key: cord-0852500-ahvljduh
authors: Giesen, Nicola; Sprute, Rosanne; Rüthrich, Maria; Khodamoradi, Yascha; Mellinghoff, Sibylle C.; Beutel, Gernot; Lueck, Catherina; Koldehoff, Michael; Hentrich, Marcus; Sandherr, Michael; von Bergwelt-Baildon, Michael; Wolf, Hans-Heinrich; Hirsch, Hans H.; Wörmann, Bernhard; Cornely, Oliver A.; Köhler, Philipp; Schalk, Enrico; von Lilienfeld-Toal, Marie
title: 2021 Update of the AGIHO guideline on evidence-based management of COVID-19 in cancer patients regarding diagnostics, viral shedding, vaccination and therapy
date: 2021-02-10
journal: Eur J Cancer
DOI: 10.1016/j.ejca.2021.01.033
sha: 019c366b09fed94804617d6557ddb3f9f832ccc7
doc_id: 852500
cord_uid: ahvljduh

The worldwide spread of SARS-CoV-2 and the associated infectious disease COVID-19 has posed a unique challenge to medical staff, patients and their families. Cancer patients, particularly those with haematologic malignancies, have been identified to be at high risk to develop severe COVID-19. Since publication of our previous guideline on evidence-based management of COVID-19 in cancer patients, research efforts have continued and new relevant data has come to light, maybe most importantly in the field of vaccination studies. Therefore, an update of our guideline on several clinically important topics is warranted. Here, we provide a concise update of evidence-based recommendations for rapid diagnostics, viral shedding, vaccination and therapy of COVID-19 in cancer patients. This guideline update was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on these topics applying evidence-based medicine criteria.

The worldwide spread of SARS-CoV-2 and the associated infectious disease COVID-19 has 54 posed a unique challenge to medical staff, patients and their families. Cancer patients, 55 particularly those with haematologic malignancies, have been identified to be at high risk to 56 develop severe Since publication of our previous guideline on evidence-based management of COVID-19 in 58 cancer patients, research efforts have continued and new relevant data has come to light, 59 maybe most importantly in the field of vaccination studies. Therefore, an update of our 60 guideline on several clinically important topics is warranted. Here, we provide a concise cancer patients 1 an update seems warranted on several clinically relevant topics. We have 72 therefore summarized an update of recommendations for rapid diagnostics, viral shedding, 73 vaccination and therapy of COVID-19 (Table 1) with SARS-CoV-2 infection. 8, 9, 11, 12 This phenomenon is well known for other community 95 acquired respiratory viruses. 13 Generally, vaccination can be successful in cancer patients even when they undergo 130 immunosuppressive therapy. 21-23 Therefore, it can be assumed that vaccination against 131 because of older age and more frequent comorbidities. 29 In particular, patients with 139 haematological malignancies are at a persistently increased risk whereas solid tumor 140 patients appear to suffer an increased risk mostly in the first year after diagnosis which 141 drops to baseline >5 years after diagnosis. 30 For any malignancy, active disease confers a 142 significantly increased risk of severe COVID-19. 31,32 143

In conclusion, cancer patients should be offered vaccination against COVID-19 using an 

Rapid SARS-CoV-2 antigen detection assay in comparison with real-260 time RT-PCR assay for laboratory diagnosis of COVID-19 in Thailand

Analytical sensitivity and 262 clinical sensitivity of the three rapid antigen detection kits for detection of SARS-CoV-2 virus

Performance 265 characteristics of a rapid SARS-CoV-2 antigen detection assay at a public plaza testing site in 266

Diagnostic accuracy of two commercial SARS-CoV-2 Antigen-detecting rapid 269 tests at the point of care in community-based testing centers

Case 272 Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic 273

With Prolonged Viral RNA Shedding From the Respiratory Tract in Coronavirus Disease 2019: 281 A Case-Control Study

Shedding of Viable SARS-CoV-2 after Immunosuppressive Therapy for Cancer

Detection of 286 community-acquired respiratory viruses in allogeneic stem-cell transplant recipients and 287 controls-A prospective cohort study

Long-Term Shedding of Influenza Virus, Parainfluenza Virus, Respiratory Syncytial Virus and 290

Factors associated with prolonged 293 viral RNA shedding in patients with COVID-19

Duration 298 of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID

Association 350 of increased influenza vaccination in health care workers with a reduction in nosocomial 351 influenza infections in cancer patients

Repurposed Antiviral Drugs for Covid-19 -Interim WHO Solidarity

Treatment of COVID-19 with remdesivir in the absence of humoral immunity: a case report

Utilization 363 of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer

Cancer Consortium (CCC19) Cohort Study

Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19

Detection of SARS-CoV-2 in Different 369 Types of Clinical Specimens

haematological malignancies and after haematopoietic stem cell transplantation (HCT)

competing interests: NG reports personal fees from MSD, personal fees from Roche, personal fees from Pfizer, grants from BMS, grants from Karyopharm, outside the submitted work