COVID-19 in cancer patients: risk, clinical features, and management

Liu, Cuiwei; Zhao, Yuliang; Okwan-Duodu, Derick; Basho, Reva; Cui, Xiaojiang

doi:10.20892/j.issn.2095-3941.2020.0289

Cited by 172 publications

(142 citation statements)

References 55 publications

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“…The decision to continue or suspend ICI treatment should be based on case-by-case approaches [ 44 , 50 ], where treatment adjustments may be performed to mitigate the risk of COVID-19 infection by reducing patients’ contacts to medical system, rather than due to ICI-related safety concerns. This is saliently important considering that cancer patients receiving active anticancer therapy may be at an increased COVID-19 infection risk due to frequent visits to hospitals [ 51 ]. Furthermore, specific approaches to certain populations may be adopted, e.g., early treatment discontinuation in patients with complete or prolonged response[ 8 ], adjustments of treatment intervals or modality [ 7 , 52 ], or adjournments of ICI therapy in high risk patients (e.g., elderly, patients with history of immune-related adverse events and/or comorbidities) [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis

Lazarus

Budiman

Rinaldi

2021

Cancer Immunol Immunother

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Background The association between immune checkpoint inhibitor (ICI) and outcomes of cancer patients with coronavirus disease 2019 (COVID-19) infection has yet to be systematically evaluated. This meta-analysis aims to investigate the effects of ICI treatment on COVID-19 prognosis, including mortality, severity, and any other prognosis-related outcomes. Methods Eligible studies published up to 27 February 2021 were included and assessed for risk of bias using the Quality in Prognosis Studies tool. A random-effects meta-analysis was conducted to estimate the pooled effect size along with its 95% confidence intervals. The quality of body evidence was evaluated using the modified Grading of Recommendations Assessment, Development, and Evaluation framework. Results Eleven studies involving a total of 2826 COVID-19-infected cancer patients were included in the systematic review. We discovered a moderate-to-high quality of evidence that ICI was not associated with a higher mortality risk, while the other outcomes yielded a very low-to-low-evidence quality. Although our findings indicated that ICI did not result in a higher risk of severity and hospitalization, further evidence is required to confirm our findings. In addition, we discovered that prior exposure to chemoimmunotherapy may be linked with a higher risk of COVID-19 severity (OR 8.19 [95% CI: 2.67–25.08]; I 2 = 0%), albeit with small sample size. Conclusion Our findings indicated that ICI treatment should not be adjourned nor terminated during the current pandemic. Rather, COVID-19 vigilance should be increased in such patients. Further studies with larger cohorts and higher quality of evidence are required to substantiate our findings. Trial registration number This project has been prospectively registered at PROSPERO (registration ID: CRD42020202142) on 4 August 2020. Supplementary Information The online version contains supplementary material available at 10.1007/s00262-021-02990-9.

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Section: Discussionmentioning

confidence: 99%

Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis

Lazarus

Budiman

Rinaldi

2021

Cancer Immunol Immunother

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“…Of particular interest, cancer patients have been reported to be more susceptible to COVID-19 infection compared to individuals without cancer, and this is attributed to either a systemic reduced immunity or anticancer therapy [137]. Moreover, this finding is distinctly observed in lung cancer patients due to the fact that they already have chronic pulmonary inflammation [138].…”

Section: Infectious Complications Of Lung Cancermentioning

confidence: 99%

Links between Infections, Lung Cancer, and the Immune System

Budişan

Zănoagă

Braicu

et al. 2021

IJMS

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Lung cancer is the leading disease of cancer-related deaths worldwide. Since the beginning of the 20th century, various infectious agents associated with lung cancer have been identified. The mechanisms that include systemic inflammatory pathways as effect of microbial persistence in the lung can secondarily promote the development of lung carcinogenesis. Chronic inflammation associated with lung-cancer infections is known to precede tumor development, and it has a strong effect on the response(s) to therapy. In fact, both viral and bacterial infections can activate inflammatory cells and inflammatory signaling pathways. In this review, an overview of critical findings of recent studies investigating associations between each of viral and bacterial pathogens and lung carcinoma is provided, with particular emphasis on how infectious organisms can interfere with oncogenic processes and all the way through immunity. Moreover, a discussion of the direct crosstalk between lung tumor development and inflammatory processes is also presented.

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“…They have also revealed poorer outcomes, due to higher incidence of acute complications [29] [31]. Moreover, Liang et al reported that cancer patients had an increased risk of severe infections with a 3.5-fold increase in the risk of ICU admission or death, compared to those without cancer [32] [33].…”

Section: Cancermentioning

confidence: 99%

Review of the Prognosis Factors of COVID-19 Infection

Besteiro¹,

Coutinho²,

Gomes³

et al. 2021

AID

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An epidemic of Coronavirus disease 2019 outbroke in December 2019 in China, Wuhan, which is becoming a Public Health Emergency of International Concern. As this entity has become one of the worst infectious disease outbreaks of recent times, with mortality estimates in general population ranging from 1.4% to 8%, it is crucial to better understand the prognostic factors which can be associated to the outcome of this disease. However, as the pandemic is still unfortunately under progression, there are limited data with regard to the prognostic factors. Hence, this review seeks to gather and provide the existing data of the literature of all the prognosis factors of COVID-19 infection such as older age, obesity, comorbidities, lymphocytopenia, d-dimers elevation, thrombocytopenia, elevated levels of high-sensitivity cardiac troponin, C-reactive protein elevation and imaging features of COVID-19.

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COVID-19 in cancer patients: risk, clinical features, and management

Cited by 172 publications

References 55 publications

Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis

Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis

Links between Infections, Lung Cancer, and the Immune System

Review of the Prognosis Factors of COVID-19 Infection

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