Annals of Hematology and Oncology Research 2020 | Volume 1 | Article 1008 023 © 2020 - Medtext Publications. All Rights Reserved. ISSN: 2692-7950 COVID-19 and Antiviral Therapies in Cancer Patients - will it Make Difference? Mini Review Mona Alshahawey, Mohamed Ahmed Raslan and Nagwa Ali Sabri * Department of Clinical Pharmacy, Ain Shams University, Egypt Citation: Alshahawey M, Raslan MA, Sabri NA. COVID-19 and Antivi- ral Therapies in Cancer Patients - will it Make Difference? Ann Hematol Oncol Res. 2020; 1(2): 1008. Copyright: © 2020 Mona Alshahawey Publisher Name: Medtext Publications LLC Manuscript compiled: May 28 th , 2020 *Corresponding author: Nagwa Ali Sabri, Department of Clinical Pharmacy, Ain Shams University, Cairo, Egypt, Tel: +201223411984; E-mail: nagwa.sabri@yahoo.com; nagwa.sabri@pharma.asu.edu.eg Abstract Coronavirus Disease 2019 (COVID-19), being a community transmitted disease, is overwhelming the current health care system capacity worldwide. It was frst detected in Wuhan, China in December, 2019. Te systemic immunosuppressive status in cancer patients make them vulnerable and susceptible to Coronavirus Disease 2019 (COVID-19) more than any other individuals. Till now, there are no treatment guidelines for cancer patients with COVID-19. Antiviral therapies were being investigated through the past months on patients with COVID-19, however, there’s a paucity of data regarding the reported incidence of COVID-19 in cancer patients compared to general population. Keywords: COVID-19; Community transmitted disease; Cancer patients Introduction In the early review of a Chinese national data repository, cancer patients with confrmed COVID-19 were mainly lung cancer patients [1]. Te risk of fatality was suggested to be 5.6% among patients with cancer [2]. Another study suggested a 3.5 times higher risk for those patients to have a severe COVID-19 disease with higher incidence of death, or ICU admission with invasive ventilation, when compared to general population (39% vs. 8%; P=0.0003), and a higher deterioration rate (median: 13 days vs. 43 days) [1]. Similarly, the Report of the WHO-China Joint Mission has suggested a 2-fold increase of COVID-19 risk for cancer patients than the general population [3]. Risk Factors Older age, with the highest fatal disease risk in patient’s ≥ 65 years, patients living in nursing homes or long-term care facilities [4], high Sequential Organ Failure Assessment (SOFA) score, or D-dimer concentration greater than 1 μg/ml, all seem to identify patients with poor prognosis at early stage [5]. Patients with comorbid conditions such as cardiovascular disease, diabetes, hypertension, chronic respiratory disease, renal disease, and cancer patients as well, were all presented with highest risk of severe COVID-19, than general population, especially in those who are not well controlled [3,4]. Smoking was also suggested by Xia et al. [2], as a risk factor for severe disease. Tere are no defnitive and accurate risk factors specifcally for cancer patients with COVID-19. However, unfortunately cancer patients showed higher deteriorating conditions and poorer outcomes from the COVID-19 infection than general population [6]. Chemotherapy and cancer surgery were considered as risk factors for severe complication, even receiving the anticancer therapy in the preceding month, was associated with severe events, as reported by Linag et al. [1], (OR: 5.34, p<0.01). Moreover, Zhang et al. [6], had reported that anticancer therapies as chemotherapy, immunotherapy or radiation, when used within 14 days of infection, were predictors for death and severe events (hazard ratio >4). Tat’s why it is recommended that cancer patients receiving anticancer therapies should have vigorous screening for COVID-19 infection. Tis adds to the real problem of poor accessibility to the necessary medical services for those patients; either in term of getting there when needed, or the provision of normal medical care, because of COVID-19 outbreak [7]. Action for patients on immunosuppressive therapy Although chemotherapy was considered as a risk factor for severe events of COVID-19, till now, there’s no evidence that support either withholding or replacement of chemotherapy drug. Same for targeted therapy, immunotherapy or radiation. Te possibility of cancer recurrence if therapy is delayed, discontinued or even modifed must be taken in consideration before any change in regimen, thus, individualization seems to be the key. In the midst of this pandemic situation, oncologists have to weigh the risks of mortality and morbidity from COVID-19 against the magnitude of beneft of resuming and continuing the intended cancer therapies [8], consequently, it’s suggested that patients may at least switch to oral drugs or home infusions, trying to limit the risk of getting infected from hospital visits [9]. On the other side, psychological support and ensuring the emotional wellbeing of cancer patients during such pandemic, will be important than ever. No doubt those cancer patients themselves must be informed about signs and symptoms of COVID-19, and should be trained in social distancing along with other hygiene practices. Antiviral therapies To the moment, there’s no proven beneft of using specifc antiviral