Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence

Abstract

The novel coronavirus, also known as SARS-Cov-2 or COVID-19 has become a worldwide threat and the major healthcare concern of the year 2020. Cancer research was directly affected by the emerging of this disease. According to some Chinese studies, cancer patients are more vulnerable to COVID-19 complications. This observation led many oncologists to change their daily practice in cancer care, without solid evidence and recommendations. Moreover, the COVID-19 manifestations as well as its diagnosis are particular in this special population. In this review paper we expose the challenges of cancer management in the era of SARS-CoV-2, the epidemiological, clinical, pathological and radiological characteristics of the disease in cancer patients and its outcomes on this population. Finally, we focus on strategies that are followed in cancer management with review of national and international guidelines. J o u r n a l P r e -p r o o f electronic search of the literature was conducted in the PubMed database until the 5th of April 2020. The following keywords with Boolean operators were used 'covid-19', 'novel coronavirus'and 'SARS-CoV-2' in combination with 'cancer', 'neoplasm', 'oncology' and 'malignancy'. A total of 223 articles were extracted. We included articles in English as well as articles in French because we are familiar with this language. Abstracts in English of articles in Chinese language were also J o u r n a l P r e -p r o o f 3 included. Duplicated articles and articles that were published before the era of SARS-Cov-2 (i.e., before December 2019) were excluded. Titles and abstracts of retrieved articles were screened for eligibility, and then entire texts were analyzed and 88 papers that respond to our objectives were included in this review. Our work is summarized in the PRISMA diagram below. ResultsOut of 88 articles, six were in French language and 19 were in Chinese language with English abstracts. Most of the papers consisted of short editorials, letters, correspondence or comments.Ten Cohort studies were identified (retrospective, prospective or cross-sectional analysis) as well as 9 case reports and one case series. Only four of the cohort studies exclusively included cancer patients. Of note, all cohort studies were conducted in China. Most of the reported cases originated from China and Italy.59% of the published papers originated from China and Italy (52 of 88). Seven works were multinational and the majority of them were multicontinental, issued in collaboration between researchers from Asia, Europe and the Americas. We identified one article originating from each of the following countries: Canada, India, Singapore, Spain and Saudi Arabia. The pie chart below

The Risk and Prevalence of COVID-19 Infection in Colorectal Cancer Patients: a Systematic Review and Meta-analysis

“…Individuals with cancer had a higher risk of COVID-19 infection due to poor immunity from tumor load and malnourishment [29,30]. Some studies demonstrated that patients with cancer seemed to be more likely to be infected with COVID-19 and have a higher risk of a severe event [31][32][33]. To date, some studies have been performed to evaluate the COVID-19 infection in CRC patients, but the results of these studies were inconsistent because most of these are single-center studies with limited sample sizes.…”

Neuroendovascular clinical trials disruptions due to COVID-19. Potential future challenges and opportunities

“…One previous letter has been published, documenting decreased enrollment related to the pandemic in cancer-related clinical trials, 5 and another systematic review on cancer research during COVID-19. 6 The Federation of Italian Cooperative Oncology group issued a brief commentary and practice indications for drug studies. 7 Other publications have included clinical trials for Alzheimer's research, 8 and a review for guidance in head and neck research.…”

Digital pathology and artificial intelligence will be key to supporting clinical and academic cellular pathology through COVID-19 and future crises: the PathLAKE consortium perspective

“…Several research articles covering the interplay between cancer and COVID-19 have been published, many from China and Italy, and they focus mainly on four areas: the effect of cancer therapy in COVID-19, epidemiological/clinical/radiological/pathological features, outcomes of patients with cancer with COVID-19 and strategies for risk reduction and management. 22 According to an analysis of 355 Italian patients, 20% of those who died from COVID-19 had active cancer. 23 However overall, further evidence for the effect of COVID-19 on patients with cancer are needed.…”