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Prolonged positive SARS-CoV-2 RT-PCR in cancer outpatients requires specific reorganization of cancer centres
Annals of Oncology ; 31:S1010, 2020.
Article in English | EMBASE | ID: covidwho-803939
ABSTRACT

Background:

Patients with cancer are more susceptible to infection because of immunosuppressive treatment given to cure cancer. Several guidelines published at the beginning of the COVID-19 pandemic recommend delaying systemic anticancer treatment until complete resolution of COVID-19 symptoms. In addition, it is important to segregate patients with cancer from patients with COVID-19 to avoid transmission. Nevertheless, some patients will present both diseases, and the duration of eviction from cancer units and delay of cancer treatment after COVID-19 remains unclear. Notably the duration of viral excretion after COVID-19 is a concern in immunosuppressed patients.

Methods:

We tested all patients with a confirmed initial diagnosis of COVID-19 who needed to receive cancer or immunosuppressive treatment for a solid tumour, haematological or inflammatory disease in our centre from April 1st to May 15th 2020. We have repeated SARS-COV2 RT-PCR until negative viral shedding.

Results:

We tested 49 consecutive patients 53% had solid tumours, 37% haematological disease and 10% inflammatory disease. 59% were under 65 years. Overall, 82% of patients had a positive RT-PCR from day 14 to 20 after the initial diagnosis of COVID-19 infection, 60% from day 21 to 27 and 30% from day 28 to 34. Only 4/37 patients evaluated remained with a positive RT-PCR after day 35. No predictive factors were associated with a positive RT-PCR but our results suggest that patients treated for inflammatory disease had a shorter duration of positive RT-PCR. 18 patients had their treatment delayed according to guideline recommendations and 17 patients received their treatment in a dedicated COVID-19 outpatient unit. No symptomatic COVID-19 recurrence was observed during follow-up in patients who had received chemotherapy despite persistent positive RT-PCR.

Conclusions:

We report here the first assessment of SARS-CoV2 RT-PCR kinetic in cancer patients. A prolonged viral excretion is observed in patients treated for cancer. A systematic retest is needed after day 14 if RT-PCR remains positive. A specific unit dedicated to outpatients with persistent positive RT-PCR allows urgent anticancer treatment and avoids the risk of viral exposure for other immunodepressed patients. Legal entity responsible for the study The authors.

Funding:

Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Annals of Oncology Year: 2020 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Annals of Oncology Year: 2020 Document Type: Article