Abstract
According to a report from the World Health Organization (WHO), the mortality and disease severity induced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are significantly higher in cancer patients than those of individuals with no known condition. Common and cancer-specific risk factors might be involved in the mortality and severity rates observed in the coronavirus disease 2019 (COVID-19). Similarly, various factors might contribute to the aggravation of COVID-19 in patients with cancer. However, the factors involved in the aggravation of COVID-19 in cancer patients have not been fully investigated so far. The formation of metastases in other organs is common in cancer patients. Therefore, the present study investigated the association between lung metastatic lesion formation and SARS-CoV-2 infectivity. In the pulmonary micrometastatic niche of patients with ovarian cancer, alveolar epithelial stem-like cells were found adjacent to ovarian cancer. Moreover, angiotensin-converting enzyme 2, a host-side receptor for SARS-CoV-2, was expressed in these alveolar epithelial stem-like cells. Furthermore, the spike glycoprotein receptor-binding domain (RBD) of SARS-CoV-2 was bound to alveolar epithelial stem-like cells. Altogether, these data suggested that patients with cancer and pulmonary micrometastases are more susceptible to SARS-CoV-2. The prevention of de novo niche formation in metastatic diseases might constitute a new strategy for the clinical treatment of COVID-19 for patients with cancer.
Highlights
The United States and other countries have found it difficult to contain the coronavirus disease 2019 (COVID-19) pandemic due to the spread through respiratory droplets of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the inconsistent adherence to effective public health measures, including wearing masks and maintaining social distancing
Previous clinical studies have shown that SARS-CoV-2 infection rates and COVID-19 severity are higher in cancer and in people with a history of cancer than they are in healthy individuals
Previous clinical studies have shown that SARS-CoV-2 infection rates and COVID-19 severity rates are higher in cancer patients and in people with a history of cancer than in healthy individuals
Summary
The United States and other countries have found it difficult to contain the coronavirus disease 2019 (COVID-19) pandemic due to the spread through respiratory droplets of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the inconsistent adherence to effective public health measures, including wearing masks and maintaining social distancing. According to the reports of the World Health Organization, the mortality rate of cancer patients infected with SARS-CoV-2 is 7.6%, which is fairly higher than the 1.4% mortality rate of individuals infected with SARS-CoV-2 without complications [1]. Among patients with cancer and COVID-19, the 30-day all-cause mortality is high, i.e., a mortality rate of 13.3%, and has been associated with general and cancer-specific risk factors [1,2]. According to a report from the Japan Ministry of Health, Labor, and Welfare, as of August 2020, the severity rate of patients with solid cancer infected with SARS-CoV-2 was much higher than that of all patients infected with SARS-CoV-2 [3]. The reason why COVID19 is more severe in cancer patients is not fully understood. Immunity against the virus seems reduced in cancer patients receiving therapeutic anticancer agents [4]
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