INFLUENCE OF CONCOMIENT ONCOLOGICAL DISEASES ON THE SEVERITY AND MORTALITY OF COVID-19
Abstract
The COVID-19 pandemic has affected the entire global healthcare system. The rising incidence of COVID-19 and the shortage of medical resources and healthcare workers in hospitals have impacted the treatment of people with various chronic diseases such as cancer and other comorbidities, especially the elderly. During the COVID-19 pandemic, cancer patients face greater challenges as they have a higher risk of progression and severe infection and, ultimately, mortality. Not all types of solid cancer and hematological malignancies have the same impact on the prognosis of patients infected with the SARS-CoV-2 coronavirus. The available data are extremely contradictory; the mechanisms of multidirectional interactions are practically not studied. On the one hand, COVID-19 negatively affects cancer patients because they have a weakened immune system, and on the other hand, the immunosuppressive state inherent in cancer excludes the cytokine storm, which predetermines multiple organ failure and mortality in patients with COVID-19. Most experts have stated that the factor in the progression of COVID-19 to severe forms and death is not so much the malignant process itself, but antitumor cytotoxic chemotherapy during the last few months before infection with the SARS-CoV-2 coronavirus, which worsens the somatic status of patients, increases susceptibility and suppresses resistance to infections. Full vaccination against SARS-CoV-2 significantly reduces the risks and increases the survival rate of cancer patients with COVID-19, but mortality remains high. Therefore, this group of patients should always be the priority for all types of preventive protection.
References
Wang H., Paulson K.R., Pease S.A. et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21. The Lancet. 2022;399(10334):1513–1536. DOI: 10.1016/S0140-6736(21)02796-3.
Tawde P., Igburuke L., Olanipekun D., Marwaha V., Lambo J. Prognostic factors for mortality in adults hospitalized with COVID-19 infection in the Americas. Cureus. 2024;16(2):e55044. DOI: 10.7759/cureus.55044.
Gupta A., Marzook H., Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med. 2023;23(2):313–331. DOI: 10.1007/s10238-022-00821-4.
Shteinberg M., Sibila O., Stein N. et al. Risk of SARS-CoV-2 infection and disease severity among people with bronchiectasis: analysis of three population registries. Chest. 2024;165(1):79–83. DOI: 10.1016/j.chest.2023.08.007.
Wu Z., McGoogan J.M. Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) оutbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242. DOI: 10.1001/jama.2020.2648.
Kocsmár É., Kocsmár I., Elamin F. et al. Autopsy findings in cancer patients infected with SARS-CoV-2 show a milder presentation of COVID-19 compared to non-cancer patients. Geroscience. 2024. DOI: 10.1007/s11357-024-01163-7.
Liang W., Guan W., Chen R. et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335–337. DOI: 10.1016/S1470-2045(20)30096-6.
Yang B., Choi H., Lee S.K. et al. Risk of coronavirus disease occurrence, severe presentation, and mortality in patients with lung cancer. Cancer Res Treat. 2021;53(3):678–684. DOI: 10.4143/crt.2020.1242.
Lee H., Choi H., Yang B. et al. Interstitial lung disease increases susceptibility to and severity of COVID-19. Eur Respir J. 2021;58(6):2004125. DOI: 10.1183/13993003.04125-2020.
Rogado J., Pangua C., Serrano-Montero G. et al. Covid-19 and lung cancer: a greater fatality rate? Lung Cancer. 2020;146:19–22. DOI: 10.1016/j.lungcan.2020.05.034.
Bestvina C.M., Whisenant J.G., Torri V. et al. Coronavirus Disease 2019 outcomes, patient vaccination status, and cancer-related delays during the omicron wave: a brief report from the TERAVOLT analysis. JTO Clin Res reports. 2022;3(8). DOI: 10.1016/J.JTOCRR.2022.100335.
Whisenant J.G., Baena J., Cortellini A. et al. A definitive prognostication system for patients with thoracic malignancies diagnosed with Coronavirus Disease 2019: an update from the TERAVOLT registry. J Thorac Oncol. 2022;17(5):661–674. DOI: 10.1016/J.JTHO.2021.12.015.
Kulkarni A.A., Hennessy C., Wilson G. et al. Impact of anti-cancer treatments on outcomes of COVID-19 in patients with thoracic cancers: A CCC19 registry analysis. Clin Lung Cancer. 2024;25(5):e229–e237.e7. DOI: 10.1016/j.cllc.2024.04.003.
Provencio M., Mazarico Gallego J.M., Calles A. et al. Lung cancer patients with COVID-19 in Spain: GRAVID study. Lung Cancer. 2021;157:109–115. DOI: 10.1016/J.LUNGCAN.2021.05.014.
