First results from the UK COVID-19 Serology in Oncology Staff Study (CSOS)
Background: The global SARS-CoV-2 (COVID-19) pandemic has caused substantial worldwide mortality. At present, there is no data regarding oncologist-specific SARS-CoV-2 infection/immunity rates in the United Kingdom (UK) which might impact planning for the management of potentially immunosuppressed cancer patients. Here, we present the first results from the COVID-19 Serology in Oncology Staff (CSOS) study with the aim of informing non-surgical oncology management guidelines. Methods: Patient-facing staff working in an oncology department during the COVID-19 pandemic at a large district general hospital in the East of England were invited to participate. Samples were collected during the first week of June 2020: blood for SARS-COV-2 antibody testing using a rapid lateral flow point of care (POC) assay and a laboratory Luminex based assay, as well as a nasopharyngeal swab for SARS-CoV-2 PCR testing. Participant characteristics were also collected. Results: Seventy participants were recruited: nurses (45/70; 64.3%), doctors (15/70; 21.2%), and other patient-facing staff (10/70; 14.3%). The majority were female (61/70; 87.1%) with a mean age of 42 years (median 41; range 23-64 years). A minority were smokers (9/70; 10%) or had chronic underlying health conditions (16/70; 22.9%), the commonest being asthma. All participants were nasopharyngeal-swab PCR negative, although 4/70 (5.7%) had previously tested positive by NHS testing undertaken during the preceding months. 15/70 (21.4%) had positive SARS-CoV-2 antibodies using the Luminex test. Nurses had the highest incidence of positive antibodies (13/45; 28.9%), with a lower incidence in doctors (2/15; 13.3%) although this difference was not statistically significant (Fischer's exact test p=0.3). No receptionists had positive antibody tests. All four participants with a previously reported positive PCR test were antibody-positive. 9/15 (60%) of antibody-positive participants reported previous symptoms suggestive of SARS-CoV-2 infection: a 3.6-fold higher odds than antibody-negative participants, of whom 16/55 reported symptoms (p=0.03). The mean duration of symptoms was 11 days (median 11; range 1-35 days) and the mean time from resolution of reported previous symptoms to antibody testing was 48.4 days (median 46; range 1-123 days). Conclusion: This study establishes the SARS-CoV-2 exposure and carriage rate amongst patient-facing staff working in the oncology department of a large UK general hospital during the pandemic. These results may help inform UK national oncology patient management prior to the development of a viable vaccine or treatment.