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CC BY 4.0 · Brazilian Journal of Oncology 2021; 17: e-20210022
DOI: 10.5935/2526-8732.20210022
Review Article
Clinical Oncology

COVID-19 and cancer: an extensive review

COVID-19 e câncer: uma revisão extensa

Tomás de Souza Mello
1   UNESA, Faculdade de Medicina - Rio de Janeiro - Rio de Janeiro - Brazil
,
Rafael Bellotti Azevedo
1   UNESA, Faculdade de Medicina - Rio de Janeiro - Rio de Janeiro - Brazil
,
João Victor Gonçalves de-Hollanda
1   UNESA, Faculdade de Medicina - Rio de Janeiro - Rio de Janeiro - Brazil
,
Leonardo Villa Leão Ferreira
1   UNESA, Faculdade de Medicina - Rio de Janeiro - Rio de Janeiro - Brazil
,
Fabricio Montalvão
1   UNESA, Faculdade de Medicina - Rio de Janeiro - Rio de Janeiro - Brazil
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ABSTRACT

Emerging data postulates that cancer is an important risk factor for disease severity and higher in-hospital mortality amongst patients with COVID-19. From a pathophysiological perspective, COVID-19 induces an overproduction of inflammatory cytokines, causing systemic inflammation, hypercoagulability, and multiple organ dysfunction syndrome. The exact pathophysiological mechanisms associated with severe COVID-19 disease in patients with cancer is uncertain. Moreover, the challenge of implementing social distancing in patients requiring specific anticancer treatments urged international societies to issue recommendations regarding the adoption of safety measures to reduce transmission risk and optimize anticancer treatment during the COVID-19 pandemic. We provide an extensive review of the clinical outcomes, prognosis and management of patients with cancer and COVID-19 infection.

RESUMO

Dados emergentes postulam que o câncer é um importante fator de risco para gravidade da doença e maior mortalidade hospitalar entre pacientes com COVID-19. Sob uma perspectiva fisiopatológica, a COVID-19 induz uma superprodução de citocinas inflamatórias, causando inflamação sistêmica, hipercoagulabilidade e disfunção de múltiplos órgãos. Os mecanismos fisiopatológicos exatos associados à COVID-19 grave em pacientes com câncer são incertos. Além disso, o desafio de implementar o distanciamento social em pacientes que requerem tratamentos anticâncer específicos instou as sociedades internacionais a emitir recomendações sobre a adoção de medidas de segurança para reduzir o risco de transmissão e otimizar o tratamento anticâncer durante a pandemia de COVID-19. Nós fornecemos uma extensa revisão dos resultados clínicos, prognóstico e tratamento de pacientes com câncer e infecção por COVID-19.

Keywords:

COVID-19 - Cancer - Pathophysiology - Clinical outcome - Management.

Descritores:

Infecções por coronavírus - Sintomas de câncer - Evolução clínica.

CONFLICTS OF INTEREST/DISCLOSURE STATEMENT

The authors declare that there is no conflict of interest.


Financial support: none to declare.


SOURCES OF FUNDING

Fabricio Montalvão had a Researcher fellowship from Universidade Estácio de Sá.




Publication History

Received: 13 April 2021

Accepted: 13 July 2021

Article published online:
13 August 2021

© 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
Tomás de Souza Mello, Rafael Bellotti Azevedo, João Victor Gonçalves de-Hollanda, Leonardo Villa Leão Ferreira, Fabricio Montalvão. COVID-19 and cancer: an extensive review. Brazilian Journal of Oncology 2021; 17: e-20210022.
DOI: 10.5935/2526-8732.20210022
 

