-19 testing and remained E484K negative and none developed signs or symptoms of COVID-19 re-infection during the 30 days following exposure. The mortality rate was 7% (3/41) and re-admission rate was zero at 30 days from exposure. Conclusion Despite the small sample size, we did not observe any evidence of re-infection among patients with COVID-19 who shared a hospital room with E484K positive patients during their acute infection. If necessary due to high hospital occupancy, patients with discordant E484K results can be safely cohorted in a shared room. Disclosures All Authors: No reported disclosures

10.
CMAJ Open ; 9(4): E929-E939, 2021.
Article in English | MEDLINE | ID: covidwho-1468744

ABSTRACT

BACKGROUND: Health care workers have a critical role in the pandemic response to COVID-19 and may be at increased risk of infection. The objective of this study was to assess the seroprevalence of SARS-CoV-2 immunoglobulin G (IgG) antibodies among health care workers during and after the first wave of the pandemic. METHODS: We conducted a prospective multicentre cohort study involving health care workers in Ontario, Canada, to detect IgG antibodies against SARS-CoV-2. Blood samples and self-reported questionnaires were obtained at enrolment, at 6 weeks and at 12 weeks. A community hospital, tertiary care pediatric hospital and a combined adult-pediatric academic health centre enrolled participants from Apr. 1 to Nov. 13, 2020. Predictors of seropositivity were evaluated using a multivariable logistic regression, adjusted for clustering by hospital site. RESULTS: Among the 1062 health care workers participating, the median age was 40 years, and 834 (78.5%) were female. Overall, 57 (5.4%) were seropositive at any time point (2.5% when participants with prior infection confirmed by polymerase chain reaction testing were excluded). Seroprevalence was higher among those who had a known unprotected exposure to a patient with COVID-19 (p < 0.001) and those who had been contacted by public health because of a nonhospital exposure (p = 0.003). Providing direct care to patients with COVID-19 or working on a unit with a COVID-19 outbreak was not associated with higher seroprevalence. In multivariable logistic regression, presence of symptomatic contacts in the household was the strongest predictor of seropositivity (adjusted odds ratio 7.15, 95% confidence interval 5.42-9.41). INTERPRETATION: Health care workers exposed to household risk factors were more likely to be seropositive than those not exposed, highlighting the need to emphasize the importance of public health measures both inside and outside of the hospital.


Subject(s)
Antibodies, Viral/blood , COVID-19/immunology , Health Personnel/statistics & numerical data , SARS-CoV-2/immunology , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Cohort Studies , Female , Humans , Immunoglobulin G/blood , Logistic Models , Male , Middle Aged , Occupational Exposure/statistics & numerical data , Ontario/epidemiology , Prospective Studies , Risk Factors , SARS-CoV-2/genetics , Seroepidemiologic Studies , Tertiary Care Centers
11.
JAMA Netw Open ; 4(9): e2123622, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1391523

ABSTRACT

Importance: Patients undergoing hemodialysis have a high mortality rate associated with COVID-19, and this patient population often has a poor response to vaccinations. Randomized clinical trials for COVID-19 vaccines included few patients with kidney disease; therefore, vaccine immunogenicity is uncertain in this population. Objective: To evaluate the SARS-CoV-2 antibody response in patients undergoing chronic hemodialysis following 1 vs 2 doses of BNT162b2 COVID-19 vaccination compared with health care workers serving as controls and convalescent serum. Design, Setting, and Participants: A prospective, single-center cohort study was conducted between February 2 and April 17, 2021, in Toronto, Ontario, Canada. Participants included 142 patients receiving in-center hemodialysis and 35 health care worker controls. Exposures: BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. Main Outcomes and Measures: SARS-CoV-2 IgG antibodies to the spike protein (anti-spike), receptor binding domain (anti-RBD), and nucleocapsid protein (anti-NP). Results: Among the 142 participants undergoing maintenance hemodialysis, 94 (66%) were men; median age was 72 (interquartile range, 62-79) years. SARS-CoV-2 IgG antibodies were measured in 66 patients receiving 1 vaccine dose following a public health policy change, 76 patients receiving 2 vaccine doses, and 35 health care workers receiving 2 vaccine doses. Detectable anti-NP suggestive of natural SARS-CoV-2 infection was detected in 15 of 142 (11%) patients at baseline, and only 3 patients had prior COVID-19 confirmed by reverse transcriptase polymerase chain reaction testing. Two additional patients contracted COVID-19 after receiving 2 doses of vaccine. In 66 patients receiving a single BNT162b2 dose, seroconversion occurred in 53 (80%) for anti-spike and 36 (55%) for anti-RBD by 28 days postdose, but a robust response, defined by reaching the median levels of antibodies in convalescent serum from COVID-19 survivors, was noted in only 15 patients (23%) for anti-spike and 4 (6%) for anti-RBD in convalescent serum from COVID-19 survivors. In patients receiving 2 doses of BNT162b2 vaccine, seroconversion occurred in 69 of 72 (96%) for anti-spike and 63 of 72 (88%) for anti-RBD by 2 weeks following the second dose and median convalescent serum levels were reached in 52 of 72 patients (72%) for anti-spike and 43 of 72 (60%) for anti-RBD. In contrast, all 35 health care workers exceeded the median level of anti-spike and anti-RBD found in convalescent serum 2 to 4 weeks after the second dose. Conclusions and Relevance: This study suggests poor immunogenicity 28 days following a single dose of BNT162b2 vaccine in the hemodialysis population, supporting adherence to recommended vaccination schedules and avoiding delay of the second dose in these at-risk individuals.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/immunology , Immunoglobulin G/blood , SARS-CoV-2/immunology , Aged , Aged, 80 and over , COVID-19/epidemiology , Case-Control Studies , Dose-Response Relationship, Immunologic , Female , Humans , Immunoglobulin G/biosynthesis , Male , Pandemics , Prospective Studies , Renal Dialysis , Spike Glycoprotein, Coronavirus/immunology
13.
Am J Infect Control ; 49(11): 1429-1431, 2021 11.
Article in English | MEDLINE | ID: covidwho-1372866

