Lai Catherine, Potosky Arnold L, McGuire Colleen, Lobo Tania, Ahn Jaeil, Haddad Bassem R, Richards Ernest W, Anand Palka, Wright Kristen, Christenson Robert H, Boyle Lisa, Goy Andre, Atkins Michael B
Division of Hematology/Oncology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Department of Oncology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
J Oncol. 2022 Feb 19;2022:8798306. doi: 10.1155/2022/8798306. eCollection 2022.
Patients with cancer and health care workers (HCW) are at higher risk for SARS-CoV-2 infection. There are limited data regarding the rate of symptomatic versus asymptomatic infection and subsequent seropositivity in both populations.
We performed a prospective study of patients and HCW across two institutions during the first wave of the pandemic to analyze the prevalence of SARS-CoV-2 antibodies, the extent of associated symptoms, and durability of serologic response.
In 1,953 persons (733 patients and 1,220 HCW), overall seropositivity rates for 3.1% patients (95% CI 2.0-4.7) and 3.7% HCW (95% CI 2.7-4.9, =0.520), were similar. Each institutions' seropositivity rates were numerically higher in HCW than patients. Non-Hispanic Whites and Asians had lower antibody rates (2.8%, 95% CI 2.0-3.8 and 3.3%, 95% CI 1.2-7.0) compared to Hispanics (6.9%, 95% CI 3.4-12.4) and non-Hispanic Blacks (5.9%, 95% CI 3.3-9.7), < 0.001. Among persons with a positive SARS-CoV-2 antibody, 87% of patients and 56% of HCW did not recall having had a fever. Among HCW, administrative and technical personnel were most likely to be seropositive. The rate of persistent seropositivity at 3 months was similar between patients and HCW and was not influenced by the reporting of fever, cancer type, or therapy.
These data suggest that patients are not at higher risk for febrile SARS-CoV-2 infections or more transient immunity than HCWs. Furthermore, racial differences and lack of association with the extent of HCW contact with COVID-19 patients suggest that community rather than hospital virus exposure was a source of many infections.
癌症患者和医护人员感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险更高。关于这两类人群中出现症状感染与无症状感染的比例以及后续血清学阳性率的数据有限。
在疫情第一波期间，我们对两家机构的患者和医护人员进行了一项前瞻性研究，以分析SARS-CoV-2抗体的流行情况、相关症状的程度以及血清学反应的持久性。
在1953人（733例患者和1220名医护人员）中，患者的总体血清学阳性率为3.1%（95%置信区间2.0 - 4.7），医护人员为3.7%（95%置信区间2.7 - 4.9，P = 0.520），两者相似。每个机构中，医护人员的血清学阳性率在数值上高于患者。与西班牙裔（6.9%，95%置信区间3.4 - 12.4）和非西班牙裔黑人（5.9%，95%置信区间3.3 - 9.7）相比，非西班牙裔白人和亚洲人的抗体率较低（分别为2.8%，95%置信区间2.0 - 3.8和3.3%，95%置信区间1.2 - 7.0），P < 0.001。在SARS-CoV-2抗体呈阳性的人群中，87%的患者和56%的医护人员不记得曾发烧。在医护人员中，行政和技术人员血清学阳性的可能性最大。患者和医护人员在3个月时持续血清学阳性率相似，且不受发烧报告、癌症类型或治疗的影响。
这些数据表明，与医护人员相比，患者发生发热性SARS-CoV-2感染的风险并不更高，免疫也并非更短暂。此外，种族差异以及与医护人员接触COVID-19患者程度缺乏关联表明，许多感染的源头是社区而非医院的病毒暴露。
