Multicenter Study of Antibody Seroprevalence against COVID-19 in Patients Presenting to Iranian Cancer Centers after One Year of the COVID-19 Pandemic

Abstract

Patients with cancer are at significantly greater risk of COVID-19 and its complications than the general population. Since IgG antibodies remain detectable well after infection with the SARS-CoV-2 virus, seroprevalence can be used to estimate the proportion of the cancer population previously infected and potentially immune to SARS-CoV-2. The current study is a multi-center, prospective observational study to assess the seroprevalence of SARS-CoV-2 IgG antibody in a cancer population referred for vaccination between April and June 2021. Of a total of 270 adult patients with cancer accrued, 16% reported a history of COVID-19 more than four weeks previously confirmed by PCR. At the same time, serologic positivity for SARSCoV2 IgG was found in 29% of patients prior to vaccination including nearly 20% of patients without a history of confirmed COVID-19. Seropositivity was significantly greater in females consistent with higher rates in patients with breast cancer and gynecologic cancers. A seroconversion rate of 79.5% was observed in cancer patients with a history of PCR confirmed COVID-19, less than observed in the general population. In multivariable analysis, gender and prior history of COVID-19 were both independently associated with seropositivity prior to vaccination. Follow-up is continuing of this cohort of patients with cancer following vaccination to assess antibody and clinical outcomes.

Keywords:

• Iran
• COVID-19
• SARS-CoV-2
• cancer patients
• seroprevalence
• antibodies
• SARS-CoV-2 IgG antibody

Acknowledgments

The authors would like to thank all patients who participate in the project. Also, a special thanks to Ms. Batol Keykhosravi, Ms. Azam Akbari Yazdi and Clinical Research Development Unit, Hospital Research Development Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran for their great help.

Author contributions

Study concept and design: S. A. J.; acquisition of data: M.D. M.A. A.G. M.N. P.P. B.P. D.F. F.H. S.A.J; analysis and interpretation of data: S.A.J and G.H.L; drafting of the manuscript: F.H.; critical revision of the manuscript for important intellectual content: M.D. M.A. A.G. M.N. P.P. B.P. D.F. S.A.J; statistical analysis: G.H.L.

Disclosure statement

The authors declare that there is no conflict of interest to be reported.

Ethical approval

The protocol of the study was approved by the Ethics Committee of Sabzevar University of Medical Sciences (IR.MEDSAB.REC.1400.027 and IR.MEDSAB.REC.1400.099) and a written informed consent form was obtained from the patients or the legal guardian.

Data availability statement

All data generated and analyzed during this study can be accessed through direct communication with the corresponding author and the agreement of all research team members.

Additional information

Funding

This research was funded by Sabzevar University of Medical Sciences [grant number 400004 and 400070] andCancer Research Center, Shahid Beheshti University of Medical Sciences [29074].