ABSTRACT

In a multifacility prospective cohort study, we identified 116 acute care, 26 long-term care, and 67 rehabilitation patients who received direct care from a universally masked healthcare worker while communicable with COVID-19. Among 133(64%) patients with at least 14-day follow-up, 3 (2.3%, 95% CI, 0.77-6.4) became positive for SARS-CoV-2. Universal masking, embedded with other infection control practices, is associated with low risk of transmission of SARS-CoV-2 from healthcare workers to patients and residents.


Subject(s)
COVID-19 , SARS-CoV-2 , Health Personnel , Humans , Infection Control , Prospective Studies
14.
Can J Kidney Health Dis ; 8: 20543581211036213, 2021.
Article in English | MEDLINE | ID: covidwho-1358990

ABSTRACT

Background: People receiving in-center hemodialysis face a high risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and experience poor outcomes. During the first wave of the coronavirus disease 2019 (COVID-19) pandemic in Ontario (between March and June 2020), it was unclear whether asymptomatic or presymptomatic cases were common and whether widespread testing of all dialysis patients and staff would identify cases earlier and prevent transmission. Ontario has a population of about 14.5 million. Approximately 8900 people receive dialysis across 102 in-center dialysis units. Objective: The objective of this study was to determine participation rates for patients and staff in point prevalence testing in dialysis units across the province and to determine the prevalence of asymptomatic or presymptomatic infection. Design: Cross-sectional study design. Setting: In-center hemodialysis units at 27 renal programs across Ontario. Participants: Patients and staff in in-center dialysis units in Ontario. Measurements: Participation rates, demographic data, SARS-CoV-2 positivity rates, and COVID-19-related symptom data. Methods: From June 8 to 30, 2020, all in-center dialysis patients and staff in the Province of Ontario were requested to undergo a symptom screening assessment and nasopharyngeal swab. Testing was done using polymerase chain reaction to detect SARS-CoV-2. A standardized questionnaire of atypical and typical COVID-19-related symptoms was administered to patients, to assess for new or worsening COVID-19-related symptoms. Results: Patient participation was 83% (7155 of 8612) of which 15 tests were positive: less than 5 (<0.07%) were new positive cases, 7 were false positive, and the remaining were recovered positives. Half of the new positive cases had symptoms. Common symptoms reported included fatigue (4%), falls (4%), runny nose (3%), dyspnea (3%), and cough (3%). Staff participation was 49% (2109 of 4325), and less than 5 (<0.24%) were asymptomatic positive. Limitations: As point prevalence testing was voluntary, not all patients and staff participated. Lower participation rate may be due to decreasing new cases in Ontario, and testing or pandemic fatigue, among other factors. This study did not use serology to identify prior infections because it was not widely available in Ontario. With respect to the standardized symptom questionnaire, it was only available in English and French and could not be tested due to the urgency of the initiative. Conclusions: Participation among patients in point prevalence testing was good, but participation among staff was relatively low. Asymptomatic positivity in the dialysis patient and staff population was rare during the first wave of the COVID-19 pandemic in Ontario.

