Systematic Review: Safety of Intravesical Therapy for Bladder Cancer in the Era of COVID-19
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COVID-19
Systematic Review: Safety of Intravesical Therapy for Bladder Cancer in the Era of COVID-19 Cale E. Leeson 1 & Asmaa Ismail 1 & Mohamed M. Hashad 2 & Hazem Elmansy 1 & Walid Shahrour 1 & Owen Prowse 1 & Ahmed Kotb 1 Accepted: 13 August 2020 # Springer Nature Switzerland AG 2020
Abstract A novel coronavirus has emerged in late 2019 capable of causing a severe respiratory disease known as COVID-19. Its pathogenesis appears to be the initiation of an immune response and resulting cytokine storm that damages the healthy lung tissue of the host. Some epidemiological studies found bacillus Calmette-Guérin (BCG) vaccine can help to decrease morbidity and mortality of the viral infection. We aim to review and summarize what is known about COVID-19 and the current implications of intravesical BCG with regard to the disease. Keywords COVID-19 . Coronavirus . BCG . Bladder cancer
Introduction In December 2019, a novel coronavirus, now officially known as severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), emerged in China and is capable of causing the infectious disease called coronavirus disease 2019 (COVID-19). [1] Since then, the World Health Organization has declared a global pandemic, with 1,051,635 global cases of COVID-19, resulting in 56,985 deaths as of April 4, 2020. [2] The clinical manifestations of COVID-19 are varied, ranging from mild symptoms such as fever, dyspnea and cough to more severe complications in the case of acute respiratory distress syndrome (ARDS), septic shock and death. Pathogenesis of the disease likely involves initiation of an immune response, resulting in the production of cytokines in a “cytokine storm” that damages healthy lung tissue of the host. [3] Future clinical trials are being arranged to determine if bacillus Calmette-Guérin (BCG), an attenuated version of
This article is part of the Topical Collection on Covid-19 * Ahmed Kotb [email protected] 1
Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
2
Urology Department, Alexandria University, Alexandria, Egypt
Mycobacterium bovis and vaccine against tuberculosis, has the ability to upregulate the immune system against the novel coronavirus. [4] Furthermore, BCG immunotherapy is often utilized in the field of urology for the treatment of bladder cancer. It is not yet determined if intravesical therapy will have a positive or negative effect on the immune system in bladder cancer patients with COVID-19. Bladder cancer is a common urologic condition, with urothelial carcinoma comprising the largest proportion of cases (90%). [5] In addition, 75% of new bladder cancer cases will be non-muscle invasive bladder cancer (NMIBC), typically treated with a high-quality transurethral resection of the bladder tumour (TURBT), followed by either intravesical chemotherapy or immunotherapy. [5–7] Compared with other intravesical therapies, BCG is the only agent associated with a decreased cancer progression risk compared with TURBT alone but is associated with a higher risk of adverse e
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