(COVID-19) Cancer Patients May Be More Susceptible to Infection With Worse Outcomes

• February 20, 2020
• 2 min read

On February 14, 2020, Professor He Jianxing's team from the First Affiliated Hospital of Guangzhou Medical University published an online article in The Lancet titled: "Cancer patients are at higher risk of contracting COVID-19, and cancer patients with COVID-19 have worse outcomes."

Researchers collected data from 1,590 confirmed COVID-19 patients across 575 hospitals in 31 provincial administrative regions of China. They found that 1% (18 cases) had a cancer history—a proportion higher than the general Chinese population cancer incidence of 0.29%.

Among the 1,590 cases, 18 had a cancer history; lung cancer accounted for the highest proportion at 28%. Excluding 2 patients with unknown treatment status, of the remaining 16 patients, 4 (25%) had received chemotherapy or surgery in the past month.

Comparison with patients without cancer history:

• Mean age: Cancer patients 63.1 years vs. non-cancer patients 48.7 years
• Smoking history: Cancer patients 22% vs. non-cancer patients 7%
• Dyspnea: Cancer patients 47% vs. non-cancer patients 23%
• Significant CT findings: Cancer patients 94% vs. non-cancer patients 71%

Furthermore, patients who had received chemotherapy or surgery in the past month had a higher risk of severe clinical events (75%) compared to those who had not (43%). Regression modeling—adjusted for age, smoking history, and other risk factors—confirmed that having a cancer history significantly predicts the likelihood of severe events. Among cancer patients, advanced age was the only significant risk factor for severe events.

Researchers concluded that malignancy and anticancer treatments lead to systemic immunosuppression, making cancer patients more susceptible to COVID-19 infection.

Recommended strategies for cancer patients during COVID-19 outbreaks:

1. Cancer patients in COVID-19 outbreak areas should consider postponing adjuvant chemotherapy or elective surgery.
2. Stricter personal protective measures should be established for cancer patients.
3. When cancer patients contract COVID-19, enhanced monitoring and treatment should be provided, especially for elderly patients or those with comorbidities.

Source: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30096-6/fulltext

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