scholarly journals Routine COVID-19 testing may not be necessary for most cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ali Motlagh ◽  
Fatemeh Elmi ◽  
Maisa Yamrali ◽  
Mansour Ranjbar ◽  
Mehrdad Azmin ◽  
...  

AbstractCancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15–0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.

2020 ◽  
Author(s):  
Halley L Brantley ◽  
Richard M Yoo ◽  
Glen I Jones ◽  
Marel A Stock ◽  
Peter J Park ◽  
...  

Understanding variations in the performance of serological tests for SARS-CoV-2 across varying demographics is relevant to clinical interpretations and public policy derived from their results. Appropriate use of serological assays to detect anti-SARS-CoV-2 antibodies requires estimation of their accuracy over large populations and an understanding of the variance in performance over time and across demographic groups. In this manuscript we focus on anti-SARS-CoV-2 IgG, IgA, and IgM antibody tests approved under emergency use authorizations and determine the recall of the serological tests compared to RT-PCR tests by Logical Observation Identifiers Names and Codes (LOINCs). Variability in test performance was further examined over time and by demographics. The recall of the most common IgG assay (LOINC 94563-4) was 91.2% (95% CI: 90.5%, 91.9%). IgA (LOINC 94562-6) and IgM (94564-2) assays performed significantly worse than IgG assays with estimated recall rates of 20.6% and 27.3%, respectively. A statistically significant difference in recall (p = 0.019) was observed across sex with a higher recall in males than females, 92.1% and 90.4%, respectively. Recall also differed significantly by age group, with higher recall in those over 45 compared to those under 45, 92.9% and 88.0%, respectively (p < 0.001). While race was unavailable for the majority of the individuals, a significant difference was observed between recall in White individuals and Black individuals (p = 0.007) and White individuals and Hispanic individuals (p=0.001). The estimates of recall were 89.3%, 95.9%, and 94.2% for White, Black, and Hispanic individuals respectively.


Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1441
Author(s):  
Suelen Basgalupp ◽  
Giovana dos Santos ◽  
Marina Bessel ◽  
Lara Garcia ◽  
Ana Carolina de Moura ◽  
...  

Serological assays emerged as complementary tools to RT-PCR in the diagnosis of SARS-CoV-2 as well as being needed for epidemiological studies. This study aimed to assess the performance of a rapid test (RT) compared to that of serological tests using finger prick blood samples. A total of 183 samples were evaluated, 88 of which were collected from individuals with negative RT-PCR and 95 from positive RT-PCR individuals. The diagnostic performance of RT (WONDFO®) and LUMIT (PROMEGA®) were compared to that of ELISA (EUROIMMUN®) for detecting antibodies against SARS-CoV-2 according to time from symptoms onset. The IgG antibody tests were detected in 77.4% (LUMIT), 77.9% (RT), and 80.0% (ELISA) of individuals. The detection of antibodies against SARS-CoV-2 increases in accordance with increasing time from symptoms onset. Considering only time from symptoms onset >21 days, the positivity rate ranged from 81.8 to 97.0% between the three tests. The RT and LUMIT showed high agreement with ELISA (agreement = 91.5%, k = 0.83, and agreement = 96.3%, k = 0.9, respectively) in individuals who had symptoms 15 to 21 days before sample collection. Compared to that of the ELISA assay, our results show sensitivity ranged from 95% to 100% for IgG antibody detection in individuals with symptoms onset between 15 and 21 days before sample collection. The specificity was 100% in individuals with symptoms onset >15 days before serological tests. This study shows good performance and high level of agreement of three immunoassays for the detection of SARS-CoV-2 antibodies.


Author(s):  
Ruijie Ling ◽  
Yihan Yu ◽  
Jiayu He ◽  
Jixian Zhang ◽  
Sha Xu ◽  
...  

