Serial Screening for COVID-19 in Asymptomatic Patients Receiving Anticancer Therapy in the United Arab Emirates

Al-Shamsi, Humaid O.; Coomes, Eric A.; Aldhaheri, Khuloud; Alrawi, Sadir

doi:10.1001/jamaoncol.2020.5745

Cited by 15 publications

(17 citation statements)

References 6 publications

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“…These studies included a total of 104,058 laboratory-confirmed COVID-19 cases, of which 25,050 exhibited no symptoms at the time of testing and 7,220 remained asymptomatic. We identified 170 studies that reported asymptomatic infections ( 11 – 13 , 17 – 183 ), 332 studies that reported silent infections at the time of testing ( 10 – 12 , 14 , 17 – 20 , 23 – 27 , 31 , 32 , 35 – 40 , 42 – 44 , 46 , 47 , 49 , 50 , 52 , 53 , 56 – 58 , 60 – 66 , 68 , 69 , 73 – 75 , 77 – 79 , 81 , 84 , 87 , 90 – 94 , 97 , 99 , 101 , 103 , 104 , 106 , 111 , 113 – 116 , 118 , 119 , 121 – 123 , 125 , 127 , 128 , …”

Section: Resultsmentioning

confidence: 99%

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

Sah

Fitzpatrick

Zimmer

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

421

351

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Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.

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Section: Resultsmentioning

confidence: 99%

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

Sah

Fitzpatrick

Zimmer

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

421

351

View full text Add to dashboard Cite

show abstract

“…However, we were able to classify malignancies in clinically relevant categories, i.e., haematological cancers, non-haematological cancers, skin melanoma, and other types of cancers. The classification was not based on clinical characteristics; rather it was based on the number of positive COVID-19 cases per each distinct cancer type (it had to be >20 diagnosed cases).Finally, we assume that controls that were not tested for COVID-19 do not develop the disease which may have induced a selection bias because some of the cancer patients might be asymptomatic [43]. We argue that given their cancer status the majority of control patients developing symptoms compatible with COVID-19 they would have been tested, also we have performed sensitivity analyses demonstrating consistency of results even if non-tested patients were excluded from analysis.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort

Lee

Nikšić

Rachet

et al. 2021

Cancers

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We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the Townsend Deprivation Index. Among 18,917 participants with an incident malignancy in the UK Biobank cohort, 89 tested positive for COVID-19. The overall COVID-19 incidence was 4.7 cases per 1000 incident cancer patients (95%CI 3.8–5.8). Compared with the least deprived cancer patients, those living in the most deprived areas had an almost three times higher risk of testing positive (RR 2.6, 95%CI 1.1–5.8). Other independent risk factors were ethnic minority background, obesity, unemployment, smoking, and being diagnosed with a haematological cancer for less than five years. A consistent pattern of socioeconomic inequalities in COVID-19 among incident cancer patients in the UK highlights the need to prioritise the cancer patients living in the most deprived areas in vaccination planning. This socio-demographic profiling of vulnerable cancer patients at increased risk of infection can inform prevention strategies and policy improvements for the coming pandemic waves.

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“…Scientific societies and health policy makers have emphasized the value of screening cancer patients under active treatment [ 7 , 12 ], but screening intensity is a matter of debate, taking into consideration available resources and potential delays. A recent study evaluated the role of performing sequential molecular testing for SARS-CoV-2 in both cancer patients and health care professionals [ 13 ]. Cancer patients under intravenous therapies were tested prior to each cycle of therapy, and site staff were tested at regular intervals.…”

Section: Discussionmentioning

confidence: 99%

Continuing Cancer Therapy through the Pandemic While Protecting Our Patients: Results of the Implementation of Preventive Strategies in a Referral Oncology Unit

Liontos

Kastritis

Markellos

et al. 2021

Cancers

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Cancer patients infected with SARS-CoV-2 have worse outcomes, including higher morbidity and mortality than the general population. Protecting this vulnerable group of patients from COVID-19 is of the utmost importance for the continuous operation of an oncology unit. Preventive strategies have been proposed by various societies, and centers around the world have implemented these or modified measures; however, the efficacy of these measures has not been evaluated. In our center, a referral oncology/hematology unit in Athens, Greece, we implemented strict protective measures from the outset of the pandemic in the country and we have prospectively recorded the epidemiological characteristics of COVID-19. Among 11,618 patient visits performed in our unit, 26 patients (case-to-visit ratio of 0.22%) were found positive for SARS-CoV-2, including 4 (1%) among 392 patients that were screened before starting primary systemic treatment. Among patients tested positive for SARS-CoV-2, 22 were symptomatic at the time of diagnosis; subsequently, 12 required hospitalization and 5 died due to COVID-19. Detailed contact tracing indicated that there was no in-unit transmission of the infection. Thus, strict implementation of multilevel protective strategies along with a modestly intense screening program allowed us to continue cancer care in our unit through the pandemic.

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Serial Screening for COVID-19 in Asymptomatic Patients Receiving Anticancer Therapy in the United Arab Emirates

Cited by 15 publications

References 6 publications

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort

Continuing Cancer Therapy through the Pandemic While Protecting Our Patients: Results of the Implementation of Preventive Strategies in a Referral Oncology Unit

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