Abstract：
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be spread by individuals unaware they are infected. Such dissemination has heightened ramifications in cancer patients, who may need to visit healthcare facilities frequently, be exposed to immune-compromising therapies, and face greater morbidity from coronavirus disease 2019 (COVID-19). We determined characteristics of (1) asymptomatic, clinically diagnosed, and (2) serologically documented but clinically undiagnosed SARS-CoV-2 infection among individuals with lung cancer.
METHODS: In a multicenter registry, individuals with lung cancer (regardless of prior SARS-CoV-2 vaccination or documented infection) underwent collection of clinical data and serial blood samples, which were tested for antinucleocapsid protein antibody (anti-N Ab) or IgG (N) levels. We used multivariable logistic regression models to investigate clinical characteristics associated with the presence or absence of symptoms and the presence or absence of a clinical diagnosis among patients with their first SARS-CoV-2 infection.
RESULTS: Among patients with serologic evidence or clinically documented SARS-CoV-2 infection, 80/142 (56%) had no reported symptoms at their first infection, and 61/149 (40%) were never diagnosed. Asymptomatic infection was more common among older individuals and earlier-stage lung cancer. In multivariable analysis, non-white individuals with SARS-CoV-2 serologic positivity were 70% less likely ever to be clinically diagnosed (P = .002).
CONCLUSIONS: In a multicenter lung cancer population, a substantial proportion of SARS-CoV-2 infections had no associated symptoms or were never clinically diagnosed. Because such cases appear to occur more frequently in populations that may face greater COVID-19-associated morbidity, measures to limit disease spread and severity remain critical.
METHODS: In a multicenter registry, individuals with lung cancer (regardless of prior SARS-CoV-2 vaccination or documented infection) underwent collection of clinical data and serial blood samples, which were tested for antinucleocapsid protein antibody (anti-N Ab) or IgG (N) levels. We used multivariable logistic regression models to investigate clinical characteristics associated with the presence or absence of symptoms and the presence or absence of a clinical diagnosis among patients with their first SARS-CoV-2 infection.
RESULTS: Among patients with serologic evidence or clinically documented SARS-CoV-2 infection, 80/142 (56%) had no reported symptoms at their first infection, and 61/149 (40%) were never diagnosed. Asymptomatic infection was more common among older individuals and earlier-stage lung cancer. In multivariable analysis, non-white individuals with SARS-CoV-2 serologic positivity were 70% less likely ever to be clinically diagnosed (P = .002).
CONCLUSIONS: In a multicenter lung cancer population, a substantial proportion of SARS-CoV-2 infections had no associated symptoms or were never clinically diagnosed. Because such cases appear to occur more frequently in populations that may face greater COVID-19-associated morbidity, measures to limit disease spread and severity remain critical.
摘要：
背景：严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可能由不知道感染的个体传播。这种传播增加了癌症患者的后果，他们可能需要经常去医疗机构，暴露于免疫受损的疗法，并面临2019年冠状病毒病（COVID-19）的更高发病率。我们确定了(1)无症状，临床诊断,和（2）血清学记录但临床未诊断的SARS-CoV-2感染肺癌个体。
方法：在多中心注册中心中，肺癌患者（无论以前是否接种过SARS-CoV-2疫苗或有记录的感染）接受了临床数据和系列血液样本的收集，测试了抗核衣壳蛋白抗体（抗NAb）或IgG（N）水平。我们使用多变量逻辑回归模型来研究首次感染SARS-CoV-2的患者中与症状的存在或不存在以及临床诊断的存在或不存在相关的临床特征。
结果：在有血清学证据或临床记录的SARS-CoV-2感染的患者中，80/142（56％）在首次感染时没有报告症状，61/149（40％）从未诊断。无症状感染在老年人和早期肺癌中更为常见。在多变量分析中，SARS-CoV-2血清学阳性的非白种人被临床诊断的可能性降低了70%(P=.002).
结论：在多中心肺癌人群中，相当比例的SARS-CoV-2感染没有相关症状或从未被临床诊断.因为这类病例似乎在可能面临更高的COVID-19相关发病率的人群中更频繁发生，限制疾病传播和严重程度的措施仍然至关重要。
方法：在多中心注册中心中，肺癌患者（无论以前是否接种过SARS-CoV-2疫苗或有记录的感染）接受了临床数据和系列血液样本的收集，测试了抗核衣壳蛋白抗体（抗NAb）或IgG（N）水平。我们使用多变量逻辑回归模型来研究首次感染SARS-CoV-2的患者中与症状的存在或不存在以及临床诊断的存在或不存在相关的临床特征。
结果：在有血清学证据或临床记录的SARS-CoV-2感染的患者中，80/142（56％）在首次感染时没有报告症状，61/149（40％）从未诊断。无症状感染在老年人和早期肺癌中更为常见。在多变量分析中，SARS-CoV-2血清学阳性的非白种人被临床诊断的可能性降低了70%(P=.002).
结论：在多中心肺癌人群中，相当比例的SARS-CoV-2感染没有相关症状或从未被临床诊断.因为这类病例似乎在可能面临更高的COVID-19相关发病率的人群中更频繁发生，限制疾病传播和严重程度的措施仍然至关重要。
