Optimising triage procedures for patients with cancer needing active anticancer treatment in the COVID-19 era.
Identifieur interne : 000145 ( Main/Curation ); précédent : 000144; suivant : 000146Optimising triage procedures for patients with cancer needing active anticancer treatment in the COVID-19 era.
Auteurs : Grazia Arpino [Italie] ; Carmine De Angelis [Italie] ; Pietro De Placido [Italie] ; Erica Pietroluongo [Italie] ; Luigi Formisano [Italie] ; Roberto Bianco [Italie] ; Giovanni Fiore [Italie] ; Emma Montella [Italie] ; Valeria Forestieri [Italie] ; Rossella Lauria [Italie] ; Cinzia Cardalesi [Italie] ; Emilia Anna Vozzella [Italie] ; Anna Iervolino [Italie] ; Mario Giuliano [Italie] ; Sabino De Placido [Italie]Source :
- ESMO open [ 2059-7029 ] ; 2020.
Descripteurs français
- KwdFr :
- ARN viral (isolement et purification), Admission du patient (statistiques et données numériques), Admission du patient (économie), Adulte (MeSH), Adulte d'âge moyen (MeSH), Anticorps antiviraux (immunologie), Anticorps antiviraux (sang), Antinéoplasiques immunologiques (effets indésirables), Betacoronavirus (génétique), Betacoronavirus (immunologie), Betacoronavirus (isolement et purification), Chimioradiothérapie (effets indésirables), Chimioradiothérapie (méthodes), Femelle (MeSH), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Immunosuppression thérapeutique (effets indésirables), Immunosuppression thérapeutique (méthodes), Infections asymptomatiques (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (immunologie), Infections à coronavirus (sang), Infections à coronavirus (virologie), Infections à coronavirus (économie), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (diagnostic), Pneumopathie virale (immunologie), Pneumopathie virale (sang), Pneumopathie virale (virologie), RT-PCR (statistiques et données numériques), RT-PCR (économie), Sensibilité et spécificité (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Techniques de laboratoire clinique (méthodes), Techniques de laboratoire clinique (statistiques et données numériques), Techniques de laboratoire clinique (économie), Tests diagnostiques courants (statistiques et données numériques), Tests diagnostiques courants (économie), Triage (normes), Tumeurs (immunologie), Tumeurs (thérapie), Études de faisabilité (MeSH).
- MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- effets indésirables : Antinéoplasiques immunologiques, Chimioradiothérapie, Immunosuppression thérapeutique.
- génétique : Betacoronavirus.
- immunologie : Anticorps antiviraux, Betacoronavirus, Infections à coronavirus, Pneumopathie virale, Tumeurs.
- isolement et purification : ARN viral, Betacoronavirus.
- méthodes : Chimioradiothérapie, Immunosuppression thérapeutique, Techniques de laboratoire clinique.
- normes : Triage.
- sang : Anticorps antiviraux, Infections à coronavirus, Pneumopathie virale.
- statistiques et données numériques : Admission du patient, RT-PCR, Techniques de laboratoire clinique, Tests diagnostiques courants.
- thérapie : Tumeurs.
- virologie : Infections à coronavirus, Pneumopathie virale.
- économie : Admission du patient, Infections à coronavirus, RT-PCR, Techniques de laboratoire clinique, Tests diagnostiques courants.
- Adulte, Adulte d'âge moyen, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Infections asymptomatiques, Mâle, Pandémies, Sensibilité et spécificité, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de faisabilité.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Antibodies, Viral (blood), Antibodies, Viral (immunology), Antineoplastic Agents, Immunological (adverse effects), Asymptomatic Infections (MeSH), Betacoronavirus (genetics), Betacoronavirus (immunology), Betacoronavirus (isolation & purification), Chemoradiotherapy (adverse effects), Chemoradiotherapy (methods), Clinical Laboratory Techniques (economics), Clinical Laboratory Techniques (methods), Clinical Laboratory Techniques (statistics & numerical data), Coronavirus Infections (blood), Coronavirus Infections (diagnosis), Coronavirus Infections (economics), Coronavirus Infections (immunology), Coronavirus Infections (virology), Diagnostic Tests, Routine (economics), Diagnostic Tests, Routine (statistics & numerical data), Feasibility Studies (MeSH), Female (MeSH), Humans (MeSH), Immunosuppression (adverse effects), Immunosuppression (methods), Male (MeSH), Middle Aged (MeSH), Neoplasms (immunology), Neoplasms (therapy), Pandemics (MeSH), Patient Admission (economics), Patient Admission (statistics & numerical data), Pneumonia, Viral (blood), Pneumonia, Viral (diagnosis), Pneumonia, Viral (immunology), Pneumonia, Viral (virology), Practice Guidelines as Topic (MeSH), RNA, Viral (isolation & purification), Reverse Transcriptase Polymerase Chain Reaction (economics), Reverse Transcriptase Polymerase Chain Reaction (statistics & numerical data), Sensitivity and Specificity (MeSH), Triage (standards).