  • REFERENCES

  • Clerkin K, Fried J, Raikhelkar J, Sayer G, Griffin J, Masoumi A. et al COVID-19 and Cardiovascular Disease. Circulation 2020; 141 (20) 1648-1655
    Search in Google Scholar
  • Zhu N, Zhang D, Wang W, Li X, Yang B, Song J. et al A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine 2020; 382 (08) 727-733
    Search in Google Scholar
  • Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A. et al World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery 2020; 76: 71-76
    Search in Google Scholar
  • Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A.. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians; 2018. 68. (6); 394-424
    Search in Google Scholar
  • Raymond E, Thieblemont C, Alran S, Faivre S.. Impact of the COVID-19 Outbreak on the Management of Patients with Cancer. Targeted Oncology 2020; 15 (03) 249-259
    Search in Google Scholar
  • Addeo A, Friedlaender A.. Cancer and COVID-19: Unmasking their ties. Cancer Treatment Reviews 2020; 88: 102041
    Search in Google Scholar
  • Emanuel E, Persad G, Upshur R, Thome B, Parker M, Glickman A. et al Fair Allocation of Scarce Medical Resources in the Time of Covid-19. New England Journal of Medicine 2020; 382 (21) 2049-2055
    Search in Google Scholar
  • Lai C, Liu Y, Wang C, Wang Y, Hsueh S, Yen M. et al Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2): Facts and myths. Journal of Microbiology, Immunology and Infection 2020; 53 (03) 404-412
    Search in Google Scholar
  • World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. Pediatria i Medycyna Rodzinna 2020; 16 (01) 9-26
    Search in Google Scholar
  • Kakodkar P, Kaka N, Baig M. A. Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19). . Cureus 2020
  • Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C. et al Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. New England Journal of Medicine 2020; 382 (10) 970-971
    Search in Google Scholar
  • Guan W, Ni Z, Hu Y, Liang W, Ou C, He J. et al Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine 2020; 382 (18) 1708-1720
    Search in Google Scholar
  • Wu Z, McGoogan J.. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA 2020; 323 (13) 1239
    Search in Google Scholar
  • Siddiqi H, Mehra M. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. The Journal of Heart and Lung Transplantation 2020; 39 (05) 405-407
    Search in Google Scholar
  • Singhal T.. A Review of Coronavirus Disease-2019 (COVID-19). The Indian Journal of Pediatrics 2020; 87 (04) 281-286
    Search in Google Scholar
  • Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. COVID-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome. American Journal of Respiratory and Critical Care Medicine 2020; 201 (10) 1299-1300
    Search in Google Scholar
  • Mehta P, McAuley D, Brown M, Sanchez E, Tattersall R, Manson J. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet 2020; 395 (10229): 1033-1034
    Search in Google Scholar
  • Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S. et al Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine 2020; 180 (07) 934
    Search in Google Scholar
  • Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y. et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet 2020; 395 (10223): 507-513
    Search in Google Scholar
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y. et al Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases 2020; 71 (15) 762-768
    Search in Google Scholar
  • CDC Weekly C. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) - China, 2020. China CDC Weekly 2020; 2 (08) 113-122
    Search in Google Scholar
  • Long B, Brady W, Koyfman A, Gottlieb M.. Cardiovascular complications in COVID-19. The American Journal of Emergency Medicine 2020; 38 (07) 1504-1507
    Search in Google Scholar
  • Guo Y, Cao Q, Hong Z, Tan Y, Chen S, Jin H. et al The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. . Military Medical Research. 2020;7(1)
  • Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S. et al SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell 2020; 181 (02) 271-280.e8
    Search in Google Scholar
  • Addeo A, Friedlaender A.. Cancer and COVID-19: Unmasking their ties. Cancer Treatment Reviews 2020; 88: 102041
    Search in Google Scholar
