Egészségbiztonság Nemzeti Laboratórium(RRF-2.3.1-21-2022-00006) Támogató: NKFIH
(K_22 142604) Támogató: Hungarian National Research, Development and Innovation Office
New National Excellence Program(ÚNKP-23-4-II-SE-24)
(TKP2021-EGA-30)
(I/82-5/2022/EKF)
COVID-19, caused by SARS-CoV-2, manifests with differing severity across distinct
patient subgroups, with outcomes influenced by underlying comorbidities such as cancer,
which may cause functional and compositional alterations of the immune system during
tumor progression. We aimed to investigate the association of SARS-CoV-2 infection
and its complications with cancer in a large autopsy series and the role of COVID-19
in the fatal sequence leading to death. A total of 2641 adult autopsies were investigated,
539 of these were positive for SARS-CoV-2. Among the total number of patients analyzed,
829 had active cancer. Overall, the cohort included 100 patients who simultaneously
had cancer and SARS-CoV-2 infection. The course of COVID-19 was less severe in cancer
patients, including a significantly lower incidence of viral and bacterial pneumonia,
occurring more frequently as a contributory disease or coexisting morbidity, or as
SARS-CoV-2 positivity without viral disease. SARS-CoV-2 positivity was more frequent
among non-metastatic than metastatic cancer cases, and in specific tumor types including
hematologic malignancies. COVID-19 was more frequently found to be directly involved
in the fatal sequence in patients undergoing active anticancer therapy, but less frequently
in perioperative status, suggesting that the underlying malignancy and consequent
surgery are more important factors leading to death perioperatively than viral disease.
The course of COVID-19 in cancer patients was milder and balanced during the pandemic.
This may be due to relative immunosuppressed status, and the fact that even early/mild
viral infections can easily upset their condition, leading to death from their underlying
cancer or its complications.