Várnai C., Palles C., Arnold R. et al. Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19. JAMA Netw Open. 2022;5(2):e220130. DOI: 10.1001/JAMANETWORKOPEN.2022.0130.
Yadaw A.S., Li Y.C., Bose S., Iyengar R., Bunyavanich S., Pandey G. Clinical features of COVID-19 mortality: development and validation of a clinical prediction model. Lancet Digit Health. 2020;2(10):e516–e525. DOI: 10.1016/S2589-7500(20)30217-X.
Gong I.Y., Vijenthira A., Powis M. et al. Association of COVID-19 vaccination with breakthrough infections and complications in patients with cancer. JAMA Oncol. 2023;9(3):386–394. DOI: 10.1001/jamaoncol.2022.6815.
Pagano L., Salmanton-García J., Marchesi F. et al. Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA
survey. Blood. 2022;140(26):2773–2787. DOI: 10.1182/blood.2022017257.
Wang L., Kaelber D.C., Xu R., Berger N.A. COVID-19 breakthrough infections, hospitalizations and mortality in fully vaccinated patients with hematologic malignancies: A clarion call for maintaining mitigation and ramping-up research. Blood Rev. 2022;54:100931. DOI: 10.1016/j.blre.2022.100931.
Deng G., Zhou Q., Meng Y. et al. Risk and outcomes of breakthrough COVID-19 infections in vaccinated immunocompromised patients: a meta-analysis. MedComm. 2023;4(3):e307. DOI: 10.1002/mco2.307.
Bellusci L., Grubbs G., Srivastava P. et al. Neutralization of SARS-CoV-2 Omicron after vaccination of patients with myelodysplastic syndromes or acute myeloid leukemia. Blood. 2022;139(18):2842–2846. DOI: 10.1182/blood.2022016087.
Anand S.T., Vo A.D., La J., Do N.V., Fillmore N.R. et al. Severe COVID-19 in vaccinated adults with hematologic cancers in the veterans health administration. JAMA Netw Open. 2024;7(2):e240288. DOI: 10.1001/jamanetworkopen.2024.0288.
Lozahic C., Maddock H., Sandhu H. Anti-cancer therapy leads to increased cardiovascular susceptibility to COVID-19. Front Cardiovasc Med. 2021;8:634291. DOI: 10.3389/fcvm.2021.634291.
Welt FGP., Shah P.B., Aronow H.D. et al. Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic: from the ACC's interventional council and SCAI. J Am Coll Cardiol. 2020;75(18):2372–5. DOI: 10.1016/j.jacc.2020.03.021.
Beigel J.H., Tomashek K.M., Dodd L.E. et al. Remdesivir for the treatment of Covid-19 — final report. N Engl J Med. 2020;383(19):1813–1826. DOI: 10.1056/NEJMoa2007764.
Hua A., O'Gallagher K., Sado D., Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J. 2020;41(22):2130. DOI: 10.1093/eurheartj/ehaa253.
Sbaraglia M., Bellan E., Dei Tos A.P. The 2020 WHO classification of soft tissue tumours: news and perspectives. Pathologica. 2021;113(2):70–84. DOI: 10.32074/1591-951X-213.
Willmer D., Zöllner S.K., Schaumburg F. et al. Infectious morbidity in pediatric patients receiving neoadjuvant chemotherapy for sarcoma. Cancers. 2021;13(9):1990. DOI: 10.3390/cancers13091990.
Grivas P., Khaki A., Wise-Draper T. et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol. 2021;32(6):787–800. DOI: 10.1016/j.annonc.2021.02.024.
Vincenzi B., Cortellini A., Mazzocca A. et al. Impact of SARS-CoV-2 vaccines and recent chemotherapy on COVID-19 morbidity and mortality in patients with soft tissue sarcoma: an analysis from the OnCovid registry. Ther Adv Med Oncol. 2024;16:17588359231225028. DOI: 10.1177/17588359231225028.
Tagliamento M., Gennari A., Lambertini M. et al. Pandemic phase-adjusted analysis of COVID-19 outcomes reveals reduced intrinsic vulnerability and substantial vaccine protection from Se-vere Acute Respiratory Syndrome Coronavirus 2 in patients with breast cancer. J Clin Oncol. 2023;41(15):2800–2814. DOI: 10.1200/JCO.22.01667.
