Haradaa Guilherme, Antonacio Fernanda F, Gongora Aline Bl, Behar Marina H, Capareli Fernanda C, Bastos Diogo A, Munhoz Rodrigo R, Costa Frederico P, Jardim Denis L, Arrais-Rodrigues Celso, Novis Yana, Katz Artur, de Castro Junior Gilberto
https://orcid.org/0000-0003-4012-3251.
Oncology Centre, Hospital Sírio-Libanês, Rua Dona Adma Jafet, 91, São Paulo 01308-050, Brazil.
Ecancermedicalscience. 2020 Sep 9;14:1100. doi: 10.3332/ecancer.2020.1100. eCollection 2020.
Cancer patients may have a higher risk of severe events and unfavourable outcomes in the setting of COVID-19. This review addresses the question of whether to test asymptomatic cancer patients before initiating systemic cancer treatments.
This systematic review was conducted based on the PRISMA framework. Pubmed, Embase, Web of Science and Cochrane Central Register of Controlled Trials were systematically searched, as well as guidelines from international institutions involved in cancer care and COVID-19 research. Studies published in English, from 1 December 2019 to 27 May 2020 were considered eligible. We included studies which mentioned testing strategies for SARS-CoV-2 of asymptomatic cancer patients before starting immunosuppressive treatments.
We identified 1,163 studies and 4 guidelines through the literature search. A total of 18 articles were considered eligible and were included in the final analysis. Two articles were cohort studies, and the remaining were expert consensuses and published guidelines. The most common recommendation among the studies in this systematic review was to test asymptomatic patients for SARS-CoV-2 prior to treatment.
There is a lack of studies which directly address COVID-19 testing of asymptomatic patients before treatment. Our systematic review showed that most of the published data favours routine test for SARS-CoV-2 before initiating systemic treatment but failed to identify a good level of evidence to support these recommendations. Based upon this review, we proposed local recommendations at our centre. Each institution should consider the pros and cons of testing asymptomatic patients, evaluating accessibility to testing resources and local epidemiology.
癌症患者在感染新型冠状病毒肺炎（COVID-19）时可能发生严重事件和不良结局的风险更高。本综述探讨了在开始全身性癌症治疗前是否应对无症状癌症患者进行检测的问题。
本系统综述基于PRISMA框架进行。系统检索了PubMed、Embase、科学网和Cochrane对照试验中央注册库，以及参与癌症护理和COVID-19研究的国际机构的指南。纳入2019年12月1日至2020年5月27日发表的英文研究。我们纳入了提及在开始免疫抑制治疗前对无症状癌症患者进行严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测策略的研究。
通过文献检索，我们识别出1163项研究和4项指南。共有18篇文章被认为符合纳入标准并纳入最终分析。其中2篇为队列研究，其余为专家共识和已发表的指南。本系统综述中各项研究最常见的建议是在治疗前对无症状患者进行SARS-CoV-2检测。
缺乏直接针对治疗前无症状患者进行COVID-19检测的研究。我们的系统综述表明，大多数已发表的数据支持在开始全身治疗前对SARS-CoV-2进行常规检测，但未能找到有力证据支持这些建议。基于本综述，我们在本中心提出了局部建议。每个机构都应考虑对无症状患者进行检测的利弊，评估检测资源的可及性和当地流行病学情况。
