Isolation precautions associated with COVID-19 infections among immunocompromised populations: A multicenter study of nine National Cancer Institute--designated Comprehensive Cancer Centers

BACKGROUND: Nine Comprehensive Cancer Centers sought to understand COVID-19 infection management experiences to improve future immunocompromised host guidelines.

METHODS: Volunteers from Comprehensive Cancer Center Infection Prevention and Control (C3IC) completed 2 surveys on COVID-19 practices from March 2020 to December 2023. Three reviewers independently validated qualitative analysis of findings. Virtual meetings were leveraged to discuss findings and identify themes.

RESULTS: 100% (9/9) of respondents changed COVID-19-associated isolation discontinuation guidance at least once. All (9/9) included patient immune status as criterion. All (9/9) required clearance testing at some point in the pandemic, 6 of 9 (66%) continued to require clearance testing at the time of the survey. Only 1 of 9 (11%) allowed antigen testing to meet criteria. Seven isolation titles were noted across 9 institutions, despite near agreement on measures employed.

DISCUSSION: Variability existed in COVID-19 management among study participants, despite serving similar populations, which may stem from limited data supporting understanding of viral transmissibility in immunocompromised hosts.

CONCLUSIONS: Guideline development for immunocompromised hosts, potential drivers for viral evolution, can lack clarity for consistent management of the population. Engaging subject matters in specialty populations with future guideline development will improve infection prevention in health care settings.