Severity of COVID-19 in patients with lung cancer: evidence and challenges

Abstract

Cancer patients are highly vulnerable to SARS-CoV-2 infections due to frequent contacts with the healthcare system, immunocompromised state from cancer or its therapies, supportive medications such as steroids and most importantly their advanced age and comorbidities. Patients with lung cancer have consistently been reported to suffer from an increased risk of death compared with other cancers. This is possibly due to the combination of specific pathophysiological aspects, including underlying pulmonary compromise due to smoking history and the increased specific pressures on respiratory healthcare services caused by the related pandemic. Rationally and safely treating patients with lung cancer during the pandemic has become a continuous challenge over the last year. Deciding whether to offer, modify, postpone or even cancel treatments for this particular patient’s population has become the crucial recurrent dilemma for lung cancer professionals. Chemotherapy, immunotherapy and targeted agents represent distinct risks factors in the context of COVID-19 that should be balanced with the short-term and long-term consequences of delaying cancer care. Despite the rapid and persistent trend of the pandemic, declared by WHO on March 11, 2020, and still ongoing at the time of writing (January 2021), various efforts were made by oncologists worldwide to understand the impact of COVID-19 on patients with cancer. Adapted recommendations of our evidence-based practice guidelines have been developed for all stakeholders. Different small and large-scale registries, such as the COVID-19 and Cancer Consortium (CCC19) and Thoracic Cancers International COVID-19 Collaboration quickly collected data, supporting cancer care decisions under the challenging circumstance created by the COVID-19 pandemic. Several recommendations were developed as guidance for prioritizing the various aspects of lung cancer care in order to mitigate the adverse effects of the COVID-19 healthcare crisis, potentially reducing the morbidity and mortality of our patients from COVID-19 and from cancer. These recommendations helped inform decisions about treatment of established disease, continuation of clinical research and lung cancer screening. In this review, we summarize available evidence regarding the direct and indirect impact of the COVID-19 pandemic on lung cancer care and patients.

Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: the CAPTURE study

“…Among patients with solid malignancy, cancer subtype did not impact neither NAbT nor T-cell responses to vaccination. Noteworthy, in patients with thoracic malignancies, who are known to be at higher risk of severe outcomes to COVID-19 8 , 11 , 55 , 56 , vaccine-induced immunity was not inferior vs other solid cancers. Furthermore, systemic therapy, including CPI and corticosteroids were not detrimental to induction of immune response to vaccination.…”

Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: The CAPTURE study

“…Among patients with solid malignancy, cancer subtype did not impact neither NAbT nor Tcell responses to vaccination. Noteworthy, in patients with thoracic malignancies, who are known to be at higher risk of severe outcomes to COVID-19 8,11,55,56 , vaccine-induced immunity was not inferior vs other solid cancers. Furthermore, systemic therapy, including CPI and corticosteroids were not detrimental to induction of immune response to vaccination.…”

A Scoping Review of Telenursing’s Potential as a Nursing Care Delivery Model in Lung Cancer During the COVID-19 Pandemic

“…Cancer patients are especially vulnerable to COVID-19 because of their frequent contact with the healthcare system, their immunocompromised, supportive medications such as steroids and, most essentially, the elderly and their comorbidities. 18 The COVID-19 and Cancer Consortium (CCC-19) complete preliminary results were derived from 928 cancer patients, together with 10% lung cancer patients. They revealed a comprehensive rate of death with 13%, a hospitalization rate of 50%, along with 14% of admission to the ICU, and a mechanical ventilation rate of 12%.…”