Department of Clinical Microbiology and Microbial Pathogenesis, University of Crete, Crete, Greece.
Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology, Heraklion, Crete, Greece.
Clin Infect Dis. 2021 Jan 27;72(2):351-356. doi: 10.1093/cid/ciaa1079.
Cancer patients are traditionally considered at high risk for complicated respiratory viral infections, due to their underlying immunosuppression. In line with this notion, early case series reported high mortality rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with malignancy. However, subsequent large, prospective, epidemiological surveys indicate that the risk for severe coronavirus disease 2019 (COVID-19) may be largely attributed to the multiple confounders operating in this highly heterogeneous population of patients, rather than the cancer or its treatment per se. We critically discuss the conundrums of SARS-CoV-2 infection in cancer patients and underscore mechanistic insights on the outcome of COVID-19 as it relates to cancer therapy and the type and status of the underlying malignancy. Not all cancer patients are similarly at risk for a complicated COVID-19 course. A roadmap is needed for translational and clinical research on COVID-19 in this challenging group of patients.
癌症患者由于其潜在的免疫抑制，传统上被认为有发生复杂呼吸道病毒感染的高风险。基于这一观点，早期的病例系列报告表明，恶性肿瘤患者感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的死亡率很高。然而，随后的大型前瞻性流行病学调查表明，严重的 2019 冠状病毒病（COVID-19）的风险在很大程度上归因于在这一高度异质的患者群体中起作用的多种混杂因素，而不是癌症或其治疗本身。我们批判性地讨论了 SARS-CoV-2 在癌症患者中的感染难题，并强调了 COVID-19 结局与癌症治疗以及潜在恶性肿瘤的类型和状态相关的机制见解。并非所有癌症患者都面临同样的 COVID-19 复杂病程风险。需要为这组具有挑战性的患者的 COVID-19 转化和临床研究制定路线图。
