key: cord-0802709-cutf02h1
authors: Fujiwara, Yu; Sato, Yasuyoshi; Wang, Xiaofei; Oikado, Katsunori; Sato, Yoshinao; Fukuda, Naoki; Enokida, Taisuke; Takeda, Koichi; Ohkushi, Daisuke; Hayama, Brian; Egi, Yoko; Tokai, Yoshitaka; Yamada, Yumi; Nakajima, Yuki; Kubota, Motoko; Haruki, Satomi; Shimizu, Takako; Uchida, Yasuko; Utsugi, Kuniko; Ito, Yoshinori; Ohno, Shinji; Takahashi, Shunji; Tsuchida, Tomohiro
title: Screening for COVID-19 in Symptomatic Cancer Patients in a Cancer Hospital
date: 2020-10-02
journal: Cancer Cell
DOI: 10.1016/j.ccell.2020.09.017
sha: b3306ce5e127c3a82c34de51b6b0d78f041eacbf
doc_id: 802709
cord_uid: cutf02h1

nan

We report here the clinical characteristics of 231 patients who underwent screening using chest CT and PCR for SARS-CoV-2. The cornerstone of COVID-19 diagnosis is the PCR test, which varies in sensitivity and may generate false negatives. Thus, multiple studies discuss the combination of PCR and chest CT for increased accuracy of detecting COVID-19. One meta-analysis of 16 studies (n = 3,186) shows that the sensitivity of chest CT was 92% (95%CI, 86%-96%), though the sensitivity of each study depends on the patients' characteristics, such as the severity of pneumonia (Xu et al., 2020) .

In the present study, all patients underwent chest CT to increase the pretest probability of COVID-19 and to facilitate diagnoses. Also, the imaging facility is physically separated from the hospital, which prevents virus transmission. Despite increasing the pretest probability, we did not detect any positive cases of COVID-19, suggesting that abnormal CT findings were more associated with multiple causes among cancer patients (Table S1 ). These findings should serve to caution oncologists that COVID-19-like symptoms and CT findings do not always indicate COVID-19 pneumonia. Because no cases of COVID-19 were detected in our research, we were unable to evaluate the sensitivity and specificity of the combination PCR and chest CT analyses. However, no studies other than ours have focused on the incidence of COVID-19 in symptomatic patients with cancer, and our results were consistent with the low prevalence (around 1%) of COVID-19 in asymptomatic patients reported by cancer hospitals in the United Arab Emirates and the United Kingdom (Al-Shamsi et al., 2020b; Lee et al., 2020b) .

Our research shows that cancer-associated causes outweighed the possibility of COVID-19 among cancer patients with COVID-19-like symptoms. Although there were no confirmed cases of COVID-19 via PCR, the strategy employing CT and separating patients suspected with COVID-19 facilitated the diagnosis of patients with COVID-19-like symptoms. Appropriate management of separation, screening, and diagnosis in a cancer hospital is required for maintaining cancer treatment during this pandemic era.

Document S1. 

A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group

Screening for COVID-19 in asymptomatic patients with cancer in a hospital in the United Arab Emirates

Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA -Secondary Publication

Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy

The hard work of all staff members who participated in the screening processes is appreciated. We thank all members of the COVID-