Implementation, adherence, and results of systematic SARS-CoV-2 testing for asymptomatic patients treated at a tertiary care regional radiation oncology network

Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is a current pandemic. We initiated a program of systematic SARS-CoV-2 polymerase chain reaction (PCR) testing in all asymptomatic patients receiving radiotherapy (RT) at a large radiation oncology network in the Charlotte, NC metrop...

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Bibliographic Details
Published in:	Radiation oncology (London, England) Vol. 16; no. 1; pp. 28 - 8
Main Authors:	Prabhu, Roshan S, Dhakal, Reshika, Hicks, Amy S, McBride, James, Patrick, Alicia L, Corso, Christopher D, Murphy, Tomain, Thonen, Melissa, Lipford, Edward H, Raghavan, Derek, Burri, Stuart H
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 04-02-2021 BioMed Central BMC
Subjects:	Aged Asymptomatic Asymptomatic Infections Cancer Cancer patients Care and treatment Coronaviruses COVID-19 COVID-19 - complications COVID-19 - diagnosis COVID-19 Nucleic Acid Testing Electronic Health Records Electronic medical records Evaluation False Negative Reactions Female Humans Information processing Male Medical protocols Methods Metropolitan areas Middle Aged Neoplasms - complications Neoplasms - radiotherapy North Carolina - epidemiology Nose Nursing Oncology Pandemics Patient Compliance Patients Polymerase Chain Reaction Prospective Studies Questionnaires Radiation Radiation oncology Radiation Oncology - organization & administration Radiation therapy Radiotherapy SARS-cov-2 Schedules Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Signs and symptoms Simulation Tertiary Healthcare Ultrasonic testing Viral diseases Viruses Workflow North Carolina United States COVID-19 Radiotherapy Radiation oncology SARS-cov-2
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Summary:	Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus is a current pandemic. We initiated a program of systematic SARS-CoV-2 polymerase chain reaction (PCR) testing in all asymptomatic patients receiving radiotherapy (RT) at a large radiation oncology network in the Charlotte, NC metropolitan region and report adherence and results of the testing program. Patients undergoing simulation for RT between May 18, 2020 and July 10, 2020 within the Levine Cancer Institute radiation oncology network who were asymptomatic for COVID-19 associated symptoms, without previous positive SARS-CoV-2 testing, and without recent high-risk contacts were included. PCR testing was performed on nasal cavity or nasopharyngeal swab samples. Testing was performed within 2 weeks of RT start (pre-RT) and at least every 4 weeks during RT for patients with prolonged RT courses (intra-RT). An automated task based process using the oncology electronic medical record (EMR) was developed specifically for this purpose. A total of 604 unique patients were included in the cohort. Details on testing workflow and implementation are described herein. Pre-RT PCR testing was performed in 573 (94.9%) patients, of which 4 (0.7%) were positive. The adherence rate to intra-RT testing overall was 91.6%. Four additional patients (0.7%) tested positive during their RT course, of whom 3 were tested due to symptom development and 1 was asymptomatic and identified via systematic testing. A total of 8 (1.3%) patients tested positive overall. There were no known cases of SARS-CoV-2 transmission from infected patients to clinic staff and/or other patients. We detailed the workflows used to implement systematic SARS-CoV-2 for asymptomatic patients at a large radiation oncology network. Adherence rates for pre-RT and intra-RT testing were high using this process. This information allowed for appropriate delay in initiating RT, minimizing the occurrence of RT treatment interruptions, and no known cases of transmission from infected patients to clinic staff and/or other patients.
ISSN:	1748-717X 1748-717X
DOI:	10.1186/s13014-021-01760-2