On cancer, COVID‐19, and CT scans: A monocentric retrospective study

Abstract

Background The use of computed tomography (CT) for coronavirus disease 2019 (COVID‐ 19) diagnosis in an area of northern Italy with a high incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection may have identified more patients with this disease than RT‐ PCR in the very early onset of the COVID‐19 pandemic. Methods We retrospectively reviewed 148 chest CT scans of oncological patients who were referred to the Radiological Unit of Policlinico S. Marco from 1 February 2020 to 30 April 2020, during the COVID‐19 outbreak in Bergamo area. In parallel, we analyzed RT‐PCR tests of these 148 patients. Results Among 32 patients with a diagnosis of COVID‐19, 17 patients were asymptomatic or had mild symptoms (53.1%), while 15 developed severe disease (46.8%). The incidence of SARS‐CoV‐2 infection was 22.9%, the mortality rate was 18.8%. We did not find any correlation between disease severity and age, sex, smoking, or cardiovascular comorbidities. Remarkably, patients who were on treatment for cancer developed a milder disease than patients who were not on treatment. Conclusions The acceptance of CT‐defined diagnoses in COVID‐19 high‐incidence areas like Bergamo region highlighted a larger oncological population affected by COVID‐19 than RT‐PCR, in particular, asymptomatic and mildly symptomatic patients, because only symptomatic patients underwent nasopharyngeal swabbing at the onset of the COVID‐19 pandemic. We observed that patients actively treated for their cancer had a milder disease, in agreement with previous studies that suggested a protective role of immunosuppression. Admittedly, the sample of patients in our study was heterogeneous regarding the oncological disease, their prognosis, and the type of treatment; therefore, other studies are needed to confirm our data.