- Hematological cancer patients receive drugs which suppress bone marrow function and contribute to higher risk for COVID-19
- COVID-19 development was tracked through CT scans of the lungs as well as COVID-19 swab tests
- In this study, 10% of hospitalized hematological cancer patients developed COVID-19
- Patients which contracted COVID-19 had a median age of 35 and non-COVID-19 patients was 49
- Additionally, during the study 11 healthcare providers were hospitalized and used for comparison in the study (See Table 2)
- Hematological cancer infection rate of COVID-19 is much higher than that of other cancers
- This higher infection rate is likely due to the types of therapy which these patients must undergo

COVID-19 in persons with haematological cancers

Table 2: Clinical and laboratory co-variates, therapy and outcomes of subjects with haematological cancer and COVID-19.

- This study attempts to analyze how COVID-19 illness affects those with lymphoma based on data gathered on 89 patients with these comorbidities in a database of 12 hospitals located in 3 French regions
- Out of the 89 patients, the mean age was 67 years old and 66% were male
- 72 of the 89 has other significant comorbidities including hypertension, diabetes, and history with previous cancer
- At admission for COVID-19, 40 patients were in complete or partial remission of cancer while 24 were in first or second line therapy, and 13 were relapsed cases of lymphoma
- Common symptoms for these patients upon arrival include dyspnea, cough, fever, and diarrhea
- As of May 26, 2020, 48 patients were discharged, 30 had died, and 11 were still hospitalized
- Most patients required oxygen with a substantial amount, 21, requiring invasive mechanical ventilation
- Survivability of COVID-19 in those who were over the age of 70 was much lower than that of the group under 70
- Patients younger than 70, without relapsed/refractory lymphoma had similar survival rates to that of the general population, while all other groups saw increased rates of mortality

Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study

- Hematologocial Cancers are types of cancers that affect the blood, including lymphoma, leukemia, and myeloma.

Ohio State University, Columbus

Michigan State University

- This node acts as a general summary of the comorbidity of cancer and COVID-19 from a paper that analyzed many other papers detailing the same thing at its time of release.
- Via a pooled meta-analysis of studies from around the globe analyzing the prevalence of cancer in COVID-19 patients, it was found that the prevalence of cancer in COVID-19 patients is about 2%, which is higher than the overall prevalence of cancer in the population (I think).
- This leads to a hypothesized conclusion that while there is not a lot of data for COVID-19 infection and cancer patients, there is an elevated risk for these patients. However, due to inconclusive and generally lacking data on this topic, this conclusion is not concrete.
- Many major cancer centers worldwide have taken extra precaution when it comes to the treatment of these patients as many cancer treatments (e.g., chemotherapy) weaken the immune system as a side effect.
- There has currently been no order to withhold chemotherapy, radiotherapy, immunotherapy, or delaying adjuvant therapy to treat cancer patients, however extra care must be taken by patients and physicians alike to not allow these high-risk patients to become infected.

Cancer as a Comorbidity of COVID-19 

 He, W., Chen, L., Chen, L. et al. COVID-19 in persons with haematological cancers. Leukemia 34, 1637–1645 (2020). https://doi.org/10.1038/s41375-020-0836-7

URL: https://rdcu.be/b6jM5

Lamure, S., Duléry, R., Di Blasi, R., Chauchet, A., Laureana, C., Deau-Fischer, B., Drenou, B., Soussain, C., Rossi, C., Noël, N., Choquet, S., Bologna, S., Joly, B., Kohn, M., Malak, S., Fouquet, G., Daguindau, E., Bernard, S., Thiéblemont, C., … Besson, C. (2020). Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study. EClinicalMedicine, 27, 100549. https://doi.org/10.1016/j.eclinm.2020.100549

URL: https://doi.org/10.1016/j.eclinm.2020.100549

- Hubei, China 
- Wuhan, China
- New York City, USA

Cancer in COVID-19 Patients by Geographical Location

Hematological Cancers and COVID-19

- Researchers aimed to investigate how different tumor types can influence the prevalence of severe SARS-CoV-2 and case-fatality rate.  It was determined that tumor type does have an effect on how susceptible one is to SARS-CoV-2 and the disease phenotypes that result.  In particular, COVID-19 patients with hematological cancers, such as myeloma, leukemia, and lymphoma, appeared to be at higher risk of exhibiting more severe clinical outcomes, needed more intense support interventions, and were more likely to die than COVID-19 patients with malignancies that were not hematological.   

- COVID-19 patients with lung or prostate cancer did not exhibit a higher case-fatality rate than the other COVID-19 patients with other cancer types.  In addition, patients with malignancies in the female genital tract or with breast cancers seemed to be at a decreased risk of being infected with COVID-19 or dying from the virus, but this protection is rather a result of the patients being female, as indicated by a multivariable analysis conducted.  


COVID-19 Prevalence and Mortality in Patients with Cancer and the Effect of Primary Tumor Subtype and Patient Demographics

As cancer patients are 3.6 times more likely to progress to severe COVID-19 if infected than individuals without cancer, some critical questions around care and treatment for cancer patients need to be asked in order to maintain their safety. 



Clinical Considerations and Precautions for Cancer Patients During the COVID-19 Pandemic 

- COVID-19 and sickle cell disease - Haematologica

Sickle Cell Disease and COVID-19

• Emerging studies show a worse trend among cancer COVID-19 patients compared to non-cancer COVID-19 patients.

• Other studies also indicate that the percentages of SARS-CoV-2 infection and severe events in cancer patients are not higher compared to the general population. Therefore, ongoing investigation is needed to better understand the comorbidity of COVID-19 and cancer.

• Because the majority of the reports associated with cancer patients with COVID-19 involve cohort studies with a relatively small sample size, limited clinical information, high heterogeneity of tumor stages and cancer types as well as diverse treatments, current understanding of the comorbidities are limited.

• Clinical outcomes and the biological basis for the comorbidity of cancer and COVID-19 remain to be resolved. 

• The possibility of COVID-19 recurrence brings a new sense of urgency to develop strategies to optimize the management and care of cancer patients with COVID-19. 

• The authors hope to bring attention to the symptoms, prognoses, and treatment options of cancer patients with COVID-19, and to stimulate research into the daunting challenge of addressing COVID-19 and cancer comorbidities.

COVID-19 in Cancer Patients: Risk, Clinical Features, and Management

- Since cancer patients are at such a high risk for COVID-19, it is very important that physicians keep their treatment regimens for all medications under extreme control and very monitored
- It was identified that patients with hematologic cancers tend to have poorer outcomes than those with solid tumors and therefore they must be kept under constant surveillance for COVID-19 infection
- The purpose of this paper is to give a 1-year recap on cancer management techniques instituted during the COVID-19 pandemic


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