- MESH :
- chemical , adverse effects : Antineoplastic Agents, Immunological.
- chemical , blood : Antibodies, Viral.
- chemical , immunology : Antibodies, Viral.
- adverse effects : Chemoradiotherapy, Immunosuppression.
- blood : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- economics : Clinical Laboratory Techniques, Coronavirus Infections, Diagnostic Tests, Routine, Patient Admission, Reverse Transcriptase Polymerase Chain Reaction.
- genetics : Betacoronavirus.
- immunology : Betacoronavirus, Coronavirus Infections, Neoplasms, Pneumonia, Viral.
- isolation & purification : Betacoronavirus, RNA, Viral.
- methods : Chemoradiotherapy, Clinical Laboratory Techniques, Immunosuppression.
- standards : Triage.
- statistics & numerical data : Clinical Laboratory Techniques, Diagnostic Tests, Routine, Patient Admission, Reverse Transcriptase Polymerase Chain Reaction.
- therapy : Neoplasms.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Adult, Aged, Aged, 80 and over, Asymptomatic Infections, Feasibility Studies, Female, Humans, Male, Middle Aged, Pandemics, Practice Guidelines as Topic, Sensitivity and Specificity.
Abstract
BACKGROUND
Immunosuppression induced by anticancer therapy in a COVID-19-positive asymptomatic patient with cancer may have a devastating effect and, eventually, be lethal. To identify asymptomatic cases among patients receiving active cancer treatment, the Federico II University Hospital in Naples performs rapid serological tests in addition to hospital standard clinical triage for COVID-19 infection.
METHODS
From 6 to 17 April 2020, all candidates for chemotherapy, radiotherapy or target/immunotherapy, if negative at the standard clinical triage on the day scheduled for anticancer treatment, received a rapid serological test on peripheral blood for COVID-19 IgM and IgG detection. In case of COVID-19 IgM and/or IgG positivity, patients underwent a real-time PCR (RT-PCR) SARS-CoV-2 test to confirm infection, and active cancer treatment was delayed.
RESULTS
Overall 466 patients, negative for COVID-19 symptoms, underwent serological testing in addition to standard clinical triage. The average age was 61 years (range 25-88 years). Most patients (190, 40.8%) had breast cancer, and chemotherapy with or without immunotherapy was administered in 323 (69.3%) patients. Overall 433 (92.9%) patients were IgG-negative and IgM-negative, and 33 (7.1%) were IgM-positive and/or IgG-positive. Among the latter patients, 18 (3.9%), 11 (2.4%) and 4 (0.9%) were IgM-negative/IgG-positive, IgM-positive/IgG-negative and IgM-positive/IgG-positive, respectively. All 33 patients with a positive serological test, tested negative for RT-PCR SARS-CoV-2 test. No patient in our cohort developed symptoms suggestive of active COVID-19 infection.
CONCLUSION
Rapid serological testing at hospital admission failed to detect active asymptomatic COVID-19 infection. Moreover, it entailed additional economic and human resources, delayed therapy administrationand increased hospital accesses.
