The global COVID-19 pandemic raised several questions for health care providers around the world. For oncologists, an important question has been and continues to be, given that COVID-19 is a respiratory infection spread when people are in contact with infected individuals: How do you deliver life-saving therapies to patients (many that need to be administered in hospital settings) while keeping patients and health care workers safe?
To answer this question with some empirical data, Matthias Preusser, MD, Head of the Clinical Division of Oncology in the Department of Medicine at the Medical University of Vienna, and his colleagues conducted a study to analyze the spread of COVID-19 within their tertiary care hospital at the Medical University of Vienna (J Clin Oncol 2020; doi: 10.1200/JCO.20.01442).
The researchers analyzed COVID-19 test results (from nasal swab testing and real-time PCR testing) conducted between March 21 and May 4, 2020, for cancer patients treated at the institution. Cancer patients receiving treatment at the hospital were regularly tested for COVID-19.
The data revealed that COVID-19 prevalence in patients treated for cancer at the hospital was similar to the general population and lower than in patients without cancer treated for other conditions at the hospital. Additionally, 0.4 percent of patients with cancer tested positive for COVID-19, but were asymptomatic.
"We report that continued care and therapy for patients with cancer proved to be feasible and safe in the population of a European capital affected by the COVID-19 pandemic," the researchers noted in the study. But, they also note that following strict safety protocols and regular testing are critical to keeping everyone healthy. The data was published late last year, but here's why Preusser told Oncology Times the evidence is still relevant and will continue to be as the world comes out of the COVID-19 pandemic.
1 What are the key findings of your research and how are they novel from what was previously known about the risk of continuing cancer care in hospital settings during a pandemic?
"We performed this research because there was controversy on whether or not continuation of cancer therapy in high-volume centers is safe, because patients with an active diagnosis of cancer are prone to a variety of infections.
"Additionally, patients undergoing active anticancer therapy are exposed to unavoidable social contacts with fellow citizens during transit, as well as with hospital staff and other patients during regular therapy and follow-up visits at the hospital.
"The key findings were that SARS-CoV-2 [COVID-19 infection] prevalence in patients with cancer was similar to the general population and lower than in patients without cancer. Our study was the first and largest, and compared patients to data in the general public generated by a systematic random sample investigation.
"Our data are in line with other publications and have helped us tremendously to make informed decision-making on standard operating procedures at our institution. Our findings show that cancer treatment can be continued safely when appropriate measures including regular SARS-CoV-2 testing is being performed.
"We believe that our findings are of general relevance, as the need for continued treatment of patients with cancer, their particular vulnerability to infectious complications, and the typical high patient turnover are of concern for cancer centers worldwide in the current COVID-19 pandemic."
2 What's the next step of your work?
"We have implemented a comprehensive research portfolio involving SARS-CoV-2 and COVID-19 in cancer patients at our institution. We are in the process of data analysis of our single-blinded, randomized, placebo-controlled Phase II trial of prophylactic treatment with oral azithromycin versus placebo in cancer patients undergoing antineoplastic treatment during the COVID-19 pandemic (NCT04369365).
"In addition, we are performing seroprevalence studies on cancer patients and oncological health care professionals to define antibody responses to SARS-CoV-2 infections and vaccinations."
3 What's the takeaway message that oncologists and cancer care providers should know about your research?
"The main implication [from this recent Journal of Clinical Oncology study] is that asymptomatic virus carriers can be effectively identified and isolated by rigorous SARS-CoV-2 testing routines in cancer patients.
"The bottom-line message of our work: Test for SARS-CoV-2 as much as you can until the pandemic is over to protect your patients, your staff, and your institution."