%0 Journal Article
%T Characteristics of Lung Cancer Patients With Asymptomatic or Undiagnosed SARS-CoV-2 Infections.
%A Somisetty M
%A Mack PC
%A Hsu CY
%A Huang Y
%A Gomez JE
%A Rodilla AM
%A Cagan J
%A Tavolacci SC
%A Carreño JM
%A Brody R
%A Moore AC
%A King JC
%A Rohs NC
%A Rolfo C
%A Bunn PA
%A Minna JD
%A Bhalla S
%A Krammer F
%A García-Sastre A
%A Figueiredo JC
%A Kazemian E
%A Reckamp KL
%A Merchant AA
%A Nadri M
%A Ahmed R
%A Ramalingam SS
%A Shyr Y
%A Hirsch FR
%A Gerber DE
%J Clin Lung Cancer
%V 0
%N 0
%D 2024 Jul 20
%M 39122606
%F 4.84
%R 10.1016/j.cllc.2024.07.007
%X 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.