Hollings researcher finds surprising results in lung cancer patients positive for COVID-19


MUSC Hollings Cancer Center researcher and radiation oncologist Graham Warren, MD, PhD, published a new study in the Journal of Thoracic Oncology detailing new findings and early markers of COVID-19 in lung cancer patients.

Protecting cancer patients against COVID-19 and its new variants remains a priority at MUSC Hollings Cancer Center. Hollings researcher and radiation oncologist Graham Warren, MD, Ph.D., published a new study in the Journal of Thoracic Oncology detailing new findings and early markers of COVID-19 in lung cancer patients.

In the study, Warren pooled CT scans from several institutions around the world selected from patients who had undergone image-guided radiation therapy and developed COVID-19 during treatment. In the majority of cases studied, the scans revealed the presence of infiltrates, which refer to the fuzzy gray areas that can appear on scans of the lungs and serve as a marker for COVID-19 before the patient shows symptoms.

“We want to try to identify very quickly a cancer patient‘s risk of having COVID-19 because these patients have a higher risk of complications and mortality,” Warren said. “By using tests to uncover potential positive cases of COVID-19 early on, we can help reduce the risk of exposure to other patients as well as facilitate earlier diagnosis and treatment for patients with COVID. “

In the study, researchers looked at the analyzes of nine lung cancer patients from Turkey, Spain, Belgium, Egypt and the United States who had tested positive for COVID-19. Warren said, surprisingly, that eight of nine patient scans revealed the presence of infiltrates in the lungs.

“These results are extremely important,” he said. “If a doctor notices something on the patient’s CT scan, they can have them tested for COVID-19 or ask them how they are doing. This gives us the ability to identify patients who may have a higher risk of having COVID-19, whether they are symptomatic or not. “

Identifying COVID-19 is particularly important in cancer settings, as patients receiving cancer treatment are at higher risk for serious complications and death from COVID. Warren said that while chemotherapy and pneumonia can also cause infiltrates to form in the lungs, the findings of this international study are important.

“Lung cancer patients receiving radiation are unique because they already have routine lung scans,” Warren said. “We can use the radiation setup already in place to identify the risk of COVID-19, and we can achieve this without significant changes to our standard radiation therapy procedures. “

With the number of new cases on the rise in some areas due to highly contagious variants, Warren said more studies are needed to better understand the early marks of the virus and ways to protect those most at risk. At Hollings, positive cases of COVID-19 among cancer patients are treated on a case-by-case basis.

“We have to manage the patient and their diagnosis and keep exposure to other people in mind,” he said. “If a patient develops COVID-19 during cancer treatment, we try to treat that person at the end of the day, asking staff to wear appropriate protective clothing to reduce the risk of exposure to others. If patients have symptoms, we can change treatment or stop treatment if necessary. “

According to Warren, two recommendations emerged from the study. First, radiation oncologists and radiation therapy departments should seriously consider reviewing imaging advice for new pulmonary infiltrates and consider immediate COVID-19 testing in patients with new infiltrates even without obvious symptoms of COVID-19. . Second, much more data is needed to determine the sensitivity and specificity of these findings and to refine this approach in standard clinical care.

It is likely that COVID-19 will remain an important consideration for society and healthcare. It is also likely that the variants will continue to evolve and that cases may have different symptoms and imaging results, he said. It will be important to continue to monitor patients during cancer treatment for years to come.

“With the current variants and symptoms of COVID-19, these imaging results could be extremely helpful in helping to minimize risks and infections,” Warren said. “These findings align directly with strategies to identify optimal cancer treatment strategies associated with harm reduction strategies for COVID-19. These simple findings can reduce risk and exposure and can immediately improve the lives of cancer patients during cancer treatment. “

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