COVID-19 and Cancer Comorbidity: Therapeutic Opportunities and Challenges

Abstract

The coronavirus disease 2019 (COVID-19) is a viral disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that affects the respiratory system of infected individuals. COVID-19 spreads between humans through respiratory droplets produced when an infected person coughs or sneezes. The COVID-19 outbreak originated in Wuhan, China at the end of 2019. As of 29 Sept 2020, over 235 countries, areas or territories across the globe reported a total of 33,441,919 confirmed cases, and 1,003,497 confirmed deaths due to COVID-19. Individuals of all ages are at risk for infection, but in most cases disease severity is associated with age and pre-existing diseases that compromise immunity, like cancer. Numerous reports suggest that people with cancer can be at higher risk of severe illness and related deaths from COVID-19. Therefore, managing cancer care under this pandemic is challenging and requires a collaborative multidisciplinary approach for optimal care of cancer patients in hospital settings. In this comprehensive review, we discuss the impact of the COVID-19 pandemic on cancer patients, their care, and treatment. Further, this review covers the SARS-CoV-2 pandemic, genome characterization, COVID-19 pathophysiology, and associated signaling pathways in cancer, and the choice of anticancer agents as repurposed drugs for treating COVID-19.

The high expression of SARS-CoV-2 cell receptors might lead to higher COVID-19 infection rates in cancer patients

“…In addition, ACE2-dependent co-receptor NRP1 was also ignored by Dr. Cai et al (1,4). These might be potential reasons why Dr. Cai et al 's results were inconsistent with previous observational studies (6).…”

“…In this study, we investigated the impact of all known potential SARS-COV-2 receptors in the four clinically observed tumor types most susceptible to COVID-19, including lung cancer, esophageal carcinoma, B-cell lymphoma and leukemia (6). NRP1, the ACE2-dependent co-receptor, and TMEM106B, a proviral host factor for SARS-CoV-2 were differentially expressed in all the four tumors (4, 5).…”

COVID-19 and Its Impact on Upper Gastrointestinal (GI) Cancer Management

“…It is imperative we use the available evidence base when deciding treatment strategies, which should be discussed openly with our cancer patients; offering anti-cancer treatment is safe, but the individualized risk to the patient should be assessed [ 22 , 26 , 27 ].…”

Dyslipidemia in breast cancer patients increases the risk of SAR-CoV-2 infection

“…According to the type and site of the primary tumor, the risk of adverse events from SARS-CoV-2 infection is significantly different ( Rugge et al, 2020 ). Among 1035 cancer patients infected with SARS-CoV-2, BC was the most prevalent type of cancer ( Pathania et al, 2021 ). BC patients are at higher risk of hospitalization and death from SARS-CoV-2 infection ( Rugge et al, 2020 ).…”