ABSTRACT
Background: SARS-CoV-2 infection and the associated COVID-19 pneumonia have dramatically disrupted the management of cancer care worldwide. Indeed, this crisis has raised the urge of thoughtfully balancing the risk of delaying potentially curative treatments and the risk of developing a life-threatening respiratory infection. In this study, we report the experience of an Italian Reference Cancer Center, where close triage procedures had to be promptly adopted. Patients and methods: We retrospectively analyzed a consecutive cohort of 787 cancer patients (pts) who accessed the Day Hospital (DH) of the Oncology Department of Udine from April 6th to June 19th 2020. Screening NP swabs and RT-PCR analysis were performed at every access in pts who, after passing the triage, were admitted to receive intravenous therapies. Clinicopathological data were collected from electronic health records and include sex, age, tumor type, disease stage, type of treatment, number of swabs received and RT-PCR results. Results: In a population of 787 cancer pts receiving intravenous therapies, 2602 NP swabs were performed. Among all pts 55.7% were female and 44.3% male pts, respectively;54.9% of pts aged ≥65. Of note, 28.2% of pts had gastrointestinal tumors, 23% breast cancer, 19.8% lung cancer and 14.2% tumors of the genitourinary tract. Approximately 32% of pts had early-stage disease whereas 68% of pts received therapies for advanced disease. Treatments most frequently included chemotherapy (60%), immunotherapy (14.7%) and target therapies (9.8%) whereas 11.1% of swabs were performed in pts who entered to DH for supportive therapy. The median number of SARS-CoV-2 tests per patient was 3 and 26% of pts received ≥5 swabs. In the whole population, only 10 SARS-CoV-2 tests (1.3%) resulted positive and the isolating procedures were promptly activated. Conclusions: In the pandemic context, the adoption and gradual improvement of rigorous procedures aimed at minimizing COVID-19 spread among pts and healthcare professionals are mandatory to ensure continuity of care for cancer pts. In our experience systematic triage, sequential screening with NP swabs and the prompt identification of asymptomatic SARS-CoV-2 carriers limited COVID-19 spread among cancer pts accessing the Oncology DH.