SummaryBackgroundThe seroprevalence of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be a more reliable approach to detect true infected population, particularly in asymptomatic persons. Few studies focus on the diagnosis of COVID-19 patients using serological tests. To detect and assess asymptomatic infections of COVID-19 among people in Wuhan, the epicenter of the COVID-19 pandemic in China, and provide evidence for planning adequate public health measures, we collected and analyzed the clinical data in the Wuhan General Hospital mandatory for 16- to 64-year-old asymptomatic people. This retrospective study estimated the seroprevalence of IgM and IgG and compared the epidemiological characteristics of asymptomatic SARS-CoV-2-infected population.MethodsDemographical and radiological data were collected from the Wuhan General Hospital between March 26 and April 28, 2020. Serological tests for IgM and IgG antibodies against SARS-CoV-2 were conducted with a colloidal gold method. Nucleic acid sequences of viruses were detected with RT-PCR. Statistical analyses were carried out using SPSS 20.0 software.FindingsBetween March 26 and April 28, 2020, 18,391 asymptomatic back-to-work participants were enrolled. Among them, 89 had positivity for IgM (0·48%, 95% confidence interval (CI): 0·38–0·58%); 620 cases had IgG positivity (3·37%, 95% CI: 3·11–3·64%), and 650 cases had either IgG positivity or IgM positivity (3·53%, 95% CI: 3·26–3·80%). After standardizing for the genders and ages in the population of Wuhan, the overall standardized seroprevalence of IgG was 3·33% (95% CI: 3·07–3·59%) and the standardized seroprevalence of IgG was 3·01% (95% CI: 2·69–3·33%) among males and 3·66% (95 % CI: 3·23–4·09%) among females. The standardized seroprevalence of IgG was higher in women than in men with a significant difference (χ2 = 2,060·3, p < 0·01). By a detection method adjustment, the seroprevalence of IgG was 1·57% (95% CI: 1·39–1·75%) in all medical records, of which males were 1·96% (95% CI: 1·64–2·28%), and females were 1·19% (95% CI: 0·99–1·39%). The assay-adjusted seroprevalence of IgG was higher in women than in men, and the difference was significant (χ2 = 5,871·0, p < 0·01). The differences were significant for the seroprevalence of IgG among people who went back to work in different categories of workplace (χ2 = 198·44, p < 0·01). The differences in seroprevalence for IgG positivity or IgM positivity among people who went back to work in different urban and rural areas was also significant (χ2 = 45·110, p < 0·01). Calculated as IgG and/or IgM antibody positivity, the number of new infections was reduced by 64·8% from March 26 to April 28, 2020. Based on the census population aged 16–64 years in Wuhan in 2017, we estimated that 172,340 (95% CI: 157,568–187,112) asymptomatic people aged 16–64 years were infected with SARS-CoV-2 in Wuhan between March 25 and April 28, 2020. This estimate was 3·4-times higher than the officially reported 50,333 infections on April 28.InterpretationThe seropositivity rate in Wuhan indicated that RT-PCR-confirmed patients only represented a small part of the total number of cases. Seropositivity progressively decreased in the Wuhan population from March 26 to April 28, 2020, comparable to Japan and Denmark, but well below the level reported in New York, Iran, Italy, and Germany. The prevalence of asymptomatic infection was higher in women than in men among people who went back to work in Wuhan. The low seroprevalence suggests that most of the population remains susceptible to COVID-19.FundingThe Emergency Management Project of the National Natural Science Foundation of China (81842035) and Advisory Research Project of the Chinese Academy of Engineering in 2019 (2019-XZ-70).


Author(s):  
Angelo Virgilio Paradiso ◽  
SimonaDe Summa ◽  
Nicola Silvestris ◽  
Stefania Tommasi ◽  
Antonio Tufaro ◽  
...  

AbstractHealth workers are at high risk for SARS-CoV-2 infection and, if asymptomatic, for transmitting the virus on to fragile cancer patients. We screened 525 health workers of our Cancer Institute with rapid serological test Viva-Diag analyzingCOVID-19 associated-IgG/IgM. Six subjects (1,1%) resulted with Viva-Diag test not-negative for IgM. All 6 cases had RT-PCR SARS-CoV-2 test negative; repeating analysis ofIgG/IgM expression by CLIA assay also, 2 cases resulted IgM positive and 1 case IgG/IgM positive. This latter subject reported a contact with an infected SARS-CoV-2 person, a month earlier.In conclusion our study seems to suggest: a) a different analytical sensitivity inIgG/IgM evaluation for Viva-Diag and CLIA assays needing to be further determined; b) the ability of Viva-Diagrapid COVID-19 test to evidence health workers positive for Immunoglobulins expression. Discordant results of rapid serological tests with respect to RT-PCR stress the different clinical meaning the two assays can have, question clearly referring to further studies to optimize the utilization of rapid serological test in asymptomatic subjects at high risk for infection.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3232-3232
Author(s):  
Helene M. Schoemans ◽  
Koen Theunissen ◽  
Marc Boogaerts ◽  
Johan Maertens

