Determinants of adverse outcomes in Lung and Colorectal Cancer patients with COVID-19 Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that leads to pneumonia, multi-organ failure, and death. Bronx County represents 17% of the population of New York City (NYC), yet has seen 22% of the COVID infected patients and COVID related deaths. COVID-19 is particularly affecting the minority groups with a higher mortality among the African American and Hispanic population as compared to Whites. To date, the largest single-institution cohort study of patients with a known malignancy and COVID-19 infection in the United States from our institution (lead authors including Drs. Goel and Halmos) revealed a 28% case fatality rate (61 deaths) among 218 patients studied. Specifically, death rates were 55% among lung cancer, and 38% among gastrointestinal (GI) cancer. The NHB and Hispanic representation in this dataset was > 70%. SARS-CoV-2 invades host cells via three potential receptors: angiotensin-converting enzyme 2 (ACE2), CD147 (Basigin or EMMPRIN) and TMPRSS2 (transmembrane protease serine). Spike protein from the virus binds to one of these receptors on the host cell, mediating viral invasion and dissemination. We hypothesize that lung and CRC cells serve as a sanctuary site for the SARS-CoV-2 virus resulting in higher viral burdens and an unusually high mortality in patients afflicted with this illness. Further, given the elevated risk of COVID-19 mortality in the cancer population, it will be important to better understand the patterns of viral shedding and seroconversion of the virus among patients with a known malignancy. Studies to this point have reinforced the importance of infection control protocols in the cancer population. In this grant proposal, we seek to determine the cause of this high death rate. We hope and expect that our findings will help answer some questions pertaining to the high mortality and lead to development of mitigation strategies to reduce the overall burden of COVID-19 disease and the high mortality observed. Expanding on our knowledge of viral shedding, seroconversion and possibly even re-infection patterns can help inform policy and enhance efforts to safely manage cancer patients amidst a pandemic.

Public Health Relevance

Determinants of adverse outcomes in Lung and Colorectal Cancer patients with COVID-19 Project Narrative Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that leads to pneumonia, multi-organ failure, and death. We have observed that patients with lung and gastrointestinal cancer have a high death rate when they get this illness. In this grant proposal, we seek to determine the cause of this high death rate.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Center Core Grants (P30)
Project #
3P30CA013330-48S4
Application #
10203573
Study Section
Subcommittee I - Transistion to Independence (NCI)
Program Officer
Roberson, Sonya
Project Start
1997-06-01
Project End
2022-06-30
Budget Start
2020-07-01
Budget End
2021-06-30
Support Year
48
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Albert Einstein College of Medicine
Department
Type
DUNS #
081266487
City
Bronx
State
NY
Country
United States
Zip Code
10461
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