Review of risk of COVID-19 in cancer patients and their cohabitants

https://doi.org/10.1016/j.ijid.2021.01.072Get rights and content
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Highlights

  • Cancer patients had higher seroprevalence of SARS-CoV-2 antibodies than the general population (31.4% vs 10%).

  • The probability of seropositivity for a cancer patient was related to intrafamilial exposure (OR 2.684, 95% CI 1.51–4.76, p = 0.001). Seropositive cohabitants are therefore the main risk factor for a cancer patient to come into contact with SARS-CoV -2 and have antibodies against the virus.

  • Among 72 seropositive patients, 54% had familial exposure to cohabitants with SARS-CoV- 2 antibodies. Among 157 seronegative patients, 30% shared the same house with seropositive cohabitants.

  • Most of cohabitants (86.5%) were asymptomatic and diagnosed by the serology test as having had exposure to the virus.

  • Age, sex, cancer type, cancer stage and cancer treatment did not significantly affect the risk of developing SARS-CoV-2 antibodies.

Abstract

Background

Patients with a history of active malignancy are at increased risk of infection and COVID-19-related complications. Sanitary protection measures are not specifically recommended within households. This study examined the risk of seroconversion in cancer patients according to their household exposure.

Patients and methods

This seroprevalence study was a prevalence study conducted in Torrejon de Ardoz (Spain). It analysed the seroprevalence of IgM and IgG antibodies in 104,299 volunteers (participation rate of 74.8% of population) from 29 May to 05 June 2020. Personal authorisation was requested to collect by questionnaire the test results from cancer patients, who attended the Outpatient Department of the University Hospital of Torrejón, and their cohabitants between 01–19 June 2020.

Results

A total of 229 cancer patients were included in the study. Sixty-four of the 229 individuals tested positive for SARS-CoV-2 IgG antibodies (27.9%) and 22 were positive for SARS-CoV-2 IgM antibodies (9.6%). The overall seroprevalence (IgG or IgM positive) was 31.4% (general population seroprevalence was 10% in Spain). Of 72 seropositive patients, 54.2% had intrafamilial exposure vs 45.8% who did not. Among seronegative patients, 30.6% had seropositive cohabitants. The probability of seropositivity for a cancer patient was significantly related to intrafamilial exposure (OR 2.684, 95% CI 1.51–4.76, p = 0.001).

Conclusions

Cancer patients are a high-risk group for SARS-CoV-2 infection. Recommendations against virus transmission need to be implemented even in a household scenario, as it was the main factor significantly related to seroconversion.

Keywords

Cancer patients
COVID-19
SARS-CoV-2 seroprevalence
Cohabitants
Household

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