Abstract
Coronavirus disease–2019 (COVID-19), a disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, has become an unprecedented global health emergency, with fatal outcomes among adults of all ages throughout the world. There is a high incidence of infection and mortality among cancer patients with evidence to support that patients diagnosed with cancer and SARS-CoV-2 have an increased likelihood of a poor outcome. Clinically relevant changes imposed as a result of the pandemic, are either primary, due to changes in timing or therapeutic modality; or secondary, due to altered cooperative effects on disease progression or therapeutic outcomes. However, studies on the clinical management of patients with genitourinary cancers during the COVID-19 pandemic are limited and do little to differentiate primary or secondary impacts of COVID-19. Here, we provide a review of the epidemiology and biological consequences of SARS-CoV-2 infection in GU cancer patients as well as the impact of COVID-19 on the diagnosis and management of these patients, and the use and development of novel and innovative diagnostic tests, therapies, and technology. This article also discusses the biomedical advances to control the virus and evolving challenges in the management of prostate, bladder, kidney, testicular, and penile cancers at all stages of the patient journey during the first year of the COVID-19 pandemic.
Highlights
The novel severe acute respiratory syndrome coronavirus (SARSCoV-2) is a positive sense single-stranded enveloped RNA virus which belongs to the Coronaviridae family of viruses, that has rapidly spread since being identified in Wuhan, China in December 2019 [1], with 202 million confirmed current cases worldwide [2]
We present a timely overview of the medical and scientific findings to date on the impact of SARS-CoV-2 on genitourinary (GU) cancers, including prostate, bladder, kidney, testicular, and penile cancers, over the past year, as we mark the first year of the coronavirus disease 2019 (COVID-19) pandemic, and offer recommendations for the diagnosis, clinical care, and therapeutic management of GU cancer patients during the ongoing pandemic
This study found that a delay in bladder cancer diagnosis greater than 9 months had an increased risk of cancer specific mortality compared to those diagnosed within 3 months [HR 1.34]; the risk was still significantly increased after adjusting for grade and stage [71]
Summary
The novel severe acute respiratory syndrome coronavirus (SARSCoV-2) is a positive sense single-stranded enveloped RNA virus which belongs to the Coronaviridae family of viruses, that has rapidly spread since being identified in Wuhan, China in December 2019 [1], with 202 million confirmed current cases worldwide [2]. SARS-CoV-2 is a highly contagious positive-sense single-stranded RNA virus that was first described as a cluster of severe pneumonia cases in Wuhan, China on December 31, 2019, and subsequently identified as a coronavirus on January 7, 2020 by the Chinese Center for Disease Control and Prevention [1]. Findings by Singh et al identified several genitourinary organs (prostate, kidney, and testis) that co-express ACE2 and TMPRSS2 and may serve as a viral reservoir and site of infection [8]. Further supporting the prioritization of cancer patients for care, is the finding that long term COVID-19 infection has been observed in cancer patients, with prolonged, viable, and infectious SARS-CoV-2 viral shedding [19,20,21]. The long-term effect of deferred patient management on outcomes remains uncertain [23]
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