16.
BMJ Open ; 11(3): e046282, 2021 03 08.
Article in English | MEDLINE | ID: covidwho-1189880

ABSTRACT

OBJECTIVES: The majority of patients with mild-to-moderate COVID-19 can be managed using virtual care. Dyspnoea is challenging to assess remotely, and the accuracy of subjective dyspnoea measures in capturing hypoxaemia have not been formally evaluated for COVID-19. We explored the accuracy of subjective dyspnoea in diagnosing hypoxaemia in COVID-19 patients. METHODS: This is a retrospective cohort study of consecutive outpatients with COVID-19 who met criteria for home oxygen saturation monitoring at a university-affiliated acute care hospital in Toronto, Canada from 3 April 2020 to 13 September 2020. Dyspnoea measures were treated as diagnostic tests, and we determined their sensitivity (SN), specificity (SP), negative/positive predictive value (NPV/PPV) and positive/negative likelihood ratios (+LR/-LR) for detecting hypoxaemia. In the primary analysis, hypoxaemia was defined by oxygen saturation <95%; the diagnostic accuracy of subjective dyspnoea was also assessed across a range of oxygen saturation cutoffs from 92% to 97%. RESULTS: During the study period, 89/501 (17.8%) of patients met criteria for home oxygen saturation monitoring, and of these 17/89 (19.1%) were diagnosed with hypoxaemia. The presence/absence of dyspnoea had limited accuracy for diagnosing hypoxaemia, with SN 47% (95% CI 24% to 72%), SP 80% (95% CI 68% to 88%), NPV 86% (95% CI 75% to 93%), PPV 36% (95% CI 18% to 59%), +LR 2.4 (95% CI 1.2 to 4.7) and -LR 0.7 (95% CI 0.4 to 1.1). The SN of dyspnoea was 50% (95% CI 19% to 81%) when a cut-off of <92% was used to define hypoxaemia. A modified Medical Research Council dyspnoea score >1 (SP 98%, 95% CI 88% to 100%), Roth maximal count <12 (SP 100%, 95% CI 75% to 100%) and Roth counting time <8 s (SP 93%, 95% CI 66% to 100%) had high SP that could be used to rule in hypoxaemia, but displayed low SN (≤50%). CONCLUSIONS: Subjective dyspnoea measures have inadequate accuracy for ruling out hypoxaemia in high-risk patients with COVID-19. Safe home management of patients with COVID-19 should incorporate home oxygenation saturation monitoring.


Subject(s)
COVID-19 , Canada , Dyspnea/diagnosis , Humans , Hypoxia/diagnosis , Outpatients , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity
17.
Clin Infect Dis ; 71(16): 2207-2210, 2020 11 19.
Article in English | MEDLINE | ID: covidwho-1153135

ABSTRACT

We report diagnosis and management of the first laboratory-confirmed case of coronavirus disease 2019 (COVID-19) hospitalized in Toronto, Canada. No healthcare-associated transmission occurred. In the face of a potential pandemic of COVID-19, we suggest sustainable and scalable control measures developed based on lessons learned from severe acute respiratory syndrome.


Subject(s)
Coronavirus Infections , Coronavirus , Pandemics , Pneumonia, Viral , SARS Virus , Betacoronavirus , COVID-19 , COVID-19 Testing , Canada , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
18.
CMAJ ; 192(41): E1247, 2020 Oct 13.
Article in French | MEDLINE | ID: covidwho-1067430
19.
Curr Oncol ; 28(1): 278-282, 2021 01 06.
Article in English | MEDLINE | ID: covidwho-1011431

ABSTRACT

Patients with cancer are more vulnerable to severe COVID-19. As a result, routine SARS-CoV-2 testing of asymptomatic patients with cancer is recommended prior to treatment. However, there is limited evidence of its clinical usefulness. The objective of this study is to evaluate the value of routine testing of asymptomatic patients with cancer. Asymptomatic patients with cancer attending Odette Cancer Centre (Toronto, ON, Canada) were tested for SARS-CoV-2 prior to and during treatment cycles. Results were compared to positivity rates of SARS-CoV-2 locally and provincially. All 890 asymptomatic patients tested negative. Positivity rates in the province were 1.5%, in hospital were 1.0%, and among OCC's symptomatic cancer patients were 0% over the study period. Given our findings and the low SARS-CoV-2 community positivity rates, we recommend a dynamic testing model of asymptomatic patients that triggers testing during increasing community positivity rates of SARS-CoV-2.


Subject(s)
Asymptomatic Infections , COVID-19 Testing , COVID-19/diagnosis , Neoplasms/virology , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Cancer Care Facilities , Female , Humans , Male , Middle Aged , Neoplasms/drug therapy , Ontario
SELECTION OF CITATIONS
SEARCH DETAIL
...