{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:43:07Z","timestamp":1761129787189,"version":"3.37.3"},"reference-count":23,"publisher":"Elsevier BV","issue":"Suppl 3","license":[{"start":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T00:00:00Z","timestamp":1604620800000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["ESMO Open"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the midst of the COVID-19 pandemic, patients with cancer are regarded as a highly vulnerable population. Overall, those requiring hospital admission for treatment administration are potentially exposed to a higher risk of infection and worse outcome given the multiple in-hospital exposures and the treatment immunosuppressive effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>COVINT is an observational study assessing COVID-19 incidence among patients receiving anticancer treatment in the outpatient clinic of the Istituto Nazionale dei Tumori di Milano. All consecutive patients with non-haematological malignancies treated with intravenous or subcutaneous\/intramuscular anticancer therapy in the outpatient clinic were enrolled. The primary endpoint is the rate of occurrence of COVID-19. Secondary endpoints included the rate of COVID-19-related deaths and treatment interruptions. The association between clinical and biological characteristics and COVID-19 occurrence is also evaluated. COVID-19 diagnosis is defined as (1) certain if confirmed by reverse transcriptase PCR assay of nasopharyngeal swabs (NPS); (2) suspected in case of new symptoms or CT scan evidence of interstitial pneumonia with negative\/not performed NPS; (3) negative in case of neither symptoms nor radiological evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the first 2\u2009months (16 February\u201310 April 2020) of observation, 1081 patients were included. Of these, 11 (1%) were confirmed and 73 (6.7%) suspected for COVID-19. No significant differences in terms of cancer and treatment type emerged between the three subgroups. Prophylactic use of myeloid growth factors was adopted in 5.3%, 2.7% and 0% of COVID-19-free, COVID-19-suspected and COVID-19-confirmed patients (p=0.003). Overall, 96 (8.9%) patients delayed treatment as a precaution for the pandemic. Among the 11 confirmed cases, 6 (55%) died of COVID-19 complications, and anticancer treatment was restarted in only one.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During the pandemic peak, accurate protective measures successfully resulted in low rates of COVID-19 diagnosis, although with high lethality. Prospective patients\u2019 surveillance will continue with NPS and serology testing to provide a more comprehensive epidemiological picture, a biological insight on the impact of cytotoxic treatments on the immune response, and to protect patients and healthcare workers.<\/jats:p><\/jats:sec>","DOI":"10.1136\/esmoopen-2020-000883","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:05:29Z","timestamp":1604685929000},"page":"e000883","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["COVID-19 risk for patients undergoing anticancer treatment at the outpatient clinic of the National Cancer Institute of Milan: the COVINT study"],"prefix":"10.1016","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8044-4207","authenticated-orcid":false,"given":"Federico","family":"Nichetti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Bini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Ambrosini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Ottini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Rametta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Leporati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Polastri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Pircher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katia","family":"Dotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Ferrari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"de Braud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","published-online":{"date-parts":[[2020,11,6]]},"reference":[{"key":"2020110610050462000_5.Suppl_3.e000883.1","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1056\/NEJMp2002125","article-title":"Defining the Epidemiology of Covid-19 - Studies Needed","volume":"382","author":"Lipsitch","year":"2020","journal-title":"N Engl J Med"},{"key":"2020110610050462000_5.Suppl_3.e000883.2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/s41571-020-0370-6","article-title":"Provision of cancer care during the COVID-19 pandemic","volume":"17","author":"Spicer","year":"2020","journal-title":"Nat Rev Clin Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.3","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.annonc.2020.03.296","article-title":"Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China","volume":"31","author":"Zhang","year":"2020","journal-title":"Ann Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.4","doi-asserted-by":"crossref","DOI":"10.1158\/2159-8290.CD-20-0422","article-title":"Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak","volume":"10","author":"Dai","year":"2020","journal-title":"Cancer Discov"},{"key":"2020110610050462000_5.Suppl_3.e000883.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30096-6"},{"key":"2020110610050462000_5.Suppl_3.e000883.6","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1001\/jamaoncol.2020.0980","article-title":"SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China","volume":"6","author":"Yu","year":"2020","journal-title":"JAMA Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.7","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.annonc.2020.04.006","article-title":"Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City","volume":"31","author":"Miyashita","year":"2020","journal-title":"Ann Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.8","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1111\/bjh.16874","article-title":"Real-world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID-19 disease) in patients with multiple myeloma receiving systemic anti-cancer therapy","volume":"190","author":"Cook","year":"2020","journal-title":"Br J Haematol"},{"key":"2020110610050462000_5.Suppl_3.e000883.9","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/S1470-2045(20)30314-4","article-title":"COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study","volume":"21","author":"Garassino","year":"2020","journal-title":"Lancet Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.10","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1016\/S0140-6736(20)31173-9","article-title":"COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study","volume":"395","author":"Lee","year":"2020","journal-title":"Lancet"},{"key":"2020110610050462000_5.Suppl_3.e000883.11","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-000947"},{"key":"2020110610050462000_5.Suppl_3.e000883.12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ejca.2020.08.011","article-title":"Mortality in patients with cancer and coronavirus disease 2019: a systematic review and pooled analysis of 52 studies","volume":"139","author":"Saini","year":"2020","journal-title":"Eur J Cancer"},{"key":"2020110610050462000_5.Suppl_3.e000883.13","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1200\/GO.20.00300","article-title":"Survey of the impact of COVID-19 on oncologists' decision making in cancer","volume":"6","author":"\u00dcr\u00fcn","year":"2020","journal-title":"JCO Glob Oncol"},{"key":"2020110610050462000_5.Suppl_3.e000883.14","doi-asserted-by":"crossref","first-page":"OP.20.00297","DOI":"10.1200\/OP.20.00297","article-title":"Assessing the impact of the COVID-19 outbreak on the attitudes and practice of Italian oncologists toward breast cancer care and related research activities","author":"Poggio","year":"2020","journal-title":"JCO Oncol Pract"},{"key":"2020110610050462000_5.Suppl_3.e000883.15","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-000853"},{"key":"2020110610050462000_5.Suppl_3.e000883.16","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-000783"},{"key":"2020110610050462000_5.Suppl_3.e000883.17","doi-asserted-by":"crossref","DOI":"10.1177\/0300891620923790","article-title":"Response of a comprehensive cancer center to the COVID-19 pandemic: the experience of the Fondazione IRCCS-Istituto Nazionale dei Tumori di Milano","author":"Valenza","year":"2020","journal-title":"Tumori"},{"key":"2020110610050462000_5.Suppl_3.e000883.18","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1001\/jama.2020.4031","article-title":"Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"key":"2020110610050462000_5.Suppl_3.e000883.19","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/s41591-020-0874-8","article-title":"Caring for patients with cancer in the COVID-19 era","volume":"26","author":"van de Haar","year":"2020","journal-title":"Nat Med"},{"key":"2020110610050462000_5.Suppl_3.e000883.20","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/s41586-020-2405-7","article-title":"Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe","volume":"584","author":"Flaxman","year":"2020","journal-title":"Nature"},{"key":"2020110610050462000_5.Suppl_3.e000883.21","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.clcc.2020.05.004","article-title":"Systemic treatment of patients with gastrointestinal cancers during the COVID-19 outbreak: COVID-19-adapted recommendations of the National cancer Institute of Milan","volume":"19","author":"Pietrantonio","year":"2020","journal-title":"Clin Colorectal Cancer"},{"key":"2020110610050462000_5.Suppl_3.e000883.22","unstructured":"Indagine sierologica su COVID-19 condotta da Ministero della Salute e ISTAT, 2020. 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