Incidence of sars-cov-2 infection in patients with active cancer: Mono-institutional series of a comprehensive cancer institution in lombardy during the covid-19 pandemic (Niguarda Cancer Center, Milano, Italy)

Background: Lombardy region, Italy, has one of world's largest coronavirus disease 19 (COVID-19) outbreak with over 80,000 cases Here, we report the incidence of SARS-CoV-2 infection in patients with active cancer at the Division of Oncology, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, a comprehensive cancer institution in the capital of Lombardy, Milano Patients and Methods: From April 15th to May 15th, 2020, SARS-CoV-2 testing has been performed in patients with active cancer by paired real time-PCR in nasopharyngeal swab (NPS) (Elitech, Torino, IT) and chemiluminescent immunoassays for detection of antiviral IgG in blood (Abbot, Sligo, IR or Diasorin, Saluggia, IT) Active cancer was defined as a solid tumor requiring anticancer treatment or supportive care Tested patients were either outpatients with at least one suggestive symptom of COVID-19 assessed by telephone triage per local guidelines, or inpatients routinely tested at hospital admission, irrespective of symptoms Additionally, patients with COVID-19 requiring hospitalization at Niguarda Hospital during the study period have been tested and results pooled for evaluating concordance of NPS with serology Results: 118 patients were tested by NSP, and paired serology is available at the moment for 63 (53 4%) In the outpatient setting, 517 underwent telephone triage and 58 reported at least one symptom (11 2%) Of these, 3/29 and 3/14 (10 3 and 21 4%) tested positive on NSP and serology, respectively In the cohort of inpatients, tested regardless of symptoms, 2/82 and 4/42 (2 4 and 9 5%) tested positive on NSP and serology, respectively Finally, among oncology physicians, 2/34 and 2/34 (5 9%) tested positive on NSP and serology, respectively 7 additional hospitalized patients displaying COVID-19 disease have been tested Overall, the accuracy between NSP and serology was 82 5% and concordance was 0 415 (Cohen's k) In 5 cases, serology was positive and NSP negative, whereas the opposite was found in 6 Recruitment and testing are still ongoing at the moment of abstract submission and complete results will be presented Conclusions: In our series of patients with active cancer during a peak period of the pandemic in Lombardy, 11% of outpatients displayed COVID-19 associated symptoms and 10% had positive NSP Among inpatients tested regardless of symptoms, 2 4% had positive NSP The accuracy between NSP and serology was 82 5%