University of Wisconsin–Madison Medical College of Wisconsin

Low Rate of SARS-CoV-2 Infection in Adults With Active Cancer Diagnosis in a Nonendemic Region in the United States

Yana Puckett, MD, MBA, MPH, MSc; Lee Wilke, MD; Sharon Weber, MD; Amanda Parkes, MD; Noelle K. LoConte, MD

WMJ. 2020;119(4):286-288.

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Introduction: The mortality rate in cancer patients with SARS-CoV-2 has been cited to be as high as 13% amidst a global pandemic. Here we present the prevalence of SARS-CoV-2 in adult patients with active cancer in a nonendemic cancer center at the time of the study.

Methods: All adult patients with an active history of cancer undergoing any elective surgery were screened for SARS-CoV-2 symptoms, including fever ≥ 38 degrees Celsius, chills, dyspnea, cough, sputum production, pharyngitis, myalgia/arthralgia, headache, anosmia, and nasal discharge. Both symptomatic and asymptomatic patients were tested for SARS-CoV-2 preoperatively via nasopharyngeal swab within 48 hours of surgery using an RT-PCR assay. Active cancer was defined as receipt of chemotherapy and/or radiation within 1 year of the SARS-CoV-2 test. Deidentified, institutional review board-exempt patient data were analyzed with IBM Statistical Package for the Social Sciences (SPSS) Version 26.

Results: Between March 16, 2020 and June 30, 2020, a total of 227 patients were tested preoperatively for SARS-CoV-2. Median age was 64.0 years (range 21 to 90). The majority of the cohort were White. Only 2 patients (0.8%) were positive for SARS-CoV-2. One 73-year-old woman undergoing hip replacement had Stage IV breast cancer and a 75-year-old man undergoing port placement had Stage IV retroperitoneal leiomyosarcoma. Neither patient had symptoms of SARS-CoV-2, underwent hospitalization for SARS-CoV-2, or proceeded to have the scheduled surgery after the positive test results until a 14-day quarantine period and a subsequent negative test result. Both patients subsequently received the procedures they were originally scheduled for with no complications.

Conclusion: Careful consideration of resource allocation and treatment limitations for cancer patients should occur in lower endemic regions.

Author Affiliations: University of Wisconsin Carbone Cancer Center, Madison, Wis (Puckett, Wilke, Weber, Parkes, LoConte); University of Wisconsin School of Medicine and Public Health (UWSMPH), Department of Surgery, Madison, Wis (Puckett, Wilke, Weber); UWSMPH, Department of Medicine, Division of Hematology/Oncology, Madison, Wis (Parkes, LoConte).
Corresponding Author: Yana Puckett, MD, MBA, MPH, MSc; University of Wisconsin Carbone Cancer Center; Madison, WI 53705; email
Acknowledgments: We would like to acknowledge Donald A. Schmitz of the University of Wisconsin-Madison Information Technology department in assisting with data acquisition.
Funding/Support: University of Wisconsin Carbone Cancer Center Support Grant P30 CA014520.
Financial Disclosures: Lee Wilke, MD, is a founder and minority stock owner in Elucent Medical.
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