COVID-19 Cytokine Storm: Who's at Higher Risk of Serious Symptoms?

Patients with cancer and suppressed immune systems are at risk of severe COVID-19 infection when treated with systemic therapies, especially immunotherapies.

Patients with cancer and a weakened immune system who are treated with immunotherapies tend to fare far worse from COVID-19 than those who haven't received such therapies in the three months before their COVID diagnosis, show findings in a new study published in the journal JAMA Oncology.

They also found that immunocompromised patients treated with drug agents other than immunotherapies had more severe COVID than untreated patients, but not to the degree as those receiving immunotherapy.

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Immunocompromised patients with cancer should be especially careful about avoiding COVID-19 and, if necessary, should be aggressive about getting treatment.

On the positive side, researchers found that patients treated with immunotherapies but whose immune systems were healthy – fared no worse from COVID than untreated patients did.

The findings suggest that immunocompromised patients with cancer should be especially careful about avoiding COVID and, if they do contract the disease, should be aggressive about getting treatment.

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Patients whose immune systems have not been suppressed, however, can safely receive cancer therapies – immunotherapies or drug agents – without being at additional risk from COVID-19.

This study was done to determine which patients are most at risk for adverse outcomes. They looked specifically at patients treated with immunotherapies, which stimulate the immune system to fight cancer, and those treated with other drugs that suppress the immune system.

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Drawing on the COVID-19 and Cancer Consortium (CCC19) registry, researchers analyzed data from 12,046 patients with COVID-19 who had a current or past diagnosis of cancer, making it one of the largest data sets to date analyzed about patients with COVID-19 and cancer.

The analysis examined whether a suppressed immune system or treatment with immunotherapy was associated with worse outcomes from COVID-19 – with hospitalization or death from the disease, and with "cytokine storm," a potentially dangerous overreaction of the immune system to infection.

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Both cytokine storm and death from COVID were three to four times higher in this group. The same trend held, but to a lesser extent, for patients who were immunocompromised and received some types of systemic treatments.

Patients at high risk for severe COVID should take steps to keep that risk as low as possible: wearing a mask, avoiding crowded places, and staying current with vaccines and boosters.

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High-risk patients who have been exposed to the disease should get tested quickly and, if they test positive, get treated with antibodies or drugs that can reduce the disease's severity.

When counseling patients about treatment, it's important that we discuss the benefits and risks of treatment with systemic therapies for COVID-19.

Source-Eurekalert