IMMUNOSUPPRESSIVE ANTI-CANCER DRUGS MAY INCREASE COVID-19 INFECTION RISKS

There is a new public health crisis threatening the world with the emergence and spread of the 2019 novel coronavirus (2019-nCoV). Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which invades cells through the angiotensin-converting enzyme 2 (ACE2) receptor. SARS-CoV-2 shares 82% genome sequence similarity to SARS-CoV and 50% genome sequence homology to Middle East respiratory syndrome coronavirus (MERS-CoV); all three coronaviruses are known to cause severe respiratory symptoms. Cancer patients are more susceptible to infections than healthy persons because of their systemic immunosuppressive state caused by the malignancy and anticancer treatments, such as chemotherapy or surgery. Therefore, these patients might be at increased risk of COVID-19. The level of ACE2 expression may play a role in the risk of reporting COVID-19 infection and the risk of developing more severe forms of the disease in cancer patients the disease in cancer patients. Treatment is essentially supportive; the role of antiviral agents is yet to be established. Prevention entails home isolation of suspected cases and those with mild illnesses and strict infection control measures at hospitals that include contact and droplet precautions. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients.