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Infectious Diseases

Updated 06 May 2020

Cancer patients may face higher risk of death from Covid-19

According to the largest study of cancer patients with Covid-19, people with cancer who develop Covid-19 stand a higher chance of dying from the disease than those without cancer.

As the new coronavirus continues to spread around the world, staying at home as much as possible in order to limit exposure cannot be stressed enough, especially for those with immunocompromised conditions, such as cancer, as they have a unique vulnerability to infectious diseases such as Covid-19.

According to a new study by physician-researchers at Montefiore Health System and Albert Einstein College of Medicine, cancer patients who develop Covid-19 are much more likely to die from the disease than those without cancer.

The study involved 218 cancer patients who tested positive for Covid-19, the disease caused by the new coronavirus and is, therefore, the largest of its kind, to date. It was published in the online edition of Cancer Discovery.

Cancer patients must be closely monitored

The study involved 218 cancer patients who tested positive for Covid-19 from 18 March to 8 April at Montefiore Medical Center in the Bronx, New York City. The results reveal that 61 of these cancer patients died from Covid-19.

Covid-19 patients with haematologic (blood) cancers, such as leukaemia and lymphoma, were also found to have the highest mortality rate, while those with breast cancer and prostate cancer had the lowest mortality rates.

"Our findings emphasise the need to prevent cancer patients from contracting Covid-19 and – if they do – to identify and closely monitor these individuals for dangerous symptoms," said Dr Vikas Mehta, co-lead author of the study and a surgical oncologist at Montefiore.

"We hope that our findings can inform states and communities that have not yet been so severely struck by this pandemic about the unique vulnerability cancer patients face."

According to the World Health Organization (WHO), cancer is the second leading cause of death globally, and accounted for an estimated 9.6 million deaths in 2018 alone. The latest (2018) South African profile from the WHO shows that just over 107 000 South Africans were living with cancer.

Cancer patients should continue treatment

Cancer patients’ immune systems are often suppressed due to their treatment, or the cancer itself. However, the data suggest that patients should not stop their treatment, co-senior author Dr Amit Verma, director of the division of haemato-oncology at Montefiore and professor of medicine and developmental and molecular biology at Einstein explained.

"Rather, [cancer patients should] develop strategies to minimise potential Covid-19 exposures and re-evaluate therapies for our most vulnerable cancer populations," Verma explained.

Taking precaution

An analysis of more than half the patients involved in the study was found to have been in places with a higher risk of exposure to Covid-19, including nursing homes, hospitals or emergency departments within the 30 days before being diagnosed with Covid-19, the study found. However, the authors note that this was before physical distancing had been implemented in the US.

Since there is currently no vaccine to prevent Covid-19, or specific treatment for it, those who are most at risk – people with immunocompromised conditions, such as cancer; those who are over the age of 65; and people with underlying medical conditions such as diabetes and lung disease – must take extra precautions to minimise their risk of being exposed to the virus.

This includes practising really good hand hygiene, avoiding crowds, as well as anyone who may be sick, and just staying at home as much as possible. Cancer patients who display any symptoms should call their doctor or oncologist for expert guidance on whether their symptoms are in line with Covid-19 or their cancer diagnosis.

The Cancer Association of South Africa (CANSA) also has a dedicated online support platform, says Lucy Balona, Head of Marketing & Communication at CANSA. “We are sharing information and are still serving and assisting patients during this time.”

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