  • Tay M, Poh C, Rénia L, MacAry P, Ng L.. The trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology 2020; 20 (06) 363-374
    Search in Google Scholar
  • Wu Z, McGoogan J.. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA 2020; 323 (13) 1239
    Search in Google Scholar
  • Imai Y, Kuba K, Rao S, Huan Y, Guo F, Guan B. et al Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature 2005; 436 (7047) 112-116
    Search in Google Scholar
  • Lalloo U, Barnes P, Chung K.. Pathophysiology and clinical presentations of cough. Journal of Allergy and Clinical Immunology 1996; 98 (05) S91-S97
    Search in Google Scholar
  • Guan W, Ni Z, Hu Y, Liang W, Ou C, He J. et al Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine 2020; 382 (18) 1708-1720
    Search in Google Scholar
  • Hottz E, Azevedo-Quintanilha I, Palhinha L, Teixeira L, Barreto E, Pão C. et al Platelet activation and platelet-monocyte aggregate formation trigger tissue factor expression in patients with severe COVID-19. Blood 2020; 136 (11) 13301341
    Search in Google Scholar
  • Goshua G, Pine A, Meizlish M, Chang C, Zhang H, Bahel P. et al Endotheliopathy in COVID19-associated coagulopathy: evidence from a single-centre, cross-sectional study. The Lancet Haematology 2020; 7 (08) e575-e582
    Search in Google Scholar
  • Fox S, Akmatbekov A, Harbert J, Li G, Quincy Brown J, Vander Heide R.. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. The Lancet Respiratory Medicine 2020; 8 (07) 681-686
    Search in Google Scholar
  • Gu S, Tyagi T, Jain K, Gu V, Lee S, Hwa J. et al Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation. Nature Reviews Cardiology 2020; 18 (03) 194-209
    Search in Google Scholar
  • Gerotziafas G, Van Dreden P, Catalano M, Colgan M, Pecsvarady Z, Wautrecht J. et al Guidance for the management of patients with vascular disease or cardiovascular risk factors and Covid-19 Position paper from VAS-European Independent Foundation in Angiology/Vascular Medicine. Sang thrombose vaisseaux 2020; 32 (06) 241-259
    Search in Google Scholar
  • Sidaway P.. COVID-19 and cancer: what we know so far. Nature Reviews Clinical Oncology 2020; 17 (06) 336-336
    Search in Google Scholar
  • Salunke A, Nandy K, Pathak S, Shah J, Kamani M, Kottakota V. et al Impact of COVID -19 in cancer patients on severity of disease and fatal outcomes: A systematic review and meta-analysis. Diabetes & Metabolic, Syndrome. Clinical Research & Reviews 2020; 14 (05) 1431-1437
    Search in Google Scholar
  • Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D. et al Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cellular & Molecular Immunology 2020; 17 (05) 533-535
    Search in Google Scholar
  • Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X. et al COVID-19 infection: the perspectives on immune responses. Cell Death & Differentiation 2020; 27 (05) 1451-1454
    Search in Google Scholar
  • Gosain R, Abdou Y, Singh A, Rana N, Puzanov I, Ernstoff M. COVID-19 and Cancer: a Comprehensive Review. . Current Oncology Reports. 2020;22(5)
  • Yu J, Ouyang W, Chua M, Xie C.. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncology 2020; 6 (07) 1108
    Search in Google Scholar
  • Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R. et al Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Annals of Oncology 2020; 31 (07) 894-901
    Search in Google Scholar
  • Tian J, Yuan X, Xiao J, Zhong Q, Yang C, Liu B. et al Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study. The Lancet Oncology 2020; 21 (07) 893-903
    Search in Google Scholar
  • Tang L, Hu Y.. Poor clinical outcomes for patients with cancer during the COVID-19 pandemic. The Lancet Oncology 2020; 21 (07) 862-864
    Search in Google Scholar
  • Liang W, Guan W, Chen R, Wang W, Li J, Xu K. et al Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. The Lancet Oncology 2020; 21 (03) 335-337
    Search in Google Scholar
  • Petrilli C, Jones S, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y. et al Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ 2020; m1966
    Search in Google Scholar
  • Liang W, Liang H, Ou L, Chen B, Chen A, Li C. et al Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Internal Medicine 2020; 180 (08) 1081
    Search in Google Scholar
