Recently, the COVID-19 epidemic has begun to spread again, and many friends have been infected. For cancer patients with underlying diseases and weak immunity, the risk of contracting COVID-19 is higher, and the consequences are generally more serious.
But as the saying goes, blessings and misfortunes depend on each other. During the three-year epidemic, some cancer patients also had their original tumors miraculously disappear after being unfortunately infected with the new coronavirus.
Case 1
Lymphoma Infected with COVID-19 after diagnosis
Lymphoma also went into remission after recovery
The patient was a 61-year-old man who went to the hospital due to progressive lymphadenopathy and weight loss. He was diagnosed with EBV-positive classic Hodgkin lymphoma through biopsy and PET/CT examination. [1] However, just when he was diagnosed and had not started treatment, he was infected with new coronavirus and had to postpone his anti-cancer treatment and be hospitalized for treatment of the new coronavirus.
After 11 days of optimal supportive care, the patient was discharged home to recuperate without any anticancer treatment. But after 4 months, the palpable lymph node swelling throughout his body began to shrink. PET/CT also confirmed that the lymph node swelling had generally subsided. , metabolic uptake was reduced, and the calculated copy number of EBV virus in the blood was significantly reduced.
All signs indicate that his lymphoma was in remission after being infected with the new coronavirus.
The patient's whole body tumor has receded
Case 2
The operation was postponed due to the new crown, and the operation was delayed after the new crown was cured
The patient is a 40-year-old man who also suffers from AIDS[2]. Four weeks before treatment, a 2cm subclavian mass appeared on the right side of his chest. The pain was unbearable. The biopsy was diagnosed as fibrous connective tissue tumor , and surgical removal was planned.
A few days before the operation, the patient suddenly had a fever and tested positive for the new coronavirus nucleic acid. The operation had to be postponed and symptomatic treatment was given acetaminophen and methylprednisolone . months later, the patient reported that the tumor had spontaneously shrunk. The doctor's palpation and CT examination also found that the original mass had disappeared.
After being infected with the new coronavirus, the patient’s chest tumor disappeared
Case 3
COVID-19 puts refractory lymphoma into temporary remission
The patient is a 20-year-old man with EBV-positive NK/T-cell lymphoma[3]. Moreover, his tumor has become resistant to multiple treatment options such as K drug, rituximab, L-asparaginase, SMILE regimen, DDGP regimen and CHOP regimen, making it very difficult to treat.
After being infected with the new coronavirus, the patient's symptoms were also more severe, including palpable hepatosplenomegaly, ground glass opacity in both lungs on CT, and blood tests showed high anemia and hemolysis. Ten days of symptomatic treatment only allowed his anemia and platelet count to stabilize.
But at the same time, patients' tumors experienced significant remission. On the 11th day, the proportion of the patient's clonal NK cell population dropped from 70% to 4.2%, the plasma EBV-DNA copy number dropped from 229876 copies/mL to 495 copies/mL, and the splenomegaly was also alleviated.
Unfortunately, after the patient's COVID-19 nucleic acid turned negative on the 34th day, the lymphoma relapsed quickly, and symptoms such as hemolytic anemia, fever, splenomegaly, and elevated NK cell count reappeared. The plasma EBV-DNA also increased from 500 copies/mL to more than 72,250 copies/mL.
The patient's EBV-DNA copy number dropped rapidly after being infected with the new coronavirus, and then increased again after the new coronavirus was cured
Case 4
The new coronavirus cured the tumor, but killed him
The patient is a 66-year-old woman who was diagnosed in the fall of 2019 with Sézary syndrome, an aggressive cutaneous T-cell lymphoma, as well as type 12 diabetes, uncontrolled hypertension, and end-stage renal disease.[4] She had been treated with extracorporeal photopheresis and bexarotene, but had failed to persist. Later, the itching caused by Sézary syndrome made it difficult for her to sleep, and the Sézary count (which reflects the severity of Sézary syndrome) climbed to 11,132.
In April 2020, she was infected with the new coronavirus for the first time. Her symptoms were very mild, with only some shortness of breath and no fever. She recovered without medication. Two months later, her Sézary count dropped to 6,494, a 42% drop from March.
In July of the same year, the patient was infected with COVID-19 again and was hospitalized with severe COVID-19. At the same time, her lymphocyte count and Sézary count both dropped significantly, reaching their lowest levels since her illness. When she returned for a follow-up visit in September, her Sézary count had dropped to 936, a 92% drop from its peak.
However, in November, the patient was hospitalized again with severe COVID-19 pneumonia. While hospitalized, she developed pulmonary encephalopathy hypotension and died after a cardiac arrest.
The patient was infected with COVID-19 twice and his tumors were in remission twice.
Generally speaking, the unexpected disappearance of tumors after infection with COVID-19 mostly occurs in hematological tumors. In fact, it is not uncommon for viral infections to cause remission of blood tumors. Infectious diseases such as influenza, chickenpox, measles have also been recorded as causing leukemia or lymphoma remission. These events also prompted the development of oncolytic virotherapy.
However, compared with other candidate oncolytic viruses , the new coronavirus genome is unstable and prone to mutation, and can replicate in normal cells, making it difficult to become an ideal oncolytic virus. Although it can lead to tumor remission in some patients, it may also lead to life-threatening situations where the tumor is cured.
All cancer patients should take personal protection and standardize treatment in the face of the epidemic. Don’t pin your hopes on curing cancer on the coronavirus. Izaguirre-Pérez M E, Valencia-Salinas J J, Mandujano-Sánchez J I, et al. Reducción inesperada de tumor torácico asociado a infección por SARS-CoV-2[J]. Revista Mexicana de Cirugía Torácica General, 2022, 2(1): 15-18.
[3]. Pasin F, Calveri M M, Pizzarelli G, et al. Oncolytic effect of SARS-CoV2 in a patient with NK lymphoma[J]. Acta Bio Medica: Atenei Parmensis, 2020, 91(3): e2020047.
[4]. Snowden C, Ng S, Choi J. Partial remission of advanced untreated Sézary syndrome after COVID-19[J]. JAAD Case Reports, 2022, 21: 165-168.
