Tumori Journal Abstract Book - October 2020 - 75

D - COVID-19	
Zambelli A.1, Milesi L.1, Bonomi L.1, Tasca C.1, Rota Caremoli
E.1, Bosetti T.1, Negrini G.1, Mandalà M.1, Fotia V.1, Di Croce A.1,
Callegaro A.1, Chiudinelli L.2, Chirco A.1, Ghilardi L.1, Tondini C.1
1

ASST Papa Giovanni XXIII, Bergamo; 2Università degli Studi di Pavia, Pavia

Background: The European SARS-CoV-2 pandemic had
its first epicentre in Italy, particularly in the area of Bergamo.
In spite of a significant mortality rate, in the majority of
cases the spectrum of Covid-19 ranges from asymptomatic
to mildly symptomatic infection. No information is available on the prevalence and clinical impact of asymptomatic
or mildly symptomatic SARSCoV-2 infection among
actively treated cancer patients during pandemic.
Patients and methods: From April 1st, 2020 to the end of
the month, 560 consecutive and unselected patients, scheduled for anticancer treatment at our facility and without
clinical suspicious of Covid-19, were evaluated and tested
for SARSCoV-2. We implemented a two-step diagnostics,
including a rapid serological immunoassay for anti-SARSCoV-2 IgG/IgM and a pharyngeal swab RT-PCR assay in
case of IgM seropositivity.
Results: In 560 patients, 172 (31%) resulted positive for
SARSCoV-2 IgM/IgG antibodies, regardless of type of
cancer, stage and treatment. All IgM-seropositives were
then tested with RT-PCR pharyngeal swabs and 55/146
(38%) proved to be SARSCoV-2 carriers, with slightly difference between mildly symptomatic vs. asymptomatic
patients (38 vs. 17). Therefore, the two-step procedure
allowed the identification of 55 (10%) silent carriers in the
whole study population and magnified the number needed
to test (NNT) with the pharyngeal swab RT-PCR assay to
detect a silent virus carrier (NNT: 2.6 vs. 10, with or without serological selection). At a very early follow up (8
wks), in 114 SARSCoV-2-seropostive/RT-PCR-negative
patients, who continued their anticancer therapies, none but
one developed a symptomatic Covid-19 illness.
Conclusions: Among cancer patients, the two-step diagnostics strategy with serology followed by pharyngeal swab for
asymptomatic or mildly symptomatic SARSCoV-2 infection
is feasible and effective and can help selecting cancer patients
on treatment who might be silent carriers of the virus. The
early safety outcome of patients previously exposed to
SARSCoV-2 supports the recommendation to continue
active treatment, at least in the case of negative RT-PCR test.

D20
Triage procedure for COVID-19
in an Oncology Department: an
Italian monocentric experience
Zara D.1, Targato G.1, Fioraso R.1, Bortot L.1, Pelizzari G.1, Corvaja
C.1, Palmero L.1, Giavarra M.1, Andreotti V.J.1, Bin A.2, Donato R.2,
Garattini S.K.2, Mansutti M.2, Minisini A.M.2, Fasola G.2
1

Dipartimento di Oncologia, Azienda Sanitaria Universitaria Friuli Centrale,

75
Udine, Italy; Dipartimento di Area Medica (DAME) - University of Udine,
Udine; 2Dipartimento di Oncologia, Azienda Sanitaria Universitaria Friuli
Centrale, Udine, Italy, Udine

Background: To minimize the risk of COVID-19 infection
spreading, we developed a triage procedure, consisting of
body temperature measuring and a structured questionnaire
that each patient (pt) was asked to fill-in before accessing to
our department. This questionnaire explored 4 items: fever,
respiratory tract symptoms (flue syndrome, sore throat,
cough, dyspnea, loss of taste or smell), previous contacts or
personal positivity for COVID-19. From 06 April 2020 we
also started to perform nasopharyngeal swabs in all pts who,
receiving intravenous therapy, had to stay in the Day hospital (DH) administration area.
Material and methods: We evaluated a consecutive series
of outpatients with diagnosis of solid tumor, accessing the
DH of Oncology Department at the Udine Academic
Cancer Center from 30 March 2020 to 10 April 2020. A
multivariate logistic regression model was used to identify
factors associated with positive triage (⩾1 item).
Results: 1054 triage procedures were performed out of 586
pts, with a median of 2 triage per pt. The median age was
64.9 years. The most common reason for triage submission
was programmed access for oncological therapy (82.5%),
followed by scheduled procedures, radiological exams or
non-oncological consultations (10.7%) and unplanned
access for urgencies (1.2%). In 30.7% of cases the neoplasm
was in early stage, while was advanced in 69.3%. 58.2% of
triage procedures were performed in pts receiving chemotherapy, 10.8% immunotherapy, 18.9% target therapy, 5.2%
other therapies and 6.9% in pts without active treatment. In
5.5% of cases the triage resulted positive. 2.9% of all triage
were positive for fever, 2.9% for respiratory symptoms and
0.1% for previous contact with a COVID-19 case. Body
temperature was ⩾37°C in 7 pts. Among negative triage, in
6 cases pts were further evaluated and considered as clinically suspect. Overall, in 0.9% of triage procedures the
oncologic program was postponed, while a test for COVID19 was performed for clinical suspect in 0.5%: interestingly
no one resulted positive. At multivariate analysis factors
associated with positive triage were diagnosis of thoracic
cancer (OR 2.06; 95%CI 1.02-4.12; p 0.04) and prior
COVID-19 test (OR 2.81; 95%CI 1.46-5.41; p 0.001). As of
May 20th, no operator was positive to surveillance swabs.
Conclusions: A well-structured triage procedure for
COVID-19 can reduce the risk of further spreading of
infection in Oncology facilities with limited impact on
scheduled activities.

D21
Association of neutrophil-tolymphocyte ratio with COVID-19
infection in cancer patients



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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Tumori Journal Abstract Book - October 2020 - Cover3
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