Thyroid cancer in the Era of COVID-19
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Thyroid cancer in the Era of COVID-19 Anabella Smulever
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Erika Abelleira
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Fernanda Bueno
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Fabián Pitoia
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Received: 5 June 2020 / Accepted: 27 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The recent coronavirus infectious disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is placing health systems in serious challenges worldwide. Shocking statistics each day has prompted the World Health Organization to officially declare the COVID-19 outbreak as a pandemic in March 2020. Preliminary studies have shown increased mortality in patients with solid cancers and infection by SARS-CoV-2. Until now, the evidence on the behavior of COVID-19 in patients with a history of thyroid cancer remains scarce, and most of the recommendations given are based on common sense. Therefore, in this viewpoint, we present a brief review of several challenges we are frequently facing during this pandemic and a series of recommendations based on what we have implemented in our clinical practice at a university hospital currently mostly dedicated to COVID-19. Keywords Thyroid cancer COVID-19 Coronavirus Cancer Infectious disease ●
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Introduction The recent coronavirus infectious disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is placing health systems in serious challenges worldwide. Shocking statistics each day has prompted the World Health Organization to officially declare the COVID-19 outbreak as a pandemic. By June 28th 2020, the rapid virus dissemination has accounted for about 9,843,073 confirmed cases and 495,760 deaths worldwide. Argentina contributed with 55,343 confirmed cases and 1192 fatal victims related to virus local circulation (https://www.who.int/emergencies/diseases/novel-corona virus-2019). Current reports have linked COVID-19-related mortality on the prominent impact of multi-organ dysfunction syndrome. This is a consequence of dysregulated immune responses given by increased cytokine levels (IL-6, IL-10, and TNFα), lymphopenia (in CD4+ and CD8+ T cells), and decreased expression of IFNγ in CD4+ T cells [1]. This phenomenon was called the “cytokine storm” by some authors and was associated with disease severity and
* Fabián Pitoia [email protected] 1
Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
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poor outcomes [2]. On the other hand, in 2018 there were 18 million new cases of cancer worldwide (https://www. who.int/cancer/PRGlobocanFinal.pdf?ua=1). Since this disease is considered an immunosuppressive status by itself, especially in some types of cancer, the medical community has become increasingly concerned about the potentially deleterious effects that COVID-19 infection may cause in these patients.
COVID-19 and thyroid cancer There is scarce evidence about the impact of COVID-19 infection in patients with a history of thyroid cancer. In an effort to investigate a corre
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