30 Oct, 2020
JERUSALEM WEATHER

Even though oncologists had no clear proof that cancer patients were at high risk for COVID19 infections, symptoms and complications, this hypothesis surprisingly does not seem to be true.

Researchers at Rambam Medical Center and the Technion-Israel Institute of Technology Rappaport Faculty of Medicine in Haifa who compared serological (blood antibody) data in patients being treated for cancer at the hospital and healthy but asymptomatic medical personnel who had been exposed to the new coronavirus found cancer patients are not at higher risk of suffering from symptoms or complications. This could be due to the fact that cancer patients receive medications for their malignant tumors that affect their immune systems. 

Tal Goshen-Lago ,Moran Szwarcwort-Cohen ,Madeleine Benguigui ,Ronit Almog , Ilit Turgeman, Nelly Zaltzman, Michael Halberthal ,Yuval Shaked and others in Rambam’s oncology department, virology lab and epidemiology department and at the Technion conducted the study. It was published in a Multidisciplinary Digital Publishing Institute journal under the title: “The Potential Role of Immune Alteration in the Cancer–COVID19 Equation – A Prospective Longitudinal Study.” 

The research was the first ever to prospectively characterize the pattern of COVID-19 infection over a period of time in cancer patients who have been undergoing chemotherapy and immune treatments, comparing them with healthcare providers working at a tertiary cancer center 

“Our results may indicate that due to differential immune cell profile of cancer patients who are treated with immunomodulatory agents, the host response to the SARS-COV2 may lessen symptom severity. Delineating COVID-19 infection trends in asymptomatic healthcare workers as well as a cohort of cancer patients who are on active anti-cancer treatment will lend credence to tailor future healthcare policy in the next phases of the pandemic,” they wrote. 

The outbreak of coronavirus disease pandemic, they wrote, has introduced a substantial healthcare challenge globally. COVID19 sickness and deaths have been correlated with old age and having chronic diseases, leading to poorer clinical outcomes and occasionally resulting in hospitalization and higher likelihood for being connected to a respirator. Having chronic high blood pressure has been found as the leading risk factor predispose for COVID-19 infection, while other supposed potential risk factors at the early phase of the pandemic had been either refuted or partially confirmed. 

“Cancer patients were at first generally postulated as a large subgroup at high risk of developing COVID-19 infection and its severe complications. Nevertheless, despite lack of solid prospective studies to support this hypothesis, several international guidelines were revisited, while postponing chemotherapy or elective surgery for specific indications in endemic areas were suggested,” they continued. 

Cancer patients who are on active treatment represent a heterogenous population, while various treatments such as intravenous chemotherapy may differentially modify their immune condition. 

The study comprised a group of 164 consecutive patients who were treated during the last week of March 2020, compared to a group of 107 hospital workers. “Our results indicate similar infection rate in both cohorts of about 2% asymptomatic cases in a longitudinal prospective study throughout a two-month period with three points of serologic assessment. Out of 8,500 cancer patients who had visited our cancer center between December 2019 to May 2020, no clinical symptomatic cases had been documented. Moreover, no symptomatic case had been reported among the 228 healthcare workers of the cancer center. 

Although the study was limited by the very small sample size, “our preliminary results indicate that cancer may exhibit differential host response to SARS-CoV2 infection. Along with the very low incidence of COVID19 in our cohort in a longitudinal serologic study, as well as no documentation of any clinical symptomatic COVID19 case in a larger cohort of 8,500 patients who were actively observed in the last six months in our center, our study indicates that the immunological perspective of cancer treatments on the risk for COVID19 infection should be further explored,” the Haifa researchers wrote.