Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy.
Crit Rev Oncol Hematol. 2020 Sep;153:103059. doi: 10.1016/j.critrevonc.2020.103059. Epub 2020 Jul 9.
The novel coronavirus respiratory illness (COVID-19) is a public health emergency of global concern. Patients with cancer are at high risk of infections, due to an overall immunocompromised status. However, this connection is not straightforward for coronavirus (CoV) infection, in which the host immune response is the main driver of tissue damage. We performed a thorough review of data on CoV pathogenesis and morbidity rate in cancer patients, through the analysis of the previous CoV pandemics. Considering the interaction between CoV and the host immune system, cancer patients receiving immunotherapy might be more at risk for an aberrant immune response in case of infection, and might therefore deserve additional precautions. The limited available data do not allow us to provide practical indications for the management of cancer patients in this critical situation. Efforts should be made to prospectively collect data, to identify effective interventions to guide treatment decision.
新型冠状病毒呼吸道疾病(COVID-19)是一个全球关注的公共卫生紧急事件。由于整体免疫功能低下,癌症患者极易发生感染。然而,对于冠状病毒(CoV)感染来说,这种联系并不直接,因为宿主的免疫反应是导致组织损伤的主要因素。我们通过分析之前的 CoV 大流行,对 CoV 发病机制和癌症患者发病率的数据进行了全面回顾。考虑到 CoV 与宿主免疫系统之间的相互作用,接受免疫疗法的癌症患者在感染时可能更容易发生异常免疫反应,因此可能需要额外的预防措施。目前可用的数据有限,无法为这种危急情况下癌症患者的管理提供实用的指导。应努力前瞻性地收集数据,以确定有效的干预措施来指导治疗决策。