DOI: 10.1136/esmoopen-2020-000885
PubMed: 32958531
PubMed Central: PMC7507249
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Carmine" sort="De Angelis, Carmine" uniqKey="De Angelis C" first="Carmine" last="De Angelis">Carmine De Angelis</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="De Placido, Pietro" sort="De Placido, Pietro" uniqKey="De Placido P" first="Pietro" last="De Placido">Pietro De Placido</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Pietroluongo, Erica" sort="Pietroluongo, Erica" uniqKey="Pietroluongo E" first="Erica" last="Pietroluongo">Erica Pietroluongo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Formisano, Luigi" sort="Formisano, Luigi" uniqKey="Formisano L" first="Luigi" last="Formisano">Luigi Formisano</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Bianco, Roberto" sort="Bianco, Roberto" uniqKey="Bianco R" first="Roberto" last="Bianco">Roberto Bianco</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Fiore, Giovanni" sort="Fiore, Giovanni" uniqKey="Fiore G" first="Giovanni" last="Fiore">Giovanni Fiore</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Montella, Emma" sort="Montella, Emma" uniqKey="Montella E" first="Emma" last="Montella">Emma Montella</name><affiliation wicri:level="1"><nlm:affiliation>Department of Public Health, University of Naples Federico II, Naples, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Public Health, University of Naples Federico II, Naples</wicri:regionArea></affiliation></author><author><name sortKey="Forestieri, Valeria" sort="Forestieri, Valeria" uniqKey="Forestieri V" first="Valeria" last="Forestieri">Valeria Forestieri</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Lauria, Rossella" sort="Lauria, Rossella" uniqKey="Lauria R" first="Rossella" last="Lauria">Rossella Lauria</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Cardalesi, Cinzia" sort="Cardalesi, Cinzia" uniqKey="Cardalesi C" first="Cinzia" last="Cardalesi">Cinzia Cardalesi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="Vozzella, Emilia Anna" sort="Vozzella, Emilia Anna" uniqKey="Vozzella E" first="Emilia Anna" last="Vozzella">Emilia Anna Vozzella</name><affiliation wicri:level="1"><nlm:affiliation>Direzione Sanitaria, Azienda Ospedaliera Universitaria Federico II, Naples, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Direzione Sanitaria, Azienda Ospedaliera Universitaria Federico II, Naples</wicri:regionArea></affiliation></author><author><name sortKey="Iervolino, Anna" sort="Iervolino, Anna" uniqKey="Iervolino A" first="Anna" last="Iervolino">Anna Iervolino</name><affiliation wicri:level="1"><nlm:affiliation>Direzione Generale, Azienda Ospedaliera Universitaria Federico II, Naples, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Direzione Generale, Azienda Ospedaliera Universitaria Federico II, Naples</wicri:regionArea></affiliation></author><author><name sortKey="Giuliano, Mario" sort="Giuliano, Mario" uniqKey="Giuliano M" first="Mario" last="Giuliano">Mario Giuliano</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy m.giuliano@unina.it.</nlm:affiliation><country wicri:rule="url">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author><author><name sortKey="De Placido, Sabino" sort="De Placido, Sabino" uniqKey="De Placido S" first="Sabino" last="De Placido">Sabino De Placido</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania</wicri:regionArea></affiliation></author></analytic><series><title level="j">ESMO open</title><idno type="eISSN">2059-7029</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Antibodies, Viral (blood)</term><term>Antibodies, Viral (immunology)</term><term>Antineoplastic Agents, Immunological (adverse effects)</term><term>Asymptomatic Infections (MeSH)</term><term>Betacoronavirus (genetics)</term><term>Betacoronavirus (immunology)</term><term>Betacoronavirus (isolation & purification)</term><term>Chemoradiotherapy (adverse effects)</term><term>Chemoradiotherapy (methods)</term><term>Clinical Laboratory Techniques (economics)</term><term>Clinical Laboratory Techniques (methods)</term><term>Clinical Laboratory Techniques (statistics & numerical data)</term><term>Coronavirus Infections (blood)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (economics)</term><term>Coronavirus Infections (immunology)</term><term>Coronavirus Infections (virology)</term><term>Diagnostic Tests, Routine (economics)</term><term>Diagnostic Tests, Routine (statistics & numerical data)</term><term>Feasibility Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Immunosuppression (adverse effects)</term><term>Immunosuppression (methods)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Neoplasms (immunology)</term><term>Neoplasms (therapy)</term><term>Pandemics (MeSH)</term><term>Patient Admission (economics)</term><term>Patient Admission (statistics & numerical data)</term><term>Pneumonia, Viral (blood)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (immunology)</term><term>Pneumonia, Viral (virology)</term><term>Practice Guidelines as Topic (MeSH)</term><term>RNA, Viral (isolation & purification)</term><term>Reverse Transcriptase Polymerase Chain Reaction (economics)</term><term>Reverse Transcriptase Polymerase Chain Reaction (statistics & numerical data)</term><term>Sensitivity and Specificity (MeSH)</term><term>Triage (standards)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral (isolement et purification)</term><term>Admission du patient (statistiques et données numériques)</term><term>Admission du patient (économie)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Anticorps antiviraux (immunologie)</term><term>Anticorps antiviraux (sang)</term><term>Antinéoplasiques immunologiques (effets indésirables)</term><term>Betacoronavirus (génétique)</term><term>Betacoronavirus (immunologie)</term><term>Betacoronavirus (isolement et purification)</term><term>Chimioradiothérapie (effets indésirables)</term><term>Chimioradiothérapie (méthodes)</term><term>Femelle (MeSH)</term><term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Immunosuppression thérapeutique (effets indésirables)</term><term>Immunosuppression thérapeutique (méthodes)</term><term>Infections asymptomatiques (MeSH)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (immunologie)</term><term>Infections à coronavirus (sang)</term><term>Infections à coronavirus (virologie)</term><term>Infections à coronavirus (économie)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (diagnostic)</term><term>Pneumopathie virale (immunologie)</term><term>Pneumopathie virale (sang)</term><term>Pneumopathie virale (virologie)</term><term>RT-PCR (statistiques et données numériques)</term><term>RT-PCR (économie)</term><term>Sensibilité et spécificité (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Techniques de laboratoire clinique (méthodes)</term><term>Techniques de laboratoire clinique (statistiques et données numériques)</term><term>Techniques de laboratoire clinique (économie)</term><term>Tests diagnostiques courants (statistiques et données numériques)</term><term>Tests diagnostiques courants (économie)</term><term>Triage (normes)</term><term>Tumeurs (immunologie)</term><term>Tumeurs (thérapie)</term><term>Études de faisabilité (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antineoplastic Agents, Immunological</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Viral</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Antibodies, Viral</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Chemoradiotherapy</term><term>Immunosuppression</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Clinical Laboratory Techniques</term><term>Coronavirus Infections</term><term>Diagnostic Tests, Routine</term><term>Patient Admission</term><term>Reverse Transcriptase Polymerase Chain Reaction</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Antinéoplasiques immunologiques</term><term>Chimioradiothérapie</term><term>Immunosuppression thérapeutique</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Anticorps antiviraux</term><term>Betacoronavirus</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term><term>Tumeurs</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Betacoronavirus</term><term>Coronavirus Infections</term><term>Neoplasms</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term><term>RNA, Viral</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>ARN viral</term><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Chemoradiotherapy</term><term>Clinical Laboratory Techniques</term><term>Immunosuppression</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Chimioradiothérapie</term><term>Immunosuppression thérapeutique</term><term>Techniques de laboratoire clinique</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticorps antiviraux</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Triage</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Clinical Laboratory Techniques</term><term>Diagnostic Tests, Routine</term><term>Patient Admission</term><term>Reverse Transcriptase Polymerase Chain Reaction</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Admission du patient</term><term>RT-PCR</term><term>Techniques de laboratoire clinique</term><term>Tests diagnostiques courants</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Tumeurs</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Admission du patient</term><term>Infections à coronavirus</term><term>RT-PCR</term><term>Techniques de laboratoire clinique</term><term>Tests diagnostiques courants</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Asymptomatic Infections</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Practice Guidelines as Topic</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Infections asymptomatiques</term><term>Mâle</term><term>Pandémies</term><term>Sensibilité et spécificité</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de faisabilité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Immunosuppression induced by anticancer therapy in a COVID-19-positive asymptomatic patient with cancer may have a devastating effect and, eventually, be lethal. To identify asymptomatic cases among patients receiving active cancer treatment, the Federico II University Hospital in Naples performs rapid serological tests in addition to hospital standard clinical triage for COVID-19 infection.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>From 6 to 17 April 2020, all candidates for chemotherapy, radiotherapy or target/immunotherapy, if negative at the standard clinical triage on the day scheduled for anticancer treatment, received a rapid serological test on peripheral blood for COVID-19 IgM and IgG detection. In case of COVID-19 IgM and/or IgG positivity, patients underwent a real-time PCR (RT-PCR) SARS-CoV-2 test to confirm infection, and active cancer treatment was delayed.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Overall 466 patients, negative for COVID-19 symptoms, underwent serological testing in addition to standard clinical triage. The average age was 61 years (range 25-88 years). Most patients (190, 40.8%) had breast cancer, and chemotherapy with or without immunotherapy was administered in 323 (69.3%) patients. Overall 433 (92.9%) patients were IgG-negative and IgM-negative, and 33 (7.1%) were IgM-positive and/or IgG-positive. Among the latter patients, 18 (3.9%), 11 (2.4%) and 4 (0.9%) were IgM-negative/IgG-positive, IgM-positive/IgG-negative and IgM-positive/IgG-positive, respectively. All 33 patients with a positive serological test, tested negative for RT-PCR SARS-CoV-2 test. No patient in our cohort developed symptoms suggestive of active COVID-19 infection.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Rapid serological testing at hospital admission failed to detect active asymptomatic COVID-19 infection. Moreover, it entailed additional economic and human resources, delayed therapy administrationand increased hospital accesses.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32958531</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>28</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2059-7029</ISSN><JournalIssue CitedMedium="Internet"><Volume>5</Volume><Issue>5</Issue><PubDate><Year>2020</Year><Month>09</Month></PubDate></JournalIssue><Title>ESMO open</Title><ISOAbbreviation>ESMO Open</ISOAbbreviation></Journal><ArticleTitle>Optimising triage procedures for patients with cancer needing active anticancer treatment in the COVID-19 era.