The COVID-19 pandemic caused a change in our society and put health systems in crisis worldwide. Different risk factors and comorbidities have been found that increase the risk of mortality when acquiring this infection. The use of alternative devices to the cigarette like the electronic cigarettes, the vapers have been studied widely and generators of great controversy since it has been discovered that they also produce different pulmonary affections. When developing the SARS-CoV2 infection, different theories have been generated about the greater predisposition to a worse prognosis of people who use electronic cigarettes; however, the information on this continues in discovery. A group of experts made up of oncologists, infectologists, pulmonologists, and epidemiologists met to review the literature and then generate theories about the impact of electronic cigarettes on SARS-CoV2 infection.

Liang et al 1 described a Chinese cohort of patients with cancer during the COVID-19 outbreak. The clinical characteristics and outcomes were relevant to our clinical practice. As a whole, patients with cancer have a higher risk for severe events (39% v 8%; P = .0003), including death. Outcomes are even worse in patients who received active treatment in the first month before infection (75% v 43%; odds ratio, 5.34). These patients also had a faster evolution to deterioration (13 v 43 days; P = .0001).

Our findings raise the need to carefully evaluate patients with metastatic cancer, in progression, and with impaired ECOG to define the relevance of cancer treatment during the pandemic, consider the risk/benefit of the interventions, and establish clear and complete communication with the patients and their families about the risk of complications. There is also the importance of offering additional support to patients with low income and residence in rural areas so that they can have more support during cancer treatment.

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