| Summary: | Abstract Background COVID‐19 infection delays therapy and in‐person evaluation for oncology patients, but clinic clearance criteria are not clearly defined. Methods We conducted a retrospective review of oncology patients with COVID‐19 at a tertiary care center during the Delta and Omicron waves and compared clearance strategies. Results Median clearance by two consecutive negative tests was 32.0 days (Interquartile Range [IQR] 22.0–42.5, n = 153) and was prolonged in hematologic malignancy versus solid tumors (35.0 days for hematologic malignancy, 27.5 days for solid tumors, p = 0.01) and in patients receiving B‐cell depletion versus other therapies. Median clearance by single negative test was reduced to 23.0 days (IQR 16.0–33.0), with recurrent positive rate 25.4% in hematologic malignancy versus 10.6% in solid tumors (p = 0.02). Clearance by a predefined waiting period required 41 days until an 80% negative rate. Conclusions COVID‐19 clearance remains prolonged in oncology patients. Single‐negative test clearance can balance delays in care with risk of infection in patients with solid tumors.
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