HERSHEY, PA – As has been made clear thus far in the pandemic, COVID-19 can range in severity from an asymptomatic viral infection to life-threatening cases of pneumonia, acute respiratory distress syndrome (ARDS), multi-organ damage and sepsis.

Because of their often immunocompromised status, cancer patients are at an increased risk of severe SARS-CoV-2 infection, according to a study at the 2021 American Society of Clinical Oncology (ASCO) annual meeting. A team lead by Penn State Hershey College of Medicine researchers and including participation from the Uniformed Services University of the Health Sciences in Bethesda, MD, raised an important question, especially for cancer patients: What is the process by which SARS-CoV-2 infection causes multiple organ damage through IL-6-mediated inflammation and hypoxia-induced cellular metabolic alterations leading to cell death?

Researchers noted that hypoxia is also induced by malignancy due to alterations in metabolism, resulting in greater IL-6 secretion.

In an effort to spotlight the possible effect of active cancer on the likelihood of hypoxia in COVID-19, the study team analyzed the correlation between cancer status and the severity of COVID-19 from the COVID-19 and Cancer Consortium data registry. To determine cancer status, researchers zeroed in on progressive cancer and remission of cancer only, as those are the two extremes of presence and absence of uncontrolled cancer. The severity of COVID-19 was used as an indication of hypoxia.

Researchers reported that they observed “a 24% positive deviation between expected and actual number of patients with actively progressing cancer who had hypoxic COVID-19 (moderate to severe), and a 26.9% negative deviation between expected and actual number of patients with active cancer who had no hypoxia with COVID-19 (p<0.0001).

“Conversely, for patients with cancer in remission, there was only a +5.8% and -5.1% deviation between expected and actual number of patients who did not have hypoxia and who had hypoxia, respectively,” they added.

The authors explained that their results suggest, when a malignancy is poorly controlled, the likelihood of hypoxia increases in patients with COVID-19, “thereby exacerbating downstream cytokine release syndrome and contributing to prolonged systemic inflammatory injury.”

In light of that knowledge, they suggested that “future therapies can be developed to target the pathogenesis of both diseases and prevent progression, as seen with mesenchymal stem cells, which demonstrated a 91% overall survival and 100% survival in patients younger than 85 years old at one month after a single treatment.”

 

  1. Leyfman Y, Emmanuel N, Tentler A, Cappelli J, Erick TK, Sharma P, Park CH. (June 4-8, 2021). Cancer and COVID-19: A proposed mechanism with therapeutic interventions. ASCO 2021 annual meeting. Virtual. https://meetinglibrary.asco.org/record/197714/abstract