High mortality with High false negative rate: COVID-19 infection in patients with hematologic malignancies

Niu, Alex; Ning, Bo; Socola, Francisco; Safah, Hana; Reynolds, Tim; Ibrahim, Moayed; Safa, Firas; Alfonso, Tina; Luk, Alfred; Mushatt, David; Hu, Tony; Saba, Nakhle S.

doi:10.1016/j.leukres.2021.106582

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…There are few reports of false-negative PCR testing in cancer patients. A high false negative rate (15%) was observed among patients with hematologic malignancies [27]. In this study, only 0.9% ( [29].…”

Section: Discussioncontrasting

confidence: 54%

Real-world data no the incidence of coronavirus disease (COVID-19) in patients with advanced thoracic cancer during the early phase of the pandemic in Japan

Fukuda¹,

Yoshida²,

Yagishita³

et al. 2022

Preprint

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The severity and asscociated mortality of coronavirus disease 2019 (COVID-19) are higher in patients with thoracic cancer than in healthy populations and those with other cancer types. Here, we investigated real-world data on the incidence of COVID-19 and false-negative cases using severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing in patients with thoracic cancer. We retrospectively reviewed patients with advanced thoracic cancer at the National Cancer Center Hospital between March 2020–May 2021. Blood samples were collected and evaluated for IgM and IgG antibodies specific for nucleocapsid (N) and spike (S) protein SARS-CoV-2 before and after rRT-PCR testing. False-negative cases were assessed based on anti-SARS-CoV-2 antibody levels before and after rRT-PCR testing. A total of 2,107 patients with thoracic cancer were identified between March 2020 and May 2021, 7 (0.3%) of whom developed COVID-19. Among the 218 patients who underwent at least one rRT-PCR test because of suspected COVID-19 symptoms or as a screening test at our institute, the most common diagnosis was non-COVID-19 pneumonia (34.4%), followed by tumor fever (30.7%). Furthermore, of the 218 patients, 120 paired serum samples before and after rRT-PCR testing were available. Seroconversion was identified in all three patients with positive SARS-CoV-2 rRT-PCR results but was only observed in 1 out of the 117 patients who tested negative; the rate of false-negative cases was low (0.9%). COVID-19 incidence among patients with advanced thoracic cancer was low during the early phase of the pandemic in Japan.

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Section: Discussioncontrasting

confidence: 54%

Real-world data no the incidence of coronavirus disease (COVID-19) in patients with advanced thoracic cancer during the early phase of the pandemic in Japan

Fukuda¹,

Yoshida²,

Yagishita³

et al. 2022

Preprint

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“…From 1871 identified references, a total of 67 studies accounting for 10,061 hematological patients and 111,143 controls were included in the systematic review (Table S3 summarizes the included studies and reported outcomes). 13 , 15 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , ...…”

Section: Resultsmentioning

confidence: 99%

“…From 1871 identified references, a total of 67 studies accounting for 10,061 hematological patients and 111,143 controls were included in the systematic review (Table S3 summarizes the included studies and reported outcomes) 13,15 ,. 17–81 A PRISMA flow‐chart detailing the inclusion and exclusion process is available in the Supplementary Material (Figure S1).…”

Section: Resultsmentioning

confidence: 99%

Predictors of clinical evolution of SARS‐CoV‐2 infection in hematological patients: A systematic review and meta‐analysis

Carrara

Razzaboni

Azzini

et al. 2022

Hematological Oncology

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Main aim of this systematic review is to quantify the risk and identify predictors of clinical evolution of SARS‐CoV‐2 in hematological patients compared to different control populations. Two independent reviewers screened the literature assessing clinical outcomes of SARS‐CoV‐2 infection in adult patients with active hematological malignancies published up to June 2021. Primary outcome was COVID‐19 related mortality, secondary outcomes were hospital and intensive‐care admission, mechanical ventilation (MV), and thromboembolic events. Variables related to study setting, baseline patients' demographic, comorbidities, underlying hematological disease, ongoing chemotherapy, COVID‐19 presentation, and treatments were extracted. A total of 67 studies including 10,061 hematological patients and 111,143 controls were included. Most of the studies were retrospective cohorts (51 studies, 76%) and only 19 (13%) provided data for a control group. A significant increased risk of clinical progression in the hematological population compared to the controls was found in terms of COVID‐19 related mortality (OR, 2.12; 95% CI, 1.77–2.54), hospitalization (OR, 1.98; 95% CI, 1.15–3.43), intensive‐care admission (OR, 1.77; 95% CI, 1.38–2.26), and MV (OR, 2.17; 95% CI, 1.71–2.75). The risk remained significantly higher in the subgroup analysis comparing hematological patients versus solid cancer. Meta‐regression analysis of uncontrolled studies showed that older age, male sex, and hypertension were significantly related to worse clinical outcomes of COVID‐19 in hematological population. Older age and hypertension were found to be associated also to thromboembolic events. In conclusion, hematological patients have a higher risk of COVID‐19 clinical progression compared to both the general population and to patients with solid cancer.

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“…Distinguishing between both conditions is crucial, albeit challenging, and may require additional invasive diagnostic procedures such as bronchoscopy. Although testing and nasal screening of SARS-CoV-2 virus before anticancer therapies initiation is largely standard in many oncologic centers, there is a relatively high rate (15%) of false-negative reverse-transcription PCR results [ 20 ]. Therefore, it is possible that patients with COVID-19 are erroneously thought to have ICI-related pneumonitis.…”

Section: Resultsmentioning

confidence: 99%

Infections Simulating Immune Checkpoint Inhibitor Toxicities: Uncommon and Deceptive

Gudiol

Hicklen

Okhyusen

et al. 2022

Open Forum Infectious Diseases

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High mortality with High false negative rate: COVID-19 infection in patients with hematologic malignancies

Cited by 5 publications

References 13 publications

Real-world data no the incidence of coronavirus disease (COVID-19) in patients with advanced thoracic cancer during the early phase of the pandemic in Japan

Real-world data no the incidence of coronavirus disease (COVID-19) in patients with advanced thoracic cancer during the early phase of the pandemic in Japan

Predictors of clinical evolution of SARS‐CoV‐2 infection in hematological patients: A systematic review and meta‐analysis

Infections Simulating Immune Checkpoint Inhibitor Toxicities: Uncommon and Deceptive

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