Cancer, more than a “COVID-19 co-morbidity”

Abstract

Patients with cancer represent a particularly vulnerable population at risk of adverse outcomes related to COVID-19. Collectively, the initial studies, including patients with and without cancer, confirmed that patients with cancer had a higher risk of complications and death related to COVID-19. Subsequent studies on patients with COVID-19 and cancer investigated patient and disease-related factors associated with COVID-19 severity and morality. Multiple interconnected factors include demographics, comorbidities, cancer-associated variables, treatment side effects, and other parameters. However, there is a lack of clarity on the contributions of any one factor. In this commentary, we deconvolute the data of specific risk factors associated with worse outcomes due to COVID-19 in cancer patients and focus on understanding the recommended guidelines to mitigate COVID-19 risk in this vulnerable population. In the first section, we highlight the key parameters, including age and race, cancer status, type of malignancy, cancer therapy, smoking status and comorbidities that impact outcomes for cancer patients with COVID-19. Next, we discuss efforts made at the patient, health system, and population levels to mitigate the effects of the ongoing outbreak for patients with cancer, including (1) screening, barrier and isolation strategies (2), Masking/PPE (3), vaccination, and (4) systemic therapies (e.g., evusheld) to prevent disease onset in patients. In the last section, we discuss optimal treatment strategies for COVID-19, including additional therapies for patients with COVID-19 and cancer. Overall, this commentary focuses on articles with high yield and impact on understanding the evolving evidence of risk factors and management guidelines in detail. We also emphasize the ongoing collaboration between clinicians, researchers, health system administrators and policymakers and how its role will be important in optimizing care delivery strategies for patients with cancer. Creative patient-centered solutions will be critical in the coming years, post the pandemic.

High-Flow Nasal Cannula oxygen therapy in COVID-19: retrospective analysis of clinical outcomes – single center experience

“…According to a study on the impact of solid cancer on in-hospital mortality in COVID-19 patients, the 30-day in-hospital mortality rate was found to be higher in patients with solid cancer (31.7%) compared to those without cancer (20.0%) ( 51 ). Cancer not only serves as an independent risk factor for the COVID-19 disease severity ( 51 ), but also increases the risk of mortality ( 52 ). The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) reported a significant difference in mortality rates between cancer and non-cancer patients (40.5% vs. 28.5%, respectively) ( 53 ).…”

The effect of COVID-19 on cancer incidences in the U.S

“…Tobacco is known to be a cancer-causing substance. Other proven causes of cancer are genetic mutations or environmental factors [ 7 ]. The American Cancer Society reported that the number of new cancer cases in the United States declined during 2019 and 2020 (by 1.5%), during the pandemic era [ 7 ].…”

“…Other proven causes of cancer are genetic mutations or environmental factors [ 7 ]. The American Cancer Society reported that the number of new cancer cases in the United States declined during 2019 and 2020 (by 1.5%), during the pandemic era [ 7 ]. This delay could cause an upward shift in the prevalence data because incidence was not immediately treated.…”