Pinato D., Aguilar-Company J., Ferrante D. et al. Outcomes of the SARS-CoV-2 omicron (B.1.1.529) variant outbreak among vaccinated and unvaccinated patients with cancer in Europe: results from the retrospective, multicentre, OnCovid registry study. Lancet Oncol. 2022;23(7):865–875. DOI: 10.1016/S1470-2045(22)00273-X.
Wagner M.J., Hennessy C., Beeghly A. et al. Demographics, outcomes, and risk factors for patients with sarcoma and COVID-19: a CCC19-Registry based retrospective cohort study. Cancers (Basel). 2022;14(17):4334. DOI: 10.3390/cancers14174334.
Di Lena É., Hopkins B., Wong S.M., Meterissian S. Delays in operative management of early-stage, estrogen receptor-positive breast cancer during the COVID-19 pandemic: A multi-institutional matched historical cohort study. Surgery. 2022;171(3):666–672. DOI: 10.1016/j.surg.2021.10.033.
Siegel R.L., Miller K.D., Wagle N.S., Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73(1):17–48. DOI: 10.3322/caac.21763.
Ma T., Ma T., Wang L., Wang H. Neoadjuvant chemotherapy is effective in those infected with SARS-CoV-2: the real-world experience of a large chinese breast cancer center. J Breast Cancer. 2024. DOI: 10.4048/jbc.2023.0299.
Sica A., Colombo M.P., Trama A. et al. Immunometabolic status of COVID-19 cancer patients. Physiol Rev. 2020;100(4):1839–50. DOI: 10.1152/physrev.00018.2020.
Hosseini-Moghaddam S.M., Shepherd F.A., Swayze S. et al. SARS-CoV-2 infection, hospitalization, and mortality in adults with and without cancer. JAMA Netw Open. 2023;6(8):e2331617. DOI: 10.1001/jamanetworkopen.2023.31617.
Abuhelwa Z., Alsughayer A., Abuhelwa A.Y. et al. In-hospital mortality and morbidity in cancer patients with COVID-19: a nationwide analysis from the United States. Cancers. 2022;15(1):222. DOI: 10.3390/cancers15010222.
Chavez-MacGregor M., Lei X., Zhao H. et al. Evaluation of COVID-19 mortality and adverse outcomes in US patients with or without cancer. JAMA Oncol. 2022;8(1):69–78. DOI: 10.1001/jamaoncol.2021.5148.
2022 National Health Interview Survey (NHIS) Survey Description. Available at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2022/srvydesc-508.pdf (accessed: 12/26/2024).
Yang N.N., Zhao J., Zheng Z., Yabroff K.R., Han X. COVID-19 vaccination, infection, and symptoms among cancer survivors in the United States. J Natl Cancer Inst. 2024:djae029. DOI: 10.1093/jnci/djae029.
Waters A.R., Anderson J.S., Mann K. et al. Drivers of COVID-19 vaccine intent among survivors of adolescent and young adult cancer: a mixed method study. J Cancer Educ. 2023;38(2):562–570. DOI: 10.1007/s13187-022-02155-x.
Dagher H., Chaftari A-M., Subbiah I.M. et al. Long COVID in cancer patients: preponderance of symptoms in majority of patients over long time period. Elife. 2023;12:e81182. DOI: 10.7554/eLife.81182.
Quintana-Lopez J.M., Rodríguez L., Portuondo J., García J., Legarreta M.J., Gascón M., Larrea N., Barrio I. COVID‐Health Basque Country Research Group. Relevance of comorbidities for main outcomes during different periods of the COVID-19 pandemic. Influenza Other Respir Viruses. 2024;18(1):e13240. DOI: 10.1111/irv.13240.
Becerril-Gaitan A., Vaca-Cartagena B.F., Ferrigno A.S. et al. Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis. Eur J Cancer. 2022;160:243–260. DOI: 10.1016/j.ejca.2021.10.014.
Ligumsky H., Safadi E., Etan T. et al. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine among actively treated cancer patients. J Natl Cancer Inst. 2022;114(2):203–209. DOI: 10.1093/jnci/djab174.
Bezzerri V., Gentili V., Api M. et al. SARS-CoV-2 viral entry and replication is impaired in Cystic Fibrosis airways due to ACE2 downregulation. Nat Commun. 2023;14(1):132. DOI: 10.1038/s41467-023-35862-0.
Li Z., He H., Li H. et al. Impaired acute-phase humoral immunity is the major factor predicting unfavorable outcomes in multiple myeloma patients with SARS-CoV-2 Omicron variants outbreak infection. Int J Cancer. 2024. DOI: 10.1002/ijc.35063.
Richardson S., Hirsch J.S., Narasimhan M. et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052–9. DOI: 10.1001/jama.2020.6775.
