Cancer as a prospective sequela of long COVID-19

Abstract

As the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to surge worldwide, our knowledge of coronavirus disease 2019 (COVID-19) is rapidly expanding. Although most COVID-19 patients recover within weeks of symptom onset, some experience lingering symptoms that last for months (“long COVID-19”). Early reports of COVID-19 sequelae, including cardiovascular, pulmonary, and neurological conditions, have raised concerns about the long-term effects of COVID-19, especially in hard-hit communities. It is becoming increasingly evident that cancer patients are more susceptible to SARS-CoV-2 infection and are at a higher risk of severe COVID-19 than the general population. Nevertheless, whether long COVID-19 increases the risk of cancer in those with no prior malignancies, remains unclear. Given, the disproportionate impact of the disease on the African American community, yet another unanswered question is whether racial disparities are to be expected in COVID-19 sequelae. Herein, we propose that long COVID-19 may predispose recovered patients to cancer development and accelerate cancer progression. This hypothesis is based on growing evidence of the ability of SARS-CoV-2 to modulate oncogenic pathways, promote chronic low-grade inflammation, and cause tissue damage. Comprehensive studies are urgently required to elucidate the effects of long COVID-19 on cancer susceptibility.