Cancer survivors at higher health complication risk: MIO director

MIO director


In the past three months the world has been going through severe apprehension due to the pandemic of coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus that emerged during November end last year at Wuhan City of Hubei province of China has now spread to the rest of the world. As on April 6 in India, 4,067 cases were detected, of which 110 succumbed to the infection.

Coronavirus induced disease is transmitted by inhalation or contact with infected droplets and the incubation period (time from inhalation to symptoms of illness) ranges from 2 to 14 days. The clinical features of COVID-19 are varied, ranging from an asymptomatic state to acute respiratory distress syndrome and multi-organ dysfunction. The common clinical features include fever (not in all), cough, sore throat, headache, fatigue, myalgia and breathlessness. Conjunctivitis has also been described. Thus, they are indistinguishable from other respiratory infections like the common flue. The only way corona can be distinguished from flu and other seasonal respiratory ailments is by the use of viral-specific sophisticated tests (RT-PCR or antigen-based) from the swabs/washings collected from the nasopharyngeal and/or throat region of the suspected individuals.

What makes corona dangerous is that in a subset of patients, by the end of the first week the disease can progress to pneumonia, respiratory failure and death. This progression is associated with extreme inflammation especially in the lungs. The median time from onset of symptoms to shortness of breath was about 5 days, hospitalization 7 days and acute respiratory distress syndrome (ARDS) 8 days. The need for intensive care admission was in 25–30% of the affected patients. Complications witnessed included acute lung injury, ARDS, shock and acute kidney injury. Recovery starts in the second or third week. The median duration of hospital stay in those who recovered was 10 days. Adverse outcomes and death are more common in the elderly and those with underlying co-morbidities like asthma, diabetes, hypertension, kidney ailments, HIV, tuberculosis and cancer (50–75% of fatal cases). The fatality rate in hospitalized adult patients ranges from 4 to 11%.

Coronavirus and its impact on patients with cancer

Cancer, a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body is today the world’s second-most killer disease. When compared to a healthy individual cancer itself may weaken the immune system and are immune-compromised’. The primary role of the immune system is to help fight infection. From a terminological perspective ‘immune-compromised’ refers to individuals whose immune system is considered weaker, more impaired, or less robust than that of the average healthy adult. Further, chemotherapy and radiation used to control cancer can severely debilitate the immune system. Individuals with compromised immune systems are at a higher risk of getting infections, including viral infections such as COVID-19.

Patients with cancer may be at a greater risk of being immune-compromised depending on the type of cancer they have, the type of treatment they receive, other health conditions, and their age. The risk of being immune-compromised is the highest during the time of active treatment for cancer, such as during treatment with chemotherapy. There is no specific test to determine if a person is immune-compromised, although findings such as low white blood cell counts or low levels of antibodies (also called immunoglobulins) in the blood are likely to indicate an immune-compromised state. Coronavirus affects people with a very severely debilitated immune system and it is in this context that care needs to be taken by patients undergoing treatment for cancer and also the survivors who have completed their treatment.

Bangalore Hot News