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Background: Patients with cancer are vulnerable to coronavirus disease 2019 (COVID-19). Given the rising number of COVID-19 cases and relaxation of stringent COVID-19 protocols, assessment of the level of protective immunity to COVID-19 in patients with cancer has assumed importance. Objective(s): Our primary objective was to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in patients with cancer. Material(s) and Method(s): We conducted a cross-sectional study on 100 patients with solid tumors attending our Oncology Department at the Believers Church Medical College, Kerala, India, between December 2020 and June 2021. Seroprevalence was assessed using the VITROS Anti-SARS-CoV-2 IgG test (Ortho-Clinical Diagnostics, Rochester, NY, USA). Additionally, we assessed the factors associated with seropositivity and collected data regarding the general experience of patients with cancer during the pandemic. Result(s): The median age of the participants was 62 years (IQR, 53-69.8);52 (52%) were males. The seroprevalence of the SARS-CoV-2 IgG antibodies was 11% (95% CI, 4.8-17.1). Age < 50 years was the only factor that was significantly associated with a higher rate of COVID-19 antibodies (77% vs 8.9% in patients >= 50 years;P = 0.007), and sex, smoking, and the use of alcohol did not show any association. The majority (77/100, 77%) of the patients were worried about contracting COVID-19 infection;some even deferred cancer-directed treatment because of the fear of visiting health care settings. Conclusion(s): Low seroprevalence of SARS-CoV-2 IgG antibodies in unvaccinated patients with cancer is a matter of concern as it indicates that many of these patients are still vulnerable to infection. There is an urgent need to continue implementing strict safety measures in oncology centers and to encourage widespread COVID-19 vaccination to prevent the uncontrolled spread of COVID-19 among patients with cancer. (Funded by the institution, Believers Church Medical College, Kerala).Copyright © 2023 Neurology India, Neurological Society of India Published by Wolters Kluwer - Medknow.
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Introduction: Chest Computed Tomography (CT) scan for Coronavirus Disease-2019 pneumonia is used widely and viral load is predicted by the Cycle threshold (Ct) values of Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). Studies correlating viral load in Severe Acute Respiratory Syndrome- coronavirus-2 (SARS-CoV-2) RT-PCR positive patients and severity of chest CT scan are limited. Aim: To find an association between viral load and chest CT findings.Materials and Methods: This was a cross-sectional study conducted on patients admitted to Believers Church Medical College Hospital, Thiruvalla, Kerala between September 2020 to March 2021. Truenat RT-PCR test was performed on nasopharyngeal swabs, targeting the Orf1 gene of SARS-CoV-2 and results were quantified as Cycle threshold (Ct) values. Chest CT-Total Severity Score (TSS) ranged from 0-40 and was calculated by summing up the acute inflammatory lesions in each of the five lobes of both the lungs. Correlation was assessed using Spearmans Correlation Coefficient. Independent sample t-test and One-way ANOVA was used for comparison of means. Results: Of the 102 patients in the study (mean age of the patients 64.13±13.17 years and majority were males (70.6%)], 11 had lung changes unrelated to COVID-19. There was an inverse relationship between viral load Ct value of SARS-CoV-2 in nasopharyngeal specimens and TSS Score of chest CT-scan. The mean viral load was highest in patients with mild (21.48±8.31), moderate (21.22±6.30) and severe (24.19±4.67) CT involvement. There was a significant difference between mean duration to symptom onset and chest CT scan among those with a high viral load (4.97±2.65) compared to those with a low viral load (6.81±4.5), (p-value 0.01). Among those who died due to COVID-19, (12/13) 92.3% were above 60 years of age. Presence of co-morbidities/dyspnoea/fever at presentation did not have any significant association with TSS severity. Conclusion: Viral load is not a critical factor that influences pulmonary manifestations in COVID-19, nor in-hospital mortality. CT-scan may be more useful to detect lung involvement when done nearing or after the first week of symptom onset, irrespective of the viral load. Viral load can be important in predicting transmissibility and to minimise potential spread, whereas chest CT can help identify cases requiring extensive medical care.