  • Kuderer N, Choueiri T, Shah D, Shyr Y, Rubinstein S, Rivera D. et al Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. The Lancet 2020; 395 (10241): 1907-1918
    Search in Google Scholar
  • Yang K, Sheng Y, Huang C, Jin Y, Xiong N, Jiang K. et al Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. The Lancet Oncology 2020; 21 (07) 904-913
    Search in Google Scholar
  • Giannakoulis V, Papoutsi E, Siempos I.. Effect of Cancer on Clinical Outcomes of Patients With COVID-19: A Meta-Analysis of Patient Data. JCO Global Oncology 2020; (06) 799-808
    Search in Google Scholar
  • Tian Y, Qiu X, Wang C, Zhao J, Jiang X, Niu W. et al Cancer associates with risk and severe events of COVID-19: A systematic review and meta-analysis. International Journal of Cancer 2020; 148 (02) 363-374
    Search in Google Scholar
  • ElGohary G, Hashmi S, Styczynski J, KharfanDabaja M, Alblooshi R, de la Cámara R. et al The risk and prognosis of COVID-19 infection in cancer patients: A systematic review and metaanalysis. . Hematology/Oncology and Stem Cell Therapy 2020
  • Robilotti E, Babady N, Mead P, Rolling T, PerezJohnston R, Bernardes M. et al Determinants of COVID-19 disease severity in patients with cancer. Nature Medicine 2020; 26 (08) 1218-1223
    Search in Google Scholar
  • Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z. et al Patients with cancer appear more vulnerable to SARS-COV-2: a multi-center study during the COVID-19 outbreak. Cancer Discovery 2020; CD20-0422
    Search in Google Scholar
  • Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G. et al Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Internal Medicine 2020; 180 (10) 1345
    Search in Google Scholar
  • Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A. et al Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discovery 2020; 10 (07) 935-941
    Search in Google Scholar
  • Guo K, Sun L, Yuan L, Wasan H, Ruan S.. Risk factors for in-hospital mortality in patients with cancer and COVID-19. The Lancet Oncology 2020; 21 (09) e406
    Search in Google Scholar
  • Meng Y, Lu W, Guo E, Liu J, Yang B, Wu P. et al Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis. . Journal of Hematology & Oncology. 2020;13(1)
  • Lee L, Cazier J, Angelis V, Arnold R, Bisht V, Campton N. et al COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. The Lancet 2020; 395 (10241): 1919-1926
    Search in Google Scholar
  • Sikkema R, Pas S, Nieuwenhuijse D, O'Toole Á, Verweij J, van der Linden A. et al COVID-19 in healthcare workers in three hospitals in the south of the Netherlands: a cross-sectional study. The Lancet Infectious Diseases 2020; 20 (11) 1273-1280
    Search in Google Scholar
  • Tartarone A, Lerose R. COVID-19 and cancer care: what do international guidelines say?. . Medical Oncology. 2020;37(9)
  • ASCO Special Report: A Guide to Cancer Care Delivery During the COVID-19 Pandemic. ASCO Practice Central. 2020
    Search in Google Scholar
  • Curigliano G, Banerjee S, Cervantes A, Garassino M, Garrido P, Girard N. et al Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus. Annals of Oncology 2020; 31 (10) 1320-1335
    Search in Google Scholar
  • Local Resumption of Elective Surgery Guidance. American College of Surgeons. 2020
    Search in Google Scholar
  • Cooksley T, Font C, Scotte F, Escalante C, Johnson L, Anderson R. et al Emerging challenges in the evaluation of fever in cancer patients at risk of febrile neutropenia in the era of COVID-19: a MASCC position paper. Supportive Care in Cancer 2020; 29 (02) 1129-1138
    Search in Google Scholar
  • Zaniboni A, Ghidini M, Grossi F, Indini A, Trevisan F, Iaculli A. et al A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic. Cancers 2020; 12 (09) 2452
    Search in Google Scholar
  • Garg P, Kaul P, Choudhary D, Turaga K, Singh M, Tiwari A. et al Discordance of COVID-19 guidelines for patients with cancer: A systematic review. Journal of Surgical Oncology 2020; 122 (04) 579-593
    Search in Google Scholar
  • Slimano F, Baudouin A, Zerbit J, ToulemondeDeldicque A, Thomas-Schoemann A, Chevrier R. et al Cancer, immune suppression and Coronavirus Disease-19 (COVID-19): Need to manage drug safety (French Society for Oncology Pharmacy [SFPO] guidelines). Cancer Treatment Reviews 2020; 88: 102063
    Search in Google Scholar