Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection

• Type of Material: Article
• Authors: Muhammad Latif, Emory University; Sudhanshu Shukla, Emory University; Perla Mariana Del Rio Estrada, Emory University; Susan Pereira Ribeiro, Emory University; Rafick-Pierre Sekaly, Emory University; Ashish Sharma, Emory University
• Language: English
• Date: 2022-03-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Published by Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.trsl.2021.12.001
• Title of Journal or Parent Work: TRANSLATIONAL RESEARCH
• Volume: 241
• Start Page: 83
• End Page: 95
• Grant/Funding Information: This work was funded by NIH and/or NCI grant 1U54CA260563-01.
• Keywords: General & Internal Medicine; IMMUNOTHERAPY; CLINICAL CHARACTERISTICS; Medicine, Research & Experimental; CHEMOTHERAPY; Science & Technology; COVID-19; RISK-FACTORS; MORTALITY; Medicine, General & Internal; INFLAMMATION; Life Sciences & Biomedicine; CORONAVIRUS; LUNG-CANCER; Medical Laboratory Technology; Research & Experimental Medicine; T-CELLS
• Research Categories: Health Sciences, Pathology

Abstract

Patients with cancers have been severely affected by the COVID-19 pandemic. This is highlighted by the adverse outcomes in cancer patients with COVID-19 as well as by the impact of the COVID-19 pandemic on cancer care. Patients with cancer constitute a heterogeneous population that exhibits distinct mechanisms of immune dysfunction, associated with distinct systemic features of hot (T-cell-inflamed/infiltrated) and cold (Non-T-cell-inflamed and/or infiltrated) tumors. The former show hyper immune activated cells and a highly inflammatory environment while, contrastingly, the latter show the profile of a senescent and/or quiescent immune system. Thus, the evolution of SARS-CoV-2 infection in different types of cancers can show distinct trajectories which could lead to a variety of clinical and pathophysiological outcomes. The altered immunological environment including cytokines that characterizes hot and cold tumors will lead to different mechanisms of immune dysfunction, which will result in downstream effects on the course of SARS-CoV-2 infection. This review will focus on defining the known contributions of soluble pro- and anti-inflammatory mediators on immune function including altered T-cells and B-cells responses and as well on how these factors modulate the expression of SARS-CoV-2 receptor ACE2, TMPRSS2 expression, and lymph node fibrosis in cancer patients. We will propose immune mechanisms that underlie the distinct courses of SARS-CoV-2 infection in cancer patients and impact on the success of immune based therapies that have significantly improved cancer outcomes. Better understanding of the immune mechanisms prevalent in cancer patients that are associated to the outcomes of SARS-CoV-2 infection will help to identify the high-risk cancer patients and develop immune-based approaches to prevent significant adverse outcomes by targeting these pathways.