Abstract Epstein Barr Virus (EBV) reactivation occurs in about 50% of the allogeneic hematopoietic stem cell transplantation (HSCT) population in the first year post-transplantation. About 1-7% of these patients run the risk of developing a post-transplant lymphoproliferative disorder (PTLD). Several authors have thus advocated systematic screening by EBV real time PCR (RT-PCR) to initiate pre-emptive treatment of reactivations using Rituximab (van Esser 2002). However, the positive predictive value of EBV RT-PCR is only of 40% (van Esser 2001), implying that this algorithm overtreats a number of patients. Methods: We have retrospectively analyzed 60 consecutive allogeneic HSCT patients transplanted in our center between 1/1/2004 and 31/3/2005. Four patients were excluded because of absence of EBV follow-up (n=2) or autologous reconstitution (n=2). EBV reactivation (EBV (+)) was defined by at least two consecutive episodes of EBV RT-PCR above 1000 copies/ml of whole blood. Any other result was considered as negative (EBV (−)). Results: 1175 EBV RT-PCR samples were collected over a median follow up of 215 days (range: 21–511). The population observed was essentially adults (median age 42 years, range: 1–65) with leukemia (29 leukemia, 11 lymphomas, 16 other diseases), mixed graft types (26 matched sibling donors, 26 matched unrelated donors, 4 haploidentical donors; 77% peripheral blood stem cells; 20% CD34+ selection) and mixed conditioning (52% non-myeloablative conditioning containing ATG, and 48% full conditioning). The EBV(+) and EBV(−) cohorts were similar for all characteristics analyzed. We observed a median of 18 EBV RT-PCR per patient (range: 4–105), with a median interval between two tests of 7 days (range: 3–45). There were 30 true reactivations, 2 intermittent reactivations (non consecutive EBV titer rises above threshold), 8 isolated reactivations and 16 patients with no reactivation episode. EBV RT-PCR was first performed at a median of 6 days post HSCT (range: 0–245), and reactivation was noted at a median of 44 days post HSCT (range: 6–375). There were no significant difference in PCR follow up (first day of screening, median test interval and length of biological follow up) except for the total number of screening tests per patient, which was higher in the EBV(+) group (p= 0.01). There was only one case of biopsy-proven PTLD in the EBV(+) cohort. No patient was administered Rituximab post- HSCT. Survival curves of the two cohorts were similar regardless of EBV reactivation (log-rank, p= 0.201). Discussion: The incidence of EBV reactivation (n= 30; 54%) and of PTLD (n=1;1.7%) were standard compared to previous studies, resulting in a standard specificity of 47% for EBV screening. However, within our limited group of patients, we could not show any significant differences in mortality between the EBV(+) and EBV (−) cohorts. Therefore, absence of preventive treatment for EBV reactivation did not result in an increase in mortality in our EBV reactivating cohort. This suggests that systematic prophylactic use of Rituximab may not affect overall mortality, whilst potentially increasing the risk of other opportunistic infections. Conclusion: Further prospective studies are needed to better define the patients at risk for developing EBV-related PTLD, within the EBV reactivating allogeneic transplant patients group, before prophylactic treatment of reactivation becomes a routine procedure.


Author(s):  
Monika Zajkowska ◽  
Emilia Lubowicka ◽  
Paweł Malinowski ◽  
Maciej Szmitkowski ◽  
Sławomir Ławicki

The VEGF family members are important factors in promoting angiogenesis and lymphangiogenesis in malignant processes. The aim of this study was to investigate plasma concentrations of VEGF-A, VEGF-B and their soluble VEGFR-1 receptor and their diagnostic utility and potency as compared to CA 15-3 in breast cancer patients and in relation to the control group. The study included 120 breast cancer patients and 60 control patients. Plasma levels of tested parameters were determined with ELISA and CA 15-3 levels were determined with CMIA. Concentrations of all tested parameters in breast cancer patients showed statistically significant difference when compared to the control groups (benign breast tumor patients and/or healthy women). VEGF-B showed the highest values of sensitivity (Sn) and predictive value of a negative test result (NPV) in total BC group (90% and 66.7%, respectively) and, more importantly, in stages I–II of BC (SE: 86.8%; 92.7%, NPV: 82.8%; 88.9%, respectively). Among all parameters tested, VEGF-A showed the highest specificity (Sf) (76.7%) and predictive value of a positive test result (PPV) (84.8%), yet they were lower than for CA 15-3. VEGF-A was also the best parameter that had statistically significant Area Under Curve (AUC) in stages I (0.678) and II (0.768). In the whole group of BC patients all parameters tested showed statistically significant AUC, but the maximum range was obtained for the combination of VEGF-A and CA 15-3 (0.817). The combined analysis of the studied parameters and CA 15-3 resulted in an increase in sensitivity and AUC values, which provides hope for developing a new panel of biomarkers that may be used in BC diagnosis in the future.


