Health
Does Cancer Chemotherapy Increase the Risk of Covid-19?
Q. I have cancer and am being treated with chemotherapy. Am I at increased risk of getting sick and dying with Covid-19?
A: Cancer patients, especially leukemia patients, appear to have a higher mortality rate from Covid-19 than the general population, but cancer chemotherapy does not appear to further increase the risk of death from Covid-19. However, research is limited and the results can be difficult to interpret.
Many types of chemotherapy work by destroying the machines in the cancer cells. Unfortunately, chemotherapy can also destroy healthy cells that grow rapidly in the body, such as the bone marrow cells that make up the immune system. As a result, people receiving chemotherapy are at risk of immunodeficiency. The immune system, which is our body’s main line of defense against microbes, can also be destroyed by blood and bone marrow cancers such as leukemia, preventing the immune system from maturing and making it impossible to fight infections. I will.
It is a logical assumption that people with a weakened immune system are more likely to catch new coronaviruses and get sick. In one recent study, patients with blood and bone marrow cancer had high viral load of coronavirus, which was associated with increased mortality. However, the lack of population-based studies of coronavirus infection rates in cancer patients makes it uncertain.
Several studies have investigated the severity of Covid-19 infection in cancer patients. A UK study of more than 1,000 cancer patients over a seven-week pandemic found that leukemia patients had twice the mortality rate, while other cancer patients compared to a similar group of cancer patients three years ago. It was double. , In front of Covid-19.
Another study of more than 900 patients with ongoing or past cancers and Covid-19 infections from the United States, Canada, and Spain found that 13% died and 26% died or received intensive care. It was as severe as I needed. These rates are much higher than the average person. Among patients with Covid-19, the estimated case fatality rate is 3% in the United States.
Cancer patients receiving chemotherapy did not appear to have higher mortality or serious illness than other cancer patients, but in patients with blood or bone marrow cancer such as leukemia or lymphoma. , 14% died and 35% developed a serious illness.
In another international study of nearly 200 patients with chronic leukemia, Covid-19 had an even higher mortality rate of 33%, but the mortality rate of patients who received chemotherapy was no higher. Interestingly, patients receiving palliative cancer treatment, which focuses on improving quality of life and alleviating symptoms rather than aggressive cancer treatment, should be treated aggressively considering the prognosis of the cancer. Because of his refusal, he was more likely to die outside the intensive care unit.
The Covid-19 registry, which is ongoing through the American Society of Hematology, has a high mortality rate of about 600 blood and bone marrow cancer patients, at 20%. More than half of the patients were hospitalized and 23% were so ill that they needed to stay in the intensive care unit. More than 50 patients abandoned the ICU and chose a palliative treatment approach. This demonstrates the difficulty of interpreting Covid-19 severity and mortality in patients suffering from other serious illnesses such as cancer.
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