Immunotherapy may protect cancer patients from SARS-CoV-2 infection: a single-center retrospective analysis

Abstract

Coronavirus disease 2019 (COVID-19) global pandemic has created unique challenges to healthcare systems throughout the world. Ensuring subjects’ safety is mandatory especially in oncology, in consideration of cancer patients’ particular frailty. We examined the proportion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgM and/or IgG positive subjects in three different groups from Istituto Nazionale Tumori – IRCCS “Fondazione G. Pascale” in Naples (Campania region, Italy): cancer patients treated with Innovative Immunotherapy (Immune Checkpoint Inhibitors, ICIs), cancer patients undergoing standard Chemotherapies (CHTs) and healthcare providers. 9 out of 287 (3.1%) ICIs patients resulted positive, with a significant lower percentage in respect to CHTs patients (39 positive subjects out of 598, 6.5%) (p = 0.04). There was no statistically significant difference between ICIs cohort and healthcare providers, 48 out of 1050 resulting positive (4.6%). Performing a Propensity Score Matching based on gender and tumor stage, the effect of treatment on seropositivity was analyzed through a regression logistic model and the ICIs treatment resulted to be the only protective factor significantly (p = 0.03) associated with positivity (odds ratio—OR: 0.41; 95% confidence interval—CI 0.18–0.91). According to these preliminary data, ICIs would appear to be a protective factor against the onset of COVID-19 infection.

Does prior exposure to immune checkpoint inhibitors treatment affect incidence and mortality of COVID-19 among the cancer patients: The systematic review and meta-analysis

“…Figure 1 shows the PRISMA flow chart for the study screening and selection process in this research. Twenty-three trials including 19 retrospective studies [21] , [23] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] and 4 prospective studies [22] , [42] , [43] , [44] , enrolling 117735 study subjects ultimately met our criteria ( Figure 1 ). Six studies were performed in USA [25] , [26] , [29] , [31] , [35] , [40] , five in Italy [27] , [28] , [38] , [39] , [42] , four in Spain [27] , [36] , [37] , [43] , three in United Kingdom [22] , [33] , [34] , two in China [23] , [30] , one in France [41] , one in India [32] and one in Australia [21] .…”

“…The incidence of COVID-19 and clinical outcome of cancer patients with COVID-19 infection prior exposure to ICIs are controversial. The study conducted by Maria Antonietta Isgrò have showed that ICIs could protect cancer patients from COVID-19 infection [28] . However, another real-world study performed by Alexia Francesca Bertuzzi did not show a high risk for COVID-19 infection in cancer patients treated with ICIs [39] .…”

Clinical Dermatology and COVID-19 Pandemic

“…[ 95 ] Evidence shows that programmed cell death protein 1 (anti-PD 1) or cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) immunotherapy may even protect cancer patients from COVID-19 infection. [ 96 97 ] The rate of immune checkpoint inhibitor-associated adverse has not been shown to be increased in COVID-19-infected patients. On the other hand, the mortality rate as a repercussion of COVID-19 infection in this cohort of cancer patients appears to be increased.…”

Covid19, Environment, Clinicopathologic Features, Laboratory Findings and Diagnosis, Treatment, Vaccines, Animals, and Cancer

“…Reduction in sepsis or infection after pneumonia and inflammatory response syndrome was observed in COVID-19 patients administered with PD-1 inhibitors (146). ICIs would likely to be a protective factor against the onset of COVID-19 infection (159). Ruxolitinib a Janus-associated kinase (JAK) inhibitor has been reported to reduce cytokine-mediated inflammation, reducing severe events such as ARDS in COVID-19 infected patients, and many trials are currently active (146).…”