2018 ◽  
Vol 12 (09) ◽  
pp. 733-740
Author(s):  
Jelena Zivadin Tosic-Pajic ◽  
Predrag Sazdanovic ◽  
Marija Sorak ◽  
Jelena Cukic ◽  
Aleksandra Arsovic ◽  
...  

Introduction: Commercially available assays were evaluated in order to determine diagnostic accuracy of Chlamydia trachomatis specific tests for screening. Methods: The study included 225 sexually active men and women, who were tested for genital chlamydial infection in Institute of Public Health Kragujevac. Three screening tests were used: direct immunofluorescence (DIF) and rapid lateral immunochromatographic test (RT) for qualitative detection of chlamydial antigens and immunoenzyme (ELISA) test for detection of serum levels of anti-chlamydial IgA and IgG antibodies. Diagnostic efficiency of these tests were determined in relation to results obtained by RT-PCR method. Results: Statistical significance between the results obtained by RT-PCR as a gold standard and DIF, RT and ELISA were analyzed using chi-square (χ2) test. Statistical analysis showed a significant difference between RT-PCR and analyzed screening tests: DIF (χ2 = 303; p < 0.001), RT (χ2 = 4.19; p = 0.041), serum IgA (χ2 = 4.19; p = 0.041) and serum IgG (χ2 = 67; p < 0.001) which indicates poor agreement between these tests. Large numbers of false positive (FP) and false negative (FN) results were observed for all tested assays. According to Youden’s index, serum IgG and DIF testing demonstrated the most-balanced sensitivity-specificity rate. RT assay exhibits the highest expanded Youden’s index, as well as the best overall diagnostic accuracy. Conclusions: None of evaluated screening tests can be recommended as individual method for the diagnosis of acute infection. We suppose that RT-PCR is unlikely to be a cost-effective screening strategy within the Serbian health system.


2006 ◽  
Vol 66 (S 01) ◽  
Author(s):  
T Fehm ◽  
S Becker ◽  
MJ Banys ◽  
G Becker-Pergola ◽  
S Duerr-Stoerzer ◽  
...  

2020 ◽  
Author(s):  
Audrey Murat-Ringot ◽  
Pierre Jean Souquet ◽  
Fabien Subtil ◽  
Florent Boutitie ◽  
Marie Preau ◽  
...  

BACKGROUND Cancer is a chronic disease with an incident worldwide had been 24.5 million and 9.6 million deaths in 2017. Lung and colorectal cancer are the most common cancer for both sexes and according to national and international recommendations platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting may persist. Moreover, cancer patient are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology decreases significantly the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. OBJECTIVE The primary objective of the present study was to assess the benefits of foot reflexology as a complement to conventional treatments on severity of acute chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed were the frequency and severity of delayed chemotherapy-induced nausea and vomiting, quality of life, anxiety, and self-esteem. METHODS The present study was conducted between April 2018 and April 2020 in French University Hospital. This is an open-label randomized controlled trial. Participants are randomized into two groups: 40 to interventional group (conventional care with foot reflexology) and 40 to control group (conventional care without foot reflexology). Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. RESULTS The severity of acute nausea and vomiting was assessed with a visual analogue scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for control group (20.6%, P = 0.01). Across all cycle, the foot reflexology group showed a trend towards less frequent delayed nausea (P=0.28), a significantly less frequent consumption of antiemetic drugs (P=0.04), and no significant difference for vomiting (P=0.99); there was a trend towards a perception of stronger severity for delayed nausea in the control group (P=0.39). According to quality of life and anxiety, there was no significant difference between the interventional group and the control group (P=0.32 and P=0.53 respectively). CONCLUSIONS In conclusion, the present study results indicated that foot reflexology decreased significantly the severity of acute nausea and consumption of antiemetic drugs in lung and digestive cancer patients. No side effects from foot reflexology have been noted. In order to better respond to a desire of patients for non-pharmacological treatments and CAMs to be used in hospitals to improve their care, the results of this study showed that foot reflexology seems to be a promising complement to conventional antiemetic drugs. To assess the performance of this intervention in routine practice, a larger study with several health care centers would be relevant with a cluster RCT. CLINICALTRIAL The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) INTERNATIONAL REGISTERED REPORT RR2-10.2196/17232


2021 ◽  
Vol 28 (1) ◽  
pp. 847-852
Author(s):  
Anna Ferrari ◽  
Marco Trevenzoli ◽  
Lolita Sasset ◽  
Elisabetta Di Liso ◽  
Toni Tavian ◽  
...  

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient’s infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.


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