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">e000885</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/esmoopen-2020-000885</ELocationID><Abstract><AbstractText Label="BACKGROUND">Immunosuppression induced by anticancer therapy in a COVID-19-positive asymptomatic patient with cancer may have a devastating effect and, eventually, be lethal. To identify asymptomatic cases among patients receiving active cancer treatment, the Federico II University Hospital in Naples performs rapid serological tests in addition to hospital standard clinical triage for COVID-19 infection.</AbstractText><AbstractText Label="METHODS">From 6 to 17 April 2020, all candidates for chemotherapy, radiotherapy or target/immunotherapy, if negative at the standard clinical triage on the day scheduled for anticancer treatment, received a rapid serological test on peripheral blood for COVID-19 IgM and IgG detection. In case of COVID-19 IgM and/or IgG positivity, patients underwent a real-time PCR (RT-PCR) SARS-CoV-2 test to confirm infection, and active cancer treatment was delayed.</AbstractText><AbstractText Label="RESULTS">Overall 466 patients, negative for COVID-19 symptoms, underwent serological testing in addition to standard clinical triage. The average age was 61 years (range 25-88 years). Most patients (190, 40.8%) had breast cancer, and chemotherapy with or without immunotherapy was administered in 323 (69.3%) patients. Overall 433 (92.9%) patients were IgG-negative and IgM-negative, and 33 (7.1%) were IgM-positive and/or IgG-positive. Among the latter patients, 18 (3.9%), 11 (2.4%) and 4 (0.9%) were IgM-negative/IgG-positive, IgM-positive/IgG-negative and IgM-positive/IgG-positive, respectively. All 33 patients with a positive serological test, tested negative for RT-PCR SARS-CoV-2 test. No patient in our cohort developed symptoms suggestive of active COVID-19 infection.</AbstractText><AbstractText Label="CONCLUSION">Rapid serological testing at hospital admission failed to detect active asymptomatic COVID-19 infection. Moreover, it entailed additional economic and human resources, delayed therapy administrationand increased hospital accesses.</AbstractText><CopyrightInformation>© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Arpino</LastName><ForeName>Grazia</ForeName><Initials>G</Initials><Identifier Source="ORCID">0000-0002-4074-2530</Identifier><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Angelis</LastName><ForeName>Carmine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Placido</LastName><ForeName>Pietro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pietroluongo</LastName><ForeName>Erica</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Formisano</LastName><ForeName>Luigi</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bianco</LastName><ForeName>Roberto</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fiore</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Montella</LastName><ForeName>Emma</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Public Health, University of Naples Federico II, Naples, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Forestieri</LastName><ForeName>Valeria</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lauria</LastName><ForeName>Rossella</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cardalesi</LastName><ForeName>Cinzia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vozzella</LastName><ForeName>Emilia Anna</ForeName><Initials>EA</Initials><AffiliationInfo><Affiliation>Direzione Sanitaria, Azienda Ospedaliera Universitaria Federico II, Naples, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Iervolino</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Direzione Generale, Azienda Ospedaliera Universitaria Federico II, Naples, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Giuliano</LastName><ForeName>Mario</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy m.giuliano@unina.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Placido</LastName><ForeName>Sabino</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>ESMO Open</MedlineTA><NlmUniqueID>101690685</NlmUniqueID><ISSNLinking>2059-7029</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000914">Antibodies, Viral</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000074322">Antineoplastic Agents, 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UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000074322" MajorTopicYN="N">Antineoplastic Agents, Immunological</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058345" MajorTopicYN="Y">Asymptomatic Infections</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D059248" MajorTopicYN="N">Chemoradiotherapy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019411" MajorTopicYN="N">Clinical Laboratory Techniques</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003955" MajorTopicYN="N">Diagnostic Tests, Routine</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" 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UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010343" MajorTopicYN="N">Patient Admission</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012367" MajorTopicYN="N">RNA, Viral</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020133" MajorTopicYN="N">Reverse Transcriptase Polymerase Chain Reaction</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">SARS-CoV-2</Keyword><Keyword MajorTopicYN="Y">cancer</Keyword><Keyword MajorTopicYN="Y">covid-19</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>08</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>08</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>22</Day><Hour>5</Hour><Minute>36</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32958531</ArticleId><ArticleId IdType="pii">esmoopen-2020-000885</ArticleId><ArticleId IdType="doi">10.1136/esmoopen-2020-000885</ArticleId><ArticleId 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