key: cord-0846392-kfw1rfut
authors: Cai, Changjing; Ahmed, Omar Abdihamid; Shen, Hong; Zeng, Shan
title: Which cancer type has the highest risk of COVID-19 infection?
date: 2020-05-19
journal: J Infect
DOI: 10.1016/j.jinf.2020.05.028
sha: e6b8cd943e925ba7fd6d314dcade3d7953b05d3e
doc_id: 846392
cord_uid: kfw1rfut

nan

many tumor cells also express ACE2 and TMPRSS2.

Our pan-cancer analysis by using TIMER [4] showed that the expression levels of are also increased; hence the risk of COVID-19 infection in patients with these tumors is higher. We also found that only UCEC is co-expressing ACE2 and TMPRSS2 receptors; therefore, patients with UCEC carry the highest risk of COVID-19

infection.

If the SARS-CoV-2 virus infects the tumor cells, it will be difficult to clear due to the inherent immune resistance in the tumor microenvironment. Numerous studies have shown that the longer the virus stays in the body, the more tissues and organs will be damaged directly or indirectly [5] . Though many tissues will not be invaded by the virus, inflammatory reactions such as cytokine storms can cause tissue damage. Also, the cytokine storm caused by COVID-19, such as IL-6, may promote the progression of the tumor, such as UCEC [6] .

Currently, COVID-19 treatment is mainly supportive care even though there is a debate on the use of ACE inhibitors (ACEi) or Angiotensin Receptor Blocker (ARB) as a treatment option. Mortality rates for patients with hypertension not taking an ACEi or ARB, taking an ACEi, and taking an ARB were 26.7%, 32.7%, and 30.6%, respectively [5] . Studies have shown that Bruton Kinase (BTK) Inhibitors can reduce inflammation reaction by blocking the Toll-like receptors signaling pathways, which is a good choice for patients with lymphoma [7] . Cytokines can promote tumor progression, indicating cytokine inhibitors, such as anti-IL-6 (Tocilizumab), may bring more benefits to cancer patients. This letter is, to our knowledge, the first to determine the risk of COVID-19 for patients with cancer by a pan-cancer analysis about the expression level of ACE2 and TMPRSS2, and want to provide some advices for clinical physicians.

In conclusion, patients with UCEC are at the highest risk of COVID-19 infection. And to this effect, we suggest the use of a nucleic acid test of curettage specimens from the endometrium in addition to the nasal swab test.

Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis

Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System

SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues

TIMER: A Web Server for Comprehensive Analysis of Tumor-Infiltrating Immune Cells

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the

Interleukin 6 promotes endometrial cancer growth through an autocrine feedback loop involving ERK-NF-κB signaling pathway

The BTK-inhibitor ibrutinib may protect against pulmonary injury in COVID-19 infected patients

Figure 1. Which cancer type has the highest risk of COVID-19 infection? (A) The expression level of ACE2 in pan-cancer analysis. (B) The expression level of TMPRSS2 in pan-cancer. (C) The body map of the risk of COVID-19 infection in cancer. (Esophageal carcinoma (ESCA), Kidney renal papillary cell carcinoma (KIRP), Lung adenocarcinoma (LUAD)