COVID-19 incidence and outcomes among patients with respiratory symptoms in a cancer center emergency department

ABSTRACT

Objective: Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is a novel coronavirus identified in December 2019 in Wuhan, China. There is limited data on coronavirus disease-2019 (COVID-19) in patients with solid and hematologic malignancies, and the incidence of SARS-COV-2 in cancer patients with respiratory symptoms is not characterized. We report on the incidence and clinical course of COVID-19 among patients with respiratory symptoms presenting to a cancer center emergency department. Methods: We retrospectively reviewed medical records of 24 patients with a diagnosis of solid cancer and hematologic malignancies who presented to the ED with respiratory symptoms at the Centro de Oncologia e Hematologia Einstein Familia Dayan-Daycoval (São Paulo, Brazil) from March 13 to March, 29, 2020. Results: Eleven patients (46%) had solid cancer, and the remaining 13 (54%) had hematologic malignancies Detected viruses: SARS-COV-2 (n=3 patients, 12%), rhinovirus (n=3, 12%), coronavirus LN67 (n=2, 8%), parainfluenza (n=2, 8%), metapneumovirus, influenza A H1N1, and respiratory syncytial virus (n=1 each, 4%). One patient tested positive for both influenza A H1N1 and SARSCOV-2. All 3 cases of COVID-19 occured in patients with hematologic malignancies - none on active treatment Conclusion: Our study highlights the importance of considering alternate diagnosis during the initial pandemic, as only 12% of patients presenting to the emergency department with respiratory symptoms compatible with COVID-19 tested positive for SARS-COV-2. Ongoing studies are needed to assess the likelihood of SARSCoV-2 infection in patients with solid and hematologic malignancies presenting with respiratory symptoms.

RESUMO

Objetivo: O novo coronavírus denominado SARS-COV-2, causador da doença COVID-19, foi identificado em dezembro de 2019 em Wuhan, China. Existem dados limitados sobre a COVID-19 em pacientes com malignidades sólidas e hematológicas, e a incidência de SARS-COV-2 em pacientes com câncer com sintomas respiratórios não é caracterizada. Nós relatamos a incidência e o curso clínico de COVID-19 entre pacientes com sintomas respiratórios que se apresentam ao serviço de emergência de um centro oncológico. Métodos: Revisamos retrospectivamente os prontuários de 24 pacientes com diagnóstico de câncer sólido e malignidades hematológicas que se apresentaram ao pronto atendimento do Centro de Oncologia e Hematologia Einstein Família Dayan-Daycoval (São Paulo, Brasil) com sintomas respiratórios, de 13 a 29 de março de 2020. Resultados: Onze pacientes (46%) tinham câncer sólido e os 13 (54%) restantes tinham neoplasias hematológicas. Vírus detectados: SARSCOV-2 (n = 3 pacientes, 12%); rinovírus (n = 3, 12%); coronavírus LN67 (n = 2, 8%); parainfluenza (n = 2, 8%); metapneumovírus, infuenza A H1N1, e vírus sincicial respiratório (n = 1 cada, 4%). Um paciente testou positivo para influenza A H1N1 e SARS-COV-2. Todos os 3 casos de COVID-19 ocorreram em pacientes com neoplasias hematológicas - nenhum em tratamento ativo. Conclusão: Nosso estudo destaca a importância de considerar diagnóstico alternativo durante a pandemia inicial, já que apenas 12% dos pacientes comparecem ao pronto-socorro com sintomas respiratórios compatíveis com COVID-19 testaram positivo para SARS-COV-2. Estudos adicionais são necessários para avaliar a probabilidade de infecção por SARS-CoV-2 em pacientes com malignidades sólidas e hematológicas apresentando sintomas respiratórios.

Keywords:

Cancer Symptoms - Viral Envelope Proteins - Signs and Symptoms - Respiratory

Descritores:

Proteínas do Envelope Viral - Sinais e Sintomas - Infecções por Coronavirus

AUTHOR'S CONTRIBUTION

Roberto Carmagnani Pestana: Collection and assembly of data, Conception and design, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Donato Callegaro Filho: Conception and design, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Ana Fernanda Centrone: Collection and assembly of data, Conception and design, Data analysis and interpretation.

Tania MIchelle Barreto Waisbeck: Collection and assembly of data, Conception and design, Provision of study materials or patient.

Heloisa Veasey Rodrigues: Conception and design, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Sergio Eduardo Alonso Araujo: Data analysis and interpretation, Final approval of manuscript, Manuscript writing, Provision of study materials or patient.

Nelson Hamerschlak: Conception and design, Data analysis and interpretation, Final approval of manuscript, Manuscript writing, Provision of study materials or patient.

Publication History

Received: 02 June 2020

Accepted: 18 June 2020

Article published online:
17 November 2020

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