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SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China

Educational Objective
Review research letter on SARS-CoV-2 transmission in patients receiving treatment for cancer
1 Credit CME

In December 2019, an outbreak of 2019 novel coronavirus disease (COVID-19) occurred in Wuhan, Hubei, which has been linked to the severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2). It is characterized by rapid human-to-human transmission from droplet contamination.1,2 A report of 138 hospitalized patients from a single institution (Zhongnan Hospital of Wuhan University) indicated that hospital-acquired transmission accounted for 41.3% of these admitted patients, thus implicating the hospital environment as a source of spread of the virus.3 Patients with cancer are often recalled to the hospital for treatment and monitoring, and hence, they may be at risk of contracting COVID-19. Moreover, cancer treatments such as chemotherapy and radiotherapy are immunosuppressive. Here, we report the incidence and outcomes of SARS-CoV-2 infection in cancer patients who were treated at a tertiary cancer institution in Wuhan.

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Article Information

Corresponding Authors: Conghua Xie, MD, Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, People’s Republic of China (chxie_65@whu.edu.cn); Melvin L. K. Chua, MBBS, PhD, Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore 169610 (melvin.chua.l.k@singhealth.com.sg).

Accepted for Publication: March 11, 2020.

Published Online: March 25, 2020. doi:10.1001/jamaoncol.2020.0980

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Yu J et al. JAMA Oncology.

Author Contributions: Drs Xie and Chua had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Yu and Ouyang contributed equally as co–first authors. Drs Chua and Xie contributed equally as co–senior authors.

Study concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Yu, Chua.

Critical revision of the manuscript for important intellectual content: Yu, Ouyang, Xie.

Statistical analysis: Yu, Chua.

Administrative, technical, or material support: All authors.

Study supervision: Yu, Chua, Xie.

Funding/Support: Dr Chua is supported by the National Medical Research Council Clinician-Scientist Award (CSA/0027/2018).

Role of the Funder/Sponsor: The National Medical Research Council had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Conflict of Interest Disclosures: No conflicts are reported.

Additional Contributions: We thank all the patients who consented to this study, and the frontline healthcare professionals who are involved in patient care during this pandemic.

References
1.
Chen  N, Zhou  M, Dong  X,  et al.  Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.  Lancet. 2020;395(10223):507-513. doi:10.1016/S0140-6736(20)30211-7PubMedGoogle ScholarCrossref
2.
Wu  YC, Chen  CS, Chan  YJ.  The outbreak of COVID-19: an overview.  J Chin Med Assoc. 2020;83(3):217-220. doi:10.1097/JCMA.0000000000000270PubMedGoogle ScholarCrossref
3.
Wang  D, Hu  B, Hu  C,  et al.  Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China.  JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585PubMedGoogle Scholar
4.
Kamboj  M, Sepkowitz  KA.  Nosocomial infections in patients with cancer.  Lancet Oncol. 2009;10(6):589-597. doi:10.1016/S1470-2045(09)70069-5PubMedGoogle ScholarCrossref
5.
Guan  WJ, Ni  ZY, Hu  Y,  et al; China Medical Treatment Expert Group for Covid-19.  Clinical characteristics of coronavirus disease 2019 in China.  N Engl J Med.Published online February 28, 2020. doi:10.1056/NEJMoa2002032PubMedGoogle Scholar
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