Background Cancer patients are thought to have an increased risk of developing severe Coronavirus Disease 2019 (COVID-19) infection and of dying from the disease. In this work, predictive factors for COVID-19 severity and mortality in cancer patients were investigated. Patients and Methods In this large nationwide retro-prospective cohort study, we collected data on patients with solid tumours and COVID-19 diagnosed between March 1 and June 11, 2020. The primary endpoint was all-cause mortality and COVID-19 severity, defined as admission to an intensive care unit (ICU) and/or mechanical ventilation and/or death, was one of the secondary endpoints. Results From April 4 to June 11, 2020, 1289 patients were analysed. The most frequent cancers were digestive and thoracic. Altogether, 424 (33%) patients had a severe form of COVID-19 and 370 (29%) patients died. In multivariate analysis, independent factors associated with death were male sex (odds ratio 1.73, 95%CI: 1.18-2.52), ECOG PS ≥ 2 (OR 3.23, 95%CI: 2.27-4.61), updated Charlson comorbidity index (OR 1.08, 95%CI: 1.01-1.16) and admission to ICU (OR 3.62, 95%CI 2.14-6.11). The same factors, age along with corticosteroids before COVID-19 diagnosis, and thoracic primary tumour site were independently associated with COVID-19 severity. None of the anticancer treatments administered within the previous 3 months had any effect on mortality or COVID-19 severity, except cytotoxic chemotherapy in the subgroup of patients with detectable SARS-CoV-2 by RT-PCR, which was associated with a slight increase of the risk of death (OR 1.53; 95%CI: 1.00-2.34; p = 0.05). A total of 431 (39%) patients had their systemic anticancer treatment interrupted or stopped following diagnosis of COVID-19. Conclusions Mortality and COVID-19 severity in cancer patients are high and are associated with general characteristics of patients. We found no deleterious effects of recent anticancer treatments, except for cytotoxic chemotherapy in the RT-PCR-confirmed subgroup of patients. In almost 40% of patients, the systemic anticancer therapy was interrupted or stopped after COVID-19 diagnosis.

Epithelial cells respond to physico-chemical damage with up-regulation of major histocompatbility complex-like ligands that can activate the cytolytic potential of neighboring intraepithelial T cells by binding the activating receptor, NKG2D. The systemic implications of this lymphoid stress-surveillance response, however, are unknown. We found that antigens encountered at the same time as cutaneous epithelial stress induced strong primary and secondary systemic, T helper 2 (T H 2)-associated atopic responses in mice. These responses required NKG2D-dependent communication between dysregulated epithelial cells and tissue-associated lymphoid cells. These data are germane to uncertainty over the afferent induction of T H 2 responses and provide a molecular framework for considering atopy as an important component of the response to tissue damage and carcinogenesis.A conserved feature of T lymphocytes is their subdivision into two main types. One, composed of CD4 + and CD8 + T cells specific for complexes of peptides and major histocompatbility complex (MHC) molecules, has been termed "conventional" and is largely responsible for clonal, pathogen-specific memory responses that are the hallmark of adaptive immunity. The second T cell type, composed of cells expressing the T cell receptor (TCR), is not generally specific for peptide-MHC complexes and may instead recognize cell surface microbial and/or self-encoded moieties, some of which are upregulated through cellular dysregulation. Although T cells exhibit some properties characteristic of adaptive immunity, a predominant function of these "unconventional" Tcells is thought to be lymphoid stress-surveillance because they do not require major clonal expansion, because their functional potentials are preprogrammed during development, and because some may be activated in vivo independently of the TCR, by cytokines or by ligands for activating natural killer (NK) receptors, such as NKG2D (1). Such cells are major components of large but enigmatic tissue-resident Tcell compartments, which include mouse dendritic epidermal T cells (DETCs) and human or mouse intraepithelial lymphocytes (IELs), among which CD4 − CD8 − T cells may also contribute to rapid lymphoid stress-surveillance.Because NK G2D ligands such as Rae-1 (mouse) and MIC class 1 chain-related protein A (MICA) (human) are activated by DNA damage (2) and are frequently expressed by tumor (3,4). However, whether lymphoid stress-surveillance describes a purely local response or whether it affects the systemic immune compartment remains a key question. To investigate this, transgenic Rae-1 expression was induced as described (4) specifically in keratinocytes by a doxycycline (dox)-dependent, bitransgenic (BTg) molecular switch ( fig. S1A). This mode of Rae-1 induction avoids pleiotropic effects of applying agents that induce a stressed state within the epidermis. Rae-1 induction on otherwise normal epithelium promoted rapid morphological rearrangements of DETCs and of epidermal Langerhans cells (LCs), whi...

Summary NKG2D is a potent activating receptor on NK cells which acts as a molecular sensor for stressed cells expressing NKG2D ligands such as infected or tumor transformed cells. Although NKG2D is expressed on NK cell precursors, its role in NK cell development is still not known. We have generated NKG2D-deficient mice by targeting the Klrk1 locus. Here we provide evidence for an important regulatory role of NKG2D in the development of NK cells. The absence of NKG2D causes faster division of NK cells, perturbation in size of some NK cell subpopulations and their augmented sensitivity to apoptosis. As expected, NKG2D−/− NK cells are less responsive to tumor targets expressing NKG2D ligands. NKG2D−/− mice, however, show an enhanced NK cell-mediated resistance to MCMV infection as a consequence of NK cell dysregulation. Altogether, these findings provide evidence for yet unknown regulatory function of NKG2D in NK cell physiology.

It is uncertain whether NK cells modulate T cell memory differentiation. By using a genetic model that allows the selective depletion of NK cells, we show in this study that NK cells shape CD8+ T cell fate by killing recently activated CD8+ T cells in an NKG2D- and perforin-dependent manner. In the absence of NK cells, the differentiation of CD8+ T cells is strongly biased toward a central memory T cell phenotype. Although, on a per-cell basis, memory CD8+ T cells generated in the presence or the absence of NK cells have similar functional features and recall capabilities, NK cell deletion resulted in a significantly higher number of memory Ag-specific CD8+ T cells, leading to more effective control of tumors carrying model Ags. The enhanced memory responses induced by the transient deletion of NK cells may provide a rational basis for the design of new vaccination strategies.

NKG2D is one of the most intensively studied immune receptors of the past decade. Its unique binding and signaling properties, expression pattern, and functions have been attracting much interest within the field due to its potent antiviral and anti-tumor properties. As an activating receptor, NKG2D is expressed on cells of the innate and adaptive immune system. It recognizes stress-induced MHC class I-like ligands and acts as a molecular sensor for cells jeopardized by viral infections or DNA damage. Although the activating functions of NKG2D have been well documented, recent analysis of NKG2D-deficient mice suggests that this receptor may have a regulatory role during NK cell development. In this review, we will revisit known aspects of NKG2D functions and present new insights in the proposed influence of this molecule on hematopoietic differentiation.